HEARING VOICES: Reflections of a Psychology Intern

Haas' anxiousness keeps getting in the way during his year as a clinical psychology intern at Boston's Commonwealth Mental Health Institute, a Harvard affiliate. It's a watershed for this graduate of Hampshire College and the Univ. of Detroit: you go in as a student and--ready or not--come out as a practitioner. Haas begins by describing the structure of the internship program--teamwork on the locked unit, milieu therapy in the day hospital, intake at the clinic--and by introducing patients, who remain elusive for the most part, being discussed only as functions of their illnesses. The writer ends with the ticklish processes of ""Termination,"" vis-à-vis both the patients who've come to depend on Haas, and the staff (senior therapists, social workers, nurses) on whom he's come to depend. Supervision, the chance to learn from experts, is the heart of the experience, but as Haas shows, it can be a real power game at Comm. Mental, where the tension between the ruling psychiatric contingent and ""lesser"" psychologists exacerbates the private straggles. And Haas has more than his share of those; they're the subject, at root, of the book. His fear of his own feelings interferes, he's told, with his ability to listen and help: ""I'm rigid most of the time, or scared about being rigid or rigid about being scared, or amused about being scared of being rigid."" Most of his superiors seem to think he's in over his head; and there's his weakness for identifying with the patient predicament (""countertransference""), whereby he wonders about ""taking away a man's freedom because he uses it to make decisions I don't agree with."" Haas already has a pretty heavy dose of self-doubt as the son of a Holocaust survivor who also happens to be a clinician (""the real Dr. Haas""). Yet, ingratiatingly, he can appreciate the surreal in a schizophrenic: of one Mr. Hummer, he says, ""I love the way he ignores his strangeness."" Genially confessional (""I tend to obsess. . .""), Haas addresses even the objective aspects of the practicum self-referentially. Too personal to matter to many.