Nick's Journal
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2020-09-15 15:43:38 (UTC)

Nurse Ratched

If I could take every therapist I've ever had and wrap them into one personality it would most resemble Nurse Ratched from the classic film, One Flew over the Cuckoo's Nest starring Jack Nicholson (a movie really worth watching).

Now, I know that Nurse Ratched was an antagonist and generally she is a caricature (or in my case, an amalgamation of characters I've encountered) for entertainment purposes. But there is just something so perfect about her demeanour through the movie. In particular in the beginning where she has this subtle way of getting under the main character's skin. Also, the way she exercises her authority is notoriously devious in part because it is so passive. For example, when Jack's character wants to watch the World Series she says that they can't change the schedule unless a plurality of the patients agree to the change. She lays a heavy emphasis on the importance of the schedule to the patients and this is something that I have encountered in every rehab place I've been to...the schedule is sacrosanct. So Jack tries to get people to vote to change the schedule but the other patients are too intimidated or too out of it to actually vote. There is finally a second scene in which he gets 9 patients to actually vote with him (a minor miracle in real life) at which point Nurse Ratched informs him that he is one vote shy (there being 18 patients on the floor). Jack desperately tries to get one more patient to vote his way, but by the time he does Nurse Ratched informs him that she had "adjourned their meeting" and that he had failed to get the requisite number of votes in time.

Talk about devious.

To be fair not all therapists/personnel are on Nurse Ratched's level. Some genuinely care and all (or most all, there are some completely disengaged/disenchanted ones) are trying their best to handle difficult people in a difficult situation. But authority is mostly exerted first and foremost in a passive manner, usually by deferring to the all powerful "rules" or "schedule" so as to shift the brunt of the patient's ire to some ephemeral entity that controls their lives. This is a necessary tactic mostly due to the fact that recovering addicts can be quite troublesome to handle primarily because they are about as close to a wounded animal as a human can get. And just like a wounded animal, they tend to lash out at anything and everything that they perceive as a "threat"; which, in most cases, is the seemingly tyrannical grip that all personnel seem to have on their heretofore autonomous lives.

I have seen many different personnel. There are the former addicts, normally the best as they have empathy and tend to be able to relate best with the recovering addicts. Then there are the purely clinical therapists who have studied addiction from here to the moon but lack the relatability of the former addicts. The clinicians can sometimes be pedantic and condescending (sometimes without intent and sometimes with intent depending on how much shit they happen to have taken that particular day) which is truly the worst demeanour to have as it comes off as patronising to the patient. Finally there are the admin and practitioners (the latter being mostly made up of students) who run the gambit from openly hostile to deer in the headlights out of their element; both regarding the patients largely as participants in a really fascinating zoological experiment.

Anyhow, the two best therapists I've had was one former addict (she got so high on meth she sat on her roof for days with a loaded rifle sure to God that the FBI and DEA were about to take her down) and a clinician who has been in the business for over 30 years. Now I've had several former addicts and several clinicians who have been around a long time but what they all lacked that these two best of the best had, was empathy and relatability. Anyone can tell you you're a fuckup, but it takes a special someone to put it in a relatable way that makes you see issues for yourself. The best therapist is a gentle guide who leads you to a fork in the road but allows you to choose which way you want to go. The worst therapist is the one who sets you on train tracks and is intent that you follow them all the way to the bitter end.

So just like any industry there are the good, the bad, and the stellar. It is a hard industry to be in and one that can be particularly grating on your nerves; but those who excel get the pure reward that they have helped someone in need. Just like most rewarding experiences, it's not easy to get to but gratifying once obtained.