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I Know What Your Shrink Did Last Summer

Did you go a little crazy while your shrink was on vacation? Well, every summer on outer Cape Cod, the shrinks go a little crazy, too.

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Lieutenant George White works for the Fire Department in Wellfleet, Massachusetts, toward the northern tip of Cape Cod. Headquarters is a cavernous old building that handles not only fires but emergency medical response (as well as permits for campfires on the beach). One of White's duties is to respond to car accidents in one of the town's two shiny ambulances.

Arriving at the scene of a collision, White says, he often encounters a helpful tourist rushing from his car.

"I'm a doctor," the man, dressed in khaki shorts and Birkenstocks, will whisper-shout. "Can I help?"

Lieutenant White is accustomed to the question by now and usually fires back one of his own: "Well, what kind of doctor are you?"

"Psychiatrist" is what he almost always hears.

"Thanks," says White. "But we'll handle this one."

Every August, so goes the joke, New York City gets a bit itchier with neurosis. That's when the shrinks depart en masse, often to partake of that Jungian oceanic feeling in and around Wellfleet. In mid-August, Wellfleet probably has more mental-health professionals than Bellevue: It's Shrink Land, as the locals sometimes say.

Men are pasty, bearded, paunchy, bald. They don't carry cell phones. They have the "practice look," as one shrink has dubbed it: sandals, khaki shorts, cute T-shirts with sayings like SORRY, YOU MUST BE MISTAKING ME FOR YOUR THERAPIST, a favorite among the New York psych crowd. "They look very Upper West Side," points out a shrink who finally shaved his head so he wouldn't look like everyone else waiting in line at the fish store.

One woman, a therapist herself, became so convinced that every man resembled her therapist -- There he is! No, there! No, there! was the doppelgänger game she played at the ponds -- that she finally fled Wellfleet for another vacation spot.

In Wellfleet, sometimes that fellow with the salt-and-pepper beard really is your shrink. And shrinks wouldn't be shrinks if they didn't have their own set of issues about such encounters, along with a word for the process that might ensue: countertransference. One New York psychologist, spotting a patient at the movie theater, was beset with just such issues, which led him to other questions. Did the patient see me? he asked himself. The therapist didn't think the patient had spotted him. But then again, there was another possibility: Did he see me and act like he didn't?

In this case, the sensitive therapist decided that the patient had in fact recognized him but chosen to ignore him. "I thought he wasn't interested in me saying hello," he explains. So the therapist obligingly made himself scarce, circling to avoid the patient's gaze. Back in the city -- during a therapy session -- he learned that the patient hadn't noticed him. In fact, he would have been delighted to have said hello.

One New Yorker, this one a patient, imagined that his therapists -- he was seeing two -- chatted about him on the beach. And this can be more than garden-variety paranoia: Sometimes they do chat about you -- only the names are omitted to protect the neurotic. Shrink war stories are Wellfleet's characteristic genre.

"You wouldn't save me even if I were dying," one woman told her husband and then her therapist. This woman was so intent on proving her husband's lack of empathy that, continued the storytelling therapist, she got a rope, ventured down into the basement, looped the rope around a beam, and made the appropriate noises. "It took him six minutes to come downstairs," she triumphantly told the therapist, who shared this at a Wellfleet dinner to appreciative laughs -- before relating how she'd managed to help this difficult woman.

Over the years, the Cape beaches must have seemed alive with psychological talk. Once, short, rotund Freud-rewriter Sandor Rado of Columbia's Center for Psychoanalytic Training and Research held court on Truro's Balston Beach in his denim hat, his back, it was said, to the sea. And just this past summer, Thomas More, author of Care of the Soul, had a bit of an epiphany on Kingsbury Beach just south of Wellfleet. "I became aware of my fantasies of her and her work," he recalled after a visit from a friend, a trauma surgeon, on the beach. "I felt a fantasy of her as a magician," he explained. "I could feel my transference, could feel it right there on the beach." Indeed, the beaches are such a hive of shrink talk that it sometimes seems you can learn any secret about anyone. One shrink remembers a conversation floating her way from a nearby blanket. Two beachgoers were discussing an interesting case. She heard no names, but she heard the details. "Oh my God," she thought. "I know the patient they're talking about."

If there's not enough shrink talk on the beach, there's any number of courses and classes and symposia you can attend. Gilbert Levin, now a professor emeritus at Albert Einstein College of Medicine, was the first to launch a continuing-education program for mental-health professionals in the Outer Cape. Two decades ago, he saw this as a way to fund other programs he had in mind for Einstein. It worked. Attendance was as good as at the med school; the program made tons of money.

Then, within a few years, Dr. Robert Guerette, an enterprising Boston psychiatrist, followed in Levin's footsteps -- to Levin's dismay, directly in his footsteps.

Levin's group called itself the Cape Cod Institute; Guerette named his the Cape Cod Summer Symposia. Levin had started at the Sheraton. So Guerette booked the Sheraton. If one of Levin's speakers was particularly popular, Guerette would ship an offer to the speaker's home.

Both Guerette's and Levin's programs let out by a little past noon. As Guerette's brochure, similar in its size and its blue color to Levin's, put it: "Combine a stimulating symposium with a relaxing summer vacation." Both programs were predicated on the idea that a shrink might enjoy a tax break for his or her vacation -- something available if one signed up for a few courses.

"His program was as close a copy of mine as you could make," fumes Levin.

Which Guerette pretty much admits. "I received his brochure," he said. "I wouldn't have dreamed this up without him." As he saw it, he was Macy's to Levin's Gimbel's.

Indeed, shrinks' seminars have been crammed into a local inn, a restaurant -- until it cut into the lunch business. (Now, attendees sometimes go out to dinner, a dozen at a time, and, establishing boundaries, request twelve separate checks, driving one local restaurateur crazy.) Seminars have been hosted by a bookstore, the movie theater next to the drive-in, a regional high school nestled on the beach. The Boston Graduate School of Psychoanalysis has run seminars, some with appropriately vacationy themes like "Is Sex Just Sex?" So has Massachusetts Mental Health Center, affiliated with Harvard.

None of these other programs particularly bothered Levin. Guerette's got under his skin. "I'm his R&D department," he boils. "One year, he even scheduled his whale watch at the same time as mine."


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