Therapy Is Hard Work: My Mental Health Journey
When I was thirteen and anorexic, I was sent to the teen psychiatric ward in the Keene State Hospital. It was my first experience with therapy, spending most of the day in group and private sessions, being asked to evaluate my overwhelming emotions, low self worth, and destructive behavior. I quickly learned to tell the therapists what they wanted to hear in order to get the hell out of there. It only took me a week to gain a few pounds and convince them I was valuing myself again, and it was safe for me to go home. Part of my release plan was seeing a therapist once a week, so every Wednesday I got to leave school early and my mom drove me the hour into Burlington to meet with Sally. She was a child psychologist and had me do things like draw a box and put the things I felt about myself in the box and the ways others perceived me on the outside. I was convinced she was full of shit and, after she confided in my parents things I had told her, without my permission (and, I should note, nothing that was a danger to me or anyone else), I decided not to trust her. I continued telling her what I thought she wanted to hear until I got the OK from the doctor that I was "cured" and didn't need to see her anymore. That experience left me wary of therapy and I didn't pursue any kind of help for another decade. I know now what a mistake that was and can't help but wonder if I had only sought out help in college (there were, of course, free counseling services that I was embarrassed and afraid to pursue), I may have felt up to participating more without drinking so much or engaging in self-destructive behavior. I might have spent less time crying alone in my room, unable to be around people or do the things I wanted to do.
I didn't seek help until after college, though severe depression and anxiety continued to dominate my life. I cried for seemingly no reason (the best therapist I've ever had would later teach me that nothing is for no reason and to analyze what factors led up to these feelings). I frequently didn't feel up to seeing people. I was miserable in my job as a legal assistant at a boutique immigration law firm. My boyfriend Dylan and I moved in together, along with two other friends, in a cheap and derelict apartment. We had separate schedules and rarely had time off together. I felt like a guest visiting the three boys' apartment. I felt like I didn't belong anywhere.
I had had every privilege, got a great education, had a steady and not-completely-terrible (though also not great) job, had a boyfriend I loved, should, by my calculations, have been happy and excelling at everything. I felt I owed it to my parents, who had such high expectations of me, to live up to those expectations. After a few months of this, Dylan suggested I see a therapist. At first, I was furious. How dare he? I thought he must see all the bad parts in me, the parts I was most ashamed of, that he could see something was wrong with me. I thought he meant that he didn't want to actually talk to me about my problems, but wanted to foist me off on someone else (that's the way it felt when my parents sent me to the teen psych ward, after all. After A LOT of therapy, I've realized a lot of my abandonment issues lead back to my feeling left there, in that terrible place, alone). I know now that it was the best thing he could have done for me. "There are things you need that I can't help you with," Dylan said. He was right.
I found Jennifer on Psychology Today. I liked her long hair, bohemian look, and zen attitude. Her profile made her sound empathetic and smart. I started seeing her on Tuesdays after work, right before a weekly potluck we hosted in the apartment Dylan and I had just moved into alone. Finally, our work schedules aligned. He supported me going to therapy (after all, he'd suggested it), but didn't seem to understand why I often didn't have the energy to host friends afterwards. A DJ we all liked played Tuesday nights across the street from us whom we'd theoretically see after the weekly potluck (though often people were too drunk, full, and stoned to make it across the street after 10 p.m.), so of course we'd have our potluck on Tuesdays, so it's after therapy, why should it matter? He didn't get, and maybe I didn't even quite get then, that therapy, and introspection of any kind, is hard work. It can exhaust you. It can drain you of mental energy and make you not want to see anyone or do anything, much less cook for 15-20+ people in your one-bedroom apartment (news of our potluck spread quickly). Every week, I cried for an hour in a room with a fake waterfall-rock sculpture and those rakes you drag through sand, then usually sat on a bench in the park outside Jennifer's office until I could stop crying and walk the two blocks home. Then I'd put on a happy face and greet the regulars and newbies and play hostess.
After two years, I seemed to be doing much better. I had finally capitulated to taking medication after a manic episode (you can read about those in an essay I have coming out in OC87 Recovery Diaries later this month). Jennifer had referred me to a psychiatrist, whom I also saw periodically as we transitioned me onto antidepressants and anti-anxiety medication. I had a new job in the educational nonprofit sector, something I was much more passionate about, and things between Dylan and me were good. Jennifer and I agreed that I'd been doing well for a while by the time she was moving out of state. She'd offered to give me a referral to someone, but it felt like our time was done and maybe I would be fine now. I didn't realize that's not really how (most) therapy works. Two days later, my mother fell down the wooden stairs and sustained a traumatic brain injury. Dylan asked if I was sure I didn't want to see anybody, and I decided I just wanted to deal with it amongst ourselves.
For the next few years, I saw my psychiatrist once every few months for quick med check-ins, but I had no other therapy or support. In that time, I dealt with the aftermath of my mother's traumatic brain injury and alcoholism and my own traumatic, life-threatening ectopic pregnancy (read about that here), and stress between Dylan and I. It would still be several years before I sought therapy again.
I had never wanted to be permanently dependent on medication, so, once my anxiety seemed to be dissipating, my psychiatrist and I decided to wean me off the anti-anxiety meds. A few months later, we weaned me off anti-depressants. I knew this was a mistake immediately. Despite being recently married, I sunk into a deep depression. I felt worthless. I couldn't understand how Dylan could love me. But I wanted to prove I could do it on my own, that I was good enough.
Eventually, I realized I needed therapy again. I asked my psychiatrist for a referral, and that's how I met Betsy. She is easily the mental health professional I've connected to the most, she reminds me in the best ways of my mother, but her way of thinking, her perception and empathy, are much more like me. She asks questions I wouldn't have thought to ask. She's taught me to take a step outside myself and try to see what's really going on. She told me listen to the introspective voice that's trying to assess my emotions, rather than the reactive voice that immediately criticizes and brings me down. (Do I always do this? No, I do not. But sometimes I can, and that's good enough). When I told her about my first manic episode in my early twenties, which caused me to agree to go on the pills Jennifer had recommended on multiple occasions, and I described it as a break down, Betsy said it sounded more like a breaking open, and I love that, the thought that something needed to be broken open, released.
After another manic episode and a series of panic attacks, when things between Dylan and I were a little rocky, Betsy suggested we move from cognitive behavioral therapy to psychoanalysis. She recommended three or four times a week. Living an hour away and working half an hour away made the time commitment a lot, so we settled on three days a week, Monday mid-morning (I wasn't working Mondays), Tuesday at 7:30 a.m. before work, and Wednesday after work. Frequently our Monday sessions exhausted me, after four days without a session there was always a lot to discuss. I often tried to have lunch with my grandmother after my sessions, but there were plenty of times when I felt I couldn't be with people after a session. For a while there, when my anxiety was a real problem again, I would go to Trader Joe's after my session with Betsy, as it was nearby, and became incredibly stressed out by the crowd, people's pushiness, feeling extremely uncomfortable. But Tuesdays were much worse, having to go into work, sit at a desk and be productive, interact with others, all day after a tough session.
Due to the worst manic episode I've experienced to date, my psychiatrist diagnosed me as Bipolar I and prescribed new medications, several of which warned of drowsiness and taking caution when driving or using heavy machinery. Sometimes, driving the hour on the highway to therapy, I'd become very sleepy and have a hard time keeping my eyes open. I mentioned it to Betsy several times, including at a session in the spring, after which I drove to work, fell asleep while driving about two miles from my office, and crashed into a guardrail on a bridge, totaling my car. Of course it was raining. We stopped our early morning sessions and my medications were adjusted again. Any time there's a medication change I become far away from myself, often groggy and sluggish, temperamental.
Eventually, things normalized again and I became a slightly muted, calmer version of myself. "You seem subdued," my friend Eddy said during one of our MFA residencies at the Bennington Writing Seminars (he's someone I'm comfortable enough with to tell that it's medication-related. I'm trying to become more comfortable talking about mental health in general. So here I am.)
Betsy and I have been doing psycho-analysis two-to-three times a week for two years now. Now every Monday and Wednesday, I lie on a couch facing a window overlooking a wooded/swampy area and a blue and purple abstract painting I like. Betsy sits behind me and I often lie with my eyes closed, particularly if I'm crying, which I often am (do you know how hard it is to sob while lying down? I'm talking phlegmy ugly cries, nearly impossible to breathe.). We dig deeper into my most painful parts, push to understand my worst feelings, assess how I react to the world around me and why. We try to unpack my depressive and manic episodes, panic attacks, feelings of extreme exhaustion (confession: I'm still on all of those medications and often/OK, usually, sleep nine or more hours a night). After a particularly "good" session, when I get a lot out, better understand my emotions, I feel drained, empty. I just want Dylan to hold me, and he usually does.
After two years of multiple-times-a-week psycho-analysis not covered by insurance, we can't afford it anymore. Betsy has generously offered to reduce her already-reasonable rate, but it's still not enough. Add that to the fact that I'm adding on more volunteer and paid jobs, limiting my time to drive an hour both ways for an hour of therapy, it looks like we'll be reducing to one session a week and, hopefully, a code that my insurance actually covers. She's told me that she's concerned about me going to just one session a week, and, frankly, so am I. But that's where we are. I've put in the work. And I'll keep working at it every day.