For as long as I’ve spent in therapy (thousands of hours at this point), I can count on my fingers the number of difficult sessions I’ve had.
It’s not that my sessions don’t involve difficult topics. While most of my early therapy experiences focused on tackling surface issues unrelated to trauma, the last nearly three years have been all about my trauma. Even then, I found myself able to detach from emotions a lot of the time.
Just a week before this latest session, I told my therapist about an incident from my teenage years. I was triggered a few days prior when the dog had split her nail and bled on the carpet. It almost instantaneously led to a flashback from when I was stabbed in the abdomen and left the same marks. When it happened, I was lost in all the same emotions. I felt like it was happening all over again. But when I told my therapist about it, I was void of emotion. I didn’t cry. I didn’t feel anything.
I thought I could do the same thing in our next session. Don’t cry. Don’t feel. Just get it all over with. Instead I cried, and I felt more than I ever wanted to feel. I was unprepared for that.
My therapist was concerned. And I knew it wasn’t just her concern. It was the treatment team’s concern. And as much I tried to deny it, it was my concern, too. My symptoms were getting worse. Not only in the last week, but in the last few months. I had been getting increasingly lethargic. No matter how well I sleep, I’m exhausted. Some days, I can barely climb the stairs without feeling like my heart is going to explode. My legs and feet swell, the right side worse than the left. Some days, it feels like I’m dragging 100-pound weights on each leg. Just moving around puts my heart into overdrive. Several times I found myself leaving group because of chest pains.
It was other things, too. Signs of heart failure. I knew it all too well. I watched my father go through it. I didn’t want to watch myself go through it.
I couldn’t avoid it any longer. If you don’t make an appointment with your cardiologist by tomorrow morning, you cannot return to program. An ultimatum with no option for negotiation. A crisis I could no longer avoid.
This session was different. My therapist wasn’t softening reality at all. She wasn’t letting me get away with avoiding the pertinent shit in my life. Not this time.
You know what, yes, you likely do have heart failure. Not going to the doctor isn’t going to change that. She was right. But there’s a difference to me, in suspecting something to be true and then actually having it confirmed. The latter is unchangeable. At least with not knowing for sure, there is just enough room for a small possibility of change, a small chance of it not being true.
Yes, you’re going to be sick for the rest of your life. And I will never understand how that feels, how you feel. It’s frustrating. It makes me angry, for many reasons. I’ll never know what it’s like to feel normal, to not be sick, for just one day. But my mother knows that. She’s not suffering. She’s living longer than I will likely live, more healthy than I have ever been and will ever be. Where is the fairness in that? I lost the genetic lottery big time.
But it can be treated. Yes. Just like my emphysema is treated. Treated, but not cured. Another diagnosis to be added to the list. Another health issue I didn’t need in my 30s. Another illness I don’t deserve.
Is it just about not wanting the diagnosis, or is it more than that? Is it another indirect way to be suicidal? It’s like she knows me. The same reasons why I still smoke with emphysema. It kills me faster, and no one really sees it as a slow suicide; they just see it as being stupid. The longer my heart goes untreated, the sooner I’ll die. Why prolong a life that’s destined to be minimal?
I didn’t tell her that, of course. I told her it was just about the diagnosis. I thought that would put a stop to the difficult conversation, but she just shifted to something even more difficult: the purpose of my life.
You may very well never be able to work again. You may not be able to get through all the schooling you want to. She was direct, in a way she had never been before. We’ve always thrown around the idea that I could eventually start working again, that my heart condition would get better and I could be normal again. But that didn’t seem like a realistic option anymore, at least not in the sense that I wanted to be normal. As far as school goes, I missed the deadline for my doctorate application because I was inpatient when the application was due. So any plans I had for getting my doctorate next year went out the window. And maybe that was meant to be, since I can barely get through the last few courses I have for my masters. Not for lack of knowledge, but for lack of energy.
But maybe you were meant for something different. Maybe you can’t be a therapist, or go into research. But maybe you can help others in a different way. She read the letter I wrote to the hospital. Another example of my never-ending drive to correct wrongs. I told her about the director’s response, how they were going to look into how they can change. See, think about the people you’ve helped just by doing this. You may likely cause this hospital system to change their ways.
I knew she was right, but it still didn’t seem like enough. I needed more. Maybe you can start an organization. I told her I already did. I told her what my dream was for PAFPAC, what I wanted to do when I first started it. But then my health (mental and physical) took a turn and I haven’t had the energy to make it what I wanted it to be. You’re still helping people.
But not as many as I wanted. I admitted to her that my life goal was an impossible one, and that’s where I’ve gone wrong. I wanted to stop mothers from abusing their children; I wanted to prevent people from hurting. And I know, logically, that will never happen.
You can still affect change. You’ve already started. Your actions help people. Your writing helps people. You give a voice to those who can’t speak. You’re going to have really bad days. That’s inevitable. But some days, some days are going to be okay. And it’s those days that you can really be you.
The dreams I had when I first ran away are now gone. My hopes of being a professional, of living a long life, of helping the world, are just not possible. The universe has given me this life of constant struggles. It has taken away too much from me. I’m just not sure if what I am left with is enough for me.
For a long time, I’ve been wanting to address something with the hospital I was admitted to several times in the year before I ran away.
I was admitted to the voluntary psychiatric unit three times, and each time, the hospital provided my mother with information and direct access to me. I felt extremely frustrated about it, but didn’t have the strength or the energy to fight back at that time.
I know it’s too late for me, but I’ve continually thought about how this needs to change, how victims of abuse and domestic violence need extra protection, how they need to feel safe in a place where they should be able to feel safe.
I finally sat down last night and wrote what was on my mind for awhile now. I sent it in an email to the hospital.
I didn’t expect an answer back. I was sitting on the couch an hour ago, and heard my phone ring. It was a number from my old town. My immediate reaction was one of fear; I wanted to deny the call, fearing it was someone from my family. I wasn’t even thinking about the letter I had just sent.
Hesitantly, I answered the phone. It was the director of patient services. He wanted to let me know that he received my letter and was taking it seriously. He is launching an investigation into my particular experience and forwarding the matter to the board. He will be contacting me again, and wanted me to know that I was heard.
I couldn’t believe it. I can only hope something comes from this. Even if nothing happens, I know that I was able to speak, and for a brief moment, I was heard.
To Whom It May Concern,
My name is Crystalie. I was a patient at * many times throughout my life. I am writing today to share my experience with several of my last hospitalizations there, in hopes that changes will be made to protect future patients.
In November 2014, December 2014, and February 2015, I was a patient in your voluntary psychiatric unit at *. The first stay, I was sent by my doctor after I revealed abuse that was going on that contributed to my suicidal thoughts. My doctor thought it best to send me to the hospital to keep me safe — not only from myself, but from my abuser. Despite multiple attempts by my abuser, the doctor refused to give out any of my information about where I was. Somehow, my abuser contacted * and had it confirmed not only that I was admitted to the hospital, but what unit and floor I was on. This allowed my abuser to contact me countless times via phone throughout my stay. My abuser also requested information via the MHAs and was provided updates about my care. I never gave approval for this person to receive any information about me. This person was not listed as an emergency contact. This person had no right to any of my information, yet she was given all of the information she needed to keep me under her watch.
I was discharged a few weeks later, back to the home of my abuser, who believed that I informed people of what she had done. I had indeed informed the treatment team, including my social worker, about the abuse that happened, but because I was an adult, not much could be done. I found myself in an unsafe situation at home, so I checked myself into the hospital just a couple weeks later to keep myself safe from her. I wasn’t suicidal as much as I needed somewhere to hide and be safe. As I waited in the emergency room for a bed to be open, I saw my abuser walking down the ER hall, right towards me. The front desk had confirmed I was there, and told her what room I could be found in. Once again, I had not revealed any of this information to her. She found me, most likely by chance, because * was the hospital most local to me at that time. She was not listed as my emergency contact. I did not okay anyone to visit me or to contact me. At this point, the hospital had it on record from my prior stay that this person was abusive. Yet she was allowed to have access to me once again. I was too afraid to tell the aide to ask my abuser to leave, for fear of what my abuser would then do to me. There was no safe way to go about it. I suffered once again, and received retributive punishment after I was discharged back into my abuser’s home.
There are multiple points where the system failed me. The system allowed a known abuser to contact me, to physically find me in a place that should have protected me, should have been a safe spot for me. My health information is supposed to be private; that information should include my general status as a patient, and should not be disclosed to anyone without my approval. It’s a violation of HIPAA. I realize it’s difficult to monitor who comes in to visit. But there needs to be some procedures in place to keep victims safe. I am not the only one. And while it’s too late to change what happened to me, it’s not too late for other victims of abuse and domestic violence. Victims of abuse rarely confront their abusers in public because of the fear. I know that was why I was unable to tell hospital staff once my abuser was there. What if there was a safe way to go about this?
My abuser was my mother. I think that’s what made it so easy for the hospital to share my information. Most people don’t expect family members to be abusive. But the truth is, they are. Mothers, fathers, grandparents, siblings, aunts, uncles, husbands, wives, partners — no one is immune. I know for me, it was difficult to tell people that I was in hiding from my mother; I had faced a lot of disbelief when I did. I know, in speaking to other victims of similar abuse, that there was a similar hesitance. But that fear and difficulty doesn’t mean we don’t deserve privacy and protection. I need to know that the hospital has changed how it shares information. I need to know that there’s a way victims of violence can protect themselves from their abusers while in medical settings. I couldn’t fight the wrongs that were done to me back then; I wasn’t safe enough to do so. I realize it’s late for me now, but I need to take a stand for others. What can we do to keep this from happening again?
Please contact me. I have provided my phone number and e-mail address.
Thank you for your time.
She jumped off the edge of the boat into the deep blue ocean. She didn’t tell anyone that she didn’t know how to swim. She took her chances. She couldn’t stay on the boat any longer, knowing that the boat was soon going to sink and they would all sink with it. The others refused to acknowledge that the boat sinking. So she left them there to drown. She couldn’t save them. She chose to go her own way, risking life or death as opposed to just the latter.
As she dove in, she found herself falling deeper and deeper into the sea. Overwhelmed, floating into a complete unknown. She opened her eyes and looked around her. She saw hundreds of fish swimming about. All the beautiful colors surrounding her. Majestic sea creatures, existing in harmony. The pink and white coral on the sea floor. The glistening sand beneath her feet. It was peaceful. It was safe. So many things she had never seen before, so many new things to explore. She walked across the sand, a stable ground, experiencing happiness for the first time in her life, experiencing freedom.
But she got so lost in the wonder that she didn’t realize she was drowning. She didn’t realize there were sharks circling her. She tried to get away, but she fell deeper into the sea, into a black abyss. There were no more beautiful colors. No more glistening sand. No support beneath her feet. Just darkness, and a shark swimming above her, waiting to attack.
She tried to swim back up out of the darkness. She tried to get away. But she had never swam before. She didn’t know what she was doing. She tried so hard to escape the shark, but it was relentless. It could smell her fear. It could see her, but she could no longer see it.
She moved her legs as hard as she could. She tried to push her feet but there was nothing to support her. She waved her hands about, hoping someone would see and save her. But no one was there. She was swimming alone, with no idea of what to do next. Powerless against the shark. Powerless within the water.
But she kept fighting. She knew she had to. She kicked and screamed her way out of the dark abyss. The shark was still following her, but she could see better now. She felt the sand beneath her feet again. She saw the colors of the new world, a world that was hidden from her for so long. She was finally learning to swim. All by herself.
Somehow, she managed to make it to the surface. She could see the sun breaking through. A beautiful sight. A new hope. Shadows of promise. She tried so hard to reach it, but she was tired. Tired of running from the shark. Tired of trying to swim when she was never taught how to. This new world had been too much for her.
She continued to look at the sun as it was breaking through the water’s surface. But she was sinking. She lost all her power. She lost her way. She sunk back into the darkness of the ocean, wondering if the shark will ever give up its hunt, wondering if she’d ever get to see the sun again.
[This piece is a writing activity I completed in therapy — the prompt was to create a story inspired by the image].
I can’t talk about anything.
I can’t write about anything.
Everything is trapped. My words, my thoughts, my emotions. In the prison cell that she created. And I don’t know how to get any of it out. It’s suffocating me.
I’m still afraid. Afraid of her. Afraid of the truth that I will never be free.
She speaks inside my head. She reads my words. She is everywhere, even when she’s not.
I went to a session today on self-compassion.
It was actually my idea. It was supposed to be an orientation group for new people, but no one was going and the other groups were getting full. So the lead therapist asked what group topic people wanted to cover instead, and for some reason, I blurted out self-compassion.
I say “for some reason” because I’ve been avoiding self-compassion groups when they’ve been offered. I hate self-compassion. I understand it on an intellectual level, but in practice it feels like one of the hardest things in the world, something I’d rather not (and don’t) bother with.
I don’t know why I said it. Perhaps it was the pain medication kicking in. Perhaps it’s because I wanted to learn how to be compassionate towards myself as I’m learning once again how to navigate the world on crutches. Or maybe another part of me knew it was needed. Regardless of the reason, I said it, and everyone was in agreement.
It was a good group. We each picked out a random card from some kind of motivational collection and shared it with the group. I happened to pick the card with the quote:
“Those who bring sunshine into the lives of others cannot keep it from themselves.”
She follows me.
A monster with eyes all around.
She sees everything.
She is everywhere.
I try to hide, but she finds me.
She follows me.
No choice to make. No chance to flee.
I beg her please, just don’t hurt me.
But she doesn’t listen.She breaks me.
She follows me.
Attaching to me
Like a leech attaching to skin.
Feeding off my blood
Sucking out the last bit of my soul.
She follows me.
Into my body now.
She is a part of me.
Tearing me up from the inside.
Never stopping, never letting go.
She follows me.
I cannot stop her.
I cannot stop the pain.
I let it be.
Hoping one day she will let me free.
She follows me.
Too weak to fight.
I try to run.
Run for my life.
Now I am free.
But she still follows me.
She infiltrates my dreams
and turns them into nightmares.
She lives on every day
Inside of me, my body and my mind.
She follows me.
Inside my head
Her voice yelling at me
Telling me everything wrong
Telling me to pay for my sins.
She follows me.
She reads my words,
watches my life.
She won’t leave me alone.
She won’t let me be free.
She follows me.
Like a storm cloud
raining on my life.
I can’t see the light.
She blocks it from me.
She follows me.
I will never be safe.
No matter where I am.
She is there.
Breaking me, killing me.
She follows me.
And I cannot escape.