The fall of ’74. I was twenty-four, a brand-new Ph.D., caught up in the novelty of being addressed as Doctor but still as poor as a student.
I’d just returned to L.A. from the Langley Porter Institute in San Francisco to begin my fellowship at Western Pediatric Hospital. The position came with a jawbreaker of a title: National Institute of Mental Health Postdoctoral Scholar in Clinical Psychology and Human Development, jointly appointed to the hospital and its affiliated medical school. My job was to treat children, teach interns, do research, and come up with a paper or two the chief psychologist could co-author.
My pay was $500 a month, which the IRS had just declared taxable. There was barely enough left over to cover rent and utilities on a dingy Overland Avenue bachelor flat, plain-wrap food, discount clothing, thrift-shop books, and ongoing life support for a moribund Nash Rambler. Not covered was an eight-year accumulation of student loans and debts filed too long under Miscellaneous. A number of bank creditors delighted in dunning me monthly.
In order to earn extra money, I took on nighttime gigs playing guitar in dance bands, the way I’d scratched by in San Francisco. Irregular work with spotty pay and all the bar food I could get down between sets. I also let the University psych department know its illustrious graduate was available for free-lance teaching assignments.
The department ignored me until one afternoon in November when one of its secretaries had me paged at the hospital.
“Dr. Delaware, please.”
“This is Dr. Delaware.”
“Alice Delaware?”
“Alex.”
“Oh. It says here Alice. I thought you were a woman.”
“Not the last time I checked.”
“Guess not. Anyway, I know it’s short notice, but if you’re available at eight tonight, we could use you.”
“Use away.”
“Don’t you want to hear what it’s about?”
“Why not?”
“Okay, we need someone to supervise Course 305A- the clinical practicum for first- and second-year graduate students. The professor who runs it was called out of town and none of the usual substitutes are available.”
Barrel-scraping time. “Sounds fine to me.”
“Okay. You’re licensed, right?”
“Not until next year.”
“Oh. Then I’m not sure… Hold on.” A moment later: “Okay. Because you’re not licensed the pay is eight dollars an hour instead of fifteen and subject to withholding. And there’s some paperwork you’ll have to fill out first.”
“You’ve twisted my arm.”
“Pardon?”
“I’ll be there.”
In theory, clinical practicum is a link between book learning and the real world, a way to introduce therapists-in-training to the practice of psychotherapy in a nurturant environment.
At my alma mater, the process started early: During their first semester clinical-psych graduate students were assigned patients- undergrads referred from the campus counseling service and poor people seeking free treatment at the University health clinic. The students diagnosed and treated under the supervision of a faculty member. Once a week they presented their progress, or lack thereof, to peers and instructors. Sometimes things stayed on an intellectual level. Sometimes they got personal.
Psych 305A was held in a windowless garret on the third floor of the Tudor mansion that housed the clinical program. The room was bare of furniture, painted a grayish blue, and carpeted in grubby gold shag. In one corner was a pair of foam-padded bats- the kind provided by marriage counselors for good clean fighting. In another were piled the remains of a disassembled polygraph.
I arrived five minutes late, “some paperwork” having turned out to be a mountain of forms. Seven or eight students were already in place. They’d removed their shoes and positioned themselves against the sloping walls, reading, chatting, smoking, catnapping. Ignoring me. The room smelled of dirty socks, tobacco, and mildew.
For the most part they were an older, seasoned-looking bunch- refugees from the sixties in serapes, faded jeans, sweat shirts, Indian jewelry. A few wore business clothes. Every one of them looked serious and burdened- straight-A students wondering if the grind was worth it.
“Hi, I’m Dr. Delaware.” I let the title roll off my tongue with delight and some guilt, feeling like an impostor. The students looked me over, less than impressed. “Alex,” I added. “Dr. Kruse can’t make it, so I’m taking over tonight.”
“Where’s Paul?” asked a woman in her late twenties. She was short with prematurely gray hair, granny glasses, a tight, disapproving mouth.
“Out of town.”
“Hollywood’s not out of town,” said a big, bearded man in plaid shirt and overalls, smoking a free-form Danish pipe.
“Are you one of his assistants?” asked the gray-haired woman. She was attractive but pinched-looking, with angry, nervous eyes; a Puritan in blue denim, she appraised me baldly, looked eager to condemn.
“No, I’ve never met him. I’m-”
“A new faculty member!” proclaimed the bearded man, as if uncovering a conspiracy.
I shook my head. “Recent grad. Ph.D. last June.”
“Congratulations.” The bearded man clapped his hands silently. A few of the others imitated him. I smiled, squatted, assumed a lotus position near the door. “What’s your usual procedure?”
“Case presentation,” said a black woman. “Unless someone’s got a crisis to bounce around.”
“Does anyone?”
Silence. Yawns.
“All right. Whose turn is it to present?”
“Mine,” said the black woman. She was stocky, with a hennaed Afro haloing a round, chocolate face. She wore a black poncho, blue jeans, and red vinyl boots. An oversized carpetbag lay across her lap. “Aurora Bogardus, second year. Last week I presented the case of a nine-year-old boy with multiple tics. Paul made suggestions. I’ve got some follow-up.”
“Go ahead.”
“For starters, nothing’s worked. The kid’s getting worse.” She removed a chart from the carpetbag, flipped through it and gave a brief case history for my benefit, then described her initial treatment plan, which seemed well thought-out, though unsuccessful.
“That brings us up to date,” she said. “Any questions, gang?”
Twenty minutes of discussion followed. The students’ suggestions emphasized social factors- the family’s poverty and frequent moves, the anxiety the child was probably experiencing due to lack of friends. Someone commented that the boy’s being black in a racist society was a major stressor.
Aurora Bogardus looked disgusted. “I believe I’m well aware of that. Meanwhile, I’ve still got to deal with the damned tics on a behavioral level. The more he twitches, the angrier everyone gets at him.”
“Then everyone needs to learn to deal with that anger,” said the bearded man.
“Fine and dandy, Julian,” said Aurora. “In the meantime, the kid’s being ostracized, I need action.”
“The operant conditioning system-”
“If you were paying attention, Julian, you would have just heard that your operant conditioning system didn’t work. Neither did the role manipulation Paul suggested last week.”
“What kind of role manipulation?” I asked.
“Change the programming. It’s part of his approach toward therapy- Communication Dynamics. Shake up the family structure, get them to change their power positions so that they’ll be open to new behaviors.”
“Get them to change in what way?”
She gave me a weary look. “Paul had me instruct the parents and siblings to start twitching and shaking too. Exaggeratedly. He said once the symptom became part of the family norm, it would cease to have rebellion value for the boy and would drop out of his behavioral repertoire.”
“Why’s that?”
She shook her head. “It’s his theory, not mine.”
I said nothing, maintained a look of curiosity.