Whatever Works 5,170 words
Chapter One
© 2003 by Lisa Dietz
The premise of “Whatever Works” is that trauma recovery is a journey which mirrors the original experience and there exists tools along this path that make it possible to lead a happy and peaceful life. I set out to prove this premise by telling about my process of recovery from trauma, exemplified by my outer experiences and inner struggles.
Lora is a teenager who irons her pajamas. She has long, naturally blond hair, and hands that are squeaky clean pink from over-washing. Her facial features are quaint and petite; a perky nose, tulip-shaped lips, and sad, drooping brown eyes. When Lora becomes anxious, she retreats to the bathroom or finds an unoccupied corner of the psych ward and bangs her forehead against a wall until she reopens her festering wound, slightly upraised and surrounded by angry purple and yellow bruises.
I share a room with her at the Psychiatric treatmentcenter. She has OCD (obsessive Compulsive Disorder) and she is a head-banger. This seems like a odd combination to me. At night, she waits until most everyone goes to sleep then slips into the common room, armed with Windex and Ajax. During the day, when the mess is being made, she is jumpy and unfocused. When she manifests her agony by banging her head, it seems like this should injure her obsessive sensibilities, but perhaps she is not bothered by messes in general, only those she can see.
The other patients in this crisis unit wear their self-destructive scars and lesions more subtly, as if their scars were underclothes designed to correct, shape, and smooth, all the while constricting breath and movement, a willing sacrifice for those who cannot resolve their self-loathing. I have always kept the dashes and dots that cover my arms under wraps, wearing long-sleeve shirts even in the summer. But here, my shame transforms to horror when I see Kelly’s arms, a teenager who is a chronic runaway and escapee from locked wards. From the palm-side of her hands runs a single, deep white laceration, upward past the ticklish side of her elbow. The gash is surrounded on both sides by about ¾” of upraised, thick scar tissue, like the build-up of corrosive toxins around spilled battery acid. When I see it, I avert my head and realized that things could be worse.
Today is my birthday. I turn 39. Ending a decade, beginning a millennium. Not the ideal place for celebrating the holidays. I had hoped for more. Time, my life, is slipping past like a train gradually picking up speed, then whizzing by, leaving behind only a thin trail to tie it all together.
In a bit of irony, my life story appears neatly summarized by my birthday cake. This morning, when the small common room kitchen was open, I noticed that there was a cake box with my name on it. I opened it and it was indeed a birthday cake with two slices missing. Apparently all birthday cakes arrive in this condition. Perhaps there are some staff members who do not wish to mingle with the residents to enjoy the confection. Perhaps it is a reminder of our lack of wholeness. To me, it is a sure sign that we, as residents, are seen as less-than-equal human beings who don’t require the simple consideration given to people outside these walls. I cannot think of any other circumstance in which the celebration of an individual could be so carelessly mutilated.
I close the cover and inform the nurse who has assumed the role of Kitchen Guard for today that I do not want their disfigured dessert.
“You are overreacting,” she tells me.
“It’s an insult.”
“No one else sees it that way. Most residents feel lucky to have any cake at all.”
“I find that sad,” I say, but the truth is that inside, I’m afraid she is right.
“Don’t be a smart-ass. The rules are set for your own good and sometimes you just can’t understand our reasoning,” she lies, thinking her invocation of mythical rules will shut me up. “Learn to accept.”
“You know,” I tell her, “I’m here because of mental illness, not mental retardation.”
“A combatitive attitude can cause you to lose all your privileges.” She turns away from me to discourage further conversation.
That is when it becomes clear to me that in order to be discharged from this place, I am being expected to show conclusively that I am transformed into a “normal” person without the aid of comfort, acknowledgement, respect, or compassion -- those emotions which I so utterly lack, it has resulted in this incarceration. I decide that I will need to mull this over since I don’t want to be here forever.
Leaving the kitchen in a daze, I spin around instantly as someone slaps my back, an automatic response I am unable to control. My hands have formed fists, ready to defend.
“Sorry,” says Anita, stepping back. She is my walking buddy. We usually walk around the long circular hallway within the octagon-shaped structure. Three times around equals a mile.
“Don’t ever slap me from behind, like that.”
“Okay,” she says.
Anita is the only patient I know who dresses like the staff. She wears makeup and skirts and fixes her hair every day, while everyone else wears sweat suits or jeans.
“Do you want to go walking?” she asks.
“Yeah,” I tell her, “but I want to get something to drink from my locker first.”
I find one of the nursing assistants at the main desk. It’s the skinny lady who always acts so proper, her mouth sucking at her face whose skin seems too tight, like she’s battling to keep her features forward lest she relax and they all travel sideways, splitting apart.
“Will you take me to my locker?” I ask. “I want to get some pop before our walk.”
She glances up at the clock, then sharply informs me, “We only open lockers at 10 minutes to the hour. You should know that.”
“That’s in five minutes,” I protest.
“Rules,” she instructs me, “are made for a reason.”
I scowl at the woman and look for a different nurse, who immediately takes me down to my storage bin. Beverages have to be locked up because patients aren’t allowed to have any kind of food in their rooms. It’s another inconsistency that baffles me because there is a pop machine in the common room. I’d rather stock up on 6-packs during our weekly evening trip to K-Mart and Cub (only for those with the highest privileges), rather than pay a dollar a piece. It seems like a conspiracy to me, another way for the hospital to make money.
Across from the locker area I notice the new patient. He sits on the floor, clad in boxer shorts and a stained white T-shirt, huddled into himself, rocking back and forth, mumbling. The nurse ignores him because, like many of the staff, she has become indifferent to people acting out their distress.
Searching for the source of his dismay, I observe a woman approaching from the hallway. Clearly an outsider, indicated by her coat, purse and umbrella, she approaches with raised voice, “Billy you stop that right now! You get up and face me right this minute like a man should. I was expecting more from you by now.”
The nurse who was my escort intercepts. “I’m sorry, Ma’am, but you’re not allowed in this section of the unit. We have visiting rooms –.”
“Yes, yes, I’ve heard, but I don’t see why. I want to see my Billy right now. Take me to his room this minute. I want to see how you are treating him! Clearly, you haven’t broken him of that god-awful habit of cringing in the corner like a coward.”
The nurse physically blocks her path and as I observe more closely, I can see that, take away the coat, purse and umbrella, this large woman with curlers plied at odd angles in her hair, too-much makeup scattered across her features, knee-high nylon stockings mostly unrolled on overly-burdened varicose veins might just look more out-of-place in the world from which she just came. But who can say for sure?
The stranger’s voice becomes shrill and her words indignant. “Just what are you saying?” she begins and I tune her out.
I don’t want to hear so I push past the scene, afraid of being in the middle when security arrives.
Anita is waiting for me when I get back. She leans toward me and whispers, “Now I understand how he got that way,” and I nod my agreement.
Today Anita is wearing a black knit knee-length skirt that curves smoothly around her slim hips, accompanied by silky black nylons and shiny dark pumps. Her delicate cashmere sweater is made from raw, homespun yarn that pulls loose from the weave in some places, forming an artistic design across her smallish chest. Her hair is pulled up in a bun and she has applied makeup with expert precision.
“You ready?” she asks.
Therapy groups have not begun for the day, so there are many people in the corridors. The circular hallway is about eight feet wide, surrounded by glass windows in the center with occasional heavy doors that lead out to the center garden, packed with wooden benches, grassy knolls and strange, brightly painted metal poles adorned with metal flags. Someone told me they are artistic sculptures that the center paid a lot of money to acquire. No one seems to notice, though. It’s chilly outside so the only ones out there are smokers, of which there are many, huddling together, sharing matches or cigarettes to light others. We’ve come to equate autonomy with the odor of lingering smoke filtered by cool wispy air from the inner doors opening and closing, breaking up the everyday hallway scent of stagnant body odor.
As we make our way around the first loop, Anita tells me about how upset she is with her doctor.
“That man must be out of his mind!” She gestures with hands open in an exacerbated shrug. “I’ve told him a thousand times that my insurance coverage does not extend this long. My boyfriend has moved into the apartment now so he can head off calls from work and tell them I’m still sick. I think I can fool the loggerheads from the office for a while.” She winks at me confidentially.
Anita is also the only patient I know of who speaks of her life on the outside as if it were real. I like her though because she is so reasonable. It’s what my psychiatrist calls logic mind. She says that there is “Logic Mind” and “Emotion Mind” and that most people spend their time in one or the other. She accuses me of using logic mind to escape emotion mind. But the goal is to be in “Wise Mind,” that place where the logic and emotion equally overlap and intersect. Until I learn to do that, however, I’m much more comfortable around the logical thinkers, like Anita.
“I’ve a busy schedule today,” she continues. “I have two meetings in the CD unit, then I’ll catch up on the latest DBT lectures. They allow me to read the meeting notes when I’m not able to be there, you know.”
Anita believes her presence here is just a big mistake. At least I can admit (be it ever so emotionlessly) that I am here for a reason and some small part of me even believes that I should be here. But it’s hard to say with her. She seems normal and looks professional. Nevertheless, I once overheard her therapist talking to the doctor about getting approval for her to stay an additional six months. We don’t talk about it.
As we round the turn that is marked by the doors that eventually lead out of the facility, we pass by two security guards, standing on either side of the locked entryway already defended by two surveillance cameras and a password key coder. They look very official anchored in a wide stance, one hand resting on a riot club, the other carrying a walkie-talkie device emitting utterances from other guards stationed at other posts, all checking in with each other, sounding very important. I have never seen one of them make actual eye contact with a resident, consumed as they are with the tenuous business of guarding. They must remain alert, composed, ready for action. After a while I do not notice them any more than they notice me. They become wall fixtures, like a display of metal-plated Elizabethan armor at attention before the Queen’s palace.
I am struck by the diametrical change in mood just a short distance further where artwork is displayed on the wall, commissioned by skilled local artisans in a state-funded program to introduce a bit of culture to government facilities. The paintings are done in black and white with abstract designs like soft-edged inkblots, bearing testimony to the artist’s state of mind or to the artist’s impression of the viewer’s state of mind.
It occurs to me that I am confined in a microcosm of the outside world, marked by the paradoxes of everyday existence, like the ultimate double-message: “To fit-in, you must fade into the isolationism of the independent American and speak the polite repartee of casual society. If your genetics and/or life experience bring about so much trauma as to cause you to act outside the boundaries of ‘normal polite indifference’ you must be modified.”
It is the acceptably indifferent people who guide me with drugs and therapy toward normalcy. It’s not that I think that strange, violent or self-harming behavior should be acceptable. Nor do I think everyone is indifferent to me or themselves or anyone else. But what strikes me as the most acceptable quality which defines “normal” -- is indifference (if the treatment center staff are any indication). I can testify that it is not easy to recover from trauma or genetic discrepancies in such an indifferent environment.
Deep down, I want to be done with it – get healthy or die, just end the chaos. I am weary of the struggle. And I don’t think I’m alone, either. All of us here would give a lot for a little peace and clarity, freedom from the inner voices and tumultuous conflict. Because of the fate of our genetics or the homes we were born into, a stream of insidious self-hatred runs at the edge of our consciousness, like an ice-cold mountain tributary fed by insurmountable ancient glaciers.
A kind-of panic is settling on me, a fear that there is no hope for recovery. I’ve been through years of therapy and some dozen hospital visits. Now it seems that I’m at the end of line, committed to an institution. What if this is the best that it gets? There must be some other way, I think to myself. I can’t go on like this forever!
As we round the circle for the third pass, we reach the dining room and encounter a line of people. It must be lunch time. There is a gang of about five guys, always the same five, young men in leather and jeans and reeking from cigarette smoke, who push their way ahead. It’s not so hard to do because the first guy in line is from the chronic rehabilitation unit, a middle-aged fellow with stringy, balding hair and ripe, urine-stained polyester pants. His eyes are focused on his fingers that he appears to be working into a cat’s cradle. One of the young men pushes him and he is thrown off-balance, spun around, looking about with unfocused eyes. He lurches forward almost stumbling into my arms. His assailant laughs and calls out, “Loser!”
What hope do I have, I wonder, of finding anything worth holding onto in this environment? With an exacerbated sigh, I am forced to consider that I will have to blaze my own trail of recovery, sifting through rules created for the worst-case-scenarios, patronizing therapeutic staff who feel superior, a system created by indifferent legislature in an environment designed to suppress rather than explore. Somewhere, in the midst of so much unintentional aberration, I need to find something, anything that works for me so that I can “recover,” or at least live in enough peace to warrant acceptability.
One of my therapists once told me, “There is no magic bullet. No one can fix you. It’s not fair, but it will always be your struggle.” I’ve resisted that notion for a long time. But now I’m in the very bowels of what others can do for me, and it doesn’t look promising.
A shift occurs in the way I’ve been thinking. I’m grasping now, desperate to grab onto anything that will pull me out of the muck. It doesn’t have to be official, it just has to work. I can’t depend on others to help me. I have to find out for myself and follow whatever works.
After we return to our unit and take our turn at lunch, we join others mulling around in the unit before therapy groups begin. We are required to gather together for five minutes of mindful meditation.
From down one hallway, a black woman with a short, but wild afro (cut at different lengths around her head as if a child had been let loose with a scissors) advances upon the desk. Her stride is fast and heavy, body bent forward. She has a large, sturdy frame and her face is screwed up into a tight squint, except her unfocused eyeballs, moving independent of all other intention. She reminds me of a quarterback trying to find a receiver downfield.
Her determined stride causes the two staff nurses behind the desk to grasp the counter like they’re afraid of being tackled.
“Marnie!” yells the head nurse, an equally large white woman wearing a two-piece pale blue pantsuit to which a pin is attached that perfectly matches the flowers on the suit’s collar. “Stop right now, Marnie!” to which the black woman slows down and looks around as if waking from a lucid dream.
“Are you hearing voices?” asks the nurse.
I can see that Marnie is insulted by the question. “Yeah, so what?” she replies.
“The voices aren’t real, Marnie,” the nurse shifts her tone now that the play has been called off as if a flag had been thrown.
“I know.” Marnie recoils. “Hush!” she whispers but I’m not sure who she is addressing.
I wonder for a moment if any of this is really helping Marnie. No answer comes, so I follow her into the common room.
All the comfortable chairs are taken by other patients so I sit on the exercise bike near the doorway. Of the twenty or so people gathered around, about half are working on crocheting projects. I don’t know who got this started, but it was in full-swing when I arrived. Crocheting is the activity of choice (unless you own a Gameboy) to pass the long, boring hours. My first roommate taught me how to do it. She said it would be best if I started out with a simple stitch and work my way up to more complicated projects. She was very patient in leading my sometimes trembling hands through the motions, loop into loop, then wrap around and pull back. I am making a blanket for my son, which I never thought I could do. But little by little, it’s growing into something. Whenever I fumble, there’s always someone around to show me what I did wrong, although I’m a bit intimidated by the man who wins my vote as the supreme crochet master. He does all these intricate stitches creating, not just quilts, but pieces of art, webbed and tufted into elegant displays. We are all in awe of him, but he brushes off our praise, telling us that anyone can do what he does, given enough time to practice. Sometimes, in horror, we watch as he pulls loose a beautiful design, explaining, “It’s just not the right kind of yarn for that stitch,” or “I want to count it out differently so I can add in another pattern.”
Usually I would seek out my own project, stored in a paper sack with my name on it and then check out a pair of blunt mini-children’s scissors from the desk. But I’m not in the mood right now, preoccupied with my obstinate search for something useful.
Amidst the chatter, someone across the room coughs and Mollie goes ballistic. Mollie is 16 and has Turrets Syndrome and is somewhat autistic. But we have come to distrust her motivation in having “an episode.”
“Stop, stop!” she shrieks, banging her fist on the table in front of her and making high-pitch squeals.
She has us all of under her control. People will often leave the room to cough because it upsets her so much. If I feel a tickle in my throat coming on, I try to suppress it if she’s in the room. She accuses any throat-clearer of doing so just to irritate her. And if there’s no staff around and she’s horribly persistent, we will all cough, our only form of revenge for her annoyance. But since there is a nurse in the room, we grit our teeth at her outburst.
The nurses keep count, like an umpire watching a batter step up to the plate. Shriek one. Shriek two (interspersed with accusations that the cougher is terrorizing her). Shriek three and the nurse crosses the room, admonishing her. “Mollie stop it or you’ll go to your room.”
“I can’t help it,” she wails and shrieks uncontrollably.
The nurse grabs her roughly by the wrist and yanks her out of her seat, ready to drag her away. Mollie stops. She’s quiet now. No more shrieking. Still she scans the room, eyes squinted, a look of dare on her face. Not a peep from the audience.
At that moment, the meditation therapist walks in, stops, and looks around. “You’re all so quiet!” he says.
Someone points to the nurse who relinquishes her grip, and Mollie, smugly returns to her seat.
“I see,” he says, understanding instantly. Taking advantage of Mollie’s effective method of calling everyone to attention, he begins the exercise.
“Close your eyes, or focus on a spot. Sit up straight but relaxed, and let your thoughts float by,” he continues with the same instructions that he tells us every day, three times a day.
I don’t know if anyone else actually tries to do this meditation thing, but it seems like a good idea to me, so I always try it. It’s only five minutes, but the whole time I struggle to disengage from my thinking and be quiet inside. Afterwards he always tells us that it’s hard at first, but the more you practice, the easier it gets. For now, I’m taking his word for it recognizing the exercise to be one of those things that could be useful if it ever worked.
I see myself as a pebble, twisting, turning, sinking to the bottom of a sandy river. Thoughts, like the rush of the moving water, pass over me, dislodge my position, then plunk me down again until at last, I become lodged in to the sand near a river rock. The battling waters don’t end, but I’m falling deeper into the sand, becoming one with the earth. It is a confused sort of darkening, clinging: escaping, beaten, then sticking.
When the therapist ends the meditation, the river dissipates. The rush of breath and onslaught of a distressed mind is my signal to head to our large group lecture. Even those without privileges are required to attend so we are all carefully escorted out of the unit and into a large room with rows of tables and chairs. On the way we pass the inner doors of the hallway and the smokers gaze out longingly, assessing the mood of the staff to see if there is a compassionate member in the group who might allow them a few drags. Apparently they are disappointed since no one tries to whine their plea.
There is a guest speaker today. He is a thinly bearded man (east Indian-looking) with hair tied back in a ponytail – perhaps in his late forties. He wears an orange shirt with a low collar that wraps around his chest, buttoning at the shoulder. I’ve seen Buddhist or Tibetan monks wearing shirts like that. The psychiatrists who usually gives the lecture, introduces him, providing a foreign name and title. Before he speaks, he waits for the patients to settle down since many have brought their crocheting and situate themselves to begin where they left off before they’re ready to listen. A staff member sits in front of the door we came in, while others are interspersed among us, taking seats between those likely to start talking amongst themselves or sitting next to patients who recently broke some rule.
When he has our attention, the man smiles and begins by saying, “I see that some of you are crocheting.” He scans the room, although his face carries no judgment. I am relieved that I chose not to bring my project today. Those who are applying their hooks, stop and look up guiltily, a few squinting at him with a challenge in their eye. “Do not stop!” he laughs. “I don’t mind. In fact, I’m going to tell you a crocheting story.”
A nearly audible sigh passes through the group and the staff members who looked like they were about to pluck the projects away from people, relax.
In a mesmerizing, sort of sing-song accent, the speaker continues. “I was giving a lecture for a meditation retreat some time ago,” he says. “It was a fairly large group and as I spoke, I noticed an elderly woman sitting in the front row off to my side. Every time I spoke about how practicing meditation can free the mind from the many details and perceived hardships of life, allowing one to focus on the moment, on what really matters, she would nod her head enthusiastically. Because of her enthusiasm and since the elderly were not usually those who responded so positively to my words, she caught my attention. I spoke about the benefits of living in the moment, about how those practicing meditation find it easier to deal with problems and she would nod her head. When I said that after a while, it becomes easier to let go of frustration and forgive others, she was nearly bubbling over with agreement.”
His story piqued my curiosity. “So at the end of the lecture,” he went on, “I looked for her and told her that I couldn’t help noticing her enthusiasm about what I was saying. So I asked her, ‘Do you meditate?’ And she said, ‘No. I crochet.’”
There was giggle from some people in the room. “She told me that in all her years of crocheting, she’d had the same experience as I did. Over time, her mind cleared, problems did not seem so overwhelming and she had forgiven many old grudges, making her relationships more peaceful.
“As she spoke I understood completely because it has ever been true that while the body is engaged in an act of the moment, even when the activity requires virtually no thought, the mind is more willing to be alert to the possibilities of the moment.”
A look of smugness passed among those in the room who were busy clicking their hooks, some checking to make sure the hospital staff got the message.
“Mindfulness has many ways,” he said, “and however you achieve it is unimportant. When you can become aware of the moment, the past and the future cannot keep you prisoner. If you are focused on now, you will realize that you are okay, that you actually need very little, and that you have the ability to put all things in perspective, and that means happiness.”
He winked at the man who was the crochet master and said, “Keep it up for you have unwittingly launched yourself on the path to self-healing.”
After his speech, our group was quieter than usual. We are used to being told how much we have to change. To have someone acknowledge our efforts is unusual. I think we aren’t quite sure how to react. For myself, I happily let go of the guilt I feel when I crochet while participating in groups, attacking my blanket project with more gusto. Later that day when my fingers wove and twisted yarn, I paid attention. It did seem like it took more effort to fall back into the darkness of my past. The traumas I had experienced seemed somehow farther away. I am willing to cling to any tangible possibility that keeps my memories at bay. I just wish that was all there was to it.
Like a knight in search of the holy grail, I am forever looking for a magic bullet. But I am learning that I need an arsenal silver bullets, wooden stakes, crosses, holy water and garlic to combat the demons within.
That night, I fell into a deep, deep sleep. My mind filled with images of the end of the world – buildings on fire, sirens screeching loudly, the odor of death clinging to the earth, a world damaged beyond hope. Suddenly I heard a screech that got louder and louder and more persistent. Something was touching me, ripping at my blankets, begging me into that other reality. Feeling confused and violated, I belted out a scream to match the screech in my dream, starting like a hollow siren and quickening into a full shout.
People were all around me, shouting my name, trying to pin my arms down because I had somehow risen and my hands were reaching out to throttle a woman standing against the wall. Voices, hospital voices and strong arms pulled me away from her.
In semi-consciousness I realized it was my roommate and that the night staff and a security guard were holding me back as she stood trembling, the sore on her head threatening to bleed. “You were snoring,” she was saying. “I just wanted you to turn over. That’s what I would do to my grandma when she snored, push her over on her side.”
Some part of me heard her, incredulous that she’d get out of her own bed to push me around in my sleep. “You can’t do that,” I yelled. “I could have killed you. How can you think to touch me in my sleep after all I’ve been through?”
I tried to come fully awake, but a trigger had been pulled and I was falling, falling, consumed by the fires of a flashback, taking over any other reality.