The crises on-the-ground related to substance abuse and AIDS was rapidly intensifying. Clients were frightened and dying in astounding numbers, getting incarcerated, treated as pariahs, selling off their possessions to get drugs, losing marriages and jobs. But that wasn’t Bob’s concern. He imposed a rigid outline to use for clinical meetings and demanded that the conversation be limited to his agenda. This had the immediate impact of stopping all meaningful case consultation. He next began targeting and openly demeaning a seasoned psychologist at the table. My colleagues’ insights were met with smirks, cold stares, or undisguised viciousness.
Bob’s next notable act was to put up a huge erasable white board in the waiting room, alphabetizing the therapists by name and listing our productivity scores. I think he borrowed this from a car dealer as a technique to motivate by using shame and fear, pressuring us to focus on the data points that senior staff were using to uncover the slackers.
I also suspect that Bob thought he was instilling competition but, in fact, the reverse happened. It brought the clinicians together, as we met secretly to discuss the clients and our methods to deal with what felt like daily combat in a war zone.
My most searing memory of Bob was when he barged into a therapy session to apparently supervise me, to show me how therapy was done. At the time, I was meeting with a middle-aged black woman who had once worked as a teacher in the local school system. She had lost any meaningful employment months before because of addiction.
Bob barged in, plopped himself down in a chair and encouraged this woman to cry, to “get your emotions out.” This reminded me of those celebrity TV reporters who arrive at a disaster and glibly ask survivors, “So how are you feeling?” or “What will it take to get closure?” She had been awake for several days on crack and had sold everything she owed to feed the addiction. She had lost all her significant friends and relatives to death or incarceration.
She was rock-bottom, but she wasn’t a blind fool. She stared at him coldly, the way I imagine she looked at all white, sociopathic racist bureaucrats.
I’ve worked in a few agencies that slipped like this into foolishness. The pattern is predictable. The few leaders leave and are replaced by managers. The vision becomes something ultimately irrelevant to the work. Community members become consumers to be sold a reproduceable product that’s measurable but much less effective. Those who are easy targets get blamed for the deterioration. Eventually the talented professionals leave while the remaining, less confident ones go to ground or actively perform acrobatics to impress the clueless bosses.
Maybe we could have used a union, but this was a right-to-work state. Maybe the grandfather I never knew would have had some suggestions.
I had been running several dynamic groups at the time with other young and creative therapists. It was demanding but rewarding work. We all sought out excellent clinical supervisors outside the agency, devoured new information, and tried anything that might be useful. And we were making a difference. But we all quit around the same time. Why would we stay? As a final act, as my two-week notice played out, I funneled some forty plus active clients to a therapist I respected in private practice. It was the most productive thing I could think to do.
