James: You’re Going to Hell

James was one of my first clients.  He was an arrogant, obnoxious, crack addict in his mid-twenties.  He had been using for most of his life.  During our last session together, I told him that I was worried  that he would be back on crack within hours of his discharge.  He told me not to worry.  He assured me that I would be better off worrying about myself instead of worrying about him.  I half agreed, but told him that not being a crack user, in all probability I would not overdose on crack; while he might.  He looked at me with indignation.  Then from my gut, without giving it any thought, I blurted out, “James, if you o.d. on crack, don’t think you’ll go to heaven.  If you o.d. on crack you’re going to go straight to Hell.”  James froze.  His face ashen white, he took a big gulp and asked with trepidation, “Jews also believe in Hell?”

James was discharged and I don’t know how long it was until he went back to the crack house; but I hope that after my comment to him about going to hell he never enjoys his crack high as much as he did previously.  As Dr. Milton H. Erickson used to say, “My voice will go with you.”  I wonder, was my intervention with James good therapy or dreadful therapy?  How much of therapy is about honest human connections and how much of therapy is about proper etiquette?