“You have to understand. Some of the people here are very ill. They have just come out of, er, the state hospital,” and here the therapist, Diana, lowered her voice. “Urban State Hospital, you see.” She was seated next to a large, unused desk, with her arm leaning against it, and was dressed in a matching tweed skirt and blazer, and I, in attempt to look presentable for my first day at Crossroads Day Treatment, wore a plaid shirt, convincingly worn jeans, and a denim vest I’d bought at a thrift shop that I was convinced made me look thinner. Outside the office door, footsteps rumbled down the stairs. The window, to my right, was cracked open and a rusty October breeze slipped through, playfully sweeping the simple, white curtain to and fro. I felt pressured to say something in response to Diana’s comment, but I shrugged my shoulders, and, feeling stupid, said nothing. “So you will be with all sorts of people, you know, during lunch and on Wednesdays when we have our outings–we, er, go in vans, all together, as a group….” Diana cleared her throat. I tried to look at her but found my eyes resting instead on a green ceramic frog on the desk. She handed me a schedule of groups. “Mondays, Tuesdays, Thursdays, and Fridays we have regular groups, with a two-hour lunch break. Group Therapy meets on Mondays and Fridays, with Rick and me. Don’t miss Group Therapy.”
The door opened. I jumped. A large man wearing a t-shirt and tie loomed in the doorway.
“Kevin, I am in a meeting with Julie now.”
“A new client?” Kevin’s voice was a deep, friendly basso. “That’s a pretty name, Julie.”
“Kevin, you can meet her later.”
“No, I want to meet her now. She’s a pretty girl. When do I get my meds?”
“You can ask Emily. She’s the nurse. See you later, Kevin.” Diana resumed her explanations, running her fingers along the pleat in her skirt. “Wednesday the doctor comes. If you are going to be taking medication, you’ll meet with him then.”
Medication? At the time, it was beyond my perception that there were medications that might help me. My knowledge of psychotropic medication consisted of the sedative (“sedagive”) given to the Frankenstein monster in the movie Young Frankenstein. I had never heard of antidepressants, antipsychotics, or mood stabilizers. If I had known that there were medications that could have helped, even then, I certainly would have asked if I could give them a try.
“We have Family Issues group twice a week and Art Therapy in the building next door on Fridays. In the beginning of each day we all meet together for Community Meeting, and at the end of the day for Wrap-Up. Each therapist meets with her–or his–own clients for Administrative Group in the morning as well. I’ll be meeting with my clients here in the Blue Room.” Rooms in the building were named after the subway lines in Boston, the Blue, Red, Green, and Orange Rooms. Group Therapy always took place in the Green Room.
And then, quite suddenly, Diana set me loose at Crossroads Day Treatment, to acclimate and acquaint myself with the other clients before my first “group.” Already, ten or twelve clients had arrived, and several were strutting nervously in the kitchen. The building had originally been a church rectory; it was lacking the institutional feel I’d expected of a psychiatric institution. The kitchen was equipped with the usual appliances; coffee was brewing; for 50 cents one could enjoy a cup with Cremora or sugar or Sweet ’n Low. A sign above the kitchen doorway clearly indicated that the dining room was the only room where smoking was allowed. It appeared that the dining room was also the main social room, with its pine wood tables and chairs, ashtrays strategically placed at each table, and a large wastebasket near the door. Two older women sat quietly drinking coffee in the corner of the room; I later would see them in Group Therapy. The living room was up front; although smoking wasn’t allowed there, smoke from the dining room made visible beams of light streaming in through the front curtains; Kevin lay fast asleep on the couch, his shirt slid up exposing his fat, bare belly, his tie under his armpit. He snored loudly. I tiptoed back to the dining room, where much of the activity had started up. A woman who appeared to have Down’s Syndrome repeated, “Tim, Tim, Tim!”
The client who I later learned was named Tim turned to her and said, “Tina, shut up. You’re embarrassing me in front of the ladies here.” He was a large man; looking around, I noticed that everyone seemed overweight. I took note of this; I was later to learn that almost all psychotropic medications cause weight gain. Tim was sweating profusely; he wore a filthy sweatshirt jacket but I sensed that his sweating came more from nervousness than from hyperthermia. His leg bounced up and down while he sat, fidgety, in his chair. “And this one is Julie. She’s new. You look too pretty and too smart to be here, Julie. You’re smart, right? You look plenty smart. You don’t smoke? You Jewish? I can tell. Shawlom. I know a chosen one when I see one. In the end, all the Jews will convert and Christ will lead them–it says in the Bible–right guys? You don’t smoke? Why don’t you have one of these doughnuts? You’re too smart to be at Crossroads. You should get out while you can–right, guys? It says in the Bible–”
“I–I–I j-j-just wish he’d stop t-t-talking about the B-b-bible,” a young man’s voice said from the kitchen. I leaned over and saw a very tall bearded man shaking his arm in front of him while he spoke. “W-w-where’s Emily?”
“It depends on what you mean by television,” said Richie S. “Have a cigarette.” But he didn’t offer me one, and I didn’t want one. I hadn’t yet entered the dining room, and he in fact was not looking at me, but staring at nothing, or perhaps at a piece of dust in front of his face. Richie’s facial expression never changed; he was always profoundly troubled.
Tim D continued, “Betcha don’t smoke. You’re too smart to smoke.”
“No, I don’t,” I admitted. I would learn that besides myself and the five other members of Group Therapy, Tim was one of only a handful that could sustain a conversation.
“Everyone here smokes. Want one, Richie? Take one. Here.” He handed Richie a Parliament, then lit one for himself. “Nicky doesn’t. He shakes too much. Emily, she’s the nurse, she told him he better give it up or else he might set the place on fire. Blow the place up.”
Richie began to laugh, smoke emitting from his wide-open mouth. “Blow the place up, that’s very funny, blow the place up, ho ho, ho ho….” He coughed, then gathered up spittle, and spat into an ashtray.
I closed my eyes for a moment.
Tim continued, “What hospital you come out of? Waltham? St. E’s?”
“Where were you locked up?”
People who had just arrived in the kitchen were laughing–at what, I wondered.
“Um, I wasn’t. I just come to this program now.”
“Sucks, huh? A nice, smart girl like you, in a place like this.”
I was still standing in the doorway of the dining room, afraid to enter. One by one, several clients turned toward me, looked me over, then sat at tables, removed cigarettes from pockets and pocketbooks, and lit up. I would learn very quickly that cigarett
e smoking was, at the time, at the social core among mental patients. Where there was smoke, there was conversation. More “group therapy” happened in smoking rooms than ever happened in official Group Therapy run by staff; more friendships were started, more conflicts resolved, more communication, more love, if you could call it that, happened within the confines of those places where smoking was allowed. Now, of course, smoking is no longer permitted in hospitals and most places where mental patients gather; the magic and mystique of the smoking room is lost forever.
I had learned about the program from a family acquaintance who had had good results here; she was about my age. We’d chatted on the phone at length and she’d explained, “There are a lot of people there who come from the state hospital. They talk to themselves. You just have to tolerate it. After a while, it’s like they’re not even there.”
I backed away from the dining room doorway. The smoke was getting to me. A woman around my age, a pretty woman wearing jeans and a sweater who I would later learn was named Irene, invited me to sit with her. “In a while,” I responded. “Thanks.”
“You shy?” she asked. “C’mon, let’s talk.”
“Yeah. Sorry.” I was in fact very nervous. It wasn’t so much the strangeness and newness of the place and the people but the mere number of people around me; by now about 20 clients had arrived and were milling around the place; the dining room had filled with smokers and people enjoying coffee and doughnuts. But no, in fact it wasn’t the sheer number of people at all, nor was it the fact that some of the people I was meeting were very different from me; it was the people like Irene I feared the most. She appeared too friendly. Don’t trust. Don’t tell her anything. Don’t eat lunch with her; don’t sit with her; don’t talk to her. Stay away. Making friends with anyone, ill or well, was one of the most frightening things I could possibly imagine, and here, at Crossroads, I was to face that possibility, and it scared me hundreds of times more than being in groups with Richie or Tim D or Kevin, or even becoming a lot like them.
“Does anyone have any community issues?” Community meeting had begun, and Diana had introduced me, telling the “community,” some 35 clients and therapists, that I would be in her “administrative group,” in other words, that she would be my therapist while I was in the program, which at the time I thought would be a few weeks. I spent nine months there.
“No community issues?” Rick asked. Rick was the therapist who ran Group Therapy, and he was running this group as well. I immediately liked him. He had more than a twinkle in his eye; his whole face twinkled.
We were seated, all of us, in a large circle. The church had rented their basement to the program to use for larger groups and groups that required lots of space. Cabinets on the far wall contained art supplies, I assumed. After I’d stared at it for a time, I noticed the basketball net up in the front of the room was twitching in the barely perceptible breeze.
“Yes, I have one,” said an older, hoarse-voiced woman. Her deformed hands were gripped around her belly. “No one throws away their coffee cups. I have to pick up after everyone. The kitchen is a mess. The dining room is a mess. Why do I always have to be the one–”
“Shaddup, Leslie,” said Tim D. “Every morning, the same thing, every morning.”
There was general hubbub in the room. Someone began to whistle. Rick held up his hands to form the letter “T.” Time out.
Rick said very quietly. “You both have a point.”
Leslie said, “He interrupted me. He interrupted me!” She flailed her arms in the air and shouted, “You! You! You!”
“Hear me out,” said Rick. “The coffee cups need to be thrown out.”
“But Leslie, you don’t have to take on the responsibility of cleaning up after everyone.”
“Tim, you need to be polite and tolerant. If there is anything further to discuss about this, we will bring it up in Administrative Group. And Group Therapy.”
Administrative Group was like a repeat of Community Meeting, only in miniature. Diana asked each of us, her specific clients, how things were going for us in general, whether we’d showered, if we were having symptoms–I’d showered, but I didn’t know what “symptoms” were, really, because I wasn’t aware that I had any sort of illness; I had problems; that was all that I knew, or would admit at the time. A young man named Kevin–a different Kevin–reported that he’d been hearing voices. “All the time, I hear them, Diana,” he said. He had deep, sad eyes circled with dark fleshy patches. I felt sorry for him.
“Kevin, we’ve tried every medication,” Diana replied.
“I still hear them,” said Kevin. “Even when I sleep, I hear them.”
“Maybe, then, the voices are only your imagination.”
After art group, lunch. I stole away to my car, avoiding Irene and Tim D; each had separately asked me to lunch. I didn’t want to eat lunch with anyone and I didn’t want to eat lunch. I was fasting that day.
I had two hours to fill. I didn’t want to drive back home, if I could call my parents’ home “home,” for it truly wasn’t. I was homesick for college, for music, for the love of learning. I wanted to banish the thought. But it was strange that I had hardly thought about school after I dropped out. I hadn’t composed a note of music or practiced trumpet once. I was deep, deep into something horrible, a stench, an enveloping goo, a dark, air-stripped tunnel of hate so intense that music, no matter how beloved, could not penetrate it. But now I had an idea. And I didn’t want it on my parents’ telephone bill.
I gathered together some change. Not enough. So I stopped at a nearby convenience store, bought a Fresca, secured some quarters, and located a reliable pay phone that afforded reasonable privacy.
I knew my advisor’s number by heart. I hadn’t dialed it many times, but the number was an easy one to remember. I didn’t know if I was shaking from hunger or from nerves. “Yes, Jeff?”
“Who is this?”
“Julie. Julie Greene.”
“What do you want?”
“I just thought I’d say ‘Hello.’ To let you know, to let you know I’ll come back to school, I promise, after I work a few things out. Just a few problems, that’s all. Like I explained when I left.”
Jeff Levine, as my advisor and instructor at Bennington College, could be intimidating at times; at other times he was kind; at all times he was an impeccable teacher and ally. But when I told him, back in July, that I was leaving school because of “psychological” problems, his demeanor changed. It was as if his attitude toward me had undergone an eclipse. His whole face sunk in. “You’re my top student,” he had said. “You’re doing so well.”
“I’m not, actually,” I had replied. “There are things–things you don’t know, nobody knows. I can’t tell you. I need to see a doctor. Soon. I need to move in with my parents. I can’t be alone anymore. I can’t bear this. Just believe me.”
“If you leave now, Julie, with only one semester left to go until graduation, don’t you think–”
Jeff shook his head. “Okay.” He sighed, looking out over the fields. “But there’s one thing, Julie. If you leave now, you’ll get involved in something. You’ll get distracted. I don’t think you’ll ever come back.”
The phone line crackled. “Jeff?”
“What do you want from me?”
“I just need to know that you still believe in me, that’s all.”
“Julie, I don’t have all day to talk to you.”
“Is there anything else?”
“I go to a program now.” No response. “A special program. I just started. It’s supposed to help me. Um, Jeff?” I breathed. “A lot of the people smoke there. Cigarettes, I mean.”
“What do you want me to do about it?”
“I guess I’d better go.” I hung up.
Contemporary Issues group consisted of watching a videotaped portion of the Phil Donahue Show. Donahue and his guests were discussing the blame and shame society placed upon people who received Welfare benefits. Most of the guests were Welfare recipients; one was a social worker. At the end of the segment, Rick, who was running the group, switched off the TV, and said to the seven of us who were in the group, “So, what does everyone think?”
“I think it sucks!” said Tim D from the corner of the room. He began to laugh loudly.
“Shut up, Tim,” said Irene.
There was silence in the room. Then a shy-looking young woman raised her hand. “I’m ashamed that I’m on welfare. Embarrassed.”
“If you can’t lick ’em, join ’em,” someone said.
“Strike three, group’s over!”
“Yeah, shut up!”
“Jenny, can you say that again? About being embarrassed? Can you say more?”
Jenny, the shy girl, shook her head. Her eyes were full of tears.
“How many people here are on Welfare?” Hands went up slowly. Someone burped. More hands went up, except mine.
“It’s a sin,” said a young man sitting up front.
“It’s no sin,” said Tim. “It says in the Bible that God forgives us for–”
“For what, Tim, for being a leach off of other people? Come off it! ‘Bout time you quit that Bible stuff,” said Leslie.
“I want a cigarette.”
“Here, have a fucking cigarette. It’s menthol.”
“I don’t want your fucking cigarette.”
Rick said, “What do you think, Irene?”
“I wish I was working.”
“I’m ashamed I’m not working. My kids are ashamed of me.”
Blood rushes to my face. I can feel it. They know. They know I’m embarrassed. They’re going to catch me in a lie no matter what I say. I want so much to belong here. I want–yes, I want to be like them.
“I had government assistance to pay for college,” I said. “I guess I was embarrassed.” A lie you stupid fool.
“You’re very lucky,” said Leslie, “to go to college. I would have liked to go to college, if I’d had the chance.”
Okay what I really mean oh god is that I’m fucking embarrassed I had it so easy, then, so easy, and didn’t have the strength to fucking struggle with real life the way you did, don’t have the calluses on my hands to prove it, I’m embarrassed that I’m different, I am ashamed of my fucking bank account.
“What are you doing here, then,” asked Leslie, “if you’re so smart? What’s your problem? Where were you at lunch? Why won’t you talk?”
I looked at Rick, who said, “Julie doesn’t have to tell us anything on her first day. She’ll have plenty of opportunity, though, in the next group, Group Therapy.”
Only certain “high functioning” clients were picked for Group Therapy, and I was one of them. “High functioning” and “low functioning” were dirty words I’d come across many times during my stay at Crossroads, which meant essentially that if you could carry on a reasonable conversation and relate to other people in a reasonable manner, you were high functioning. If you couldn’t, you were “low functioning.” It went deeper than that, but on the surface that was how it seemed. The six members of Group Therapy, besides myself, were Irene, June, Leslie, Jackson, and Roy; I knew their names already, so the silly introductions were superfluous.
Jackson appeared very nervous.
Leslie was applying hand lotion.
Irene said, “I don’t think it’s right that Leslie puts on hand lotion during group. It’s distracting and she’s not really participating, she’s putting on lotion and that’s not right. It means she’s not really paying attention.”
June whispered something about a tissue and started fishing for one in her purse.
“Jackson has an issue,” said Irene, “and nobody’s paying attention.”
“I’m listening,” said Roy.
“I know Jackson has an issue,” said Leslie. “He told me so at lunch.”
“Oh Jackson,” said Irene. “Look at Jackson. He’s shaking. He’s got so much anxiety in him. He needs meds real bad. Jackson, take an Ativan, for Gods sakes. Look at you.”
“Oh, Jackson,” murmured June. “Here’s a tissue. There. Let it out. Is it your mother again?” She turned to Leslie. “His mother, you know.”
“Yes, it’s his mother.”
Roy stretched. He was wearing a heavy cable-knit sweater and jeans. “Jackson, you’ve got to tell her to stop arranging dates for you.”
“Is that what she’s doing, Jackson?”
“Did Jackson tell you that?”
“Oh, Jackson. Let it out.”
Irene said, “She’s not your fucking matchmaker–”
Jackson wailed, “Don’t say fucking about my m-m-m-mother….”
June said, “Jackson, can you refuse to go on those dates, just cancel?”
“Tell your mother you won’t. Tell her.”
“Yeah, tell her.”
“Take an Ativan.”
“I c-c-can’t tell her. She’s my mother!”
“Blow your nose. Here. Blow.”
tell her tell her tell her tell her why don’t they–
“Jackson, sober up.”
“Ask Julie what she thinks. She hasn’t talked.”
“Not a word.”
My eyes were little slits. Paisley patterns thumped behind my eyelids, pissing fuzz in my pupils, tingles in my fingertips, rattles in my toes. The floor rose and fell; the earth itself rose and fell beneath me, and all went gray. I gripped the chair. Martians. I had to get out of there.
“Not a word, Julie.”
“Let her talk. Don’t interrupt.”
“Julie’s going to say something.”
Roy cleared his throat.
I said, “It’s very nice meeting all of you.”
Irene said, “She talked.” Her long, expressive fingernails were painted purple.
Jackson said, “I need another tissue.”
June said, “I only have a napkin from Dunkin Donuts.”
“Yeah, gimme that.”
And so, I settled into the routine at Crossroads. After a few months I had taken up smoking and had put on ten pounds, though I wasn’t taking medication of any sort. My hair became knotted from neglect, and I made a habit of wearing a hat to cover it. I dressed unbecomingly, choosing soiled clothing over cleaner clothes when I dressed each morning, my tattered old jacket over the newer down jacket my mother had given me, “With an adjustable waistband,” my mother had explained when I opened the package on my birthday. The next semester came without a thought; I was still at Crossroads, and, despite all the warnings I’d given myself, Irene was my best friend.
The subject was finally brought up, in Group Therapy, that I had not once discussed my problems, that I’d kept the focus on everyone else’s problems. I was supportive, the group said, but very secretive. “You’re either angry or scared,” said Irene, boldly. “Today is your day to talk. Do it today. Today is your day.”
The group murmured in assent.
“I fear,” I began, “I fear that I would end up screaming.”
Irene said, “That’s okay. That’s allowed, right, guys?”
Roy said, “There are other groups in the building.”
“Screw the other groups,” said Irene. “Let her scream if that’s what she’s going to do. The walls are pretty soundproof, anyway, don’t you think, Roy?”
Roy had been an architect once. “Not really, but–”
“Well, then, scream.”
Jackson began to laugh nervously. “You’ll get me going, Julie. I could use a good hullabaloo myself.”
“There’s such thing as scream therapy, you know.”
They said afterward that the floors heaved and spat up something like lava, shook the foundations of the building and tossed chairs and people helter-skelter, that pipes broke, toilets overflowed with a metallic, steamy liquid, the coffeepot imploded, Jenny broke her arm and Tina’s rubber boot went missing, right off her foot. I don’t know if that was exactly the case. People have a way of turning stories around. But after that, everything was different at Crossroads. I was one of them. There was no question now; I belonged.