I Choose Elena

by Lucia Osborne-Crowley

  I masked the pain with drugs that numbed me and refused to engage in any sensible long-term care for my condition. I could not accept that my new life was permanent. Gently, my doctors kept saying: This is not going to go away. You have to stop thinking you are going to get better. But I couldn’t let go.

  Instead of allowing myself to be vulnerable to the illness I could not wish away, I became defensive and bitter and angry. I rarely accepted help. I got sicker. In refusing to give in to my illness, I kept up as many aspects of my life as I could, trying desperately to play the part of the functional woman I had imagined I would turn out to be. I overcompensated. I took on too much. I got sicker.

  I managed to construct a life this way. A deeply fulfilling one, and one for which I am very grateful. I had relationships and heartbreaks that I thought might kill me. I learned to drive. I discovered Adele. I got into university to study politics and I joined every club on campus.

  I started reporting for the university newspaper. I moved to San Francisco to work with a team of investigative reporters. I built a fledgling career writing about gender for a national news site. I found editors who believed in me and who trusted me. A few years later I decided to do further study alongside my writing career so I started doing a law degree at night. I built a life that started to make sense to me. Sometimes I felt as though I had outrun myself.

  By 2015, six years after my initial acute episode of pain, vomiting and bleeding, I had two diagnoses: endometriosis and Crohn’s disease. How unlucky, I thought at the time. Now I know the two are intimately connected: both are inflammatory disorders; both are a result of the malfunctioning of the autoimmune system. Studies now show that both can, in some instances, be connected to the long-term physical effects of untreated sexual trauma.

  And here’s the other thing about the medical records. They reported what I know now to be telltale signs of untreated trauma: consistent pain, an overactive inflammatory response, extreme distress and anxiety pre- and post-surgery, a problem with drinking too much to dull my pain and/or anxiety about pain, tremors.

  To my twenty-six-year-old self, having now read countless books and attended hundreds of hours of therapy about the physiological symptoms of trauma and listened to lecture after lecture after lecture from the best trauma specialists in the world, it is so clear to me that I was presenting to emergency as a traumatized young woman whose unspeakable story, held deep in her blood and her bones, was beginning to show up on her skin. Whose body was trying to say something her mind could not.

  If someone – anyone – had intervened at that stage, I might not now have two lifelong illnesses to contend with. But they didn’t intervene because I had finally achieved the thing I’d always wanted: to them, I was invisible. My body was screaming the answer but no one was listening to it. Not even me.

  For years I blamed doctors for not making the connection. I thought if someone had asked the right question, I might have been spared. But that was never true. It was just easier that way.

  The truth is that one doctor did ask me if I had been raped. It was 2010, not long after I got sick, and I was being tested for Crohn’s disease. He asked the question, and somehow I found myself telling him the story. It was the first time I had ever told it, out loud, from start to finish. I told him every detail. Once I started I couldn’t stop. He looked deeply concerned and tried to respond but I didn’t let him.

  As soon as I’d finishing telling the story, I realized what I had done: that I had given myself away. The panic of that realization was unbearable. I couldn’t take back the words so I, quite literally this time, ran away. I reached for the door and ran down the hallway to the elevators, and when I got to street level I kept running. I was hysterical, sobbing, crying, wishing I could disappear. Eventually, a taxi driver pulled over and asked if I was okay, and he drove me home. It was 10.30 a.m. but I got straight into bed and lay in a dark room for hours, punishing myself, wondering what had come over me, what on earth could have made me feel it was okay to tell the truth about my life.

  The doctor called me every week for a month but I never spoke to him again. He tried everything he could to help me, but I wouldn’t let him.

  By far the most dangerous element of my assault was the fact that I lived in a world where it was unspeakable. I knew, as soon as it happened, without ever being told, that I must say nothing. Indignity is painful but silence is a prison.

  What I now know is that no doctor would have been able to help me while I was trapped by silence and shame. The need to keep my secret was more powerful than anything else. Silence mattered more to me than my body, my health, even my life. I had always thought that the violence of this experience had been swift and obvious, a Swiss army knife and a bruised ribcage, but I was wrong. The far greater loss was invisible and insidious. It was the compulsion I felt every day to say nothing. It was not the terror of a bottle smashed over ceramic but the steady, everyday shame that followed. It was every tiny signal – in films, in conversations with friends, in music, in politics, in language – that made me believe this was my fault. It was a death by a thousand paper cuts.

  The most important thing that was taken from me was the ability to say something, and with it, the ability to ask for help. This is a theft from which I will never recover.

  But it is also more than a theft; it is an act of violence itself. Trauma studies have now proven that abdominal surgeries can themselves cause symptoms of post-traumatic stress disorder (PTSD). Although the patient is unconscious, the body registers the intrusion and, depending on the person’s predisposition to PTSD symptoms, the surgery itself can be a form of trauma. So in a truly cruel irony, my inability to voice my trauma led me to do diagnostic surgery after diagnostic surgery, each time causing further re-traumatization.

  Since being diagnosed with endometriosis and Crohn’s, I have had to undergo five surgeries to clear out the disease. Each of these was profoundly invasive. A disease caused by trauma for which the only known treatment causes trauma.

  This is to say nothing of the fact that for a person with undiagnosed post-traumatic stress disorder, surgeries are particularly distressing because of the result of anaesthesia: the way you wake up from the surgery completely helpless, right back in that echoey bathroom with tall walls and a locked door and the glass and the tiles and the smell of whiskey.

  To me, the most devastating part of gaining an understanding of the lifelong physical impacts of trauma is that they are unnecessary. Gratuitous. If trauma is treated immediately, full recovery is possible. Almost all of the long-term effects can be prevented.

  This means, more often than not, the permanent impacts of trauma are reserved only for those with unspeakable stories. This strikes me as both one of the most catastrophic human tendencies and, simultaneously, one of the easiest to fix, which perhaps just makes the heartbreak worse still.

  IV

  A truth was being revealed to me: that I had always tried to attach myself to the light of other people, that I had never had any light of my own. I experienced myself as a kind of shadow.

  Zadie Smith, Swing Time

  DISAPPEARANCES

  On 2 January 2018, a mentor and I were playing Cluedo with her young children, and she passed me a note asking me to give myself a score out of ten based on how much I agreed with the following statements:

  I am a good person

  I am selfish

  I deserve to be happy

  The kids accused us of cheating. I handed the note back:

  I am a good person 2/10

  I am selfish 9/10

  I deserve to be happy 2/10

  She handed it back and left a scrawled note next to them saying: This is not your voice. Whose voice is it?

  I stared at the note. The voice of violation. The voice that tells you that you are worthless. I know now that one of the effects of untreated trauma on the body and mind is to make us ashamed; to make us believe that we are, and always will be, people to whom terrib
le things happen – people who deserve to be hunted.

  This is put best in Meera Atkinson’s Traumata:

  Shame is often transmitted, paradoxically, by shameless acts, acts in which one person’s avoidance of shame demands another carry it.

  She says of the man who abused her: ‘I was ashamed for him yet it was not my shame.’

  The voice telling me I did not deserve to be happy was one that had been transmitted to me by a savage, shameless act. The decision of an unrepentant man who will never feel ashamed of his actions. So I am condemned to carry the shame for him, and I have. For so long, I have.

  It is not my shame.

  When I think now about the long therapeutic process of learning to manage that shame, I can’t help but think of this moment as the moment I started to realize that perhaps this wasn’t a fixed part of me.

  That’s not your voice. Whose voice is it?

  Unlearning shame is one of the most difficult parts of trauma recovery, but it is possible. When I think back to the time when shame had a tyrannical hold over my life, unnamed and not yet recognized as something that did not belong to me, I think of a stanza from a poem by Megan Falley, called ‘Holy Thank You for Not’, one that I loved at the time but did not understand the prescience of:

  Once you heard that Shame is the closest thing to Death.

  Once you said you in a poem when you were too ashamed to say I have wished to give my life back to my mother

  In a long dark box.

  Shame really is the closest thing to death.

  In the course of my recovery I have thought a lot about the nature of shame. How it is forced upon us by others; how it feels so personal but never belonged to us in the first place.

  Once, sitting on a plane on my way to visit my sister and her new life in London, I stumbled upon a lecture by social scientist Brené Brown about the difference between shame and guilt, and it felt as though some fundamental truth about myself crystallized in one fell swoop.

  Guilt and shame, she explained, are profoundly different emotions. Guilt is the feeling that you have done something bad; shame is the feeling that you are bad. Guilt is internally constructed, based on our knowledge of ourselves and the recognition that our behaviour has deviated from that self; shame, on the other hand, is given to us by others. Shame is inorganic.

  Guilt says, I made a mistake.

  Shame says, I am a mistake.

  Guilt requires us to recognize that we have acted in a way that we regret, in a way that is out of character. This process is impossible for those who live with shame: for us, shame is our character.

  There is no sense in which we can act in a manner that is ‘unlike ourselves’ when we have no ‘self’ to speak of. Shame devours us from the inside out and leaves us empty: with no solid form, no edges, no boundaries, no structure.

  This is known in trauma literature as a lack of ‘self-leadership’. When a person’s development is defined by, or interrupted by, violence, they become unable to develop a clear sense of self. This is because their interiority – their capacity to make decisions, to understand what they want and don’t want in the world – can only develop in an environment of safety. It is only in safe places that they can look inward. When their lives are beset by violence, they do not have that luxury.

  As a traumatized child, you become accustomed to having to protect yourself, which means having a razor-sharp awareness of everything around you. You have to be able to sense danger from a mile away. You become hyper-vigilant.

  Once you experience this fight, flight, freeze response, particularly in a truly life-threatening situation, it lives on in your body and resurfaces again and again in everyday life. Scientists call this a false positive bias: once you learn how perilous the world can be, you will interpret every single moment of ambiguity as danger.

  Hyper-vigilance is very sensible from an evolutionary perspective. But when trauma becomes chronic and hyper-vigilance becomes a way of life, it is this very survival instinct that ironically keeps us from living in any meaningful sense of the word. We become a bundle of reactions, with no internal core, moulded together by circumstance. A precarious glue. The only sense of self we can find is the one we see reflected back to us by others. We hunt for clues in others’ behaviour as to the type of person we are. This delivers to us a funny kind of magic trick: we are able to construct a new self from one moment to the next depending on our audience. Like the tree falling in the proverbial forest, we feel that if no-one is watching, we won’t really exist at all.

  And so, as I grew older, I learned to curate different versions of myself around different people. I learned to reflect back to each person their favourite parts of themselves. I learned that this is the surest way to win approval. I was no longer a girl. I was a mirror.

  I gave whatever the audience asked for. I took nothing because I had no self to nourish. I built a personality out of my unending capacity to respond to the needs of others.

  Once I was sitting in a close friend’s apartment texting a boy about meeting up later that night. He was so clearly keeping his options open, not even remotely interested in me as a person. I kept saying to my friend, I wonder when he’ll text so I know what I’m doing tonight. She looked bemused at this prospect: What do you actually want to do? I had no answer and we sat in silence. I had no earthly idea what I wanted to do. It’s not something I ever thought about.

  Once I lied about desperately needing a glass of water, even though one was being offered to me, on a humid Sydney summer’s day because I was so afraid of inconveniencing anyone. It’s almost as if I was scared that if I said yes to the offer, they might notice that I was there.

  Once I lied to a nurse in an emergency department about needing more morphine because she looked so busy and I didn’t want to cause her additional stress. The truth was I needed the morphine. Badly. But that was an internal need, and I had learned that external cues must always take priority.

  This notion of a lack of self-leadership, a lack of interiority, of a stable personality, is connected to our deeply held belief that there is something putrid inside of us; something poisonous and toxic and immutable. We become people-pleasers as a way of ensuring that no-one ever looks at us too closely. We conceal ourselves because we are so ashamed that if we are seen, the rotten core will be seen too. It is an ongoing act of disappearance.

  I found myself dependent not only on the approval of others but also on external symbols of success: good marks and gold medals and perfect report cards. I stayed up all night perfecting every piece of homework I submitted because I knew if I got a good mark, I’d have something to hang my hat on. Look, I would be able to tell myself, this is me.

  It is shame that silences us, and spreads our silence to others. It is a deathly contagion. If shame is erasure, then its opposite must surely be our insistence on structure: on shape, on form. It must surely be a relentless insistence on being seen. On telling the truth.

  I looked down at my mentor’s note again. As well as her question, she had also crossed out my answers and replaced them with her own, so now the note read:

  I am a good person 9/10

  I am selfish 3/10

  I deserve to be happy 10/10

  For weeks, I carried that note in my pocket wherever I went, I tried to get serious about treating my post-traumatic stress disorder.

  I was in my final year of law school and was desperately trying to hold it together. I had a job I loved but found myself unable to keep up with it. I was determined to run far enough away from my illnesses that I would never have to face their common cause. I was a girl who desperately wanted to get better, who secretly knew the way out, but couldn’t accept it. Couldn’t accept that getting better would mean disclosure, would mean breaking the most important promise she had ever made to herself.

  I hated my body because it had caused me so much pain and because so many doctors had convinced me it was untrustworthy. I distrusted it deeply, I wished it would disa
ppear. I wanted a new one. But instead, in that decade between my assault and my recovery, with all the surgeries and doctors and question marks, I simply left my body altogether. I only acknowledged its pain when it was physically crippling me; the rest of the time I numbed it with heavy painkillers, alcohol and potent self-hatred. By the time I was nearing my final law exams, my physical and mental health were deteriorating rapidly.

  It’s strange that the body’s dissociative fight, flight or freeze response can be so destructive, because its evolutionary purpose is a very sensible one: it is designed to protect us from experiencing the pain of our dying moments; moments the brain does not think it will ever have to fold into any kind of narrative because it does not think it will live to tell the story at all.

  Unfortunately, this means that the act of living through these moments is a subversion with which the brain cannot fully cope, and it tortures us physically as it tries to make sense of it. This is why they call us survivors.

  I struggled through preparations for an important trial, I wrote a law thesis and tried to squeeze in freelance journalism on the side. I was distracting myself. I was still unable to accept the truth of my illness, and of my assault, plagued by nightmares and memories that were closing in on me like a pack of wolves.

  One night in late 2017, I found myself going home with a man I had already had a non-consensual sexual encounter with. I knew he was aggressive. I told him I was in pain and couldn’t have sex, and he pretended to be okay with it.

  A dedicated friend, one of the only people who knew what I was going through, tried to stop me from leaving with him. When that failed, she texted me three times while I was in the cab to tell me it was okay just to go home, I didn’t have to go through with it. I thanked her, and meant it, but stayed in the Uber with him anyway. Frozen.