It’s 7:45 A.M. and I’m at a crossroad.
I’ve done the morning shift with my children and can feel the sweat pool on my back as every urge in my body drives me upstairs to a shower. The morning went fine. The children have eaten, watched Frozen for the dozenth time. I’ve had my coffee, read the paper. My wife, Julie, got to sleep in, and in an hour I’m meeting my friend David for a run.
But now my two-year-old, Matthew, is throwing his toys and my daughter, Esme, is crying that she wants to wear an Elsa dress. Julie’s making her lunch and I can feel myself tense. I start singing Hayden. Julie mentions something about how I put away the dishes wrong and now Matthew’s banging his dinosaurs against the television and Esme wants another waffle. “If you don’t like the way I put the dishes away, you put them away,” I say to Julie, or something equally charming, as Matthew rubs yoghurt all over his face.
“You can go upstairs if you want,” Julie says, and I hop straight up in the air and grab Matthew roughly into the kitchen for a cloth and tell Esme that she’s already had enough waffles and it’s time to eat fruit and stop crying.
“Psychiatrists are supposed to think deeply, but sometimes I’m not sure if he’s thinking deeply or catching some sleep.”
“Of course I can go upstairs, I can do anything I want,” I say. “I have free will.”
It’s now 7:49 a.m. and I’m getting mean and ugly, ruining a perfectly good morning when I had really done — up until five minutes ago — everything like a boss. And so I’m looking for a psychiatrist because I have a fundamental question: at 7:45 a.m., why the fuck didn’t I just go upstairs?
I’ve grown up around therapy — my dad is a shrink and he still sees patients and my mom was a social worker her entire career. My sister’s a social worker, too. While my best friends have had therapy, it’s never seemed necessary to me. But after 10 years of marriage and two children, I think it’s finally time.
I feel anxious, surprised by the things I do and say. There’s a disconnect between what I want to have happen and what actually happens and, hard as I try, I can’t seem to find an all-encompassing How to Act rule. I’m a runner and train for marathons. I do speed drills and long runs and all sorts of things to work on my endurance and speed. Psychiatry could be a version of this, but for my feelings. I want to get stronger emotionally. I want to know what to do, what to say, how to feel. And the goal is something much more important than breaking three hours; it’s finding a better way to live, to be happy, to be the person I want to be. Is it too much to ask that I stop hopping up and down when I’m angry?
The only advice my parents give me when I start this — and when I start I’m so proud I’m taking control of my life — is that I should shop around. There are plenty of psychiatrists and I deserve someone whose empathy I can transform into action.
Some definitions from the therapeutic persuasion: a psychiatrist is a medical doctor trained in diagnosing mental illness. A psychologist doesn’t have a medical degree and can’t prescribe meds. Either can be called a therapist, and if you want to picture what one looks like, imagine Dr. Melfi talking Tony Soprano through issues of his mother (then think drabber, a public servant in flannel with an office that overlooks Bagels-R-Us). In Ontario, where I live, psychiatry is covered by Ontario Health Insurance and psychologists are not. It matters what kind of therapist you see. The Canadian Counselling and Psychotherapy Association has 5,600 members. In 1999, there were 1,800. And now, 12 per cent of the Canadian population is on an anti-depressant (10 per cent, male; 14 per cent, female).
“If I’m not on the verge of breaking down, isn’t free therapy kind of like going to the emergency room for a cold?”
To see a psychiatrist in Ontario, you usually need to be referred by your GP, although the one I see first, I simply call directly (David, my running mate, has recommended him). He looks like Elmer Fudd. His office is straight out of the 1970s. I sit on a dusty old blanket on his corduroy couch and stare at his fax machine and can’t believe how much he looks like a turtle. He’s about the same age as my father, mid-60s, and doesn’t say much. The room is mine and I talk so much that it gets annoying, even for me, so I apologize and he kind of adopts my accent and picks up my vernacular and says something like: “Life is sometimes a compendium of chicken shit little things.” We hit it off right away. Losing my therapy virginity is exciting. I can’t believe there’s help out there, and that it’s free. Who wouldn’t want it? I use my OHIP card like a Visa. I feel like I’m getting away with something. If I’m not on the verge of breaking down, isn’t free therapy kind of like going to the emergency room for a cold?
“You don’t scratch where it doesn’t itch,” says Dr. David Goldbloom, former chairman of the Mental Health Commission of Canada, member of the Order of Canada, author of How Can I Help, A Week in My Life as a Psychiatrist. What Goldbloom’s saying is that if you feel like you have a problem, even if it isn’t schizophrenia, even if it’s just that you’re frustrated with doing the same stupid shit you do — you don’t need to be Woody Allen to seek treatment. “Nobody’s so suffused in contentedness that things couldn’t be better,” he says. “We’re all creatures of habit and destined to repeat ourselves, but behaviour’s malleable and professional feedback is one way we can learn.” It’s not unique to imagine a happier version of yourself existing somewhere out on the horizon. Since the Mad Men-era, pharmaceutical companies, medical professionals, and self-help book writing quacks broadened mental health care to create a happiness industry. I’m well, goes the thinking. But I want someone to make me more well — to physically train my mind.
I like my little Dr. Turtle, but he makes me nervous. Psychiatrists are supposed to think deeply, but sometimes I’m not sure if he’s thinking deeply or catching some sleep. Sometimes he looks like my great uncle Lou after too much schnapps. He’s helped talk me through a recent salary negotiation and made some interesting points about how I frame situations as if they happen to me, as opposed to me driving the action, but something down deep tells me he’s no Sigmund Freud. So David sets me up with a woman who looks a little like Cruella de Vil. She doesn’t like me and that makes me sad. Over the phone, before she agrees to meet — again with no GP referral — she grills me about my symptoms. I’m not abusing my wife or drugs and I’m not having affairs. I’m able to get up in the morning, to work, to put my children to bed. I want to stop talking to myself in the shower, saying strange things like, “You’re OK, you’re OK, you’re OK.”
Julie thinks I sing Hayden lyrics at her, as if I’m using the music to say what I want to say, but don’t. I don’t think I do that. I certainly don’t want to. And I certainly don’t want to be the kind of person who can’t handle being criticized about the way he peels Brussels sprouts. Cruella asks me if I’m OK with dogs and I am not, but I feel like if I tell her that, she won’t see me. I’ve infused therapists with this magic healing power and it’s imperative to me I do everything I can to get as much out of them as possible. I want them to like me so they care about my case (and because I’m a putz). Since she’s covered by OHIP — I have no idea what’s covered by my insurance and I don’t want to pay and be reimbursed (money is one of my issues) — the ball’s in her court.
I’ve learned you judge therapists mostly on their offices. Her window looks out on her green backyard and things here are stark and modern and white. I have a vision in my mind that she’s had work done, but maybe that’s just because her bookcase looks Danish, like it cost more than iMac. I tell her that life’s stressful. I got a raise and still feel unsettled. I took my wife to Quebec and still feel like a bad spouse. I yelled fuck in front of my kids. Meanwhile, I have therapy every Friday with this small guy who I keep putting to sleep.
“Maybe it would have been better if I just stayed home and poured myself a big fat drink.”
The psychiatrist wrinkles her forehead. If my guy’s a turtle, she is a hawk — she interjects, takes notes, asks questions. “You sound like you’re reactive; your wife upsets you; your kids upset you; work upsets you; what’s your role in your life?” She sits on the edge of her chair, expensive clothing and penetrating smarts. Jesus, I say, painting myself as a victim is pathetic and we talk about my childhood and life and it’s strange that I’m in therapy, perhaps, when there’s not much rooting around in my unconscious. I don’t think we’re supposed to spend our hour talking about why I don’t like dogs. When I ask if I can use the bathroom, she tells me we’re almost through. When she tells me she can’t see me again, that she doesn’t think she can help me, I say: “Please?” There’s a disparaging term in psychiatry for people who see analysts but don’t need them. We’re called the Worried Well, which is some variation of First World Problems. I get that. “Why won’t you help me live well?” I ask. Her reply is something like: “I just don’t think I can.”
I use my now-ex-psychiatrist’s bathroom before leaving. Before I can get there I walk past her dog. It’s humongous and perched on the staircase, staring me down. Maybe it would have been better if I just stayed home and poured myself a big fat drink. At least I could’ve gotten up to pee.
I sometimes think that I since I wash the dishes I shouldn’t have to hear anything about not making the bed with matching pillowcases and sheets — and when I do, it shouldn’t make me not want to have sex. Things I don’t do — pay the bills, notice when Matthew has pink eye — I can’t see. I don’t want to be the kind of person who carries around a mental scorecard — who’s done what, specifically, and who’s ahead on points — because those that do are fated to always find themselves behind. Some part of me is in therapy to remove my sense of injustice. If I’m braving Mississauga and the Greek Orthodox Church, I don’t want to hear shit about what shoes I wear. And I’m serious, too. Julie says something about my Skechers and I hit the roof and even to me it’s embarrassing. Why wear red sneakers to a church event? Am I rebelling? And if so, rebel — don’t act like Esme when she can’t wear her Elsa dress.
Joanna Polley is a philosophical therapist and she understands. Philosophy was started to help people live well, and so philosophical therapy (which is not covered by OHIP) is growing. It’s about asking questions, finding new perspectives, and using the texts of Nietzsche and Henry Miller to change how people think. Joanna has a doctorate degree from the University of Toronto, some sort of degree from NYU on the wall, and is the sister of a Canadian icon.
In 1995, there were no registered philosophical therapists. There are 11 in California today and one in Calgary, one in Vancouver and two in Ontario. Joanna’s young and has children. She hosts salons with wine to “bring philosophy out of its ivory tower.” And, most importantly, she tolerates my bullshit when we meet. It’s been four months since I’ve started therapy and these chicken shit little things still have me distressed.
“We need to talk about what you want to change into rather than just not wanting to be as we are,” she wrote me after our first session, and talked about Aristotle’s notion of habit: that people can change if they’re able to accept that changing requires suffering. “If you know it’s pain you have to suffer to get yourself to a place where you want to be, you might be more willing to force yourself to do it — endure and one day you’re the person you want to be. And that, I think, is self-control.”
I print out her email and underline it. In our next session, I bring the email in and rub it all over, hoping that some of it will actually rub off. She’s alert, which isn’t something to take lightly because, meanwhile, things have gone sideways with my little man. The first time he fell asleep I ignored it. Instead of waiting for insight, I wanted to offer him an afghan. My parents told me this is abominable, and I was defensive. The second time he fell asleep, I waited him out. But the third time I caught him cat napping as I bared my soul, I was forced to action. I ask if last night he had trouble sleeping.
“No, actually, last night I slept well,” he said. “It must have been my lunch.”
“What’d you have?” I ask him. “Turkey?”
“Chicken,” he says, and it’s a betrayal. I never see Elmer Fudd again.
The earth cracks under my feet on a Thursday and my family is in disarray. My wife’s sister Jayne is exhausted on Tuesday, then critical on Thursday and rushed to Intensive Care. It’s chaos. Julie’s distraught. I go to the grocery store and gas the car up and my wife gathers her sister’s three kids and brings them to our house. It’s tears and spaghetti and junk food, and then I drive Jayne’s 16-year-old twins to the hospital to see their mother and Julie puts Jayne’s three-year-old, with our two- and four-year-olds, to sleep. I hold onto the boys like a buoy. I tell my wife we’ll get through this. I tell Julie’s mother that everyone’s OK — that we’re handling things, that we are strong.
Lay this on your GP and getting a psychiatrist is as easy as getting a marijuana dispensary membership card. I always thought my GP was a schmuck. Twice a year I get styes. Two times a year he sends me to a specialist to remove them. Two times a year I ask him if he could just give me a referral and avoid me schlepping uptown. Two times a year I go to his office and delay the whole process by a month.
“Psychiatry for the worried well is a luxury. It can be helpful, but so can running, yoga, and standing on your head.”
In order to get my referral — because I divorced my old guy, the woman won’t see me, and Joanna’s not covered — the schmuck GP asks me if I’m suffering from hallucinations. I mention anxiety and describe my situation, and he eventually finds me a photocopied single sheet of psychiatrists. He faxes me a referral to the Medical Clinic for Person Centered Psychotherapy, and five days later I’m told they can see me in six weeks. “The only way we can expedite a referral is if you have private insurance,” I’m told. Then I’m told (by the same person) that I can have an appointment for 10:45 a.m. the next day. Bureaucracy! Meanwhile the family coalesces and my wife and I are soldiers at war fighting a common enemy — cancer — and I feel focused and proud, love and loved. Brussels sprouts? Bed sheets? Faces covered with yoghurt? The chicken shit little things all melt away.
“I’m happy but not as happy as I could be is a dream psychoanalysts sold to rich people in the ’60s and one thing people would do is they would divorce,” says Dr. Benoit Mulsant, chair of the department of psychiatry at the University of Toronto and senior scientist at the Centre for Addiction and Mental Health. Mulsant says psychiatry covered by public healthcare should be solely the domain of the mentally ill. He knows people who’ve killed themselves while waiting for a referral, and when I meet him in his CAMH office (art on the wall, no couch, but a table and chairs), I pass a woman in purple bunny ears and ride the elevator up to his office with a man wearing head-to-toe camouflaged clothing. I don’t take a breath.
I ask him who doesn’t need therapy? What are its limits? Why am I functioning so well in a crisis and function so poorly at 7:45 a.m.? I find therapy helpful (even when my therapist’s sleeping) but I’m not certain how to get it working for me. Does therapy do anything for people who don’t suffer from mental illness? The sage advice of Dr. Benoit Mulsant, perhaps one of the keenest psychiatric minds in the coun- try, is that it couldn’t hurt. Psychiatry for the worried well is a luxury. It can be helpful, he says, but so can running, yoga, and standing on your head.
“Life is hard and you work and sometimes you’re off with your family on a Sunday and the weather’s wonderful and that’s happiness,” he says, “but there’s suffering in between and that’s life.”
That seems to be the answer. Chekhov couldn’t write our current situation, but when I see my shrink from the Medical Clinic for Person Centered Psychotherapy, she tells me I’m doing great. This place is clinical; the office is antiseptic. It doesn’t matter. The psychiatrist takes notes when I talk and draws little pictures, animating my family tree. There’s a kindness to her; she nods sweetly as I describe my conundrum and even cry as I let Jayne’s sickness envelope me in a way that I’ve been trying to resist in order to be strong for our family. I imagine that with so many people depending on me, she’s someone I can secretly talk to. (Plus she’s covered by OHIP.) We agree to meet two times a month. I’m even going to see her on my birthday because therapy, I’ve concluded, is like a little gift that I’m giving to me.
I know life’s not going to be a commercial for butter: Julie and I holding hands through a field of daisies with a coozy for our Heinekens under the sun. I need to evolve somehow from this experience and, moving forward, I want to pass through the 7:45 a.m. of the soul with more grace. Will a therapist help me? Will it help you? I think it’s worthwhile for every man to speak his mind to a professional stranger who listens and offers some sort of diagnosis. Like anything, therapy can’t bare the weight of outsized expectations — I haven’t transformed but I’ve cleared some cobwebs off my mind. Make no mistake, there are serious mental illnesses and for people suffering, doctors who practice psychiatry save lives. Personally, I just want to know myself, calm down, and be solid. I’m meeting my psychiatrist every other Tuesday to try.