In: Psychology
As part of his internship, Trey is working night intake at a
psychiatric hospital in a medium-sized college town. It's been
pretty quiet all evening until a little after 1 a.m. when he hears
shouting in the outer hallway.
Trey looks at Lisa, his fellow student intern, who says, "What's
going on out there?"
A moment later the doors burst open, and a young man, who looks
about 18 years old, is escorted into the intake desk. He is
agitated and has tears on his face, but he is not showing signs of
violence or aggression, beyond the brief shouting he did out in the
hallway.
He plunks himself down in the chair across from the intake desk and
buries his face in his hands, rocking slightly and moaning. He has
a slight body odor and is perspiring heavily.
"He's all yours," Lisa whispers.
Trey ignores her and moves quickly to the intake desk. Lisa runs
off to find the supervising nurse, who has gone on break.
"Hey there," Trey says calmly, bending over to look into the
patient's eyes. "I'm Trey. What's up?"
He is almost surprised when the patient stops rocking, sits up, and
lowers his hands. "Hey," he says quietly. "I'm Matt, and this is
hell, dude."
"Not quite," Trey smiles. "I'm here to help. Can you tell me what's
happened?"
"I'm going all to pieces," Matt says, "little screws and bolts and
debris flying off everywhere."
Trey says nothing; he just waits.
"I had kind of a breakdown in my dorm," Matt says. "I threw my
laptop out the window."
"Ooh, that's rough. Bad night, huh?"
"Bad week, bad month, bad year, bad bad life. Bad
badbadbadbadbadbadbad BA-A-A-AD."
"What happened?"
"Where you wanna start?"
In fits and starts, Matt conveys small clues that hint at his
story.
Matt has always been a "nerd," he says, according to his older
brothers. As a child, he often withdrew from playgroups at school
to play on his own. In isolation, he has always managed to perform
well academically, but in group work or group assignments, he has
tended to resort to outbursts and a refusal to participate. He says
he has always been awkward in social situations and has always
found it hard to carry on "a good, rewarding conversation."
"And I'm freakin' clumsy. Klutzy. A klutz," he says, looking
everywhere but at Trey. "I'm the opposite of an athlete, the
opposite of my brothers."
Although his speech is frequently eccentric, Matt manages to convey
a very brief picture of how, because of his withdrawal, negative
thoughts, and social awkwardness, people tend to leave him on his
own, both at large extended family gatherings or social functions
in his family's community and place of worship.
In his senior year of high school, Matt's grades and SAT scores
gained him entrance to a leading Midwest university-despite his
disruptive problems.
Matt had been looking forward to going away to school, hoping that
part of his problems "fitting in" had to do with his family's
"obscenely proper prominence" in the community, and his older
brothers' "super-dude images, which," he says, "I will never live
up to."
"At the same time," he says during intake, "I was also pretty
nervous, pretty stressed, pretty freaked out, pretty freaky."
In his first week of college, Matt found orientation week
"disorienting," he jokes with a slight smile. "Orientation
disoriented me. It dissed me. I got dissed. There were
people everywhere, like climbing-the-walls-and-on-top-of-you
everywhere."
Except when Trey first initiated a conversation, Matt, for the most
part, has worked to avoid eye contact and continually bounces his
left leg nervously. He is gripping the arms of his chair and looks
as if he's about to fly right out of it.
"My roommate is a jock," he says. "Jocular jock. Oh, Jocularity,
wouldn't you know they'd put me with a
jocular-not-so-very-jocular-jock. They plan that stuff, you know.
Just to keep me from escaping, from making a fresh start. Guy's a
jerk, and now, here I am." He grins and expands his arms, gesturing
the psychiatric ward around him.
"And now here I am, just 8 weeks into my first semester away from
home, and I've just been admitted for totally breaking down,
shooting laptop missiles from the second freakin' floor. They
win."