Review: San Francisco Tenderloin

Will Siegel is a technical writer who also writes fiction and who also served in Ethiopia with Marian Haley Beil and myself back in the day (1962–64). Will went to San Francisco State for his masters degree in creative writing and lived there during the summer of love (and lots more) before moving to New York City, and next to Boston where he has lived for the last twenty plus years. Then and now, he is a fine writer and one of the sweetest guys we know and here he reviews Larry Wonderling’s (PC Staff: COR Puerto Rico 1968–70; Afghanistan 1970-73; early ’80s Central and Latin America; late ’80s Africa) book on a tender and tough spot in San Francisco.

San Francisco Tenderloin: True Stories of Heroes, Demons, Angels, Outcasts & a Psychotherapist
Expanded Second Edition
By Larry Wonderling, Ph.D.
Cape Foundation Publications
415 Pages
$24.95
Reviewed by William Siegel (Ethiopia 1962-64)

Larry Wonderling’s penetrating portraits of people who came to a full stop in the San Francisco Tenderloin district are colorful, interesting and insightful.  These are mostly patients that he treated over the course of 20 years – from his naïve beginnings as a therapist to his experienced self as a seasoned professional.  It seems he arrived at being a pro, because of his own dogged intuition rather than any philosophy of psychotherapy.  He is practical to the core, because that is what works on the edge of the social psychotic Tenderloin where the world is really flat and it takes a mere nudge or a dark wind to cause a fall to the death.  These are clients who came to him not to reveal their own traumas and get some relief from neurotic tendencies, but rather to keep their SSI benefits flowing.

My own sojourn in the San Francisco Tenderloin came as a result of the need to hide from my peers as well as myself.  Leaving the confines of the Haight Ashbury during the darker days of the 60’s slide into the diaspora of real life, I fled to an SRO hotel in the district – probably not too different from those described as home to many of Larry Wonderling’s clients.  My own roost there had to do, like many of his clients, with feeling comfortable.  Having run out of friends’ couches and my own good wits, I headed to the Tenderloin, about which I had been duly warned, where no one would take much notice and I could spend the days brooding in my room alone.  I don’t remember the area being as dangerous as Wonderling describes, but that may have been due to my own dangerous state of mind.  I think at times I heard voices from street corners.  They might have been merely the ghosts of one or two of Wonderling’s Tenderloin outcast patients.

There are not many happy endings to these stories, but the workings of each one reveal intimate relationships of the inner self and also perhaps a bit about our own selves.  Dr. Wonderling tells it like it is – no sugar coating, no sitcom endings.  These are sad and sometimes dreadful stories about people who, because of aberrant tendencies, usually coming from abusive upbringings, have not learned society’s game on society’s terms and need a whole other skewed society ­­- just to function minimally.

Dr. Wonderling knows and describes his patients without jargon in this unsentimental, free-form, yet focused look at people he holds dear but also with objective discernment.  He describes the reality of those who feel most comfortable with others who suffer from the same feelings of frustration, doubt, and lack of confidence which we associate with society’s losers.  We also get a good insight into the therapeutic process as developed by Dr. Wonderling – special to the people he deals with – which evolves into a simple yet sophisticated method for helping the disenfranchised find a semblance of their own voice.  He doesn’t always succeed in bringing his patients to a satisfactory resolution.  He does succeed in allowing a lot of room for listening to his clients – a method that builds trust and adds clarity to his client’s self knowledge.

As someone who has spent a fair number of years in one type of therapy or another, as well as being married to a therapist, I understand that some might think his methods involve too much license.  Some might call for a stricter therapy to treat the extreme clients Wonderling finds among his Tenderloin population.  These are individuals who are willing to navigate extreme danger just to stay out of their own spotlight or run away from their tortured self – often preferring the oblivion of drugs and death to nursing along a more normal psychological neurosis.

After a somewhat rambling attempt to describe the San Francisco Tenderloin district — its history and how the name Tenderloin came about, we get a quick look at Dr. Wonderling’s early knowledge of the area.  A San Francisco native, he mentions that he moved to the district for a short period in high school due to trouble at home.  He relates how he came to feel comfortable in that forbidden district despite his early reservations.  However, the doctor was able to get himself through a Ph.D. Program and set up shop as a psychotherapist in the area, where most, if not all of his clients, were obliged to see him or someone like him if they wanted to keep their checks coming.

The essence of Dr. Wondering’s book, his descriptions and treatment of his patients and how the stories reveal themselves in his patient’s behavior become more and more fascinating as the book progresses.  We learn about how his clients present themselves, their background, and their ins and outs through the Tenderloin district, and how these reluctant patients help the therapist in determining their plan of therapy.  In each case we are led into the story by the thoughts and details of patient and therapist-story teller.  Of the 26 stories related in these pages, some six of them are new, and nearly all of them are updated with further outcomes and insights in this expanded second edition.

“I was one of those therapists willing to endure low fees and excruciating paperwork,” Dr. Wonderling tells us.  The patients range from con men, junkies and ex-convicts, to alcoholics, prostitutes, lost souls and petty crooks ­­- many with difficult behavioral problems.  One tough customer was cured by an earthquake, another liked to dine for free at San Fran hotel functions.

Many of the portraits illustrate some life lesson for the author.  He returns to the Tenderloin at the invitation of an old friend, Bert, who turns out to be one of Dr. Wonderling’s heroes. “My heroes are generally mavericks of some sort who ignore destiny by getting up every time they’re knocked flat into life’s muck,” he tells us and we believe him.  Bert, the head of a drug abuse treatment agency hired Wonderling to treat some of the most untreatable.  He developed plans for the most forlorn and dysfunctional, and listened to the misfortunes of people who ended up there.  The listening part was perhaps his greatest therapy tool, and it always worked to some extent – not always wonders, but usually to alleviate the heavy burdens on people who were more often than not stuck on the yo-yo, ping-pong axis of society’s rewards and slights – misfits is hardly the word for most of the people Wonderling describes.

I bypass here for the most part the specifics of the 26 remarkable stories of patients that Wonderling describes in terms of his practical treatment.  In my view most important are the patient’s universal needs, and the doctor’s varied responses to these needs – psychological and practical.  I mention only a few of – all colorful and interesting cases showing patients’ character, assessment and practical treatment with fleeting and sometimes grim outcomes.

Andrew, quiet as a mouse, eventually had his treatment out of the office in order to free him from of his self-imposed shell.  This went very well for a time, until Andrew humiliated himself in public.  Later, after Andrew died from AIDS, Dr. Wonderling discovered his patient was sending nearly a quarter of his meager monthly IIS check to an orphanage in Africa.

Ody, full of rage, traded an 8 x 10 prison cell for a 10 x 10 SRO hotel room from time to time.  In and out of prison, Ody was a fearsome and feared fighter wherever he landed.  Therapy in the Tenderloin is often about keeping patients out of trouble.  With Wonderling’s help Ody learns to do the simple task of returning a quart of sour milk without violence.

And then there is the annual Christmas party described near the end of the book.  This party is like no other you’re likely to attend.

There is also something to be said about Dr. Wonderling’s therapeutic time in the tenderloin and his work as a psychological consultant to the Peace Corps.  Those of us who served in developing countries are familiar with basic lack and the overwhelming needs for health, nutrition, and education.  What we sometimes forget is the similarity of many parts of our own country that manifest the same fundamental deficiencies – though these needs at home are played out in a more subtle and psychological manner.  Many, if not most of the San Francisco Tenderloin district patients revealed by Dr. Wonderling are missing the social skills, emotional maturity, and inner stability that the majority of us learn – skills that allow us to participate in the fuller scope of life as part of a social community – family,  job, friends and even dreams.  Dr. Wonderling reveals how time and again psychological realities are denied to his patients just as the basic physical needs of many individuals and landscapes that we returning PCV’s encountered in our years working abroad.  The similarities are provided in the pages of his book.

I recommend Dr. Wonderling’s book without reservation if you are at all interested in psychology, human behavior and even perhaps meeting the mirror image of your years working and toiling with our many friends in the developing world.  For my own Tenderloin memories, let me acknowledge a certain miracle rescue from the swirling confusion that landed me there in the first place.  In lieu of that, I certainly would have been fortunate to find Dr. Wonderling and his patient’s chair for a hand up and out of that confusion – a hand which he extended for many years to those who were also fortunate enough to stumble upon miracles – for the good doctor provided a few of his own.

Will Siegel (Ethiopia 1962–64) is a technical writer living in Boston where he also works at writing fiction.