The Diagnosis

     (A therapist's office.)

THERAPIST:  Well, I have some really good news.

PATIENT:  Great, I could use it.

THERAPIST:  As you know, you've been coming here for a few years, and we've been trying to figure out the right diagnosis for you.

PATIENT:  That's right.

THERAPIST:  And I think we've finally landed on it.

PATIENT:  Really?

THERAPIST:  Yup.  I've been doing a lot of reading, and consulting with other experts, and I'm fairly confident in what I'm about to say.

     (A beat.)

PATIENT:  Okay, well--Go ahead.

THERAPIST:  Okay.

     (A beat.)

THERAPIST:  You're an asshole.

     (A beat.)

PATIENT:  What?

THERAPIST:  It's the only explanation.

PATIENT:  Uh...I'm sure there must be...other explanations?

THERAPIST:  No, I think it's safe to say, this is it.

PATIENT:  But I have anxiety.

THERAPIST:  Well, everybody has anxiety, but I wouldn't say your anxiety is any worse than anybody else's anxiety.

PATIENT:  But--

THERAPIST:  I mean, you don't have an anxiety disorder.  You just have anxiety.

PATIENT:  How much anxiety do you have to have to have an anxiety disorder?

THERAPIST:  A lot more than you seem to have.

PATIENT:  Maybe I haven't been describing my anxiety correctly.

THERAPIST:  You've been describing it to me for five years.

PATIENT:  But clearly I haven't done a very good job if you're saying it's not a problem.

THERAPIST:  I'm not saying it's not a problem.

PATIENT:  Okay, good.

THERAPIST:  I'm saying it's not as big of a problem as you might want it to be.

PATIENT:  I don't want it to be a problem at all!

THERAPIST:  IIIIIIIIIIIIIIIIII think you do.

PATIENT:  Why would I want that?

THERAPIST:  Well, because, as I said, you're an asshole.  And I don't think you want people to think you're an asshole, but you also don't want to stop being an asshole, so you're looking for something--a term to adopt--that'll let you off the hook for being an asshole--

PATIENT:  I--

THERAPIST:  When really, even if you did have something you were dealing with--like on a medical level--you still wouldn't be allowed to be an asshole.

PATIENT:  What about my trauma?

THERAPIST:  What trauma?

PATIENT:  My unidentified trauma.

THERAPIST:  We haven't been able to identify it.

PATIENT:  And?

THERAPIST:  And so, I can't factor it into--

PATIENT:  But it doesn't mean it doesn't exist.

THERAPIST:  I mean, it could exist the way anything could exist, but I can't diagnose you based on something that hasn't been identified.

PATIENT:  Then what are you saying?

THERAPIST:  I'm saying you're an asshole.

PATIENT:  What about my anger?

THERAPIST:  Assholes are frequently angry.

PATIENT:  My depression?

THERAPIST:  It seems to stem from the fact that sometimes you get angry at people and act like an asshole and then they don't want to hang out with you anymore and that makes you depressed.

PATIENT:  But I can't help how I'm acting.

THERAPIST:  Some people can't.  You can.

PATIENT:  I don't accept that.

THERAPIST:  You're welcome to get a second opinion.

PATIENT:  But you're the fifth doctor I've had in the last ten years.

THERAPIST:  Then you're welcome to get an eleventh opinion.

PATIENT:  I just don't want you doctors to keep gas-lighting me.

THERAPIST:  Disagreeing and gas-lighting are two very different things.

PATIENT:  I think by you saying that you're attempting to gaslight me.

THERAPIST:  I just need you to start taking some responsibility for your behavior.

PATIENT:  I can't control my behavior.

     (The PATIENT stands up and knocks over a table.)

THERAPIST:  Why did you do that?

PATIENT:  I have no idea!  That's the whole point!

THERAPIST:  There's nothing wrong with you.  I mean, there is, but nothing that you can't fix.

PATIENT:  So you're refusing to medicate me?

THERAPIST:  You don't need medicine.

PATIENT:  Maybe I don't need therapy either.

THERAPIST:  Everybody needs therapy.  Although you could probably just write 'Don't be an asshole' on a piece of paper and carry it around with you everywhere.  That might help just as much.

PATIENT:  I have never been so insulted.  You're a loser and you have weird teeth.

THERAPIST:  That's really mean.

PATIENT:  I'm sick!

THERAPIST:  You're not.

PATIENT:  I'm leaving!

THERAPIST:  Sounds good.

PATIENT:  YOU'RE GAS-LIGHTING.

THERAPIST:  You're not crazy.

PATIENT:  I AM AND STOP SAYING I'M NOT THAT'S GAS-LIGHTING.

     (PATIENT exits.)

THERAPIST:  If I keep this up, I won't have a practice much longer.

     (THERAPIST crosses another name off the list in their tiny notepad.)