In Treatment 2-- Walter, Week 6

Walter is in the waiting room. He has a hospital ID band on and his daughter is with him. He tells her she is not going in with him. Paul comes to the door to greet them.

Walter tells Paul it is good ti get out. He says his wife and Natalie have taken him out for lunch. His wife cried over lunch. He is humiliated that he has to have his daughter or wife with him to leave. Paul says it is because he is a danger to himself. Walter does not like the hospital -- the staff is not very bright, he thinks, not like Paul. He says the staff talks to him like he is a child. Paul says he feels patronized and Walter uses it as another occasion to compliment Paul. But Paul points out that in fact Walter seems annoyed by him and does not like how he works. Paul asks why he is sucking up to him. 

Walter's face gets hard. Then he shows Paul a potholder he made in OT. He speaks scornfully of the whole program -- group therapy and what the other patients say. He says he cannot relate to them. He does not believe that he belongs with those people. Paul suggests he is angry that Paul couldn't save him from the depression he fell into. So walter counters by telling him that one of the psychiatrists said Paul was reckless and opened Pandora's box at the wrong time. Walter then bullshits about how highly he thinks of Paul. And finally he says he wants out of the hospital. He pleads with Paul to call them and tell him he can go home. Paul says first they need to talk, that he has to become honest with him.

Walter says he was ashamed. He says it has been hell being in the hospital -- nothing to do and he can't do what he wants to do. Being unable to do anything bothers him so he paces and walks the hall. The time drags and he stares out the window and thinks about how much he could be doing if he were at his job. He says he is just not comfortable wasting time. Pul suggests he might find the time now to reflect and see how things are inside. Walter says Natalie tells him he should listen to his inner voice.

Paul asks what he thinks about as he walks the hall. Walter says he thinks about money, the bills, what happened to the kids hurt by the formula -- their families.

The staff keeps wanting to go over the crisis and the firing. He compares it to a deposition. He hasn't talked about his history with them at all. He painted the picture he thought they wanted. Because he thinks the staff is just worried about his medication and how much insurance he has. Paul asks if they might be thinking about anything else and Walter reluctantly says they are wondering of he will try it again and he knows that will be with him the rest of his life. Walter gets up and walks to the window and says Paul lives on a pretty street.

He sits down again and asks Paul what he would have done if he were Walter. Paul tells him he has thought about it and he understand s how hopeless it felt and how he wanted a way out. He tells Walter that the worst night of his life has now passed. Walter says he kept wanting to come up with a way to stop feeling. He had always been able to get out of bed and work but not this time. He says he never knew this Walter existed, the one who is weak and unable to stand up to the pressure. Paul suggests maybe this is the first time he hasn't had to answer the call to work and so now there is room for the other Walter to emerge. Paul refers to Connie's rehab. Walter is angry but Paul tells him that people in therapy talk about these kinds of things. He defends Connie. He says her problem is his fault because he was always traveling and she gets in a mood and slides downhill and he would have to come home. He says he ha always been her rock until now and he has let her and everyone down. Paul says he has been everyone's rock -- but he wonders about the pressure and the need. Paul says it worries him that he doesn't know what to do without a crisis, a situation he has been in since his brother died. He can't just be, play, not be in charge.  Paul asks what would happen to this other Walter, the little boy who lost his childhood, if walter goes home now? Walter cannot understand why Paul thinks it is important to connect to the part of himself that crumbled -- Paul says that is not the part that crumbled, it is the part that wants to live. Walter starts to sob. Paul walks over to the couch and puts his hand on Walter's shoulder.


Paul again does a very nice job with Walter, continuing from their session in the hospital. 

Walter wants out of the hospital and he starts by sucking up to Paul, because he sees Paul as holding the keys. Inpatient units have their own culture and what is normal outside the hospital is not normal inside. For example, an introvert enjoys time alone and may well choose to spend time in his own company every day but in a hospital setting, this could well be seen as isolating behavior and not acceptable in someone who is depressed. This can be frustrating and difficult, especially for someone like Walter who is used to being in charge. So he tries to game the system -- answering what he is asked but not offering much more, trying to butter up Paul, anything that will get him his way. This is the Walter who will not accept that he has a problem, who if allowed out quite likely would attempt again to kill himself .

The version of himself that Walter says he never knew is the one who carries the pain and suffering and is something more than work. This Walter has a faint inkling that he needs to be taken care of for a while -- the Walter who sobs at the end when Paul talks about him. Paul had to find a way to connect with this more open and vulnerable Walter in order for there to be much hope for treatment. The hard-driving executive Walter has contempt for his little boy self, for the one who cried, for the one he left behind when his brother died and he will resist any attempt to reveal him. There is a lot more resistance, aggression and denial in store for Paul if Walter actually continue in therapy.


© Cheryl Fuller, 2016. All  rights reserved.