Psychiatry at Work

When 15-year-old Jim was arrested on a Seattle street two years ago for indecent exposure, police discovered that he was wearing a stolen brassiere, slip and woman's panties under his own clothes. Since he had been arrested for a similar offense nine months before, Jim was examined by psychiatrists. Their conclusion: the tall, husky boy, although physically normal, was a transvestite* who was losing not only his sexual identity but his self-control, and should be put away as "potentially dangerous." Jim faced a black future. As with other sex deviates, confinement might intensify his condition, prepare him for further offenses and a lifetime of abnormality after release. Because he had already begun to act out his neuroses, many private psychoanalysts would be reluctant to treat him. A conscientious case worker in juvenile court sized up Jim's situation, put through a hasty telephone call to Seattle's Ryther Child Center, a small (165 patients) social agency dealing exclusively with emotionally disturbed youngsters.

Resistance. Ryther was the natural place to turn for help. Founded in 1935 and developed into a treatment center by Lillian Johnson, a career social worker who is now executive director, it has scorned stuffy precedents, snatched many a "hopeless" case from the door of a state school or mental institution by entering difficult areas of child therapy. Its formula : a combination of dedicated social workers, psychoanalysts and house staffers giving treatment in an informal but disciplined family atmosphere (there are no bars or locks at Ryther). The center has become the model for 20 other residential-type child treatment centers in the U.S., attracts social workers from all over the world for training.

Ryther accepted Jim. (Jim accepted Ryther only after he and his parents reluctantly decided that the center was better than a state institution.) The boy began a series of weekly consultations with William Gleason, a social worker and former (1938) halfback for the University of Washington, who regularly consulted with Dr. Edith Buxbaum, a psychoanalyst attached to the center. At first the interviews were unproductive; Jim missed many, or showed up hostile and taciturn for others. But the counselors steadily broke down his resistance over a six-month period by treating him as an adult and convincing him that they would not violate his confidences. Then the disturbing tale of Jim's life began to come to light.

Wrestling. Jim's mother was a heavyset, masculine woman who ran the household, even to repairing the plumbing; his father was a light-boned, slightly effeminate weakling who talked in a high-pitched voice. Jim's older brother was a perfectly normal, completely masculine boy whom Jim worshiped. When Jim was born, his mother wanted a girl, kept him in dresses and let his hair grow until he was four, later taught him to do girls' household chores. As Jim grew up. he learned to please his mother by playing her game, wore her clothes around the house and put up his blond hair in curlers.

In school, he spent most of his time thinking about sex and losing himself in wild fantasies in which he sometimes played several sexual roles. As he grew into adolescence, he began to despise his father, a reaction his mother unwittingly encouraged by making his father look ridiculous. She, meanwhile, intensified her masculine role. Every morning, she wrestled with Jim to get him out of bed; since she won every wrestling match, Jim keenly felt that his was the passive role.

Controls. Ryther's psychiatrists were convinced that Jim was not essentially effeminate; they believed that his exhibitionism was, in fact, a rebellion against the part that his mother had encouraged him to play. While therapy and interviews were uncovering significant material, he underwent no overnight transformation. But firm controls at the center helped him improve his own self-control, and the counselors' patently impartial concern for his welfare brought him slowly to understand his problem and its causes. He began to exert himself, gruffly ordering younger children to obey the center staff.

After eight months, Jim was permitted to go home for several holidays. Carefully coached by his counselors at Ryther, he rebuffed his mother when she tried to resume their wrestling. When she began to reject him in his new role, he faced a real, personal crisis: whether to please her and thus win back her love, or exert his latent masculinity.

Recovery. The center had done its work well. Jim soon resolved his role dramatically in three ways: he became violently enamoured of a young house mother (who carefully kept him at arm's length), he got a crew cut, and he acquired a girl friend and took her home to show Mama. When, after two years of interviews and treatment, he was discharged, he landed a good job (making more money than his Ryther therapist), continued going with his girl. He is reported to be in excellent mental health, has applied for a branch of the armed forces.

Ryther's staff see no reason why he should not be accepted. They worry sometimes that Jim's parents are not changed. ("At their age and in their state.'' says Miss Johnson, "they'd need four years of analysis.") But the counselors reason that if Jim can conquer his old environment, he will never meet a tougher test in life.

*Medical definition: one who has "a morbid desire to dress in the clothing of the opposite sex."

This file is automatically generated by a robot program, so reader's discretion is required.