Step wanted to say, He talks quite often? You mean we’ve been paying for sessions in which he hasn’t talked at all? After two months he’s only now getting used to you? But he remembered DeAnne’s concerns about him and curbed his tongue.
“Beyond that,” she said, “I’m still in the process of diagnosis. His reticence to speak is, of course, one of the symptoms of his disorder, but it also makes the process of diagnosis rather slow. I think that in another month or two I may be prepared to give you a prognosis. In the meantime . . .” She turned over a couple of sheets of paper on her desk.
Trying to keep his voice calm, Step interrupted. “What I’m interested in today, Dr. Weeks, is not a final statement, but an explanation of what you know so far, or what you suspect so far. DeAnne and I have to decide now, not two months from now, whether to continue treatment.”
“I’d be happy to work out a payment schedule with you,” said Dr. Weeks. “But I can hardly discuss an ongoing process, especially when you are not the patient.”
“The patient is eight years old,” said Step. “And if I were a fellow psychiatrist, you would have no trouble at all talking with me about what you think the diagnosis might turn out to be.”
“But you are not a psychiatrist, Step.”
“I have a Ph.D., Dr. Weeks. It’s in history, which isn’t an exact science like psychiatry, I know, but it does mean that I’m an educated human being, and I think that if you try to explain to me what’s wrong with Stevie, I’ll understand you.” Thinking of what was going on at the hospital with Zap, he added, “For instance, you must have some idea of what his condition isn’t. Things you’ve eliminated.”
“It would be much more helpful to the whole process, Step, if you and your wife came in for some sessions with me yourselves. In fact, I suspect that your insistence on hurrying the diagnostic procedure may suggest possible sources for Stevie’s abnormal reaction to stress.”
I should have expected this, thought Step. The very fact that I want to hold her accountable is proof of my disorder. Well, he was not going to let Weeks establish a doctor-patient relationship with him. “Fine,” he said. “If you explain to us what you think the problem might be and why our coming in for sessions might be helpful, then we might well agree that our joining in the therapeutic process might be the indicated course of action.”
“Step,” she said, “you seem to feel some hostility toward psychotherapists, along with an apparent fascination that has caused you to learn some aspects of psychological jargon. I wouldn’t be surprised if you have unconsciously communicated this hostility to Stevie.”
“Dr. Weeks, my efforts to find out what’s going on between you and Stevie did not cause his problems.”
“I wasn’t implying anything of the kind,” said Dr. Weeks. “Why do you think you felt a need to defend yourself just now?”
“Dr. Weeks, I think you misunderstand our relationship. I’m here as Stevie’s parent. If I had brought him to a pediatrician with a bad cough, I’d have a right to expect the pediatrician to tell me what he thought might be causing the cough and what he intended to do about it, and he wouldn’t give me any crap about how I couldn’t possibly understand the ramifications of pulmonary function and, by the way, have I been short of breath myself lately? Stevie’s been with you for two months, and apparently all you’ve observed about him is that he’s morose and has imaginary friends, which is strikingly similar to what we already knew when we brought him here. I hope you’ll understand that I’m not trying to interfere with Stevie’s treatment. I simply have a responsibility to know what that treatment consists of and what it’s designed to accomplish.”
“Let me tell you why I’m reluctant to discuss this with you, Mr. Fletcher. Given the importance of parents in a child’s life, it is inevitable that Stevie’s parents are involved in the source of his problems. This idea is obviously threatening to you, and I fear that you may withdraw Stevie from treatment in order to protect your own ego. This might cause the boy great harm.”
Step recognized that she was attempting to manipulate him into backing off—any objection he raised to her diagnosis could be dismissed as ego protection. But he held his temper and said none of the vicious retorts that came to mind. “Dr. Weeks,” he said, “DeAnne and I knew from the start that solving Stevie’s problems would almost certainly mean us changing our lives somehow. We’re willing to do whatever it takes to help our son, and I’m not afraid to find out flaws in my own parenting. But I can promise you that if you don’t tell me what you’ve learned about his condition, then we certainly will withdraw Stevie from your care.”
She regarded him for a while, her expression aloof and uninvolved. She must have spent hours in front of mirrors during graduate school, Step thought, practicing that detached, I’m-above-emotional-engagement-with-mere-humans-and-their-petty-problems look.
“All right, Mr. Fletcher,” she said, “I will tell you what possibilities I am currently considering as diagnoses for your son’s condition. First, we may be seeing a simple factitious disorder. Second, we may—”
“Factitious disorder?” asked Step.
“Factitious means the opposite of what it sounds like, Mr. Fletcher—”
“I’m aware of the meaning of factitious,” said Step. “It’s the meaning of the phrase factitious disorder that I’d like you to explain.”
“In layman’s terms, it means that Stevie might be lying about these imaginary friends because he knows it upsets you and he’s hungry for the attention that ensues.”
Step stifled his desire to say, Stevie doesn’t lie, he has never lied, he tells the truth even when it causes him to be embarrassed, even when he’s sure that he’ll be punished for it. If Stevie says that he’s playing with imaginary friends, then that’s because he really thinks he’s playing with these friends, and it’s not some damned cockamamy factitious disorder. Instead, he merely said, “And your second hypothesis?”
“It is possible that this is a mere adjustment disorder with depressed mood and withdrawal.”
“And what would that mean?’ asked Step.
“That he was seriously disturbed by your move to North Carolina. That he felt dislocated from his friends, from a familiar and safe setting, and instead found himself plunged against his will into a terrifying environment where he is incapable of making sense of what is going on and feels himself unable to protect himself from others. In that case, these imaginary friends would be a hallucinatory effort on the part of his unconscious to re-create the safe environment of the past, while his depression would be a sign that in fact the hallucinations are not successful in masking his unhappiness. He does not quite believe the falsely happy reality that his unconscious mind has created for him.”
Step kept himself from saying, That’s precisely what DeAnne and I thought before we ever brought him to you. “What do we do about it?” he asked.
“That was a hypothesis,” she answered, “not a diagnosis, and therefore we will do nothing about it.”
“But if it turned out to be the true diagnosis, what would be the right course of action?”
“We are getting into dangerous territory here,” said Dr. Weeks. “Highly speculative.”
“I understand that, and I’m not proposing that you do anything improper. I just want to have some idea of what the treatment might consist of if this turns out to be the diagnosis.”
“Well,” she said, “we might begin by having you contact the parents of some of his former friends back in Indiana, to get them to write to him or telephone. However, that may not be effective because at his age children are not very adept at making meaningful emotional contact through indirect media like the telephone or letters.”
“And?” asked Step.
He meant for her to propose other possible treatments that might be used if Stevie’s condition really was adjustment disorder with depressed mood and withdrawal. But she took it as a request for the third hypothesis.
“The third poss
ible diagnosis, and the one that I think is most likely, is also the one that will be most difficult for you to hear impartially, and therefore I ask you to keep an open mind as best you can.”
Step nodded, even though it was clear that she didn’t think him capable of it.
“I think we can best account for Stevie’s behavior if we view it, not as a new condition brought on by the move to North Carolina, but rather as an exacerbation of a preexisting condition of some severity, one which remained unobserved because it had gone on so long that you thought it a part of Stevie’s underlying character.”
“So why would we only have noticed it since—”
“Please,” said Dr. Weeks. “An open mind. The stress of the move changed his pattern, you see, and it was the change you noticed, not the actual onset of his condition.”
“And the condition would he . . .”
“Atypical dissociative disorder,” she said. “This has been primarily documented in people who have undergone intense brainwashing experiences, but it is my belief that it shows up far more commonly and merely remains undiagnosed.”
Step was baffled. What experience could Stevie have undergone that would produce the same effects as brainwashing?
“Actually, most children in America are subjected to a particular form of indoctrination from their earliest years, in which they are repeatedly reinforced in their belief in a powerful figure who does not actually exist. However, evidence is given to them to support that belief, accompanied by stories to make the child believe that the whole world believes in this particular mythic figure.”
“You’re saying Stevie’s problems are because we taught him to believe in Santa Claus?” asked Step, incredulous.
“On the contrary. I think Santa Claus is, by and large, quite beneficial, for when the child is finally allowed—or forced—to recognize the nonexistence of Santa Claus, then the child is able to go through the vital intellectual process of reconstructing reality in light of new evidence, complete with back-forming new stories to account for past events. This prepares the child for many other disillusionments and gives her vital and well-supported experience in maintaining her grip on reality independent of the stories told to her at any given time.”
“So Santa Claus is good,” said Step.
“Santa Claus is usually not maladaptive,” said Dr. Weeks, “and can be turned to a good end. I doubt many parents actually have that outcome in mind when they tell their children the ludicrous chimney story.”
“No, I imagine not,” said Step.
“Santa Claus is certainly not at the root of Stevie’s problem. He has a healthy skepticism toward that story already.”
We paid you ninety bucks an hour to find out whether Stevie believed in Santa Claus?
“Stevie has been subjected to another nonconsonant belief system whose implications are far more all-pervasive in his interpretation of events in his life. He feels an enormous weight of pressure to demonstrate his loyalty to this belief system, and therefore has for a long time been forced to come up with supporting personal experiences to tell you and your wife about. However, Stevie also has been taught to have an absolute commitment to truth, and cannot do as many children do and simply lie, claiming to have experiences that they do not have. Nor, being a child of a rather placid temperament, has he been able to work himself up to a level of emotion in which hysterical phenomena appear, which is the most common means of satisfying these expectations.”
“You’re talking about religion, aren’t you?” asked Step.
“And the Mormon religion in particular, since yours is, as I understand, a somewhat, though not extremely, charismatic sect. As I have learned from Lee, there is considerable emotional display at your testimony meetings once each month, at which many people stand up and weep while they speak. This is clearly a hysterical phenomenon, and is not unhealthy—many churches throughout the South have long had a similar tradition and it has served them well as an emotional release. However, Stevie is one of those unfortunate enough not to be able to produce the appropriate hysteria, and he is also unwilling or unable to he or pretend. Therefore, he produces hallucinations.”
“Dr. Weeks, the only hallucinations Stevie has had are his imaginary friends, dating from our arrival in Steuben.”
“On the contrary,” said Dr. Weeks. “Stevie has told me that he had several experiences in early childhood in which he sensed a very evil presence, threatening to destroy him. I immediately recognized this as the father-fear that is not unusual in boys of that age and which they usually outgrow. However, he says that he told you and your wife about these ‘frightenings’ and ‘bad feelings,’ as he called them, and you both informed him that these feelings were from the devil.”
“We said they might be,” said Step. He was trying to stay calm, but it made him feel invaded, to have her skeptical eye turned on those tender moments from Stevie’s childhood, when he and DeAnne had tried so carefully not to impose their own interpretation on Stevie’s dreams.
“To a child of his age at the time, of course, there was no meaningful distinction between ‘might be’ and ‘is.’ But I would not have expected you to know that, since you are also caught up in the same belief system. In any event, Stevie began to associate all spiritual phenomena, about which he heard much but of which he experienced nothing, with this oedipal anxiety from his earlier childhood—”
“When he felt afraid at night,” said Step, “I would lie by his bed for an hour or two hours, until he fell asleep, singing or humming to him. It wasn’t me he was afraid of.”
“Of course he did not know it was you he was afraid of. He had displaced the fear and shifted it to a nameless imaginary entity which you conveniently named for him. From that point forward, then, his response to the pressures of your culture was to hallucinate, and in every case you labeled these hallucinations as spiritual experiences. Thus he was able to be part of the culture. He was brainwashed.”
“I’m surprised that you allowed Lee to join our church if that’s what you think we’re about,” said Step.
“I’m a scientist, Mr. Fletcher,” she said. “I mean no offense by this. I simply feel that we would be doing Stevie a disservice if we did not recognize that he has long had hallucinations unconnected with the move to North Carolina, and therefore treating only the symptoms that arose since your move here would leave his basic underlying condition unresolved.”
“If it turns out that this is the correct diagnosis,” said Step.
“As I said, I only lean toward this interpretation. But you must understand that when he told me about his baptism, and how during that experience he saw a bright light in the water, which entered him and drove all the darkness out of his body, well, that shows me that he is hallucinating more than just imaginary friends.”
Stevie had told no one about this experience, no one but Dr. Weeks, who thought of it as madness. “Do you know that it was a hallucination?” asked Step.
“You were there, Mr. Fletcher,” said Dr. Weeks. “Did you see that light?”
“No,” said Step.
“When one person in the midst of witnesses sees something that no one else sees, we are generally safe in identifying these experiences as hallucinations.”
“Or maybe he has clearer sight than the others,” said Step.
“Oh? You think there really was some underwater light source that no one else was able to see?”
“I think,” said Step, “that it’s possible for something to be both subjective and real at the same time. Just because only one person sees something doesn’t necessarily mean that what he sees isn’t there.”
“But by that standard, Mr. Fletcher, I fail to understand why you have even brought Stevie to me. After all, what worried you and Mrs. Fletcher was the fact that Stevie was seeing imaginary friends that no one else could see.”
Step had never thought of the imaginary friends this way. It made him angry, her linking spiritual experiences with Stevie’s delusions.
But she had linked them, and if she was right, if they really were alike, then all of Stevie’s extraordinary sensitivity to other people, his ability to perceive good and evil, his aliveness to the spiritual side of life—all of that was also imaginary, hallucinatory.
On the other hand, it might also mean the opposite. That just as Stevie’s sensitivity to spiritual things was real, so also his ability to see imaginary friends was real. In which case Dr. Weeks was right, and they had made a colossal mistake bringing him to her. Just as he had been telling them the truth with his absurd-seeming story about Mrs. Jones’s mistreatment of him, so also he was telling them the truth about these imaginary friends.
Which meant there really were invisible boys playing in their yard whenever Stevie went outside.
No, thought Step. No. The reason this is not true is that Dr. Weeks is wrong from the start. His imaginary friends are not the same thing as his spiritual sensitivity. The other thing she said—adjustment disorder with depressed mood and withdrawal—that was enough to account for all his symptoms, or at least all of them that Step and DeAnne thought were symptoms. Dr. Weeks simply hated religion, and so she was going to read psychological disorders into the cosmology of Mormonism.
Of course, if she hated religion, why was she driving Lee Weeks to church every week?
“Is there any other possible diagnosis?” asked Step.
She spoke briefly about residual-type schizophrenic disorder, but it was clear she didn’t think much of the possibility. “But I can see that you would prefer almost any diagnosis to the one that casts doubt on your cherished belief system.”
“I prefer whatever is best for Stevie,” said Step. “I’m perfectly able to see how our religious beliefs appear to those who don’t believe in them.”
“Do you intend to let Stevie continue receiving treatment?”
“I don’t make such decisions alone,” said Step. “I’ll have to confer with my wife.”
Lost Boys: A Novel Page 38
