The Book of the Week is “Brooklyn Zoo” by Darcy Lockman, published in 2012. This is a personal account of an internship of a PhD candidate in psychotherapy.
Lockman started her internship in summer 2007 at Kings County Hospital in Brooklyn, New York State, the final leg of training before she got licensed to practice. Throughout the book, she reveals the lingo, issues and people encountered by clinical psychologists.
A few aspects of the personalities of humans include developmental level (psychotic, borderline or neurotic), and character applicable to it (“masochistic or obsessive or narcissistic or depressive, etc.”). Patients might be diagnosed with a thought disorder, mood disorder or personality disorder, or a combination thereof. These were documented in a reference guide for psychiatry, the “DSM IV.”
During her training, the author saw what she perceived to be a disturbing trend– of treating all ailments, even ones suspected to be psychological in whole or in part, by prescribing drugs with little or no accompanying psychotherapy. The psychiatric professionals at the hospital perceived part of their jobs to be to instill “medication compliance” in patients. Lockman was taught that treatment should include “the talking cure.”
However, it is controversial how effective psychotherapy is in treating addicts, because drugs and alcohol can permanently change the brain chemistry that controls learning. Lockman describes one alcoholic patient’s case: “angry young man plus bad neighborhood plus psychosis equals short life expectancy.”
Since psychotherapists themselves are human, they sometimes cannot help but become emotionally affected by their patients. One time, Lockman realized she was biased by the socio-economic level of a patient she saw: “…upper-middle-class and white… familiar to me.” Lockman later momentarily broke down in front of her supervisor, who told her, “Never apologize for having an emotion. Just make sure you give it some thought.”
Some patients, such as a narcissistic-borderline (personality disorders) married couple, recounted stories of extreme past behaviors, some of which were laughable. The two consisted of a male narcissistic ex-convict and borderline, pregnant female who had four kids total; the oldest two had a different father. The husband had been a pimp, and had committed adultery with one of his employees. The couple ended up at the hospital because they had become physically violent with one another. They had shamelessly revealed this information to Lockman. The husband said, “I’m a shooter, not a hitter.” The wife said she had committed a bank robbery to save her kids from starvation.
Another issue the author had to deal with was the hierarchical nature of the career field. ‘We all needed somebody to buttress our professional worth.” People in different specialties put other ones down. The medical doctors feel superior to psychiatrists; psychiatrists to psychologists; psychologists to social workers.
Read the book to learn the slew of other issues Lockman had to face in her quest for experience in clinical psychology.