In a town this size, there’s no place to hide
Everywhere you go you meet someone you know
— John Prine

The whole setup seems sketchy. It’s the only place I know in town with its principal entrance in an alley. You park out of sight from the street – nestled in the midst of single-story warehouses and a low-income apartment building. It feels like a great big secret. And I suppose it is. MacGregor Behavioral Health – this is where my therapist practices. This is where I go to talk about anxiety and OCD.

I spent most of my adult-life living in Washington, DC. Unless you’ve lived in a small town, it’s hard to comprehend how invisible you are in a city. Surrounded by a million people, the odds of running into someone you know anywhere outside of your neighborhood is mathematically unlikely. Sure you cross paths with the same people time and again – on your commute, or at the gym, at the place you buy your lunch – but these are people you only know from this context. When you run into a person from the lunch-counter at your gym, you both smile and say small world.

When I moved to Gettysburg, the first person I met was the children’s room librarian. I was reading a story to Sophie, when Andrea came up and introduced herself. Obviously a bookish adult, I was someone she thought she should meet. The next day, while walking to the post office, I crossed paths with Andrea in a park. And that’s how it is here. There are thirty-thousand people living Gettysburg and its suburbs. Therefore, I see the same people all over town several times a week. I learned almost immediately that when another driver is being annoying, don’t honk the horn. The chances are high that it’s my kid’s teacher.

The waiting room at MacGregor’s is small and stark. Only three therapists work there. I’m often alone while awaiting my appointment, but more likely, another person will be there at the same time. There’s almost nothing to look at in the waiting room, except two paintings on opposite walls of the room.

One is clearly a rip-off of Whistler’s Mother – a sepia toned painting of an aging woman’s profile. Everything about the painting is identical to the Whistler masterpiece, except the skill with which it was created. The overriding feeling of the MacGregor version is alone-ness. A woman approaching the end of her life – facing her short future or reminiscing her long past. Any life-long friendships are over, now existing only in her head.

On the opposing wall is the contrasting painting – reminiscent of nothing. Three toga-clad Greek teens lounge on castle-balcony happily listening to an Aristotle-like friend expound on philosophy or logic. These youths are immersed in friendship and discussion. Lazily passing their day, in no hurry to dive into the lives that await them.

Both paintings are hung fourteen inches too high. It takes effort to look up that far, so the people in the waiting room look at each other… or at their phones. I don’t have a phone, so I look at the other patients.

For a guy with social anxiety, I know a surprising number of people. I run financial operations at the only community center in town – it’s one of the main social hubs where people congregate. We have thousands of fitness members and hundreds of daycare families, and at some point, I interact with most of them. Plus, my kids are three grades apart, so I know two sets of school parents. I volunteer for a fitness oriented non-profit, and I’m active with the local running community. Not knowing the other person in MacGregor’s waiting room seems unlikely. But I’m also terrible with faces. I know when I’ve met someone before, but I rarely remember where we met or who they are. When I share the waiting room with another person, I just keep my mouth shut.

I’m sure the other patients appreciate this.

One-fifth of adult Americans are diagnosed with a mental illness. And we all know plenty of people who have never been diagnosed. Head-cases we called them when I was a teen – unreasonably sad or stressed or jumpy or awkward. And then there are the people who can’t keep a job; who drink too much; who use drugs; are overly bombastic or excessively timid. Most of us could benefit from talk-therapy. We all need some space to honestly analyze our thoughts and actions, a time to get to the root of our motivations. Cost is an obvious barrier, but looming larger is the stigma of seeing a psychologist or a therapist. This makes the whole topic unconsiderable; what if someone found out.

Some illnesses we just don’t talk about. It used to be cancer, now it is HIV/AIDS. And it’s always been mental illness. The mentally ill are fearful of judgement, or being seen as weak. People might make fun, they might gossip. Because people are generally ignorant, I worry that they’ll assume the worst. I’ll be branded as dangerous, unstable, incapable, or unworthy. I’ll lose my job, my friends, my stature. The guy sitting across from me in a meeting will know he’s better than me – he’s heard I’m nuts.

Like everyone else with mental illness, I kept mine a secret for years. I snuck into MacGregor’s hidden waiting room each week and sat there without a phone – trying to figure out what subliminal message the therapists were sending with their odd paintings. I sat there hoping no one I knew came in and “caught” me. A note on my door at work stating the generic “Doctor’s appointment.” I talked about my problems with my therapist and then shut them in a drawer, out of sight from me and everyone else until my next appointment.

A little more than a year ago, I gave up on stealth. I decided that it was healthier for me to tell everyone about my anxiety and OCD, my Tourette’s Syndrome, and my past alcohol abuse. Keeping it a secret was a pain in the ass. I felt disingenuous, like a fraud. By hiding it away, I never had a chance to address these issues in my day-to-day life, just in my fifty-minute therapy session. I’m sure everyone saw me as that head-case anyway. I involuntarily roll my eyes and make noises. I grind my teeth. At times, I’m unreasonably reclusive. I’m moody and weird – now, at least, people know why.

I once asked one of the therapists at MacGregor’s what they were trying to achieve with those paintings. They are too strange, too opposite to be randomly selected. She said she didn’t know, probably nothing. She didn’t pick them out and had never even thought about them. But she also never sat in the waiting room all alone trying to sort out her problems either.

I don’t believe in coincidence. Those paintings were selected because they are so different, even if the buyer didn’t realize it. I’d like to say that over the past eighteen months, my mental health has improved, but I know this is untrue. I still have all the same problems I had before – sometimes they’re worse, sometimes they’re better, but they don’t go away. But the thing that’s improved is my comfort with those problems. By wearing them on my sleeve, keeping them out in the open, I’ve taken away most of their power. I know this is verboten, something not done in polite company. Much like discussing cancer several decades ago.

In my house, when we watch a nature show on PBS, and a cute, innocent animal gets mauled by a predator, we always say something along the lines of “Good for the lion, not so good for the gazelle.” This is my mantra for dealing with my mental health. If my openness leaves those around me feeling uncomfortable, well, at least it’s good for me.