Shrinks and Other Mental Health Professionals

Volume 27, No. 4, Winter 2011-12

Shrinks and Other Mental Health Professionals
Buy this back issue! Available in hardcopy or as a downloadable PDF.



  • Murder, with Shrinks by Donna Andrews
  • My Muse by Sandra Levy Ceren
  • Hand Holding and Knee-Rubbing by Jacqueline Corcoran
  • Kinky Shrinks by Carole Nelson Douglas
  • Another Kind of Detective by Michael Dymmoch
  • When a Character Needs a Shrink… by Hallie Ephron
  • The Perfect Fix by Barbara Fradkin
  • Forensic Psychiatry: Shrinking the Dead by Meg Gardiner
  • The Doctor Is In by Roberta Isleib, aka Lucy Burdette
  • When Frasier Meets Murder She Wrote by Mary Kennedy
  • The Paths Not Taken by Shirley Kennett
  • Cop Docs: The First Responder’s First Responder by Ellen Kirschman
  • On Getting the Right Counselor by J.J. Lamb and Bette Golden Lamb
  • The Psychiatrist’s Wife by Sujata Massey
  • Method and Madness by Val McDermid
  • Mythbuster by Daniel Palmer
  • Railway Spine and Hysteria: Convenient Mental “Failings” of the 19th Century by Ann Parker
  • The Therapist as Hero by Dennis Palumbo
  • Putting the Psycho in Psychotherapist by Sandra Parshall
  • Walking Through a Killer’s Mind by Michael Robotham
  • Exploring the Scarred Psyche by Mark Schorr
  • My Counselor, My Characters, and Me by Del Staecker
  • School Psychologist, Writer, and People Watcher by Denise Swanson
  • Shrink To Fit by Rochelle Staab
  • Case Notes of a Recovering Clinical Psychologist by Stephen White
  • My iPhone Quacks: A Modern Shrink in Murder Mystery Land by Marilyn Wooley
  • Imperfect Shrinks: Writing a Character Who Has More Flaws Than I Do by Elizabeth Zelvin


  • Mystery in Retrospect: Reviews by Lesa Holstine, L.J. Roberts
  • Children’s Hour: Kids Need Shrinks, Too by Gay Toltl Kinman
  • In Short: It’s All in the Mind by Marvin Lachman
  • True Crime: The Interior View by Cathy Pickens
  • Crime Seen: Criminal Insight by Kate Derie
  • From the Editor’s Desk by Janet A. Rudolph

When a Character Needs a Shrink…
by Hallie Ephron (Milton, MA)

Agoraphobia. For many of those who suffer from it, the prospect of leaving the safety of home can generate a panic attack so severe that it feels like a heart attack. It’s what Diana, the main character in my last novel, Come and Find Me, experiences whenever she tries to leave the safety of the fortress she’s created within her home. There, she “lives” on the Internet and gets whatever she needs delivered to the house. She makes it through the average day with the help of Xanax and regular sessions with her therapist, whom she sees, of course, via Skype.

But even the arrival of the UPS man, whom she knows by name, can be traumatic.

Heart pounding, she peered through the peephole in the door. Wally’s eyeball seemed to bulge back at her.

Opening the door can be terrifying.

As she opened the door, she felt as if an abyss opened in front of her, like an elevator door sliding open into an empty shaft. She grasped the door frame with both hands.

Fear keeps Diana in her house—until her sister goes missing. Then fear of what might be happening to her sister drives her out. In a sense, Diana is her own worst enemy; her own psyche is the villain she has to deal with before she can begin to confront her real enemies.

As I was writing the book, I need to learn as much as I could about agoraphobia. It helped that I was able to call on my former collaborator for advice, psychologist Donald Davidoff. Together we wrote a series of five mystery novels that were published by Minotaur. The books were set at a fictional version of Harvard’s famed McLean psychiatric hospital where Don still runs one of the units. The powers-that-be have shown great restraint in letting Don keep his day job, even after we made the director of our fictional version of the MacLean an egomaniacal villain in one of the books. They understood that it was “just fiction.” Really, it was.

It helps that the hospital has become accustomed over the years to being featured in books—The Bell Jar, Girl Interrupted, and Mount Misery, to name a few examples. And it’s the setting of one of James Taylor’s early songs. Sample lyric:

Just knocking around the zoo on a Thursday afternoon,
There’s bars on all the windows and they’re counting up the spoons…

Those spoons would have been silver back when James Taylor was a teenage inmate. Back then the healing grounds of the very rich, the MacLean had its own golf course and served tea each afternoon on silver tea service to patients who might be there for years on end. Its massive Victorian buildings still look as if mad women could easily reside in their attics, though with the arrival of managed care, few patients stay there for more than a few weeks.

I miss having a resident shrink for my characters, but fortunately Don still takes my calls. So when I was writing Diana for Come and Find Me, I called Don for a crash course in agoraphobia. I learned about its symptoms and about the medication and therapy to treat it. I learned that agoraphobia usually isn’t triggered by a single traumatic event. Its victims have often struggled with it, to varying degrees, throughout their lives.

Today I’m working on my third solo suspense novel. One of the inspirations for this new story is a possibly apocryphal tale that Don once told me about the McLean.

As the story goes, the members of a wealthy family, despairing of getting their demented matriarch to accept the care she needed, had an exact replica of her house built on the grounds of the McLean. In the dead of night, the old woman was spirited out of her house along with her furniture, belongings, and cats. When she woke up the next morning it was in a bedroom just like hers in the replica. She lived out her years in that house on the grounds of the MacLean, never realizing she’d ever left home.

I’ve always loved that story, though Don refuses to divulge whether it’s true or not. And I won’t say how I use it in the new novel because that would be a spoiler. Let’s just say that the main character in the book is old, very old, but things happen that make her wonder if she’s losing her marbles.

My friend Don happens to be an expert on memory and aging, so these days, once again, I have him on speed dial.

Hallie Ephron writes novels she hopes will keep you up nights. Her latest: Come and Find Me. She is also the crime fiction book reviewer for the Boston Globe and author of the Edgar-award nominated Writing and Selling Your Mystery Novel.

Method and Madness
by Val McDermid (South Manchester)

The Mermaids Singing, the book that introduces my clinical psychologist and criminal profiler Dr. Tony Hill, is unique in my experience as a writer. For the one and only time, the plot dropped into my head fully formed. The shape of the story, the nature of the criminal, the cruces of the plot and the occupation of the detective; they were all there from the very beginning. It was a great gift, but it brought its own set of problems.

I’d been intrigued by the idea of using a profiler in a novel ever since I’d read Thomas Harris’s Red Dragon. But the most rudimentary research had revealed that, as in so many areas, in the UK we do it differently from the US. Unlike the FBI, who train their own officers in the famous Behavioral Science unit at Quantico, we Brits have traditionally used practising clinical psychologists to consult with detectives. Right there, I knew I had a built-in area of dramatic tension; cops never like outsiders coming into the heart of their investigation.

Which was all well and good, but I still had no real idea how it worked in practice. No other British crime writer had written about this relationship, so I couldn’t crib anyone else’s research. I didn’t know where to start. I didn’t imagine for a moment that Greater Manchester Police—notorious back then for their hostility to the media—would blithely hand over the details of whoever they worked with. I was stumped.

And then one evening I turned on the local news programme on TV halfway through a item about a clinical psychologist who worked with the police on offender profiling. Hastily I scribbled down his name and where he worked. If he’d talked to the TV, he might just talk to me.

Next day, I called the secure mental hospital where he worked and asked to speak to him. To my surprise, I was put straight through. I hadn’t expected that, and I suspect my explanation for why I was calling him was a pretty stumbling affair. When he finally understood what I was asking, he said, “How do I know you’re not a nutter?”

It was a good question. I suggested sending him a couple of my published novels so he could decide for himself. He agreed. I sent the books off and heard nothing for a few weeks. Then he called me and said, “I read your books. So did my wife. We don’t think you’re a nutter.” And he agreed to meet for lunch.

We ended up in an Indian restaurant in Southport, a genteel seaside town on the Irish Sea, where conversation does not generally run to serial homicide. Over our set lunch, he gave me a brief outline of his professional life, touching on the kind of patients he dealt with in the hospital and the types of crime he helped the police with. The more he talked, the more excitement I had to disguise. I could see so much potential in what he was telling me, it was hard not to jump up and down.

The second time we met, he took me inside the secure mental hospital where he worked and showed me a couple of live cases he was working on. He took me through every step of his process, starting with the crime scene photos and ending with his report. He explained painstakingly how he arrived at the conclusions he delivered to the police. By the end of the afternoon, I had Tony Hill’s method. And that has remained at the heart of what Tony does ever since.

I had the method, but I didn’t have the man. When I started The Mermaids Singing, I intended it to be a standalone, so when I started thinking about the character who would be at the heart of this book, it was tempered by what I needed him to be capable of for the sake of this particular story. So, for example, his impotence was not intended as anything more than a plot point that I needed to make sense of his interaction with another key character. I knew that he was someone who struggled with the normal building blocks of social intercourse too; the clue is in the title of the book, which comes from T.S. Eliot’s poem, “The Love Song of J. Alfred Prufrock.” The narrator of the poem is a man who yearns to be part of the world of love and affection, but he feels like he’s trapped behind a glass wall, unable to connect. My central idea was that both Tony and the killer should share this perspective; that they had much in common, but that at some crucial point, they had diverged in terms of the direction taken.

More than that, Tony had to be someone the reader cares about. I gave him a potentially lethal dose of empathy, a self-deprecating insight into his own foibles, and the capacity to love Carol Jordan. He’s an oddball, but his personality connects sufficiently with the rest of us for him to be an oddball for whom we feel affection rather than irritation.

Seven books in, I am still developing the seeds I sowed in that first novel. We have discovered his monstrous mother, the person who first saved him from bleakness, and the man who sired him. We’ve followed him to the edge of hell and back again. And what underpins it all is his understanding of the way people work. I’ve got no formal education in psychology, but I was a journalist for years and observed people in all sorts of situations. Really, the Tony Hill method is an extrapolation from that observation, salted by common sense and spiced with bits and pieces of knowledge I’ve picked up along the way. And I’ll be writing Tony Hill for as long as I can find fresh and interesting things to say about human beings.

Hard to see how that could ever stop.

Val McDermid is the author of 24 bestselling novels. She has won virtually every mystery award, including the Crime Writers Association Cartier Diamond Dagger for outstanding Achievement in the Field of Crime Writing, as well as the Pioneer Award from the Lambda Literary Awards.

Walking Through a Killer’s Mind
by Michael Robotham (Sydney, NSW)

When I began writing my first novel Suspect, I had no idea it was a psychological thriller. I wasn’t even sure it was a crime novel. I wrote in the first person, using the voice of clinical psychologist, Professor Joseph O’Loughlin, who was perched on the roof of the Royal Marsden Hospital in Chelsea, London, trying to talk to a teenage boy who was threatening to jump.

“This is some view,” I say, glancing to my right at a teenager crouched about ten feet away. His name is Malcolm and he’s seventeen today. Tall and thin, with dark eyes that tremble when he looks at me, he has skin as white as polished paper. He is wearing pyjamas and a woollen hat to cover his baldness. Chemotherapy is a cruel hairdresser.

There was no hint of a crime in Suspect until the Chapter 2 and, depending upon which version you read (the US edition is slightly different to the rest of the world) Joe O’Loughlin doesn’t get involved in the investigation until page 65.

I didn’t realise I’d written a psychological thriller until the first publicity came out and then the reviews. I remember wondering if having a psychologist in a thriller automatically made it a “psychological thriller” or if there was some mysterious ingredient that I’d inadvertently included.

I still don’t know the answer.

The first question any crime writers gets asked is “why crime?” For a long while I couldn’t answer it. I had no idea.

To start with I didn’t read much crime fiction. I know this is a bizarre confession to make and it could possibly get me strung up at the next Bouchercon and roasted over a bonfire of my books (which, by the way, are very combustible).

My fascination as a reader and a writer has always rested with the characters and their motivations. Sure the story is important, but only as a vehicle to explore the human condition.

All crime is psychological. When a university graduate in urban preservation flies a passenger plane into a skyscraper killing thousands of people; or when a student barely out of his teens sprays a university campus with bullets; or when a teenage mother give birth in a toilet and leaves the baby in the wastepaper bin, it all comes back to some aspect of human behaviour and interaction. Everything we think we know and understand—the good, the bad and the inexplicable—is produced by four pounds of grey matter between our ears.

When we first meet Joe O’Loughlin in Suspect he’s a man with a perfect life, which begins to unravel when he is charged with a murder that he didn’t commit. In the back of my mind, while writing, I was thinking of the classic Hitchcockian dilemma of an innocent man caught in the wrong place at the wrong time.

Joe isn’t your typical fictional hero, as he admits himself.

I am not handsome in the conventional sense. I am tall and pale with watery brown eyes and when I look at myself naked, I am reminded of a winter animal that sheds its fur in the hotter months and looks out of place until the cold returns. That’s one of the reasons that I don’t wear shorts or T-shirts or flip-flops, which Australians call thongs. I wonder what they call G-strings?

I gave Joe a brilliant mind, but then threw a cruel twist into the mix—a diagnosis of early onset Parkinson’s Disease, which has turned his life upside down.

Nobody ever dies of Parkinson’s Disease. You die with it. That’s one of Jock’s trite aphorisms. I can just see it on a bumper sticker because it’s only half as ridiculous as “Guns don’t kill people, people do.”

I began to realise something was wrong about five months ago. The main thing was the tiredness. Some days it was like walking through mud. I still played tennis twice a week and coached Charlie’s soccer team. During our training games I managed to keep up with a dozen eight-year-olds and picture myself as Zinedine Zidane, the playmaker, dispatching through balls and doing intricate one-twos.

But then I started to find that the ball didn’t go where I intended any more and if I took off suddenly, I tripped over my own feet. Charlie thought I was clowning around. Julianne thought I was getting lazy. I blamed turning forty.

In hindsight I can see the signs were there. My handwriting had become even more cramped and buttonholes became obstacles. Sometimes I had difficulty getting out of a chair and when I walked down stairs I held on to the handrails.

It seems especially cruel to give Joe such a degenerative disease, but I have always been fascinated by the idea of someone having a brilliant mind but a crumbling body. Think of Stephen Hawking, the genius of our generation, trapped in a wheelchair and suffering from Lou Gehrig’s Disease.

Joe cannot out-run, out-fight and out-bed his adversaries. He’s not a fictional superman like James Bond, Jason Bourne or Jack Reacher. Instead he has to outsmart his enemies. He has to use his prodigious talent to pick apart their crimes and put a face in the empty frame.

Of all my characters, Joe is probably the most autobiographical in the sense that we’re both the same age. We both have daughters. We have similar views politically and socially. He’s a far braver version of me, but also more tortured.

When I wrote Suspect, I never imagined bringing Joe O’Loughlin back. Instead, I chose lesser characters to star in subsequent books. It wasn’t until I came up with the idea for Shatter that Joe returned to centre stage because the story was so dark and confronting, that I felt it needed someone like Joe to guide readers safely through it and not leave them traumatised. He has such a wonderful sense of humour and sense of humanity that he lightens up the darkest moments.

In my upcoming novel Bleed for Me, Joe is back again, this time at the request of my wife, who insisted that I couldn’t leave Joe’s private life in disarray and had to give him a happier ending. (Which I can’t promise. No spoilers here.)

Although Joe O’Loughin is a fictional creation, I have worked with clinical and forensic psychologists who have helped the police investigate violent crimes. Fifteen years ago I spent a lot of time with Paul Britton, the forensic psychologist, who became the inspiration for the brilliant BBC series Cracker in the early 1990s.

Experts like Britton aren’t called into most murder investigations, because most murders are mundane. (Tragic, of course, but also boring and pointless.) When two men get into a fight in a bar and one hits the other over the head with a barstool, you don’t need a psychologist to tell you what happened.

The police call on psychologists when the crime is beyond their comprehension—so violent or random or motiveless they have little grasp on where to start looking for the perpetrator.

Britton once described to me the process of examining a crime scene, looking for the psychological clues left behind.

People sometimes talk about “reading between the lines” as a way of explaining the abstract processes used in inference and deduction. In my work the analysis has to leave the page and go into the mind of the killer. To know him, I have to be able to see the world through his eyes.

This means putting aside my own compassion and moral values. I step away from the vocational impetus of my clinical career and sink fully into the killer’s sense of climactic achievement. At the same time, I see the shock, pain and final terror of his victims.

As always, I asked myself four questions: What has happened; how did it happen; who did it happen to, and why? Only when I had answers to these questions could I address the fifth: who is responsible?

This is what fascinated me—the process of “walking through the killer’s mind.” In February 1994, Paul Britton was called to 74 Cromwell Street in Gloucester where police had recovered the remains of three people in the back garden. The house belonged Frederick and Rosemary West and the bodies were believed to include the couple’s eldest daughter Heather Ann West who was last seen alive seven years earlier.

The police struggled to understand what they were dealing with and asked Britton to help. He read the statements and viewed the remains. He walked through the garden and the house and looked at Fred and Rosemary West being interviewed. At this point they were denying all knowledge of how these bodies got into their garden.

Finally the psychologist sat down with the senior investigating officer and listed point by point what the police were dealing with.

“These are sadistic sexual psychopaths,” he said. “They have a combined depravity—a husband and wife working together, each legitimising the actions of the other. These victims were playthings who were tortured and abused.”

Paul revealed how this couple, driven by their corrupt fantasies, had kidnapped, raped and tortured their victims, keeping them alive for as long as possible before burying their bodies close because they liked to fantasize about what they had done.

“So that’s why he used the back garden?” said the senior detective.

“No,” said Britton. “They used the garden because the house is full.”

That is when the police dug up the basement of 74 Cromwell Street and discovered five more bodies.

I wasn’t interested in how those young women died—and they died in terrible ways. I wanted to know how Paul Britton knew where they were buried. Where did that sort of knowledge come from?

That’s why I write psychological thrillers. I’ll leave it to Joe O’Loughlin to explain. In Shatter he talks to a group of first-year university students:

“Forget everything you’ve been told about psychology. It will not make you a better poker player, nor will it help you pick up girls or understand them any better. I have three at home and they are a complete mystery to me.

“It is not about dream interpretation, ESP, multiple personalities, mind-reading, Rorschach Tests, phobias, recovered memories or repression. And most importantly it is not about getting in touch with yourself. If that’s your ambition I suggest you buy a copy of Big Jugs magazine and find a quiet corner…

“A piece of human brain the size of a grain of sand contains one hundred thousand neurons, two million axons and one billion synapses all talking to each other. The number of permutations and combinations of activity that are theoretically possible in each of our heads exceeds the number of elementary particles in the universe… Welcome to the great unknown.”

Michael Robotham was an investigative journalist in Britain, Australia, and the US before his career as a novelist. He lives in Sydney with his wife and three daughters. His novels Shatter and Bleed for Me are being released in the US in January and February 2012.

Case Notes of a Recovering Clinical Psychologist
by Stephen White

I have recently announced that I am in the process of concluding the series—featuring clinical psychologist Alan Gregory—that I began writing, quite by accident, in 1989. The conclusion will take place over two books. The penultimate story, number nineteen in the series, is called Line of Fire. It will be published next year.

With the planned end in sight, it seems like a good time to take a look back at some strange parallels in the unplanned beginning.

The initial inspiration to write crime fiction passed by without my recognition.

I first met Jonathan Kellerman three decades ago—I think it was 1981—only because he and I were members of a professional club that had so few members. We were both young Ph.D.s, and both practitioners in the then-nascent field of pediatric oncology psychology. We worked in different hospital settings—Jon was at Los Angeles Children’s Hospital, I was at The Children’s Hospital in Denver—developing clinical programs designed to help ameliorate the psychological and emotional challenges associated with pediatric life-threatening illnesses, primarily cancer.

We were, frankly, doing important work. Dr. Kellerman was a pioneer; at the time we met he had published the only book available in our field. My admiration for his book, Psychological Aspects of Childhood Cancer, was the reason I invited myself to California to spend time with Jon and his team.

I learned during that visit to LA that Jon was already writing short stories. Although he told me that he intended to focus more time and energy on his fiction, I was unconvinced that it was anything more than a lark. He and I had stressful careers; I presumed then that Jon’s writing provided an escape from some of the emotional load that inevitably accumulates for therapists who provide clinical assistance to sick and dying kids. Anyway, back then young academic professionals like Jon and I didn’t write novels. If we were ambitious enough, and talented enough, we wrote fat books like Psychological Aspects of Childhood Cancer.

Jon was ambitious enough, and talented enough. I would have considered it folly for him to consider tossing away a career like his to write stories.

Not that I disrespected storytelling. One of my escapes from the stress of work was reading—I consumed three or four thrillers and mysteries a week, and I wandered bookstores at every opportunity to keep my stash fresh.

On one of those trips, while browsing in the mystery section of the Tattered Cover bookstore in Denver in the summer of 1985, I could hardly have been more surprised to stumble upon Jon Kellerman’s first novel, When the Bough Breaks.

I bought it. I read it. I applauded Jon’s accomplishment. But even then it did not cross my mind, not for a moment, that he and I would join ranks in a second club that has precious few members—that would be the small brotherhood of crime fiction writers who also happen to be recovering clinical psychologists.

In 1985, Jonathan Kellerman had that club all to himself. He founded it. He proved it could thrive. I had no inclination to join him. And no fantasy that I would. My professional life was going great.

I had moved on from pediatric psychology and opened an outpatient adult practice in Boulder. Jon and I had lost touch. He continued to write his new fiction series. I continued practicing my craft, and I continued reading crime fiction, including Jon’s.

As the Eighties were coming to a close I made a decision that I thought had nothing significant to do with my future: I decided to sell the IBM Selectric I’d bought to write my dissertation, and to enter the computer age, such as it was. My first computer was a Compaq portable that had the heft of a Samsonite suitcase packed with bricks. I invested in two software packages, buying floppy disks of a billing program for my practice, and a word processing program that would permit me to write psychological reports.

All in all, I thought I was a pretty cutting edge practitioner.

The problem was that I didn’t know how to use any of it. Learning the billing software turned out to be trial and error, mostly error. The word processing software, called Write and Spell, was a cipher to me. I decided the only way to master its intricacies—intuitive it was not; there is a good reason you have never heard of it—was to spend time writing something inconsequential. So I began to compose a story that had been tumbling around in my head. The idea had to do with an esoteric psychotherapy/legal dilemma called a Tarasoff problem. I had no illusions that anyone but me found the issue interesting.

Story to me meant indeterminate length, but I was thinking short. My dissertation, at thirty-seven pages of text, was the longest thing I had ever written. Writing it had been like doing self-surgery without anesthesia—it hadn’t been fun—and I had no plans to ever again write anything approaching that length. My expectations were to master the puzzle that was Write and Spell long before I got around to conjuring an ending to my little Tarasoff story. In fact, I went into the process believing that if my inconsequential tale reached fifteen or twenty pages it would be evidence that Write and Spell had me stumped.

Much to my surprise it turned out that I loved writing the story. I wrote every morning, getting up between four and five so I could insure myself an uninterrupted hour or two at the keyboard before I would leave the house to see my first patient.

Less than six months after I began, I completed the first draft of Privileged Information. The manuscript was over ten times the length of my dissertation. It took Write and Spell, and my dot-matrix printer, an entire day to print the damn thing.

Would I have ever written a novel had I not met Jonathan Kellerman at LA Children’s Hospital in 1981 to discuss the psychological care of pediatric cancer patients? I believe it’s possible, even likely, that I would have. I’d like to think that I was destined to seek out and discover the joy and the satisfaction that writing fiction, getting lost in a world of my creation, provides for me.

But had Jonathan Kellerman not imagined the possibility of crime fiction written by and about a clinical psychologist, and then gone out and demonstrated the market for it, I do not think I ever would have believed that this narrow subgenre was a viable commercial form.

In that very real sense, Jon Kellerman was the horse I rode in on. I tip my hat to him.

I have had the pleasure of watching him be a pioneer. Twice.

Stephen White is the author of the soon-to-be concluded Alan Gregory series. Both author and protagonist have practiced clinical psychology in Boulder, Colorado. Professionally he was known as Stephen White, Ph.D., but no one has referred to him as Dr. White, absent irony or sarcasm, since the mid-nineties.

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