"The Ladder": you can climb and descend.
Article Type: Short story
Author: McAdams, James
Pub Date: 03/22/2012
Publication: Name: Annals of the American Psychotherapy Association Publisher: American Psychotherapy Association Audience: Academic; Professional Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2012 American Psychotherapy Association ISSN: 1535-4075
Issue: Date: Spring, 2012 Source Volume: 15 Source Issue: 1
Accession Number: 282741121
Full Text: You don't like me."

"It's just that--"

"You don't like me anymore," Julie C. said. The left over cake she'd brought to Susan's from Mr. Roderman's birthday celebration at work remained untouched on the counter. "You don't want me here because you're jealous." Susan L. counted to three and then exhaled, remembering how she and her support team had rehearsed this scenario at her team meeting when she had admitted that Julie C.'s recurring visits were agitating her. The conversation had started with the two ex-roommates on the brown loveseat (Susan L. had moved the longer couch into the room Julie C. had vacated when she graduated), but now they were both standing, Julie C. edging closer to the door with her briefcase, and Susan L. behind the coffee table as if she needed to be protected, both of them talking very quietly and avoiding eye-contact.

Susan L. had rehearsed a variety of scenarios and cognitive thought-blocking techniques with the support team in the carriage house. This was located behind the group home where she and Julie C. had shared a bedroom before they had both graduated into the supervised apartment program. There was never any question that they would be roommates. She and her treatment team had practiced empathy, which meant being able to see through someone else's eyes. Laura, Susan's case manager, who looked like an actress and drove an old VW Jetta with flowers on the console, explained that there could be many reasons for Julie C. to continue to return to the supervised apartment community, even though she had her own apartment and was legally responsible for herself.

Some people, Laura asserted, thought it was a form of bragging, the way Julie C. kept coming by dressed in business suits, parking her new car (which was actually nicer than Laura's) up close to the office, talking loudly about how much she enjoyed her new job, and how all the men sat with her at lunch. Another possibility was that it's a kind-hearted attempt to not forget where she came from and also to act as an example for her previous peer group, whom she genuinely cared about. The case managers, resident advisors, and clinical psychologists knew it could also be a function of someone decompensating, returning to the womb as it were, but Laura didn't mention this. Ml Susan L. knew was that the Julie C. who had started coming back now was different and weird, and that this had something to do with "The Ladder."

"The Ladder," Susan L. muttered. She fluffed out the sleeves of her sweater so they covered her hands. She had no control over the thermostat, which was set low to save funds. "The Ladder's it."

"What about the ladder? What's the ladder got to do with it?"

Julie C. knew as well as anyone who had been processed in the mental health community that there were hierarchies and tiers signified by your residential status. At the bottom were those in state mental hospitals, or 302'd into the one-floor psych ward of regional hospitals. Next up was living in a group home or assisted living facility, where your SSDI was handled by social workers, and you were forced to go to treatment centers during the day and make baskets or play bingo with the developmentally disabled. Then there were the supervised apartment communities, such as apartment 8F, and then finally what some called "graduation," unsupervised apartment living, just like being a "real adult." Many consumers in the region called this "The Pyramid," but Julie C. and Susan L. had called it "The Ladder" since their days in the state hospital when they were in their early 20s.

"The Ladder, Jules. You've climbed it. And remember what we've always said, why The Ladder and not The Pyramid?

Julie C. just looked down, fingering the frayed clasp on her briefcase.

"The Ladder 'cuz you kick it down once you've climbed it," Susan L. said. "The Ladder 'cuz you've recovered for good, that's why it's better than The Pyramid, 'cuz you can slide back down a pyramid, remember, Jules?" Her voice actually had emotion, which was rare, and she moved slightly towards Julie C. still without making eye contact.

"Don't I look like I'm recovered," said Julie C., dropping her briefcase and splaying her arms out. "What do I have to do for people to stop--?"

"What people? Of course I believe you're recovered, but I'm not. I'm still here, Jules, and seeing you like a real adult is hard, talking about boyfriends, and your job, and how everything's great, and I'm still..." Susan L. folded herself on the couch again and looked at the stain on the carpet, "here."

Later that night Julie C. sat in her dark studio apartment that was furnished with hand-me-downs from family and members of her support community. There was some kind of party going on next door where girls cooed with pleasure that sounded fake to her and this hurt. What she'd wanted to tell Susan was that she didn't feel recovered, that it was unbelievably hard to pretend at work, it was true that no men were interested in her, and her social life was so empty and unordered that there were times she missed the supervised apartment community. She had in her hand both Susan's number and the number for the on-call mobile crisis manager, but she just sat there, not having the energy to explain what she felt. There was a stain, similar to the one at Susan's, on her carpet, which she kept thinking was a sign. It was embarrassing. Maybe "The Pyramid" made more sense than "The Ladder," she thought. When the party next door ended around 4:00 am, she was coiled in a fetal position on her bed, still wearing her business suit, planning to call in sick tomorrow.

JAMES MCADAMS recently received his MA in Literature from Villanova University and is currently pursuing his PhD in English at Lehigh University. Prior to obtaining his BA in creative writing from the University of Pittsburgh, he worked for over five years in the mental health industry, occupying such positions as house supervisor, resident advisor, and case manager. He is working on a novel about those experiences.
Gale Copyright: Copyright 2012 Gale, Cengage Learning. All rights reserved.