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.”
Levin wanted Guerette to leave: Go to Hyannis, just an hour down the Cape; be near the Kennedys.
“Never,” Guerette told him. “No one was going to kick me off this island,” he later explains, comparing himself to Rich, the Machiavellian character who won CBS’s Survivor earlier this summer.
Rather than compromise, Guerette hired Levin’s Einstein colleagues – most recently a chairman – to lecture at his program. “I enjoy that,” he says.
Levin, who as an academic was sometimes concerned with issues of stress reduction, couldn’t find any.
How did the good doctor Levin feel about Guerette? “The word murder comes to mind,” Levin says with mock menace.
Eventually, Levin and Einstein took Guerette to court, claiming unfair competition. They wanted $1 million or Guerette’s removal. And so this scrap – over a stretch of sand where there may be more psychological help available than anywhere in the world – moved to Manhattan federal court.
“They’re like two crazy old coots,” says one of their staff members.
If Guerette and Levin have lost their empathy, that’s not true of everyone. Indeed, this shrink-infused culture rings out with it. Parents, for one thing, don’t yell at misbehaving kids. Instead, there’s negotiating. Understanding. Reasoning. Supporting. Tons of it. “Susie, I need for you to come out of the water now,” called one mother. When the girl suggested through moans and noises that she’d prefer to stay, the mother bent down to be at her daughter’s level, to make eye contact. “I know you want to stay,” she said, intoning evenly, “but right now we all need to go home.” Another psychologist recalled hearing a lesbian couple at a pond with their boy, a 5-year-old. He was playing Kadima with the girls of other lesbian couples when he suddenly yelled, “I don’t want to play with you,” his face distorted. Quickly came the psychologically attuned response. “Honey, I know you really miss playing with someone of your own gender,” a mom said.
Ira Wood, publisher and novelist, recalls psychiatrists blocking the narrow aisles at the local Wellfleet supermarket. “They sit cross-legged on the wood floor counseling their children: ‘Do you really want to be sticking your fingers through the cellophane wrap in the ground chuck?’ “
“Sometimes you wish they’d just get it over with,” remarks one shrink. “Yell or grab the kid, put your foot down. Not every kid needs his inner world examined all day long.”
Any therapist can tell you, though, that sometimes it’s best to express your feelings – and they do. One therapist, whose reservation had been lost by the local repertory company, said, through tears, that she felt, well, violated.
One day, a children’s fashion designer was at White Crest, a beach with a wide sand bar where the kids can wade out for a quarter-mile. She’s a single mother who was explaining to a psychotherapist acquaintance how much her daughter wanted a dog.
“Puppy, huh?” said the therapist with a hint of a raised eyebrow. “Well, you know, it’s probably transference. She’s lost her daddy; she wants a substitute.”
The designer considered that. “No,” she decided. “I think she wants a dog.”
Another characteristic of this community may be that they didn’t just offer understanding professionally, sincerely – they also demanded it, even on vacation.
“I’m a psychotherapist who currently has several suicidal patients,” one told a landlord from whom he was renting a funky backwoods cottage for one week. “I use e-mail to help maintain their equilibrium.” He wanted an e-mail-ready hookup – touch-tone phone, long-distance access – in the woods.
“He’s lucky he has a telephone,” the landlord says. “They always want you to deal with their anxiety.”
Or their needs. A shrink, one who practiced scream therapy, was looking to buy in the Cape and wanted to make sure the house fit her requirements. So she asked Gayle DeSimone, a broker for Kinlin Grover GMAC, to scream at the top of her lungs. The shrink marched to the top of the house to listen. “I was pretty hoarse afterwards,” says DeSimone, who reports that the shrink was pleased with the acoustics though she didn’t buy the house.
Some, of course, just want to share. At the Conservation Commission in Truro, a psychiatrist wanted permission to add a second bathroom. Usually, the contractor appears. The matter is cut-and-dried, after all. Does it follow the regulations? is all the commission needs to know. But this psychiatrist wanted the commission to understand his situation. “I’ve come to this time in my life” was how he began a lengthy discourse about his nightly bathroom needs. The psychiatrist wanted to explain how often he urinated at night, how far he had to travel to the other bathroom, and the like. No one had ever said anything like this. “It was embarrassing,” says one commissioner. “It was beyond plumbing. I felt like I should have an inflatable cot.”
The therapeutic community itself seemed to have big therapeutic needs. Take the seminars where mental-health professionals come to tune up their skills. “These shrinks all come for the issues they’re trying to fix,” says Audrey Greenway, a manager of the Cape Cod Institute’s program. Thus, at lovely Nauset Regional, a high school on the beach, the stress-reduction group is wired, flying on caffeine. One therapist shook his mug defiantly at a caterer, as if to say, “See, I got some despite you.” The sex therapists ate tons, though not as much as those who treat eating disorders. “For them, it’s a feeding frenzy,” says Lori McKenzie, one of the caterers. The spiritually oriented therapists float through the day, says Greenway, while the attention-deficit therapists are distracted. They fill out the same form twice. They assemble a pile of books to buy, abandon it, only to begin another pile.
“Who’s the shrink here?” Greenway sometimes asks herself. “I’m like the playground director.”
Indeed, the shrinks do not always practice what they preach – least of all Drs. Levin and Guerette. Six days of a jury trial did not settle the matter.
“We crushed the hell out of them,” Guerette says gleefully. Their conflict-resolution skills, in other words, have totally failed. “He’s been in my face for fifteen years” is the way Levin put it recently.
Every few years, Guerette, who has a goatee, offers to bury the hatchet. “After all,” he says, “Levin has advanced mental health considerably through his programs.”
Each time, Levin, who has a beard, turns him down. “He wants to know what I’m up to now,” says Levin – who nevertheless says he’d agree to meet if Guerette would provide a detailed written agenda.
So it goes. Charges are traded. The battle is joined. They even, it can sometimes seem, appear to enjoy it.
They’ve become the Hatfields and McCoys of Shrink Land. As in that famous conflict, they’ve managed to pass the strife along. As fate would have it, Guerette’s daughter and Levin’s son ended up at the same college, Skidmore, where, as told by Guerette, the Levin boy remarked to the Guerette girl: “My father sued your father.”
“And my father beat the pants off your father,” snapped the Guerette girl.
“Honey,” Guerette later said, “whatever you do, don’t fall in love with him.”
Think of the terrific issues this sort of conflict might create for daughter and son. Think of the 50-minute hours it might take to resolve them – and think of the beach house all of that billing could pay for.