Feanor
12-25-02, 09:45 PM
what people's reactions to this one case is. It's recounted in M. Scott Peck's book "People of the Lie" starting on page 47. There's quite a bit of description, along with some of his reactions and impressions, and what he's come to learn from the years he's been a practicing psychiatrist, since this case came to him. I'll just quote from his initial encounter with the boy in question. There's too much material to include it all below.
It was February in the middle of my first year of psyciatric training. I was working on the impatient service. Bobby, a fifteen-year-old boy, had been admitted the night before from the emergency room with a diagnosis of depression. Before seeing Bobby for the first time I read the note written in his chart by the admitting psychiatrist:
Bobby's older brother, Stuart, 16, committed suicide this past June, shooting himself in the head with his .22 caliber rifle. Bobby initially seemed to handle his only sibling's death rather well. But from the beginning of school in September, his academic performance has been poor. Once a B student, he is now failing all his courses. By Thanksgiving he had become obviously depressed. His parents, who seemed seem very concerned, tried to talk to him, but he has become more and more uncommunicative, particularly since Christmas. Although there is no previous history of antisocial behavior, yesterday Bobby stole a car by himself, crashed it (he had never driven before), and was apprehended by the police. His court date is set for March 24th. Because of his age he was released into his parents' custody, and they were advised to seek immediate psychiatric evaluation for him.
...I shook his limp hand and motioned him to sit down. "I'm Dr. Peck, Bobby," I said. "I'm going to be your doctor. How are you feeling?"
Boby did not answer. He simply sat staring at the floor.
"Did you have a good night's sleep?" I asked.
"Okay, I guess," Bobby mumbled. He started picking at a small sore on the back of his hand. I noticed that there were a number of such sores on both his forearms and hands.
..."It's a pretty scary thing to steel a car, especially when you're alone and when you're not used to driving and don't even have a driver's license. Something very strong had to be pushing you to do it. Do you know what that something was?"
No answer. I didn't really expect one. Fifteen-year-old boys who are in trouble and seeing a psychiatrist for the first time aren't likely to be very verbal--particularly when they're depressed, and Bobby was clearly very depressed. By this time I had had a chance to catch several quick glimpses of his face when he inadvertently raised his gave from the floor. It was dull, expressionless. There was no life in his eyes or mouth. It was the kind of face I had seen in the movies of concentration camp survivors or victims of natural disasters who had seen their homes destroyed and their families wiped out: dazed, apathetic, hopeless.
..."I suspect you have some very good reasons to feel sad," I told him. "I know that your brother, Stuart, committed suicide last summer. Were you close to him?"
"Yes"
"Tell me about the two of you."
"There's nothing to tell."
"His death must have made you hurt and confused," I said.
No reaction. Except that maybe he dug a little deeper into one one of the sores on his forearm. He was clearly not able to talk yet in this first session about his brother's suicide. I decided to drop the issue for the present. "How about your parents?" I asked. "What can you tell me about them?"
"They're good to me."
"That's nice. How are they good to you?"
"They drive me to scout meetings."
"Yes, that's good, I commented. "Of course that's the kind of thing parents are supposed to do when they can. How do you get along with them?"
"Okay."
"No problems?"
"Sometimes I'm mean to them."
"How do you hurt them, Bobby?" I asked.
"Like when I stole the car, that hurt them." Bobby said, not with tiumph but with a dreary, hopeless heaviness.
"Do you think maybe that's why you stole the car--to hurt them?"
"No."
"I guess you didn't want to hurt them. Can you think of any other ways you've hurt your parents?"
Boby didn't answer. After a long pause I said, "Well?"
"I just know I hurt them."
"But how do you know?" I asked.
"I don't know."
"Do they punish you?"
"No, they're good to me."
"Then how do you know you hurt them?"
"They yell at me."
Bobby was feverishly picking at his sores now and his head had drooped as far as it would go. I felt it would be best if I steered my questions to more neutral subjects. Perhaps then he would open up a bit more and we could begin developing a relationship. "Do you have any pets at home?" I asked.
"A dog."
"What kind of dog?"
"A German shepherd."
..."Do you and Inge do a lot together?"
"No."
"Do you take care of her?"
"Yes."
"But you don't seem very enthusiastic about her."
"She's my father's dog."
"Oh--but you still have to take care of her?"
"Yes."
"That doesn't seem quite fair. Does it make you angry?"
"No."
"Do you have a pet of your own?"
"No."
..."It's not long since Christmas," I said. "What5 did you get for Christmas?"
"Nothing much."
"Your parents must have given you something. What did they give you?"
"A gun."
"A gun?" I repeated stupidly.
"Yes."
"What kind of gun?" I asked slowly.
"A twenty-two."
"A twenty-two pistol?"
"No, a twenty-two riffle."
There was a long moment of slience. I felt as if I had lost my bearings. I wanted to stop the interview. I wanted to go home. Finally I pushed myself to say what had to be said. "I understand that it was with a twenty-two rifle that your brother killed himself."
"Yes."
"Was that what you asked for for Christmas?"
"No."
"What did you ask for?"
"A tennis racket."
"But you got the gun instead?"
"Yes."
"How did you feel getting the same kind of gun that your brother had?"
"Yes."
"How did you feel, getting the same kind of gun that your brother had?"
"It wasn't the same kind of gun."
I began to feel better. Maybe I was just confused. "I'm sorry," I said. "I thought they were the same kind of gun."
"It wasn't the same kind of gun," Bobby replied. "?It was the gun."
"The gun?"
"Yes."
"You mean, it was your brother's gun?" I wanted to go home very badly now.
"Yes."
"You mean your parents gave you your brother's gun for Christmas, the one he shot himself with?"
"Yes."
"How did it make you feel getting your brother's gun for Christmas? I asked.
"I don't know."
I almost regretted the question. How could he know? How could he answer such a thing? I looked at him. There had been no change in his appearance as we had talked about the gun. He had continued to pick away at his sores. Otherwise it was as if he were already dead--dull-eyed, listless, apathetic to the point of lifelessness, beyond terror.
The following day he spoke with the parents and in the end they seemed more defensive and irritated then they were concerned about their son. To concern about the Christmas present they gave, they're excuse was pretty much "we're hard working people and not educated folk like you. How the hell are we supposed to know how he would feel getting his brother's suicide weapon for Christmas?" It ended with him arranging to have Bobby live with his aunt (not to his mother's liking as she strongly disliked her sister and had disliked her) and the Dr. Peck being so repulsed by them he eventually just wanted to wrap things up and couldn't stand being in the same room with them anymore.
It was February in the middle of my first year of psyciatric training. I was working on the impatient service. Bobby, a fifteen-year-old boy, had been admitted the night before from the emergency room with a diagnosis of depression. Before seeing Bobby for the first time I read the note written in his chart by the admitting psychiatrist:
Bobby's older brother, Stuart, 16, committed suicide this past June, shooting himself in the head with his .22 caliber rifle. Bobby initially seemed to handle his only sibling's death rather well. But from the beginning of school in September, his academic performance has been poor. Once a B student, he is now failing all his courses. By Thanksgiving he had become obviously depressed. His parents, who seemed seem very concerned, tried to talk to him, but he has become more and more uncommunicative, particularly since Christmas. Although there is no previous history of antisocial behavior, yesterday Bobby stole a car by himself, crashed it (he had never driven before), and was apprehended by the police. His court date is set for March 24th. Because of his age he was released into his parents' custody, and they were advised to seek immediate psychiatric evaluation for him.
...I shook his limp hand and motioned him to sit down. "I'm Dr. Peck, Bobby," I said. "I'm going to be your doctor. How are you feeling?"
Boby did not answer. He simply sat staring at the floor.
"Did you have a good night's sleep?" I asked.
"Okay, I guess," Bobby mumbled. He started picking at a small sore on the back of his hand. I noticed that there were a number of such sores on both his forearms and hands.
..."It's a pretty scary thing to steel a car, especially when you're alone and when you're not used to driving and don't even have a driver's license. Something very strong had to be pushing you to do it. Do you know what that something was?"
No answer. I didn't really expect one. Fifteen-year-old boys who are in trouble and seeing a psychiatrist for the first time aren't likely to be very verbal--particularly when they're depressed, and Bobby was clearly very depressed. By this time I had had a chance to catch several quick glimpses of his face when he inadvertently raised his gave from the floor. It was dull, expressionless. There was no life in his eyes or mouth. It was the kind of face I had seen in the movies of concentration camp survivors or victims of natural disasters who had seen their homes destroyed and their families wiped out: dazed, apathetic, hopeless.
..."I suspect you have some very good reasons to feel sad," I told him. "I know that your brother, Stuart, committed suicide last summer. Were you close to him?"
"Yes"
"Tell me about the two of you."
"There's nothing to tell."
"His death must have made you hurt and confused," I said.
No reaction. Except that maybe he dug a little deeper into one one of the sores on his forearm. He was clearly not able to talk yet in this first session about his brother's suicide. I decided to drop the issue for the present. "How about your parents?" I asked. "What can you tell me about them?"
"They're good to me."
"That's nice. How are they good to you?"
"They drive me to scout meetings."
"Yes, that's good, I commented. "Of course that's the kind of thing parents are supposed to do when they can. How do you get along with them?"
"Okay."
"No problems?"
"Sometimes I'm mean to them."
"How do you hurt them, Bobby?" I asked.
"Like when I stole the car, that hurt them." Bobby said, not with tiumph but with a dreary, hopeless heaviness.
"Do you think maybe that's why you stole the car--to hurt them?"
"No."
"I guess you didn't want to hurt them. Can you think of any other ways you've hurt your parents?"
Boby didn't answer. After a long pause I said, "Well?"
"I just know I hurt them."
"But how do you know?" I asked.
"I don't know."
"Do they punish you?"
"No, they're good to me."
"Then how do you know you hurt them?"
"They yell at me."
Bobby was feverishly picking at his sores now and his head had drooped as far as it would go. I felt it would be best if I steered my questions to more neutral subjects. Perhaps then he would open up a bit more and we could begin developing a relationship. "Do you have any pets at home?" I asked.
"A dog."
"What kind of dog?"
"A German shepherd."
..."Do you and Inge do a lot together?"
"No."
"Do you take care of her?"
"Yes."
"But you don't seem very enthusiastic about her."
"She's my father's dog."
"Oh--but you still have to take care of her?"
"Yes."
"That doesn't seem quite fair. Does it make you angry?"
"No."
"Do you have a pet of your own?"
"No."
..."It's not long since Christmas," I said. "What5 did you get for Christmas?"
"Nothing much."
"Your parents must have given you something. What did they give you?"
"A gun."
"A gun?" I repeated stupidly.
"Yes."
"What kind of gun?" I asked slowly.
"A twenty-two."
"A twenty-two pistol?"
"No, a twenty-two riffle."
There was a long moment of slience. I felt as if I had lost my bearings. I wanted to stop the interview. I wanted to go home. Finally I pushed myself to say what had to be said. "I understand that it was with a twenty-two rifle that your brother killed himself."
"Yes."
"Was that what you asked for for Christmas?"
"No."
"What did you ask for?"
"A tennis racket."
"But you got the gun instead?"
"Yes."
"How did you feel getting the same kind of gun that your brother had?"
"Yes."
"How did you feel, getting the same kind of gun that your brother had?"
"It wasn't the same kind of gun."
I began to feel better. Maybe I was just confused. "I'm sorry," I said. "I thought they were the same kind of gun."
"It wasn't the same kind of gun," Bobby replied. "?It was the gun."
"The gun?"
"Yes."
"You mean, it was your brother's gun?" I wanted to go home very badly now.
"Yes."
"You mean your parents gave you your brother's gun for Christmas, the one he shot himself with?"
"Yes."
"How did it make you feel getting your brother's gun for Christmas? I asked.
"I don't know."
I almost regretted the question. How could he know? How could he answer such a thing? I looked at him. There had been no change in his appearance as we had talked about the gun. He had continued to pick away at his sores. Otherwise it was as if he were already dead--dull-eyed, listless, apathetic to the point of lifelessness, beyond terror.
The following day he spoke with the parents and in the end they seemed more defensive and irritated then they were concerned about their son. To concern about the Christmas present they gave, they're excuse was pretty much "we're hard working people and not educated folk like you. How the hell are we supposed to know how he would feel getting his brother's suicide weapon for Christmas?" It ended with him arranging to have Bobby live with his aunt (not to his mother's liking as she strongly disliked her sister and had disliked her) and the Dr. Peck being so repulsed by them he eventually just wanted to wrap things up and couldn't stand being in the same room with them anymore.