Against the backdrop of doing a job that addressed poverty with the most cynical bureaucratic hypocrisy, Dr. Kohl and I continued to wrestle over the burns. He’d given me time to argue and burn, so I kept right on at it.
“Burning is real,” I said. “Smoke, fire, odor: Pain is real. Not like the rest of the day. Maybe I’m burning myself for Dr. Kohl. So fine, I’ll make it for him,” I told him. “Then I’ll say, ‘This is for you. This is for you, Cree.’”
“Dr. Kohl is inside her. Not knowing what to do about this,” he wrote in a note to himself after this comment. What he said to me was, “Burning is very confusing for you.”
“It’s you. It’s not confusing. I’m trying to get it out.”
“Proving to yourself that you’ll get burned for trusting.”
“Yes, going back to betrayal thing. People trick me into trusting. Once I do there will be a trick.” This was the 11s talking.
“Will be?” he asked.
“You can’t tell.”
“Physical, sexual abuse?” he asked, speculating.
“No, this trick was an illusion. It will be gone and I’ve learned to rely on it,” I said, missing the strength of my own magic.
“Is it worth killing yourself to preserve that?” he asked.
“Yes,” I said. The whole exchange was enigmatic, with references to the trickery behind the 11s nestled against every word.
In his finishing notes for the day Dr. Kohl wrote, “Danger of therapy, caring, bonding: furious with Dr. Kohl for knowing what she wants and needs (to be held and comforted, parented) and not doing it.”
∗ ∗ ∗
Our argument over what I was doing and why crawled into the first week of August.
“Stop burning yourself,” he said simply after I told him I’d finished off five in a row the night before.
“Does it matter?” I asked.
When I told him that I almost cried because I got shampoo in my eye the same night I burned myself five times, he wrote to himself, “Suffered child abuse, maybe there was torture.” But this was all wrong and I think he knew that.
The next day, Tuesday, August 6, I arrived for my regular 8:00 A.M. appointment.
“I don’t like the deadline,” I told him. “I think I can stop doing it. The deadline feels like a dare—it’s making the desire worse, more urgent.”
I had burned myself three times the night before. As a kid, “I craved rules so I could break them. I can see that now.” But I can also see, I said, “I am in fact losing, not winning” this game.
I watched him figuring out how to respond. He was uncharacteristically quiet. Changing the subject, filling the air with words, I told him I actually went out with my friend Jess the night before. I then told him, “I didn’t take the Trazodone last night. But I slept. I didn’t take the Prozac this morning either.”
“Why not?” I was surprised at how irritated he sounded. I smiled.
“Eyes batting. Little Miss Innocent,” he wrote. Whatever was going on in his mind felt risky. I usually knew where I stood; not that day.
“I need to convince you not to put me in the hospital.”
“I accept the candor but not the lie,” he cryptically replied.
“What lie?”
“Something else,” he said.
I genuinely didn’t know what he was talking about, but whatever it was he meant it. As it turned out, from my caution in not taking my medication he deduced that I had had a drink or two with Jess. He was right and, as he said at the beginning of treatment, he wouldn’t see me if I was abusing alcohol or drugs. I didn’t consider a drink or two abuse.
He’s convinced I’m in danger of becoming an alcoholic like my mother. I don’t have a problem with drinking—it’s a form of social play I’ve rarely indulged in since college. I’m aware that getting drunk swallows sadness. I loosely agreed not to drink while in therapy but in my mind it wasn’t a strict prohibition; it was more of a strong recommendation against excess. I’m pretty conservative—two drinks are hardly a bender.
“You are furious with me,” he said. I couldn’t believe he was accusing me of lying. I didn’t think having a drink or two was a big deal and if I had I certainly wouldn’t have omitted the information only to be accused of lying.
“Yes, I’m pissed off … there’s no way out … I won’t leave.”
In his notes for the day he wrote, “This is a tantrum. If she can’t tell the truth therapy isn’t good for her? Clarification of line. Limit is Thursday. NO Alcohol.”
The next day, sitting in the blazing light of day in the graveyard a block from my desk and coworkers, I burned a deep hole on the bottom of my foot. Because the foot is difficult to burn effectively, the extra-thick skin richly crosshatched with layers of nerves, it took a full three cigarettes to get to the painless point. My Converse on, laced up, with only a trace of sensation at the spot as a reminder of my work, I walked back to my desk. No need for a Band-Aid at this stage—the center of the burn was tough and dry as cured cowhide.
I called the receptionist after that to ask for an extra session. Leaving work an hour early, I told Dr. Kohl about the burn.
“I feel like I want to hurt myself”—and I didn’t mean with cigarettes. As he had done since I began treatment, he tried to help me peel away the layers of how pointless and hateful I felt. By the end of the session I was no better.
“I’m afraid I might kill myself. I feel nasty. Burning myself isn’t good enough.”
It was then that he told me the jig was up. No more games. I had less than twenty-four hours to stop—the burning needed to end by my appointment on Thursday.
CHAPTER 13
Not Safe Enough
An original Daffy Duck hand-painted cel hangs neatly matted and framed to the right of Dr. Kohl’s office door. I look at it every time I walk out of there. Arms akimbo, head at a jaunty angle, eyes fixed in a low, knowing gaze, the duck expresses an assertive, unrestrained bravado at odds with Dr. Kohl’s placid demeanor. In the stillness of the morning session, backlit by dust particles floating demurely in the washed-out northern sunlight separating our two chairs, I dodged the echo of the duck’s humor and the irony—if that’s what it was. “Of course you realize, this means war.”
I wouldn’t be heading to some hellhole of a hospital, if it weren’t for the foolish deal I made with Dr. Kohl the next day. The contract I signed that day laid me open to dismissal. Therapists can do that. They fire their patients for abusive language; threats; tardiness; being drunk, high, or asleep; or simply not showing up or not paying up. I’ve just discovered you can also be fired for holding too many lit cigarettes to your skin. Or for agreeing not to and then doing it anyway.
That Thursday, August 8, I began the session by telling him I’d dropped my German class at the University of Vermont. To put off what I knew would be the day’s real conversation, I also told him I needed to sell my car to pay for my lit class because my dad, having paid for college, was done. Delay.
Finally, having spent half the session on nothing, I got to the real business at hand. “I did burn myself again yesterday.” I figured Thursday was the deadline—it was Thursday, so I’d had one more fling right up to midnight the night before. But he was immediately stern, as if he was about to throw me out for breaking the rules. I genuinely didn’t understand. He’d said I had until Thursday’s session—of course I wasn’t going to stop a second before I had to. Then the contest escalated. By filling the air of that session with the mundane mechanics of my life, by waiting until late in the hour to mention the burn, I didn’t give us much time for discussion.
“Was I going to say that, tell me?” he asked.
“Yes.”
“When?”
“I just told you,” I said, adding, “I’ve done it the last time. That’s the theory.”
“The theory isn’t safe enough,” he said.
“I was trying to say … I’m unsure about what you’re saying …” I was at a loss. In
trouble. I’d snared myself with my own words.
“It’s what you’re saying that’s scary,” he said.
“I really don’t intend to do it anymore.” I thought from then on, I’d be done.
“Not safe enough.”
“I have said it, I mean it.” Oh God. I remember thinking how out of hand our conversation was getting.
“You don’t have to say anything. You had your infection, you’re on Keflex? Remember?” He was genuinely convinced that the infection was life-threatening; this seemed a bit of a stretch, but given the surface area maybe it was. I’m not a doctor. Keflex was the strongest, widest-spectrum antibiotic out there. My arm had been grossly infected; it was much improved by then.
“I went right away” to have it looked at when it got infected last time, I said, just so I could fill the air, however irrelevant my words. He didn’t take the bait of my diversion.
“You’re living on borrowed time.”
“I hate this game,” I said, scared I’d pushed it too far, blown it for good. He looked at me with that penetrating, caring, but authoritative gaze. Cut the shit was how I read it.
And then he said, “Okay,” and he told me I had to agree to a contract. Then it was negotiation time—again.
As if we were at the altar, he said, “Repeat after me: ‘I won’t do it again, ever.’”
“I won’t do it again, ever.” As I spoke he wrote the words verbatim in my file.
“Are you a person of your word?”
“Well, I can’t guarantee I won’t do it again ever, but I will certainly try hard not to do it again. I’ll probably call you.” I was looking for space, instinctively trying to perforate the clarity he wanted. I thought it might work … maybe?
He looked at me as if he couldn’t believe I was still trying to wiggle out of the deal, and rather obviously at that.
“Not good enough,” he said. Time was running out. “No decision by 5 minutes to 5 P.M. is a decision.” That meant out into the world alone or to a hospital.
I saw then that my slippery, equivocal promises weren’t sliding by him. Stepping into line, I tried it again and he wrote my words down.
“I feel certain I can call or get myself somewhere if I feel I am going to burn myself. I’m not going to burn myself.”
Again, he asked, “A person of your word?”
I replied dutifully, “I am a person of my word and I’m telling the truth.”
He then took his eyes from the clipboard and stared me down, holding my gaze. “Are you fully telling the truth?”
“Yes,” I said.
He then handed me the clipboard and his pen, still warm from his hand. I fixed my scrawl of a signature at the bottom, on the line he’d made by my name, and that finished it.
Although I’d promised and sworn and signed his document, he left nothing to chance. He asked me to unwrap the gauze from around my arm so he could see the burned area. In the bit of white space remaining on the left of the paper he drew two crude sketches of arms. He then marked the burn area with black ink, annotating the drawings to document the extent and exact placement of the damage. Indicating the specifics with arrows, he wrote, “Scary deep one, deep 3rd degree,” “pus,” “scarring.”
After finishing the ill-fated evidence he bandaged me up oh so carefully—my favorite thing in the whole fucking world. That was when he ordered me back to Dr. Ahlers for another round of debriding.
In my file he noted, “Burn area has increased. Fresh burn on lateral arm.”
We were moving forward. It was a deal. I thought I could do it. I thought I could stop.
∗ ∗ ∗
Once the written contract kicked into effect stopping was an abstraction: a game more than an imperative. He prodded me to call when the urge came on, when I got close, or even when I felt lost or confused. Sitting by the phone at home, I’d stare at the device as if I was waiting for it to come to life. But I wasn’t waiting for a ring. When I want to call him I’m a girl getting up my courage to ask for a kindness I can’t believe he wants to give me; the thought of speaking to him on the phone makes my gums hurt and lards my stomach with unworldly weight, all the while shooting adrenaline through my cells, and with its arrival come nausea and the desire to spin, pace, walk, run. I know I can pick up the phone and have Dr. Kohl’s voice there, all mine, for as long as I can talk to him. But most of the time I can’t get close to calling because the process of thinking it through and deciding to do it is so excruciating it’s better not to begin.
How many nights have I stared at the phone, lighting the next cigarette, holding the fresh one between my lips while the embers of the old one burn down between my fingers. When I press the two together, they mate perfectly—fire to fire. The shiny black clumsy lump of technology waiting by my side: pick up the receiver, bring the dial tone to life, punch the keypad in the pattern I know all too well; listen as each of the seven shrill beeps registers the sound of a self-fashioned purgatory.
On the third ring it’s all up—are they just sitting down to dinner? In the middle of a movie? Watching their favorite TV show? In bed? Sleeping? Reading? Having sex? I always want to hang up. Why did I call? I imagine his wife’s annoyance even though her voice barely betrays it when she says, “Hello.” If her cool neutrality can be mistaken for a chill, I felt it. She’s a pro.
But she never fails to hand him the receiver and then I’m his.
“It’s nice you called,” he purrs, as I swoon with guilty pleasure because the illusion of comfort is on me again, a cloying syrup I can’t take in fast enough, and all I can do is hold him on the line without keeping him too long, because if he winds it down first I’ll succumb to humiliation and remorse until I see him again and talk it away. So I speak, keeping the conversation brief while clinging to enough of what he says and what he makes me feel to get through the night intact—long enough not to expand the design, long enough not to stay up all night smoking, reading, writing. Long enough to find sleep.
Our contract was in effect, inked onto paper in my file in his office file cabinet: no more burning or I was out. I felt like a junkie with tracks all the way up my inner arm and a habit that wouldn’t give. Dr. Kohl made it as clear as possible that if I slipped I’d have to go somewhere else. He claimed he couldn’t be liable for more damage—he couldn’t, in good conscience, let it go on, the wounds and the ordained scar traces expanding up the right arm to meet the torso, creeping from the feet up the calf to the thigh, only to meet in one massive raised cicatrix at the belly button, the disfigurement a dividing line between left and right body; one pristine, the other ravaged. Where he sees scarring I see strength and beauty. I deny myself a smooth, pure whole.
I remain bewitched by the ritual. I lack the signs of a penitent ready for reparation. I wake nearly every night to crusty sheets, the fabric of my pajamas glued to the oozing bandages. The raised florid pink halo around the newer burns itches. I scratch and rub as the healing process evolves but the epithelial cells migrate in from the circumference of the wound to the center, where the nodules rise up, raw and wart-like, eager to break and bleed at the lightest touch. The preoccupation with bandaging, washing, wrapping, and, if I only could, laying fresh tracks had taken up a roomy corner in my brain.
A flash of remorse when the mind clears is pure hypocrisy. Regret, if I have any, shows itself only briefly in the moment after the pressure to act is released. Then the cycle repeats. Burning myself is better than anything I can think of, except the feeling of sitting in that chair facing him. I’m so not sorry. But I had to try.
CHAPTER 14
Quackery
From August 8 until September 4 I didn’t burn myself once. I was taking the Trazodone and Prozac. Going to work. Hanging on, I tried to forget the exquisite pain of a fresh burn.
I was distracted that month by going public—Dr. Kohl insisted I tell my family and friends what I’d been up to. Putting my dirty secret out there would make it worse if I backslid. Letting my family
and friends know was supposed to make me connected. All telling did was defile the preciousness of the secret and the magical thinking that made the burns feel special—that made me special. I felt used and pathetic. Vulnerable.
I did agree to call my father from Dr. Kohl’s office. I recited the number and he handed me the receiver.
“I generally lie to people,” I said. “I don’t want to lie to you, it’s distancing … I’ve been burning my arm with cigarettes.”
The idea of saying this to him was agony. Fortunately, I was hardly present when I spoke, my words forming automatically, devoid of emotion. My anxiety at what was happening had long since spun me into a nether zone. I handed Dr. Kohl the receiver after I spoke and he told my father I’d agreed to go to a psychiatric hospital if I continued burning myself. He also suggested my father might feel better if he met Dr. Kohl and saw me.
My mother didn’t require any information. She had accepted the lie about “poison ivy” I’d offered in Connecticut during Dr. Kohl’s July vacation. I have her at a distance as much as she’s had herself at one with the help of pint glasses of Stolichnaya over lunches of Cobb salad. I didn’t owe her the truth.
When I told my sister over the phone from my apartment she was horrified. We’d been thinking of doing a backpacking trip together in Idaho. Her response was, “You’re not doing that here.” Dr. Kohl thinks it’s pretty healthy as responses go. The trip was canceled; I wasn’t leaving Dr. Kohl.
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