REHAB

            As once before in The City, I am again involved in what is otherwise known as ‘Day Treatment’, or psychiatric rehabilitation.  As I’ve suffered from mental health issues on and off throughout my life, I thought it would be interesting to reflect on some of the recurring themes involved in getting professional help.

            The umbrella organization in Orange County, NY is Occupations, and the specific offering for individuals such as myself is PROS, or Personalized Recovery Oriented Services.  I began at the Middletown branch, and have since moved to the much smaller population served at nearby New Windsor; but both have involved an acquaintanceship with staff and peers, resulting in a daunting learning curve.

            This may be a snarky or cynical framing of it, but my observation at times has been that some staff serving at these facilities have been tracked into a career that they reckoned would be easy work for a fat paycheck; in other words, a sophisticated form of babysitting.  The prime motivating reason for my departure from the Postgraduate Center for Mental health in NYC was being assigned to a counselor who seemed utterly passive in delivering services, a kind of psychiatric sponge.  Although a kindly person, I had determined I needed to escape from the sensation of being allowed to indulge in runaway logorrhea.

            Sometimes the result of this kind of professional passivity is a regrettable loss of control, at times unrecoverable.  I’ve seen individuals allowed to continue onward with cross conversation all the while others, struggling to be heard, are discounted or dismissed.  In one group, involving anger management, an Eastern European émigré struggled to express her anxieties, only to be waved away with a diagnosis of ‘acid reflux’ disease.  Driving back to Newburgh after this particularly chaotic workshop, I struggled with how this dismissive atmosphere had been allowed to thrive in what is supposed to be a caring environment.  In the same workshop, a younger woman held forth for a good 20 minutes with a looping complaint of how she would continue to refuse medication until and unless a stomach complaint was diagnosed.  At one point, she averred she’d previously been on meds for something like 26 years.  Later, since she’d been incarcerated, I figured it was more like crystal meth.  In no way had she been on psychotropic drugs for that length of time; too animated, ADD.  But then why had the facilitator just put up with her floor show?

            Then there are the New Age types who bring extensive texts on ‘Metta’ meditation, thoroughly confusing some clients.  A recitation of Buddhist maxims invites the question “Do we have to do this?”  Or the exasperating reliance on pages of boilerplate seemingly exempting the group leader from retrieving clinical information from her own memory bank.  “What,” I found myself thinking, “you can’t hold forth on guilt?”  Give me the group.  I’ve got a lot to say.