Dangerous Situations

People sometimes ask whether therapy sessions or diagnostic interviews ever turn dangerous. They do. You are never quite as safe as you assume. I once spent close to two hours interviewing a man, and near the end he mentioned that he had considered bringing a gun to our meeting and that someone had talked him out of it. Before that, he had already described stalking another man while armed, saying the only reason he never fired was that his target stayed inside the building he was watching until he gave up and left. That was the nearest thing to a crisis I ever had, and it didn't even happen at one of the prisons where I worked and was frequently alone with inmates. (These days the counseling at those facilities is done over video, with the counselor and the offender in separate rooms.)

Something physical happened to me much earlier, back when I wasn't braced for it. I was filling in temporarily at a large psychiatric institution, and I often found myself responsible for a big group of patients. One afternoon I was by myself in the cafeteria overseeing three separate wards. Only one of the three was actually mine, and at least one was an open ward. On paper I had company, but the kitchen staff were not there to keep an eye on the residents.

A woman, who I found out afterward belonged to one of the open wards, started making a scene, smearing condiments across herself and over the tables and chairs. I chose to stay calm. I walked up to her and put my hand on her arm, a gesture I would only later learn you do not make with a patient you don't know, and she slapped me across the face, hard. Caught off guard would be putting it mildly. A nurse who knew her happened to come into the cafeteria, spoke with her, and steered her out. Did anyone check whether I was hurt? No. That slap was the one and only time the job ever left a mark on me.

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