Transcript

264:

Special Treatment
Transcript

Originally aired 05.07.2004

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Full audio: http://tal.fm/264

Prologue.

Ira Glass

Everyone in the family agrees. Edie's the youngest, and so she gets more attention. She gets more stuff. Ayla, her 15-year-old sister, puts it this way.

Ayla

She's spoiled. For her birthday last year, she got a scooter, you know, one of those high-tech things, and then I got a CD. And my parents were like, yeah, well, you know, you'll be getting a car soon. But she'll get a car sometime, too, and-- yeah.

Ira Glass

Even Edie sees it this way. One of our producers, Jane Feltes, is their cousin, and Jane got this out of the 10-year-old under tough, tough questioning.

Jane Feltes

You or your sister, who gets treated better?

Edie

Me.

Jane Feltes

Who gets more stuff?

Edie

Me.

Jane Feltes

Who gets punished more?

Edie

Ayla.

Jane Feltes

But who gets a worse punishment?

Edie

Ayla.

Kathy

Edie gets more attention. Edie gets more stuff, but she gets smaller stuff.

Ira Glass

This is Kathy, their mom.

Kathy

Well, you want to treat them exactly the same, but that's hard to do because they're so different. Every kid is different, and with my two kids, they are totally opposite of each other. I mean, you do try to be fair, but you do treat them different. And you know, that's just the way it is. I don't know how else to say it.

Ira Glass

You know, you don't really hear a positive word about favoritism very often. Most of us think that parents are supposed to treat all their kids exactly the same. But the fact is, sometimes it just doesn't matter.

Amanda Kowal

I think what we're finding is what's more important than equal treatment is kids' perceptions about what they're getting.

Ira Glass

That's Amanda Kowal. She co-authored a study of 300 kids in 135 families, where they asked everyone in the families questions like, is one child favored over the other? Who gets praised more? Who are the parents stricter with? And OK, let's just start with the big news first, America. We are not giving equal treatment to our kids.

Amanda Kowal

Very few kids actually said their parents were exactly equal in every aspect.

Ira Glass

Really? How rare is that ideal?

Amanda Kowal

I think we had about five kids.

Ira Glass

Out of 300?

Amanda Kowal

Out of about 300 that said, in every instance it was exactly equal.

Ira Glass

And all the others said--

Amanda Kowal

Most kids were able to think of a way that their parents did treat them differently.

Ira Glass

But here's the other news flash. Most kids didn't care. 70%-- 70, seven, zero, 70% of the time-- when a kid said they or their sibling got praised more or punished more or whatever, they said it pretty much made sense to them. It pretty much seemed fair.

Amanda Kowal

Most kids think differential treatment is fair, whether or not they're benefiting or their siblings are benefiting.

Ira Glass

And they felt that way because why?

Amanda Kowal

I think one of the most compelling reasons was when they felt that their sibling needed differential treatment or that they did. For example, one child said that his sibling didn't have very many friends, and he felt very sorry for him. So it made a lot of sense to him that his parents would spend more time with this sibling. If one child is older than another, he may have more chores. He may have a later curfew. He may also be punished more, potentially, because he has the ability to maybe get into more dangerous situations. She's driving now, so mom may punish her more when she makes mistakes or gets in trouble because she's more worried about her.

Ira Glass

So it's important that it's fair. It's not important that it's equal.

Amanda Kowal

Exactly. And I guess the basis of it is that each child feels they're getting what they need and what they want.

Ira Glass

Which brings us back to Edie and her big sister Ayla. Ayla says it doesn't matter to her that she gets in trouble more and that Edie gets more stuff. Ayla's got band and band camp and choir. She loves school. She loves reading. Edie needs more attention from their parents, Ayla says. So she can have it. Like most of the kids in that study, Ayla understands why the two of them are treated differently. And she is fine with it.

Ayla

Well, I don't want them to treat us exactly the same or anything because everybody's different. And I understand the whole age difference thing. I'm at that age where you gotta watch out, I guess. Just troublemaker teenagers.

Ira Glass

From WBEZ Chicago, it's This American Life, distributed by Public Radio International. Today in our program, in defense of special treatment here in the land of the free, the place where all men are created equal, and all kids. We have stories of when some people should be treated more equally than others.

Our show in four acts today. Act One, Lunchtime with the King of Ketchup. In that act, Jonathan Goldstein stands up for one man's right to be treated differently than you have ever been treated by waiters, store owners, and takeout delivery guys of every race, creed, and religion. Act Two, Except for that One Problem, It's Perfect. In that act, we hear the story of a woman who is solving something that has plagued prisons for years. And the only thing wrong with her solution is prison guards hate it. Act Three, Mommy's Psychic Helper. One woman gives special treatment to her two kids based on a horoscope given to them at birth. Act Four, The Way to a Boy's Heart Is Through His Stomach. In that act, a nine-year-old who never eats, and what that does to everyone around him. Stay with us.

Act One. Lunchtime With The King Of Ketchup.

Ira Glass

Act One, Lunchtime With The King Of Ketchup.

And now the story of a man with a simple mission in life, to give a little special treatment to a group of people whose contribution to society is often overlooked, the men and women of the food service industry, who, when they meet this guy, tend to give him a little special treatment in return. Jonathan Goldstein tells the tale.

Jonathan Goldstein

Howard Chackowicz and I have been friends since we were kids, and so I can say with great authority that almost every day for the past 10 years, Howard Chackowicz has either dined out or ordered in at least one of his meals. Sometimes when Howard isn't sure what he's in the mood for, he'll lift an empty hand up to his mouth and pretend that he's eating. He stares straight ahead, trying to figure out if he likes the taste of the imaginary food he is shoving into his mouth. Sometimes his hand is holding a hamburger, sometimes a fork wrapped in spaghetti, and other times, he's double-fisting either end of an invisible pork rib.

Howard's always loved restaurants. He was raised in a Jewish Eastern European household, where the very idea of a restaurant was a ridiculous piece of decadence, something for Cossacks and cocaine addicts who enjoyed flushing their money down the toilet. Restaurants had a transgressive allure, and as soon as Howard was old enough, he started sneaking away to them after school or sometimes on weekends while the whole family was still asleep.

In fact, Howard was the very first person I've ever dined out with alone without any family. We were 12 years old, and we ate at Atomics Pizzeria, a place just down the street from us. It was owned by a crotchety, old Greek man named Costa, who served ridiculously large portions of food. We'd get a plate of fries the size of a dead Shetland pony, but right alongside of it, Costa would place one measly packet of ketchup. When we asked for more, he looked at us like we had just asked for more blood from his mother's still-beating heart. Whereas I learned to ration, eating 400 to 500 French fries with a bottle-cap-sized dollop, Howard learned how to talk to Costa, how to win him over, how to make him see that giving us more ketchup was just the right thing to do. Along the way, Howard learned how to say in Greek, "Thank you, kind sir. Bless you for the ketchup," as well as the excellent [SPEAKING GREEK], "Here's many years to your ketchup."

Ever since way back then, Howard has had a very special rapport with the men and women of the food service industry, and he has worked very hard over the years to cultivate this relationship.

Howard Chackowicz

This is my neighborhood here. I've been to every single restaurant in this neighborhood several times, so I feel like I can comment on every restaurant.

Jonathan Goldstein

A couple of weeks ago, Howard took me on a walking tour of the best places to eat in his neighborhood. I've walked into bakeries with Howard where the young girls and old men alike who worked there have dropped their doughnut tongs to cry out with joy, Howard! I've watched him get moved to the front of the line outside restaurants in Chinatown. When he's relating to a waiter or a delivery man, all that Howard sees is one person giving another person food. He talks to them as though they're friends, brothers even. His servers are able to sense his purity of vision, and they bestow on him in every exchange some little bit of special treatment.

Howard Chackowicz

Let me show you a ghost here. On the corner, there was a place called-- I'm not sure what that was. That used to called Le Defi, which is "The Challenge," and that was a really great place. And then they closed, and they moved right across the street, and they had $1.99 spaghetti meal. I would go there every day, and I brought a lot of friends.

But it got to the point where, when I came in, I was actually able to serve myself. That's how close we got. We'd go in. They'd greet me, and they wouldn't even get up. I would go, and I would pour myself coffee, and I would actually serve other people coffee. I'd say,"More coffee, sir?" At first, it was a novelty. Then they got very used it. They actually liked it. The other funny thing is, too, one time they actually let me make toast and stuff there, so make some of my food. That's actually a true story.

Jonathan Goldstein

We come to a little shop on the corner.

Howard Chackowicz

Like, you wanna go in here? This is my friend. This is my friend Tino.

Jonathan Goldstein

Where are going into right now?

Howard Chackowicz

This is Chez Vito. It's a great butcher shop, an Italian butcher shop.

Jonathan Goldstein

Howard takes me inside and makes the rounds, saying hi to everyone, even craning his head into the kitchen in the back so as not to snub a soul.

Howard Chackowicz

Hello.

Jonathan Goldstein

When he's done, he stops at the cash to buy a few things, and the owner throws a small box of cookies into his bag. He says they're on the house.

Howard Chackowicz

All right, what just happened is that Tino's given me a free box of Lazzaroni Saronno, which I've never even had before. So Tino's saying that I'm nice, but he is the nicest. These guys are the nicest, and that's why I say Chez Vito's the best butcher shop.

Jonathan Goldstein

I haven't gotten free cookies from a bakery since I was maybe eight years old, and that probably wasn't achieved without the use of fake tears. It pays to be Howard. He always gets a little something extra. In fact, Howard is such a beloved figure in the neighborhood that whenever our friend Tucker goes in to get takeout from Sarah's, a local Middle Eastern restaurant, he'll tell whoever is serving him that, in fact, the food was not for him, but that he was picking it up for Howard. This earned him portions that were almost twice as large as what he'd normally get. "Howard, he is the best man," his server would say, as he piled food onto his plate. "You are so lucky to have a friend like Howard." Indeed, he was.

But the funny thing is that Howard is so doted upon when he eats in restaurants that sometimes it makes it difficult for him to just sit back and enjoy his meal. He feels he has to balance things out, and so he dotes right back. Because of that, it can be hard to carry on a conversation with him. His eyes will nervously scan the restaurant for any way he can be of help to the waiting staff. Howard's ears can detect the muted clink of cutlery falling to the carpet from clear across the room. And when he does, he'll do a kind of concerned gym-coach trot over to the mishandled piece of silverware and pluck it up off the floor.

So as much as Howard loves restaurants, when he really wants to relax, he'll get home delivery. And since it was nearing lunch time, rather than step into one of the many restaurants we were passing, Howard ushered us back in the direction of his house to dial out for our grub. At his place, he pulled open his top kitchen drawer, and I saw the many choices that lay before us.

Jonathan Goldstein

There's about 400 menus in that drawer.

Howard Chackowicz

I wouldn't say that's 400. I'd love to count it. I'd say if this handful is about 10-- 10, 20, 30, 40, 50, 60, 70--

Jonathan Goldstein

As much as restaurant owners and waiters love Howard, it's delivery men who really, really love him. I mean, who among us even knows their delivery man's name? Howard knows their names and the names of their wives and children. When they come to his door, he invites them in and offers them water. And in return, they'll actually call Howard later on to see if his meal was to his liking, that it was warm enough, that there was enough ketchup.

Howard Chackowicz

190, 200-- this is very embarrassing-- 210, 220, 230, about 250 menus in here. There are some doubles, for sure, or even multiple copies, but only of restaurants I order from all the time.

Jonathan Goldstein

We decide to order from Howard's favorite restaurant, a souvlaki place called The Greek Village.

Howard Chackowicz

I'm going to take a Number 10, the two-gyro pita. And I think that's it. Thanks, have a nice day.

Jonathan Goldstein

While we wait for the food, Howard waves me over and opens his kitchen cupboard to reveal physical proof of his good standing with the service industry.

Howard Chackowicz

Here we go. These are all bags of ketchup, salt, soy sauce.

Jonathan Goldstein

And this is all from takeout?

Howard Chackowicz

Yeah.

Jonathan Goldstein

And these are like big bags full of nothing but ketchup?

Howard Chackowicz

Ah, there's some soy sauce.

Jonathan Goldstein

So gone are the days where you had to wheedle out a single packet out of Costa's hands for your French fries?

Howard Chackowicz

It's true that I have so much now, you know. I have so many packets here. But no matter how many packets I amass, it will never catch up to what I missed as a child: ketchup.

[KNOCK ON THE DOOR]

Jonathan Goldstein

Then, with vaudeville timing, our delivery arrives.

Howard Chackowicz

Hey, Shamir!

Jonathan Goldstein

Howard greets the delivery man like an old friend he hasn't seen in quite some time.

Howard Chackowicz

Thanks so much, man.

Shamir

Your friend, he's a beautiful man. He's such a nice man, I'm telling you.

Howard Chackowicz

I didn't get you in trouble, though, right?

Shamir

The best customer in Montreal I have. Each time I come, he give me apple. He give me a juice. He give me everything.

Jonathan Goldstein

When I order in, like most people, I figure these guys want out of my house as badly as a bird that's accidentally flown in down the chimney, and I assist in their passage, usually having the exact change with a tip all ready for them at the door. But at Howard's house, delivery men stay a long time. They seem to want to.

Howard Chackowicz

Shamir, can I offer you something?

Shamir

No, thank you, thank you. Thank you.

Howard Chackowicz

Yeah, so Marvin's not working there any more?

Shamir

No, because I think he find some other job.

Howard Chackowicz

Oh, OK, OK. Actually, I feel so bad. When I call, I want to ask for Shamir. I feel like, well, we don't know who you're going to get.

Shamir

Well, you don't have to feel bad.

Howard Chackowicz

I know, but I don't want to get you in trouble.

Jonathan Goldstein

After about 10 minutes of this, I just want to eat. I find myself eyeing the bag of souvlaki lying on the floor like a campground bear. I realize then that I'm just not made of the same stuff as Howard. And I never will be.

Howard Chackowicz

I can't offer you something?

Shamir

No. Thank you very much. Thank you. So thank you--

Howard Chackowicz

Thank you so much, Shamir. I thank you, man.

Shamir

I thank you, Howard.

Howard Chackowicz

Thank you for your kindness.

Shamir

Thank you.

Howard Chackowicz

You're the best. It's the best restaurant with the best guy.

Shamir

Thank you.

Howard Chackowicz

Yeah, you're very kind. Thank you for your time today, Shamir. See you later, man. Thanks, Shamir. He's such a good guy.

Jonathan Goldstein

When we finally sit down to eat, I can't even get Howard to admit that he's doing anything so special with guys like Shamir. We go back and forth on this.

Jonathan Goldstein

Yeah, because, I mean, most people won't go to the extent that you do, which is why you have guys that work the telephone coming by your house to meet you. That probably doesn't happen that often.

Howard Chackowicz

Well, I really believe I don't really do anything. I'm nice to them.

Jonathan Goldstein

But, I mean, just empirically, you have to see at this point that you're getting responded to differently than most people, so there must be something different, no?

Howard Chackowicz

You know, if someone's going to come to my door more than a few times and they know my face and they're saying how are you, I'm going to start treating that person like a human being. And most people I think are probably rude to them. Like, most people that I know give delivery men a buck, and I think that they have a harder job than a waiter or a waitress, because here's a guy who takes your food, gets into a car, risks his life, goes into traffic--

Jonathan Goldstein

Hang on a second. Risks his life?

Howard Chackowicz

Oh, you know, he's driving a car, you know?

Jonathan Goldstein

Howard's worked all kinds of food service jobs himself, as a waiter, a bus boy, a short order cook. And he says that, as a result, he absolutely loathes the feeling of being served. There's something that just feels embarrassing and unnatural about it. But it even goes further than that.

In his interactions with the service industry, he's looking for a particular feeling, a kind of cozy moment where he can palpably sense that the waiter has forgotten that he is a waiter and that they are both simply relating as human beings. And then, once he knows this, once he knows they're both getting along and everyone's happy, he can move on. He isn't looking for anything else from them. His motives are pure that way. But these kinds of special moments don't come without strings attached, and sometimes Howard gets into trouble.

Earlier in the day, during our walking tour, there was one place we didn't stop into, a little convenience store around the corner. Howard became uncharacteristically somber and quiet as we walked by the storefront window. The owners, a Greek woman in her 60s named Vula, and her older sister, used to be pretty friendly with him. Sometimes Vula wouldn't charge him the tax on his chocolate bar, and on occasion, she'd have him sit behind the counter with her on a plastic milk crate. It wasn't much, but it was still more than what the other customers got, and it made Howard feel special. But then, at a certain point, things started to get more intense.

Howard Chackowicz

There had been several holdups there by knife point, gunpoint, and I felt really bad for them. I'd see them really shook up. And they're kind of tough ladies, but they're alone. And I told them, I said, if you ever need anything, if there's any trouble or something, I'm just around the corner. You give me a call. And I really meant it like in case of emergency or, you know, just that there'd be someone they can call, like some kind of community-- some kind of effort at community. But she would call every day.

Jonathan Goldstein

She would call him for all kinds of reasons, to have him come by and fix things or to run errands for her, and he would try his best to be accommodating. She'd even call him just to chat. Even though all of this was more than Howard could shoulder, he was reluctant to put an end to it. It was only after the calls got later into the night at 1:00 and 2:00 in the morning that Howard's friends started insisting he tell her that enough was enough. And against his better judgment, he did so. Howard wonders if it was right to give her his number in the first place.

Howard Chackowicz

I made that offer, assuming that it would be understood that there's a cutoff point. But to another person, you know, that offer is a real genuine offer. If I need help, I'm going to call you. And she did. And maybe she's the one that's right. So it's ironic that just being nice to someone actually had the adverse effect, the opposite effect, and it ended up being like a disaster, and now two people are not even friendly with each other.

Jonathan Goldstein

There have been other disasters for Howard, disasters where he was the one who went a little too far. Like, there's the time he became so consumed with helping this neighborhood Chinese restaurant that, without being asked, he took it upon himself to draw pamphlets for the place. The owner accepted Howard's flyers but never circulated them. Later, the owner picked a screaming fight with Howard over an order, and Howard never went back.

And then there was the time he brought in beautiful framed photos of Lebanon to his favorite Lebanese restaurant so they could be reminded of home, but the photos were never hung up nor were they ever referred to again.

But for Howard, those things don't matter, and I know that he'd probably even do them all again. There are so many other moments that make his good intentions feel repaid in full. Some of his favorites are when delivery men he knows pass him by in their cars as he's walking down the street. It shocks him out of his reverie when they honk their horns in a quick, affectionate burst. For a brief moment, it feels like a reassuring slap on the back. Howard thinks to himself that they're the best, and it fills him with so much gratitude that if he had a pear or a peach in his coat pocket, he would wave them over and give it to them.

Ira Glass

Jonathan Goldstein is currently writing his own version of the Bible. He is the host of a new upcoming series on CBC Radio called Wiretap.

[MUSIC - "MAKE ME SMILE (COME UP AND SEE ME)" BY STEVE HARLEY & COCKNEY REBEL]

Act Two. Except For That One Problem, It's Perfect.

Ira Glass

Act Two, Except For That One Problem, It Is Perfect.

Prisons operate on the idea that if inmates don't control themselves they get consequences, punishments. So what do you do with inmates who don't understand consequences, whose emotions take over? Well, there's this thing called Borderline Personality Disorder.

People with this disorder are ruled by their emotions. They are hypersensitive. They demand attention. They mutilate themselves. They attempt suicide. And in prison, they end up spending a lot of time in isolation cells. They require a lot of time from guards and medical personnel. They clog the system. They cost millions of dollars. They are a huge management problem. Medication doesn't work on this disorder, and psychoanalysis only makes them worse. They're too unstable.

There is a new program to deal with them, and it's getting some results. But unfortunately, it goes against some of the basic rules of prison life. In particular, it goes against the rule that everybody in prison should get treated the same. Gregory Warner went to Springfield, Missouri, to check out the program, to the oldest and largest prison hospital in the country.

Gregory Warner

It's more prison than hospital, the United States Medical Center for Federal Prisoners. It was built in 1933, back when they were still designing prisons to look like fortresses. It stands alone in a huge field like something that should be approached on horseback.

Inside are some of the more advanced medical services for inmates in the country: a dialysis unit, a cancer ward. But there's still a feel of the prison stockade: bars, guard stations, a wheelchair-accessible chow hall. Another building houses the mental health ward. A few people in Springfield, even the guy who rented my car at the airport, warned me about running into Hannibal Lecter here. But inside the prison, the mention of Hannibal gets only an embarrassed shrug.

The controversial inmates are on the third floor in the unlocked unit for inmates with Borderline Personality Disorder, some of the most problematic inmates in the entire federal prison system. The unit is surprisingly calm, given these guys' histories. Unless there's a therapy group in session, we find the men clustered around card tables or reading, or just pacing down the narrow corridor. The whole unit is one L-shaped hallway with brooms and cells off of that.

This is where I find Randy Nielsen, 45 years old, he's been in for bank robbery since he was 19. He's tall with graying hair and shining gray eyes. The scars on his arms actually overlap, new scars on top of old ones, from all the times he's tried to hurt himself.

Randy Nielsen

I never knew what was wrong with me. And I really thought I was crazy because I would have crying fits in the middle of-- in a chow hall or walking, and somebody would be talking, and then all of a sudden, I'd just start screaming and pulling my hair and beating my face until they sedated me.

Gregory Warner

And why do you think you were doing that?

Randy Nielsen

I got attention. And they had to deal with me. One way or the other, they had to deal with me.

Keith Smith

They've learned that that's the only reason and the only way that people will listen to them, is if everything is a crisis.

Gregory Warner

Keith Smith is a treatment specialist who works with Nielsen and the other guys on this unit.

Keith Smith

Every headache that he might get, that's a tumor. Every ache and pain, that's a broken joint or cancer or something horrible. He needs very expensive tests. He needs them right now. So today, you might go through a huge ordeal to get him seen for one thing, and you think it's passed. And then the next day, it's something totally different. Same crisis, new ailment.

Gregory Warner

What makes people with Borderline Personality Disorder so difficult to deal with is they can be incredibly hostile and manipulative, and at the same time, phenomenally needy. They crave attention and approval. They can't deal with people, but they can't bear to be alone, and they fear being abandoned. And the littlest things can throw them into a crisis, someone not saying hello in the hallway, or not getting the right amount of food. And once they're upset, they're uncontrollable. They'll mutilate themselves if they don't get their way. They'll threaten suicide, and they'll mean it for as long as the crisis lasts.

In prison, they start fights and sew drama. They attempt suicide, and then sue the prison for rescuing them. Generally, prison has two ways of dealing with these inmates. They can transfer them to a new facility with the idea that a change of scenery might change the behavior, a temporary solution that works often enough there's even an unofficial term for it: diesel therapy. Or they could use punishment to deter the behavior: solitary confinement. The hole, it's called.

But diesel therapy is expensive and only works temporarily. And the hole for borderlines can often exacerbate the symptoms. Mostly, prisons don't know what to do.

Dr. Georgina Ashlock

They are exhausting. They are difficult. They wear you out.

Gregory Warner

This is psychologist Georgina Ashlock. Two years ago, the Federal Bureau of Prisons hired her to launch the experimental program here in Springfield to stop borderline inmates from mutilating themselves or attempting suicide. It's a daunting task. She didn't have much competition landing the job. Only one other psychologist in the entire Bureau of Prisons applied for it.

Dr. Georgina Ashlock

Why would anybody be motivated to want to take on one or two, let alone 48, individuals who are at high risk of killing themselves or mutilating themselves and who absolutely wear you out day to day as you try to facilitate change?

Gregory Warner

So the experimental program that Dr. Ashlock started uses a treatment called DBT: Dialectical Behavior Therapy. DBT was developed in the '90s, and it's still the only treatment that's ever shown to work on borderlines. What it is, it tries to stop borderline behavior by teaching them techniques to deal with emotions, skills like breathing deeply to relax, or keeping an emotion diary to gain self-awareness.

Because mostly this disorder is diagnosed in women, a lot of the skills are specific to women, like taking a bubble bath or painting your nails. The worksheets had to be modified for men, of course, and Ashlock said modified further for men in prison.

Dr. Georgina Ashlock

You cannot say drive in the countryside and look at the leaves, the autumn leaves, or go see a movie, or even one of the suggestions on one of the handouts is something like you can sit in the lobby of a hotel, you know, maybe a historic hotel or building or something and look at the surroundings. So adapting, helping them discover what they do have access to, that's a challenge.

Gregory Warner

What prisoners do have access to are things like photos ripped from magazines of puppies or beaches to focus on. They have rubber bands to snap on their wrists when they feel like cutting. And they also have the distraction of the weight room.

DBT also teaches interpersonal skills, like how to ask a nurse for aspirin. A lot of these guys have no idea. They'll demand aspirin, and the nurse will tell them to wait, and then they'll start screaming, and the whole situation just escalates. They don't get the aspirin, and they get thrown in the hall for making a scene. So DBT has all this worksheets on how to break the interaction down, like how badly do I want to aspirin? Does the nurse have any aspirin? Is she really busy? Or is she in a giving mood? And what's the body language of someone in a giving mood?

DBT is like a Berlitz guide to dealing with the world. As basic as all this seems, Ashlock says these are skills that these guys never learned, in large part because of abusive childhoods. And all these little skills add up. You learn how to ask for aspirin, people see you as a nice person. Your personality begins to change. Even the big things can start shifting, like one's ability to empathize with others. But sometimes that can cause more problems in prison, where being a nice guy can be seen as a sign of weakness. Acting reasonably can be difficult or even dangerous.

Edwin Torres

It's hard to live in this environment and actually go by these rules. But you want to because you're actually trying to better yourself.

Gregory Warner

This is Edwin Torres. He's 33 and has served two years of a 20-year sentence for drug dealing.

Gregory Warner

Can you give me an example of a time when you faced that pressure?

Edwin Torres

Sure. I had a problem not too long ago, actually. I was arguing with a guy in recreation. I came back to the unit because I was so mad. Normally, I would have just fought with the guy right there. But I was so mad and I'm thinking about the program, so I just walked away from the guy while we were arguing. I just said-- you know, I just walked away, didn't even say nothing to him. I walked all the way back to the unit, sat in the unit for, like, three or four minutes. And then I decided, you know what? I'm going to go back. Whatever happens happens.

And I'm fighting myself all the way down the hallway. And then I didn't even get back to recreation. By the time I'm halfway there, I see my buddies coming. And they're like, you know what? It ain't worth it. He ain't worth it. Remember, you can't make decisions in an emotional mind and just-- and I was, like, you know what? It actually made me happy. I started laughing. I'm like, man, guys, thanks a lot for you guys being here. You really helped me out.

Gregory Warner

The inmates throw these terms around. Emotional mind, which refers to an excited emotional state, versus wise mind, which is more balanced. A lot of DBT jargon derives from Eastern philosophy. Here's C.J., a 31-year-old inmate.

C.j.

You know, they got a skill here called radical acceptance. You've just got to accept what the situation is. I'm in prison. These cops have their job. The other inmates are going to do what they're going to do. Because I let little things just work me up. But if I can just look at the thing and laugh and say, wow, that's not a big deal at all, man, then I just radically accept the situation. I know I can't change it. It's just the way it is. And then it just passes for the moment.

Gregory Warner

My interview with C.J. had been rescheduled at the last minute. And in the past, he told me that would have spun him out of control, ruined his whole day. This time, he knew what to do. He went back to his cell and did the things he knew would calm himself down. He made coffee. He changed his shoes. He used his skills.

The DBT program's only two years old, and most of the success is anecdotal, but the initial statistics are promising. Out of 21 inmates who finished at least half the program, suicide attempts are down by 94%. And the same inmates are spending 73% less time in the hole. And this is after they leave the program or they go to a new prison.

But that doesn't mean all the prison staff is happy with the program, because the operative word in Dialectical Behavior Therapy is behavior. And for it to work, the therapists have to be involved in deciding how misbehavior is punished. And this brings them directly in conflict with the guards, who traditionally have control over that. So DBT has set off a turf war between the corrections staff and the therapists.

For instance, sending prisoners to the hole is one of the main tools the corrections staff has as a form of punishment. But under DBT, Dr. Ashlock can actually take an inmate out of a hole. That's a pretty big deal. And she also allows the inmates to voluntarily place themselves in the hole if they feel like it's the only way they can get control of themselves. Instead of acting out to get there, they can just go, like taking a sick day for work. Guards hate all this special treatment.

Dr. Ashlock tells me this story about an inmate who attempted suicide. Normal procedure is that the prison guards would strip him and place him in a suicide cell. But Dr. Ashlock spoke to him and decided that the suicide cell wasn't the best place for him.

Dr. Georgina Ashlock

Well, it was very obvious with talking with him that the crisis had passed. So I made a decision clinically that he could return to the semi-locked unit. Oh my God. You would have thought that we had taken the guy out for a steak dinner and bought him a plane ticket home. I mean, the institution went crazy. And they were calling the union, saying just what a stupid decision that was, and that I rewarded his behavior, and that it wasn't safe, and that he should have been, at the minimum, punished by being placed in a stripped cell overnight. It was completely ridiculous, and it was just so destructive to the whole treatment milieu that I ultimately had to ship the inmate out. I mean, it was over. It was just over. There was so much controversy, so much heated emotion about it that it was impossible to even keep the inmate there and continue to work together.

Larry Caudle

Many of these guys are here for being manipulative criminals, master manipulators.

Gregory Warner

Larry Caudle has been a corrections officer at Springfield for 13 years and was president of the guards' union when the DBT program was introduced. He says in prison you have to be suspicious of everything to protect your own safety, and you're trained to resist inmates who want to manipulate you.

Larry Caudle

A lot of them have learned that sometimes if you can't get what you want by verbalizing a problem, stick a pencil in your arm. Somebody's going to listen. Throw a fit. Scream, cuss, carry on like a little kid. Threaten to kill somebody. Somebody will listen to you. That's how a lot of staff view it, that people come here, they get out of a penitentiary where they have problems. They play the game for a year. And a lot of times, if they're really successful, they eventually get their custody level downgraded, and they go to a little bit less restrictive, a less dangerous place. And a lot of staff feel like that they're just manipulating the system.

Gregory Warner

It all just looks wrong, one officer told me. Even the idea of calling inmates "patients" sends some guards into a cussing fit. They're not there to help cure anyone. They're there to keep control.

The prison anticipated trouble from officers even before the DBT program started. So they launched a Hearts and Minds campaign to convince officers that DBT would help them control inmates. There was a DBT role-play at the annual staff training, but the message wasn't getting through. The officers asked Dr. Ashlock if the inmates would get flowered curtains and pizza parties. They told another therapist to expect gladiator battles and daily rapes.

So then the prison set up a special website with a thing called an Ask-It Basket, where Dr. Ashlock would field anonymous questions to dispel the various rumors, but that just led to more hostility. Officers basically accused Ashlock of tossing out misbehavior reports to make the program look good and said the program was just a cozy hideout for inmates to go masturbate. The Ask-It Basket was shut down after two weeks.

Keith Smith has seen both sides of this argument. He was an officer in the prison, and then he became a treatment specialist in the DBT program. And ever since he took the job, his best officer friends won't talk to him. They stopped going bowling with him on Friday nights, and their families don't get together anymore.

Keith Smith

A lot of officers see you as either you're with the officers or you're with the inmates. So if you take any kind of a position where you're not directly, absolutely against the inmate, you're for them. And that means giving them special favors or being soft on them, not calling them on their incidents or not writing incident reports, things of that nature, letting them get away with things that you shouldn't.

Gregory Warner

Dr. Ashlock doesn't see what the big deal is. She thinks officers should be in favor of a program that helps them handle these inmates, that leads to fewer outbursts and less violence. She says what the officers don't understand is that by giving these prisoners special treatment, by bending the rules for them, she's not giving into their manipulation, she's trying to stop it. She tells the story of an inmate who swallowed a piece of razor blade and was sent to the hole. And then she discovered that he did that so he could avoid guys he owed gambling debts to.

Dr. Georgina Ashlock

I immediately took him out of lockup. Same kind of thing. Backlash, people appalled. Oh, she's rewarding his behavior, and she's not doing what she said she was going to do in the program. But they did not understand that that was what the inmate wanted, was to hide in lockup. And we came in and said you're coming out. We brought him to my office and said you're going to figure out who you owe and how much you owe. You're going to go meet with those inmates on the compound. You're going to work out a plan for repayment. You're going to face your situation that you created.

Now, did that inmate stop racking up debts? No, because this is a very long pattern of behavior for him. However, we certainly took away his motivation to use self-harm to avoid that responsibility. So to me, it seems like a very simple solution.

Gregory Warner

The problem is, when a prisoner mutilates himself or tries to kill himself, the guards see it one way, the therapists see it another. There's a jail in Kentucky that reportedly uses something officers call the fingernail test to tell the difference between a real suicide attempt and a manipulative one. The officer basically uses his fingernail to measure if the wound is deep enough to be a real suicide. That's a pretty gross example, but it's an issue that every prison struggles with it and that's at the heart of this disagreement. No one wants a suicide on their watch, but no one wants to be sucker either.

Ira Glass

Gregory Warner lives in New York. Coming up, mommy knows best, but sometimes she needs the power that comes with cassette tape. That's in a minute, from Chicago Public Radio and Public Radio International, when our program continues.

Act Three. Mommie's Psychic Helper.

Ira Glass

It's This American Life. I'm Ira Glass. Each week on our program, of course, we choose some theme and bring you a variety of different kinds of stories on that theme. Today's program, Special Treatment. We have stories about the pros and cons of not treating everyone the same.

We've arrived at Act Three of our show. Act Three, Mommy's Psychic Helper.

When Aimee and Andrew were babies in Southern California, their Vietnamese mom got their horoscopes done by a fortune teller, and had them recorded onto a cassette tape.

Aimee Phan

She listened to this tape all the time.

Ira Glass

She did?

Aimee Phan

Uh-huh. At one point, she had three jobs, and it was really stressful for her. And we would be upstairs going to bed, getting ready for bed, and she would sit in the living room, and she would listen to the tape sometimes. And if we would go downstairs, sometimes I would hear her listening to the tape, just her sitting, usually lying down.

Man

[SPEAKING VIETNAMESE]

Aimee Phan

It became a part of our everyday for her to talk about these tapes whenever she would be talking about our personalities. But since Andrew and I can't understand Vietnamese very well, it was just this voice. It was just this deep voice, very somber voice.

Man

[SPEAKING VIETNAMESE]

Aimee Phan

The fortune's content would change with her attitude sometimes.

Ira Glass

Really?

Aimee Phan

Yeah.

Ira Glass

What parts of the fortune would happen in what mood?

Aimee Phan

Well, when she was in a good mood, when she was happy, she would talk about how the fortune said how smart and clever I was, and how independent I was going to be, and how much I'd travel. And whenever the credit card bills would come in and my mom would find out how much she thought I was spending, she would say how much money I wasted, and how the fortune had warned her that I was going to be a money waster, and if I wasn't careful, I would be broke for the rest of my life. And even now-- I haven't lived at home for eight years-- even now when the bills come home, my dad will say that she still blames me.

Ira Glass

And do you use their credit card?

Aimee Phan

Never.

Ira Glass

Wait. And she still gets the credit card bill, and then she goes, like, that Aimee?

Aimee Phan

Right. I think I was actually really sensible about money, but I did feel this guilt every month.

Ira Glass

So basically, all your life, you've been haunted by this idea that you're really terrible with money and you're spending too much money. Can I just run something from the fortune by you?

Aimee Phan

OK.

Ira Glass

So we had a translator translate this, and we have some recordings of her, and then some parts of this I'm just going to read to you.

Aimee Phan

OK.

Ira Glass

It says right here, talking about characteristics, you are loquacious and disgruntled, which will cause you back pain. You will be a good treasurer-- which I think means good with money-- and quickly become a wealthy person. And then here's the translator.

Man

[SPEAKING VIETNAMESE]

Translator

The five years after 49, she will be very rich.

Aimee Phan

Oh my gosh! So all the money stuff isn't in there. Like, it doesn't say I'm going to waste money. I've never heard that fortune. Maybe she was scared to tell me that.

Ira Glass

OK, Aimee. I have another clip of tape of the translator to play you. I hope you're ready for this.

Aimee Phan

OK.

Man

[SPEAKING VIETNAMESE]

Translator

The reason why I laughed is that she will be very chubby in these years.

Aimee Phan

What years?

Translator

She must be on diet because too fat.

Aimee Phan

Oh my God! See, this is the thing. My mom's always warning me about being chubby, too.

Ira Glass

She is?

Aimee Phan

And I'm not chubby! I'm not chubby. And the thing in Vietnamese culture is you're always putting more food on people's plates, right? This is the thing. You have to eat more. You have to eat more. It's like the custom. She stopped doing that and that really hurt me. But Andrew's never had a problem with his weight. He never looks bad. He never has to be watched over for that kind of stuff.

Ira Glass

Wait. Are you saying that you actually believe in the fortune?

Aimee Phan

Honestly, I don't know. Sometimes I wonder if that horoscope didn't exist I would maybe be different. I wouldn't have problems with money. I wouldn't have problems with work and in making decisions in my life. I know Andrew's horoscope said he was going to be very hard-working. He was going to be like Confucius, very slow and steady, and work very hard for his life, and he would have a good life. And part of me was kind of jealous of that, the fact that his fate seemed to be happier than mine.

Ira Glass

Aimee Phan has just missed four student loan payments. Her brother Andrew is in medical school, as his horoscope predicted. Aimee has a book of short stories called We Should Never Meet. That will be published by St. Martin's Press in September.

Act Four. The Way To A Boy's Heart Is Through His Stomach.

Lisa Carver

At first, they hoped that eventually he would eat, and so they wanted him to know how to eat, and they wanted the sensory experience of eating to stimulate talking. And so he would have tastes of different foods in really small amounts, all different kinds of foods, and he just loved all food. He never rejected any kind of food. but he kept on getting pneumonias, and so we did a swallow study where they let him swallow something and take an x-ray of his throat, and they saw that a small amount of every bite, just maybe 1/10 of it, was going down into his lungs because his epiglottis wasn't closing correctly or fully over the part of the esophagus that goes to the lungs.

Now he eats nothing, and he drinks nothing. Every once in awhile, when there's a holiday, he'll chew on some stuff for fun and social pleasure, and then he'll spit it out into a napkin. So he's NPO. That means nothing by mouth. I don't know what it actually stands for, but that's for life.

I think it was harder on him when he was having tastes of things because it would get him all excited. And now that he doesn't have anything, he's more accepting, but it just doesn't die. It's like he still remembers what things taste like. And people eat all the time. I never realized how much people eat until I had a kid who couldn't eat, who was looking at me eat. But he wants it all the time, and it's all around, always. It's always there.

You are about to hear the sound of every child but one at the elementary school down the road having lunch.

[SOUNDS OF CHILDREN IN THE LUNCHROOM]

Lisa Carver

The school that he's at now, they've always been just really caring about Wolf. When there's a birthday party, they have toys and stickers and games without the usual cupcakes and food creations. And when they made gingerbread houses for Christmas, they didn't use gingerbread and marshmallows and jelly beans. They used art materials that looked like those things.

And now we're on our way down the hall to where the one child has his lunch. And at lunch, when all the kids go down to the cafeteria, Wolf goes to his own private decorated cafeteria, which is in the health office.

Wolfgang

Hello!

School Nurse

Hello! Hi, Wolf!

Lisa Carver

When it's time for Wolf to have a meal, he lifts up his shirt, and there's his little plastic G-tube, which is about three inches to the left of his belly button. And it's like a little plastic valve with a button on it or a snap, sort of like your gas tank has that little cover. And you take the cover off, and somebody puts the long skinny tube into the little hole, and pours the food down the long skinny tube. And it's sort of a creamy color, and it goes down like that, and his meal is done.

School Nurse

OK. Good, good.

Lisa Carver

This room where Wolf eats is decorated with all the things that Wolf loves, mainly caterpillars and aliens. There's a couple stuffed animals bought especially for him, his little companions. And I just found out, doing this story, that they built this room especially for Wolfgang. They had it built this summer. They had workers come in and build the structure.

I mean, we know what school budgets are like. Can you imagine? They would never say anything, but can you imagine the battles that went on, with people saying-- you know, there had to be somebody on the staff saying, why should this one kid get $7,000 of our budget when think about if that money were to go to something on the playground so that all the kids could learn unicycling? There could be 100 unicyclers out there or there could be one kid whose meal time is a little bit more pleasurable and private. And I used to be a libertarian and a bit of an elitist, which I never recognized until I had a child with special needs. And I don't know how I would have voted. I might have voted for the majority. I might have voted for the unicyclers, thinking where's the bigger benefit with this $7,000?

Now, I think that this boy, who is not doing so well on several fronts, deserves to not just survive his school day, but to actually thrive and have a wonderful day, even if that means a lot of effort. And what's amazing is that everybody seems to feel this way about Wolf once they meet him. Every single person that's around Wolf tries to come up with some different creative solution to a dilemma that's not their own.

And it's not just school. His friend Sarah, who lives next door, is constantly exerting all this extra effort to be his friend, and she's only 11.

Lisa Carver

When the ice cream truck comes, what do you do?

Sarah

We usually just go and give him some ice or something. Then we put a little bit of food coloring in it so he can eat ice and I can eat the ice cream so we can actually have something, too.

Lisa Carver

How do you feel when Wolf is watching you eat your ice cream?

Sarah

I think it's kind of not OK because he doesn't get to have ice cream. So it's not that easy for him, yeah.

Lisa Carver

I was watching TV the other day, and I saw this Fox News guy talking about the school budget in Massachusetts and how this judge just gave all this extra money-- three times as much money-- to the schools, and that a huge chunk of it was going to special needs. And his gripe with it was basically that we've already been pouring all this money into special needs, and where has it gotten us? Has it made them normal? No.

There are stragglers, and there are shooting stars, and that's just the way it is. That's being realistic. But how can you go on thinking that way when you put it in terms of an actual boy's life? How can you say to him, because you can't eat normally, you would cost too much and it's inconvenient to the staff and the other children, so you can't come in.

Last year, I was trying to get Wolf into overnight summer camp for the first time, and he was denied due to his G tube. Can you imagine if a kid was not allowed to go to camp because he has a wheelchair? But I think not eating is just so unusual that people don't know what to think. So they're forced to be creative, and that's not always easy, especially in a group setting when you have all these other people to think about, too: campers, staffers, the campers' parents. So I ended up threatening to sue the camp for discrimination, and suddenly, they got over their discomfort.

And once they met Wolf, they saw that he's a little boy, and he's not this scary proposition and a drag on their time. So they were all very kind and wonderful to him, and Wolf had a wonderful time. He had to gather around the campfire and see other kids eating marshmallows, but that matters so little against the fact that he now has memories of gathering around the campfire.

Sometimes Wolf says-- while he's watching other people eat-- I'm happy for you that you get to taste that. It must be so good, which, of course, I translate to I am so filled with sadness and longing, but thanks for inviting me anyway. It's worth it.

Ira Glass

Lisa Carver lives in New Hampshire.

Credits.

Larry Caudle

If you can't get what you want by verbalizing a problem, stick a pencil in your arm. Somebody's going to listen. Throw a fit. Scream, cuss, carry on like a little kid. Threaten to kill somebody. Somebody will listen to you.

Ira Glass

Management tips from the greats. I'm Ira Glass. Back next week with more stories of This American Life.

Announcer

PRI, Public Radio International.