Warning Signs

CHAPTER 13

I went to bed knowing that I needed help. And I woke up the next morning knowing that I needed help.

Although I would've loved to have discussed the whole Naomi Bigg situation with Lauren, and would have welcomed her reasoned counsel, confidentiality concerns and peculiar circumstances made that impossible.

The peculiar circumstance, of course, was the possibility that Lauren was one of the potential targets of Paul and Ramp's wouldn't-it-be-cool games. And the very real possibility that the game was really only a mind game.

The way I looked at it was that my position was simple. I couldn't risk saying anything and I couldn't risk not saying anything.

What I'd decided I needed was what psychotherapists call supervision. In another profession, I suppose the same thing might be called consultation. Basically, supervision means that one psychotherapist invites another, hopefully more objective, usually more experienced professional to review and comment upon his or her work.

On those occasions when I decided I needed some objectivity with my practice, I relied on one of three different people, depending on the specifics of the case. When the issues in the case involved ethics, as this one did, my first choice was almost invariably Raymond Farley, Ph.D. Raymond's capacity to detect prevarication and rationalization was finely honed, and I knew I could count on him to help show me which side of the trees the moss was growing on in the forest where I was lost.

I called his home at seven-fifteen on Thursday morning. His youngest daughter was a junior in high school, so I figured the Farley household would already be humming along.

Raymond's wife answered.

"Cyn? It's Alan Gregory, how are you?"

"Alan, hello. How am I? Not quite as awake as you are. You want my sugar, right? I'm trying to get my daughter out the door. Let me find him. Raymond? It's for you."

A moment later I heard Raymond's baritone. "Alan. Long time. How's your new baby?"

"Grace is great, Raymond. How're your kids?"

He answered me at great length and with great patience. There was little hurry in the blood that coursed through Raymond Farley's veins. No one ever, ever took more care while finishing a story, and no one ever finished a meal after Raymond Farley finished his. "You didn't call to get an update on my kids, though, did you? What can I do for you?"

"I've got a case I would love to run by you. It's urgent, unfortunately. I see this woman again tomorrow evening and I should probably talk to you before her next appointment."

"Outpatient?"

"Yes."

"What's the urgency?"

"Columbine issues, Raymond."

"It's that time of year, I guess. What are we talking, grief? Anniversary reaction? Post-traumatic stress?"

"I'm not referring to the last Columbine, Raymond. I'm referring to concerns about the next Columbine."

"Oh," he said. "Oh."

"Can you squeeze me in?"

"I'm going to be at CU in Boulder doing a seminar on suicidal tendencies from one to three today. Meet me outside of Wardenburg-the student health center-at three. If the weather holds we'll find someplace pretty to sit, and we'll talk."

I rescheduled my two forty-five patient, picked up sandwiches and drinks at Alfalfa's on Arapahoe, and started to wait for Ray on the University of Colorado campus.

The campus is over a hundred years old and the founders had had their pick of prime foothills real estate for the location of the university. They'd chosen wisely. The CU campus is far enough from the vaulting mountains to maximize views, close enough to ensure that the Rockies would never cease to be a dominating presence. The flagstone buildings and red tile roofs of the major buildings on the University of Colorado campus are as distinctive an architectural feature as can be found on any campus in the western United States. The feeling is vaguely Italian, and that afternoon, the brilliance of the April sunshine added to the Mediterranean ambience.

Raymond Farley walked out the front door of Wardenburg a few minutes after three. I held up the bag I was carrying. "Grilled chicken on sourdough. I seem to recall you have a fondness. And Dr Pepper? Did I get that right?"

He rewarded me with a welcome embrace and his wide grin. His rich brown skin glowed in the springtime sun. "You recalled correctly, on both counts. I'm afraid I'm responsible for the demise of way too much fowl. Cynthia says that she thinks I'll have to answer to Saint Peter about that."

"If that's all that Saint Peter has to question you about, Raymond, you'll have a fine day at the pearly gates."

We walked in the direction of the planetarium and found a bench below a small mountain ash that was just beginning to leaf out. Raymond unwrapped his sandwich and popped the top on his Dr Pepper. "You talk while I eat," he said.

"The patient I'm concerned about is a fiftyish female whom I saw for the first time this past Monday. Tomorrow's appointment will be our fourth session this week. That alone should tell you something."

It told him something: Raymond whistled between chews.

It took about five minutes for me to explain Naomi Bigg's situation-her daughter's rape, her husband's jail sentence, her son's friendship with Ramp and their preoccupation with retribution. All the details I could remember about the wouldn't-it-be-cool games.

His first question surprised me. He asked, "Your patient's white?"

Raymond wasn't. I wondered about the question. "Yes, why?"

" 'Cause, for some reason, black kids don't tend to do these things."

Raymond gave me a moment to digest his remark, then asked me to repeat the part that had to do with Royal Peterson's murder.

I did, finally adding, "Lauren was involved in the plea bargain of the kid who raped Naomi Bigg's daughter."

"Ahh," Ray said. "That explains your tone."

"My tone?"

"My impression, listening to you, is that you don't like this woman you're treating. I'm not accustomed to hearing negative countertransference so clearly from you. But now you say that you fear your wife's in danger-that explains your negative feelings."

"I'm pushing her, Ray. Pushing her hard. Her resistance… is intense. She desperately wants to believe her son is uninvolved in anything other than some retribution fantasies. I've known her-what?-three days and already I'm pounding away at the resistance, and the reality is that I don't have the alliance to get away with it. She's getting angry at me."

Raymond chewed methodically, appreciating each mouthful of food the way that I imagined Mozart appreciated each note of a concerto. After Ray swallowed, he asked, "Whose idea was the four sessions this week? Yours or hers?"

A simple question. But one that told me that Raymond Farley already understood the crux of why I'd asked him for supervision on this case.

I sighed involuntarily. "Mine."

"You're trying to goad her into taking some action against her son, aren't you? Confront him, turn him in?"

"I suppose I am. That would protect Lauren. And maybe a whole lot of other people, as well."

"Sure it would. But it's not your job. Here's what I'm thinking: Given your concerns about Lauren's safety, you probably shouldn't be treating this patient at all. You know that you can't be objective as a psychotherapist if you're putting your wife's interests in front of your patient's interests."

"Raymond, that's the dilemma. Given my concerns about Lauren's safety, there's no way in the world I'm not going to treat this woman. If Lauren's really at risk, I have to be in a position to know what's coming next. If I refer her to someone else, Lauren could be in danger and I wouldn't even know it."

He kissed the last bit of sauce from the tips of his fingers and wiped his hands with his napkin. He said, "If you've already made your decision, what do you want from me?"

He read my reaction in my expression-I imagined I looked as though I'd been slapped in the face-and he grinned at me kindly. "Step back, Alan. You want from me exactly what she wants from you. She wants you to validate her inaction in regard to her concerns about her son. You? You want me to validate your inaction in regard to your concerns about continuing this treatment. You won't do what your patient wants you to do, and even though I've been bribed with an excellent sandwich, I won't do what you want me to do. I'm not about to tell you that you have a 'get out of jail, free' card on this one."

With some effort, I managed to smile back at him. "I actually didn't think you would, Raymond. Help me with something else then. This kid-her son-how dangerous is he? Because of my anxiety over Lauren, maybe I'm misreading the facts. You work with more young people than I do."

"What do you know about him?"

I told him everything Naomi had revealed about her son, Paul.

When I was through, Raymond leaned back and rested his weight on his hands. "There're some concerns there, no doubt about it. I've been on a committee at Wardenburg trying to help the university develop criteria for identifying kids who might be at risk of violent acting out. Your patient's son has some warning signs, that's for sure."

"What criteria has your committee developed?"

"We started with the criteria the FBI proposed and we're modifying them slightly." He held up one of his big hands, flicking out one finger after another as he ticked off the criteria. "One, kids who are on the outside socially and have verbalized their anger at popular kids, or even bullies. That fits this kid. Two, kids who have made overt threats, especially threats to kill. That fits. Three, kids with a prior mental health history. That fits. Four, kids who feel that they've been wronged, that they're victims. That fits. Five, kids with a history of the troublesome triad-fire setting, bed-wetting, cruelty to animals. I'm assuming that you don't know enough about his history to confirm that one, do you?"

"No."

He gave me his wide, all-knowing grin again. "You know what they say? With four out of five, you get egg rolls."

"You're not making me feel any better, Raymond."

"Is that my job? Helping you feel better? How about I just give you a massage. That should help."

"Funny."

He touched his watch. "Couple more minutes, Alan. Then I have to hit the road back to Denver. Damn turnpike, you know?"

I knew all about the damn turnpike. I said, "I'm thinking of leaking some of what my patient told me-the part about the boys' plans to use explosives. I have a friend on the Boulder Police Department, and I'm thinking of suggesting he find a way to sweep Royal Peterson's house for explosives."

Raymond's eyebrows rose like a pair of levitating caterpillars. "You're thinking of what?"

"I know it sounds absurd but hear me out. What if those two boys were in Royal's house to plant an explosive device and Royal discovered them after it was already in place and there was a scuffle and they killed Royal? Then the kids ran. The bomb, or device, or whatever, could still be there, right?"

Raymond gazed at me as though he was wondering what psychotropic medicine I needed.

I pressed on. "When I talk to my detective friend, I wouldn't reveal my patient's name, wouldn't even say that a patient told me. I'd just make an oblique suggestion about my concerns, just enough to get my friend to get the police department to look for explosives at Royal's house."

Raymond's face could hardly have been more skeptical. "I've heard your rationalization. I'm still wondering about your reasoning."

"What if there is a bomb planted there? Somebody could get killed if it went off. Royal's wife, Susan, Susan's health aide-somebody. If it turns out that nothing's there, I just look a little silly. My cop friend is used to that."

Raymond didn't quite smile and he didn't quite start shaking his head. But it was close. "Say there is something there. And the police find it… What if your patient's son's fingerprints are on the device? In effect, you've turned him in to the police, based on confidential information you had no right to divulge."

"Lesser of two evils. Tarasoff says I have to give a warning if I feel that someone's in danger based on what a patient tells me."

He opened a palm and held it up like a traffic cop. The pink edges of the soft flesh around his palm surprised me, even though I'd seen Raymond's hands a hundred times before. He said, "Not quite right. The court's Tarasoff decision says that you have to provide a warning if your patient makes an overt threat against an identifiable person. Based on what you've told me, your patient hasn't threatened anyone, Alan. No one. And regardless, I've not seen any court decision that extends the Tarasoff ruling to include hearsay. This isn't your patient threatening anybody. This is your patient talking about what somebody else might be planning." He removed his eyeglasses and blew at one lens. "If Lauren weren't involved-if you didn't think she was at risk-you wouldn't be considering this kind of action and you know it."

I argued back. "But if it were child abuse that I was hearing about, it wouldn't make any difference. Hearsay or no hearsay, right?"

"The child-abuse exception is handled specifically under Colorado law, Alan. This isn't."

I couldn't argue with the point that Raymond was making, so I moved the argument in a different direction, saying, "What if what's going on is that my patient actually wants me to turn her son in? What if that's her agenda with me? She can't stop him herself, she can't bring herself to turn him in, so she wants me to do it for her. She keeps talking about the Klebolds and the Harrises. There's a message there that I can't ignore."

He didn't respond right away, so I persisted. "The parents of the Columbine murderers may have failed their children and their community with their ignorance or their denial of what their children were planning, Raymond. But the Jefferson County Sheriff's Department had enough information, too. The family of a kid that Klebold and Harris threatened told the sheriff's department all about the threats and about the crap that was on Harris's Web site. The sheriff even linked Harris to a pipe bomb that somebody had exploded and went ahead and drafted an affidavit for a search warrant for his house. That was a year before the killings, but the sheriff didn't follow through with any of it."

"And you don't want to be accused of making the same mistakes as the Jefferson County sheriff?"

"No, I don't, Raymond. I don't. One of those two, Harris or Klebold, was in psychotherapy, too. He was seeing a psychologist. What if he actually told the guy he was planning to kill some students at his high school but didn't mention anyone in particular? Are you saying that the psychologist didn't have an ethical obligation to report that?"

"We don't know what that psychologist knew."

"But I know what I know."

"Do you?"

I said, "I don't want people to die when I might have had enough information to prevent their deaths."

"Especially your wife."

"Of course, especially my wife."

"You're not even certain she's been threatened, are you?"

"I can't risk it, Raymond. I can't."

"I suggest you step back and see the parallel process, my friend."

"What are you talking about, Ray?"

"Your patient is struggling with whether or not she has enough information to do what most parents consider unthinkable-turning her own son in to the authorities because she believes he may be planning an unspeakable atrocity. Go ahead and underline 'may.' Remember Styron? Sophie's Choice? This is one of those. You, too, are struggling with whether or not you have enough information to do the unthinkable-breaching your patient's confidentiality and turning this woman's son in to the authorities because you believe he may be planning an unspeakable atrocity. Go ahead and underline 'may' one more time."

I said, "The moral obligations are clear for both of us, Ray. My patient should act. Failing that, I should act."

"Are the moral ambiguities so invisible to you? Are you in any position to make that judgment? I think I've made a damn good case that your objectivity is compromised, Alan. The bottom line is that you shouldn't be treating this woman at all. Your motivation as her therapist is not limited to assisting her with psychological concerns. Not at all. That alone should cause you to excuse yourself. Another therapist, an objective therapist, should make the decision about what to do with these supposed threats."

"How can I turn my back on what I know?"

"You know a mother's fears. That's all that you know. I don't think that's enough."

"She's telling me something, Raymond. She's telling me enough."

Raymond stood. He said, "I've not seen you like this before. You seem to want to believe that the rules don't apply right now."

I could no longer keep the intensity I was feeling out of my voice. "What rules? There aren't any rules that apply to this situation. Ethical standards evolve, Raymond, we both know that. There are always new situations developing that the old rules don't address."

"And this is one?" he asked skeptically. "You're sure of that?"

"Before Tarasoff, therapists couldn't even warn potential victims that they'd been threatened. Now we can-we must. That's a change. That's an ethical evolution. Circumstances required it."

"And you want the freedom to decide that this is the foundation for another ethical evolution? Tarasoff wasn't the result of a rogue therapist rewriting the rules, Alan. It was a California Supreme Court decision."

I scrambled to my feet. "I've never been in a position like this before. You have to admit these circumstances are unique."

His eyes flaring, he countered, "You have a patient who needs an objective outlet for exploring an issue that is troubling her. What, I ask you, is unique about that circumstance? It happens to both of us every day. The only thing that's unique about this situation is that you've decided to substitute your judgment for your patient's. How long do you think our profession can survive therapists doing that?"

"You know exactly what I mean. This is… different."

He dabbed at one corner of his mouth with the paper napkin. "Then act like it's different, Alan. The way I see it is that you're trying to straddle a high fence and you can't seem to get either foot on the ground. On one side you're making a case that your concerns are so great that they warrant your violating ethical principles that I know you hold dear. On the other side you're apparently not quite concerned enough about any of it to just go to the police and state your case. You have to get off the damn fence one way or another. Either it's a serious threat and you put your judgment ahead of your patient's, or it's not a serious threat and you shut up and help her with her struggles."

I pressed. "How would you get off the fence? If it were Cynthia in danger? Or one of your kids?"

"Is Lauren really in danger? Is Grace? Are you certain of that?"

"No, I'm not certain."

"Then your question about what I would do if it were Cynthia or one of my kids is too facile. I get to answer your question in the abstract. I get to play 'What if?' You? You have to make your decisions in the here and now when your head is full of nothing but I-don't-knows."

He stared at me while I struggled to reply. Finally, he said, "Where the heck did I leave my car?"