Motorcycle Man: My First MAGA Patien

Back in 1987, I was in a doctoral psychology program outside of Los Angeles. I had the good fortune to do my final internship in a solidly middle-class section of town at a community mental health center staffed with social workers, psychologists, interns, and a psychiatrist. Every week, we had meetings to discuss new cases as well as chronically troublesome ones. In many instances, the patients who came to the clinic were from the local community and had been coming there for years, as had their families. Such was the case with the man I came to call Motorcycle Man.

When you received a case, you discussed the intake with the entire staff; thus, there were other people who knew about your patients and from whom you could seek advice or additional information. I had learned from the staff that this man's family life had always been turbulent. His mother was severely bipolar and had bouts of psychosis that resulted in ambulances arriving in the middle of the night to cart her off to the hospital while he cried, uncomforted and terrified. Whenever she came home, it was only a matter of time before she would decompensate again. His father was ill-equipped to manage a household with a crazy wife and two children, so he tried to create order in the family by inflicting harsh punishments. Perhaps this came easily to him. He worked for the government managing the feral animal population; this often involved some kind of extermination.

Motorcycle Man was a burly man in his thirties whose muscles exploded from his shirtsleeves and pants. When I first encountered him in the busy waiting room, one knee was shaking so that his boot tapped the floor in an anxious beat. He was one of my first individual psychotherapy cases in an outpatient setting and I, too, was self-conscious as I led him into my little office. I invited him to tell me why he was there. He was a man who I would never have encountered in my ordinary life and I wondered, no