My blood was taken twice daily. I had an EEG. I had an MRI, gaining the distinction of being the first adult in the lab's history to somehow wiggle my way back out of the claustrophobic tunnel after the test had begun. Now I was pricked and probed, injected, and scanned on a daily basis. After a week in intensive care, Dr. Padgett gave up on the Tegretol, switched my antidepressant, and transferred me to the stress unit.
It was a series of human experiments, described in dressed-up clinical terms as “medication adjustments.” I adjusted to the new antidepressant and different anti-anxiety pills by throwing up, passing out, shaking uncontrollably, and hallucinating my way through a host of medications to find the right combination. It reached the point where I manifested nearly every possible side effect of every medication I tried.
Finally I demanded to be taken off all of them. Dr. Padgett wasn't sure if I was really physiologically averse to the drugs or if some of the reactions were a self-fulfilling prophecy. I was growing impatient with both him and his infuriatingly calm insistence that this was the trial-and-error nature of determining the correct psychiatric pharmaceuticals for an individual's chemistry. Easy enough for him to say, I thought.
The demographics of the general psych ward patients this time were considerably older and disproportionately female in comparison to my first stay. Most were veterans of previous stays, as well as psychiatric drug “adjustment” scenarios.
Because I had gained little benefit from classes and group sessions during my first hospital stay—and indeed had distracted from the benefits others may have gained—I did not go to group therapy or psychodrama sessions.
This stay was far lonelier than the first one. I spent most of it questioning whether embarking on therapy with Dr. Padgett had been a wise decision. Could I ever trust him again? And—as much as I hated to ponder it—I wondered if I were destined to spend the rest of my life in and out of the psych ward, like some of the patients I'd met who were in for the third, fourth, and even tenth time. Was I a lifer? Had I snapped irrevocably—the crazy old aunt in the attic?
Still, as depressing as the hospital ward was, I feared the life that awaited me on the outside even more. It was one I wasn't sure I was equipped to handle now or maybe ever. The news of my release order was, once again, a disappointment, although I was careful not to let Dr. Padgett know.
After my release, I proceeded to act more out of control than ever. I carried around a renewed skepticism and resentment of Dr. Padgett and a heightened fear that I had been rendered irrevocably insane—something I also blamed on the doctor. Therapy sessions followed a consistent pattern. I was either belligerent, defensive, and hostile, attacking everything that Dr. Padgett said. Or I was numb, without emotion. I'd cross my arms and state flatly that therapy was a waste of time and money, and I had nothing to talk about. Dr. Padgett was pressing even harder to get to the early childhood issues, and I resisted him with all the fury I could muster. I not only threatened my own life but also threatened to tell both the American Medical Association and the media that he was an incompetent fraud, something I sincerely believed.
“My father was right about you shrinks,” I told him. “You are nothing more than a bunch of greedy quacks, screwing with people's heads and trying to get people hooked on you.”
It was hard to remember that there had ever been soothing moments and harder yet to figure out why, despite all the hatred I felt toward him, I was still paying $120 a session, three days a week, to see him. I couldn't imagine life without him. It was too late to walk away now, I thought. I was already hooked and convinced that the only way out of this downwardly spiraling trap was to die.
Clearly the therapy had lost its stride. We were rehashing the same issues, and I was throwing up explosive roadblocks to the exploration of anything new. I was quickly losing confidence, not only in the process, but also in myself.
Thus Dr. Padgett suggested a more intensive form of therapy: use of the couch. The couch, the therapist in a chair vaguely nodding, the patient on her back, staring at the ceiling. It was the epitome of the psychotherapy stereotype. Vienna-style. At the beginning of the next session, I headed straight for the couch.
“Umm, this is weird,” I said, staring at the ceiling to spot its imperfections and distract myself from a surprising jolt of anxiety. “Dr. Padgett? Are you there?”
“Yes,” I heard his voice, the gentle tonic. “I'm here, right here.”
I was surprised by how much his words reassured me. Without the eye contact, I felt strangely isolated. This, indeed, was more intense than I'd thought it would be.
“Dr. Padgett?”
“Yes.”
“What do I do here? I mean, what am I supposed to say?” Anxiety was beginning to overwhelm me.
“Say anything that comes to your mind. Just relax. I'm here. Just say what's on your mind.”
After a short period of silence, a vision flashed in my mind. I began to whimper. I wanted to stop, but I couldn't.
“It's okay,” he said in a hypnotic voice. “What's happening right now?”
“I'm in my room.” I was breathing heavily, my heart pounding. I began to sweat. “Looking out my window. It's black out there. Total darkness. Scary. And I'm thinking about what happens when I die, about where I was before I was born, and it's really scaring me. What was I before I was born?”
“How old are you?”
“I'm little. Maybe six.” I could feel myself starting to hyperventilate.
“It's okay. I'm here. Why don't you go tell someone? Why don't you go get your parents?”
“I can't! They'll get so mad at me. I'm a baby—afraid of the dark. I think about such stupid things anyway. They hate that. They're already mad at me. I can't bother them anymore. It's late, they'd … they'd …”
I was visibly shaking by now.
“It's okay. I'm here. What would they do?”
“I have to go to the bathroom. Really bad.”
“So why don't you?”
“Because I can't leave my room. I'm afraid. He's in his underwear; he's mad; he told me he didn't want to see my goddamned face anymore tonight if I know what's good for me. He'll see me; he'll … he'll …”
“What will he do?”
“He'll take out the belt. He told me to shut up and go to bed. I have to stay here. I'm too scared.”
“Too scared to go to the bathroom when you need to?”
“He told me to shut up and go to bed. I can't leave here. I'm scared! I kind of wish I could be dead, but I can't because I don't know what happens to dead people. I don't know where I came from.”
“Haven't you talked to them about death? About how much it scares you?”
“I can't! Grandpa just died. They don't wanna talk about it. She cries all the time; he never cries at all. No one talks about it. They tell me I think too much, and that's bad. Very bad. I just think I'm too smart for my own good, but I'm not that smart. I just want to be the center of attention. I can't tell them! I can't go to the bathroom! I can't even die. I'm too scared. Please help me!”
“It's okay. You're here in my office, and I'm with you. These are feelings, that's all. The feelings can't hurt you. You aren't there anymore; you're here. And you're safe with me.”
My breathing slowed a bit.
“So you're feeling very frightened. You want to die, but you're afraid of it because you aren't sure what happens. You need to go to the bathroom, but you're afraid to do that too. So what happens? What do you do with these feelings?”
“I … I … I can't tell you that.”
“Why can't you tell me that?”
“Because it's a dirty, horrible, filthy, disgusting sin, and I'll burn in hell for it.”
“There's nothing a six-year-old can do to make her burn in hell, but if you don't want to tell me, it's okay.”
As if I didn't hear him, I continued. “Daddy caught me once, started snapping the belt. Told me how dirty and shameful I was. Told me if he ever caught me doing so
mething that shameful again, he'd use it on me.”
“The belt?”
I nodded in tears.
“Did you feel ashamed?”
“Yes! It was really bad. I … I … I was playing with myself. I was masturbating. I'm gonna die and go to hell! Grandma's looking down on me, saying how nasty and shameful I am. She was a saint, and I'm horrible, and she hates me!”
“Does it feel pleasurable to masturbate?”
“Yes! That's what's so bad about it. I know it's nasty and sinful. It's shameful. But I like doing it. I can't stop. I do it every night, really quiet. Sneaky. I'm really bad.”
“No, you weren't bad. You were very afraid, so you were doing something to mix some pleasurable feelings to drown out the terrible ones so you could stand it. There's nothing wrong with that. Nothing shameful or bad. You were only six, doing what you needed to do in a very scary place.”
I was crying in a nearly piercing wail by then, flooded with feelings of the scene, almost trapped in it.
“We only have ten minutes left in the session,” said Dr. Padgett. “Why don't you go ahead and sit up. That's good.”
Looking in his eyes, finally, I was transfixed by them. He wasn't crying, like me, nor visibly anguished as I was. But even through the blank screen of his face, I could see the sadness in his eyes and felt a rebirth of connection. We'd been through something together, something intense and shameful to me, and he'd stood by me, guiding me through it. He hadn't laughed, judged, scolded—or left me.
“You need to remember,” he said, “that what you just experienced are memories. Of the past. They feel very shameful to you, but they weren't shameful at all. The only people who deserve to feel some shame are your parents for making you feel that way. You're an adult now; they can't hurt you like that anymore. You aren't so dependent on them as you were then. This is the present. And you're with me now. It's safe here. It took a lot of courage to endure what you just did now and what you did then. You survived it. You made it. You grew to be an adult. You should be proud.”
I was completely drained and numb from the entire ordeal. Words couldn't find their way out of my mouth, but I could have listened to him forever. When the time was up, I tried to burst out of the room, still crying, but Dr. Padgett stopped me. He bent the rules. The session went on for over an hour, delaying the next patient. As I was still visibly shaken, he offered to let me collect myself in an adjacent conference room while he saw his waiting patient. But I declined. The scene was still all too real for me, and I had trouble negotiating the blurry line between past and present. I just wanted to get out of there, as far from that couch and those memories as possible.
Choking in a heavy fog of emotion, I headed to the hospital parking lot, which was cluttered with a dizzying array of detours, barricades, and yellow caution lights to facilitate a major expansion. After starting my car, I proceeded to crash into every wooden barricade, smashing them to pieces—energized and accelerating at the sickening sound of scraping metal and splintering wood.
It was the only time we ever tried the couch. I was neither emotionally ready nor stable enough to handle the intensity. Still, the lid had been taken off the desperately guarded Pandora's box of my early childhood. And I was about to face a past I had denied for years, a reality I had feared so much that even death had seemed preferable. Indeed, the notion of death was comforting in comparison.
The shattered barricades were only the beginning of a rapid descent out of reality and into loss of control.
I was more caustic, sarcastic, and belligerent than ever in sessions as I tried desperately to slam the lid down on the past. I was barely functioning at home, shrieking obscenities, hurling objects at the wall, sometimes writhing on the floor in howling agony, as a stunned and frightened pair of children looked on and a helpless Tim feared what might happen next. About the only stability the kids had was at the babysitter's.
I was more convinced than ever that I had snapped and insanity had taken over permanently. And I was just as convinced that it was Dr. Padgett's fault. I hated him—at least, I fervently wanted to hate him—and yet, the angrier and more erratic I became, the more I felt I couldn't survive without him. Not even between sessions.
It was becoming a nightly ritual. I'd go off like a detonated explosive, and in the aftermath of the tirades and vicious acts of self-destruction, I would immediately call Dr. Padgett. I wanted him to see me this way, to know how crazy and despicable I was, to know how crazy he'd made me by toying with the past.
Secretly, more than anything, I wanted him to put me back in the stress unit. I was safe there.
It was a shameful, embarrassing feeling, one I did not dare share with Dr. Padgett or anyone else. Who could possibly want to be on the psych floor instead of at home with family? What kind of a sick, twisted, and pathetic individual would want to be stripped of the adult freedoms of coming and going as she pleased?
Horrified by these secret desires, but nonetheless compelled by them, I expressed them in an indirect fashion. If I was destructive enough—could clearly display my utter insanity—Dr. Padgett would have to put me there.
Chapter 5
I'd been outside the house raking leaves when Tim called out to me from the front porch.
“Rachel! Telephone!”
Damnit, I thought. I'll never get these stupid leaves raked up.
“It's Dr. Padgett.”
I dropped the rake as my heart raced with excitement. Imagine, Dr. Padgett calling me! Maybe he wanted to tell me how worried sick he was about me. Maybe I'd convinced him to admit me on the psych floor again. I ran as quickly as I could and breathlessly picked up the phone.
But he spoke neither of worry nor of hospital wards. He was calling to say he wanted Tim to accompany me to my next session. I was confused and disappointed. Why did he want Tim there? As it was, I only had the doctor to myself for three painfully short fifty-minute “hours” a week—not nearly enough. The last thing I wanted was to be forced to share my time with Dr. Padgett with Tim. I was overwhelmed with jealousy until a possibility came to mind. Maybe he wanted Tim there to drive the car home if he chose to admit me as an inpatient.
I wished Tuesday was now so I could find out.
Tim pretended to focus on a pamphlet about depression as he fidgeted in the waiting room. I stared at him with burning resentment. This wasn't a trip to the obstetrician. He didn't belong here. It was my place. Tim knew this, as I'd been griping about it since Dr. Padgett's call.
The doctor appeared with his customary broad smile and gave Tim a firm handshake. He shook Tim's hand! I seethed with envy. Dr. Padgett had never ever so much as touched my hand. He strictly prohibited any physical contact whatsoever (another of his many rules), and here he was shaking Tim's hand.
The doctor invited both of us into his office. By then I was ready to explode. Dr. Padgett sat behind his immaculate desk instead of his usual chair.
Then he began speaking to both of us. “As you both know, Rachel has been completely out of control these past few weeks. Losing contact with reality. Losing awareness of her responsibilities. Every act of self-destruction just seems to fuel this; to make it worse …”
My ears perked up. This had all the earmarks of a preadmission announcement.
“… I just can't be available all the time, and neither can you, Tim. This is becoming a dangerous situation …”
I crossed my fingers. This was music to my ears. Please put me back in the ward, Dr. Padgett, please!
“… which is completely unacceptable. Rachel, you have it within yourself to regain and maintain control. But you aren't doing that. I can't conduct psychoanalysis with a child in tantrum. You have to participate too. You have to be able to find some insights. And you can't do that when you've lost all control. I'm going to have to draw the line here. If you can't get it together, therapy just can't have any benefit. It's accomplishing nothing and costing a lot of money. If you can't bring yourself to at least some degree of ra
tional reality, I see no other choice but to temporarily suspend our therapy.”
Numb weightlessness and shock consumed me, a knot of nausea balling in my stomach. A stinging sensation as if I had been slapped in the face. Hard. I had really blown it. I'd pushed too far, and now Dr. Padgett was bailing out. How could he? I ought to kill myself, I fumed. It would serve the sonofabitch right for leading me on and then dumping me.
Tim, meanwhile, was open-jawed in near panic, probably wondering how he could possibly manage my uncontrollable outbursts on his own. He, too, in a short time, had come to rely on Dr. Padgett.
As if sensing this, Dr. Padgett continued firmly, “I told you, Rachel, that I will not abandon therapy, and I won't. This is a temporary break I'm talking about, just until you can show me you're ready to be an active part of therapy. If you can't manage that and your behavior becomes a threat to your own life or your family, I will commit you. But not to this hospital. If you can't afford another stay and your insurance limit is up, it may have to be the state hospital.”
State hospital! I gulped hard. The government-funded state hospital was a chilling nightmare. I'd be trapped with felons, junkies, and psychotics. Those scary people with rusty grocery carts filled with crumpled newspapers, mumbling to themselves. I shuddered at the thought of being locked up in the closest thing to a prison not run by a warden.
Dr. Padgett continued to lob bombshells. If I were placed in the state or any other hospital, therapy would come to a temporary halt until I was released. He would refer me to another competent psychiatrist to make rounds visits and monitor medications. Dr. Padgett would continue to consult and closely follow my progress, but we would have no direct contact until I was released and my self-control had significantly improved—as long as that might take. At the state hospital, there would be no insurance company demands to release me.
In the interim, my constant after-hours emergency calls to him had been a privilege I had grossly abused. Taking pains to preface that this was not based on any inconvenience to him, he explained that the constant calls were undermining my ability to control my own behavior. Until further notice, he limited me to one call per week. Period.
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