He sits behind his desk, clean and ready to go. “All right, Calista. Breathing. The relaxation techniques I’m going to teach you today will be the foundation for our entire immersion procedure. You will be exposed to situations that you don’t like, ones that will make you uncomfortable at a variety of different levels.”
I must flinch at the thought because he pauses for a moment and starts again in a gentler, less clinical voice.
“You will be uncomfortable at times, Calista, but I’m going to show you some ways to lessen that discomfort.” He stops and catches my nervously wandering eyes. “Trust me, Calista.”
There is that word again. Trust. I’m supposed to trust him entirely for this to work. I tell myself that I can do this. I am pretty convinced that he is genuinely trying to help me. I trust that he’s not going to just leave me in an unsafe location or seriously dangerous situation. I do. What I don’t trust is the idea that I’m going to be able to use relaxation techniques to make me calm. I don’t trust that I’m going to have the patience or endurance to not run away. I don’t think that I’ll be able to just breathe when I’m in one of these tough spots. With him around, I’m having a hard enough time breathing as it is…
He looks at me, concerned now. Gotta fix that.
“So…what are these techniques?” I sidestep the trust conversation. Hopefully.
“Okay, if you are ready, I will teach you.” He leans back in his chair as he begins his explanation. “I referred to this as yoga-type relaxation only because I thought that might be a familiar point of reference for you. Since it’s not, I will refer to it as what it really is—Progressive Muscle Relaxation.” Never heard of it.
He continues. “It’s rather simple, really. When feeling overwhelmed or highly uncomfortable during our sessions, you may have difficulty with controlling your anxiety. Your first instinct will be to run from the place, from the circumstances, from me.” From him? Doubtful. “I am teaching you some relaxation skills today so I can perhaps help you prevent yourself from running. Essentially, I want to show you how to relax before I cause you any anxiety.”
I nod slightly.
“All right, to get started, I am going to go through some steps with you.” He stands up and wheels his chair around the desk. He sits down, and we face each other. Again. Knees not quite touching.
He looks right into my eyes, searching for approval to continue. So gentle. So concerned. So, so sad…still. That’s pity, Callie. He feels sorry for you, just like he does for his mom.
Pity or not, I hate seeing that sadness so I nod. Nod number 6,003, I think.
He nods slowly in return, somewhat convinced that it’s okay to move on. As he starts to explain, he catches my eyes every twenty seconds or so–to check if everything is okay, I guess. Kind of like when I check my alarm clock at night. Maybe he understands this disease even more than he knows…
Pay attention, Callie.
“And the first thing we’ll need to do involves recreating some of the tension you experience when uncomfortable or scared. To do that, we’ll concentrate on specific areas of your body, ones that you personally feel are most affected when you are stressed.”
And these areas are? How the hell could he know when I don’t have a clue?
“Calista?”
Oh. He wants an answer. I have no idea. I don’t really concentrate on specific muscle groups that I can’t even name while I’m trying to avoid catching Hepatitis or the Swine Flu. I kind of have a lot of other things to worry about in those situations, Doc.
I, of course, say none of that and just shrug my shoulders instead.
“That’s okay, Calista.” Understanding, as always. “I understand that you probably haven’t really thought about any of this before. We are going to practice with some commonly tensed muscle groups for now. If later in the week you find that some areas become more strained than others, we’ll focus on those at that time.” Pause. “Okay?” Quiet. Concerned.
Yes, I think so. I nod.
“Okay then.”
He says “okay” a lot. “All right” too. He probably remembers to spell it as two words instead of—
“Let’s start with your stomach. Many people talk of nervous stomachs when discussing anxiety.”
I wonder if he knows how spastic my stomach gets when he looks at me. Probably does.
“I want you to lean back in your chair like this.” He rests his back and head against his chair. As he moves, his knee brushes mine ever so slightly.
Yep, there goes my stomach. Tense and fluttery at the same time.
“Sorry,” he says quickly, and his face reddens a bit. Guess that wasn’t the way he intended to create tension.
I do as he says, leaning back in my chair. Careful not to move my legs.
“Okay, now…”
Okay. Okay. All right. All right. Okay. All right.
Focus, Callie.
“—should inhale and tightly squeeze the muscles in your stomach for about ten seconds. As you do this, really concentrate on that tension. Feel it. Become familiar with it. After that, you will exhale and relax that muscle group and again concentrate on the experience. The feeling of it. And the power you have over your body.” {Enter Debarge with “Rhythm of the Night.”}
“Ready, Calista?”
Nod. Nod. Nod.
“Close your eyes and begin.”
I close my eyes and suck in my stomach as hard as I can. Think stomach. Stomach. {The DJ turns up the volume.}
“Now, release the tension.”
Release. Exhale. Concentrate. Stomach. Stomach. {BIG refrain.} Stomach. Stomach. {And repeat.} Stomach. Relaxed…ish.
“Okay. Open your eyes. Let’s move on. We will use the same process, but this time you will focus on creating and relaxing tension in your hands. Ready?” Nod. Eyes closed again. “Begin.”
We continue this process over and over. Neck, face, legs, etc. It’s not too bad. Not going to make me calm about catching MRSA or anything, but not too bad. A little relaxing.
After tensing and untensing my feet, he tells me that he would like for me to practice these exercises at home a few times a day. He even tells me about a website that gives tips for the techniques. I should probably write the website down, but I don’t have a pen or any paper. Well, I do, but they are in my purse. Which is on my hook.
Behind his desk again, he paces a little. What now?
“Calista, there is one other relaxation technique I’d like us to practice.” Still pacing.
“Okay…?” I borrow a piece of his sophisticated vernacular. What is the problem?
Still pacing.
“Well?” I push for an answer, raising my eyebrows for emphasis. Wasted emphasis. I’m sure he doesn’t see it.
Nothing. Just stupid pacing.
“Dr. Blake?”
He stops.
“Aiden,” he almost whispers, looking straight into my eyes. He is sad again.
I am suddenly very aware of the tension building in various parts of my body. Acutely aware.
“Aiden,” I repeat softly. “What do we do next?”
Silence. Eyes. Locked. Together. {Damien Rice cuts ba—}
Focus, Callie.
“Please tell me.”
He squeezes his eyes shut for a moment. When he opens them, they are still sad but also a tiny bit hopeful, I think.
“Calista, I’m afraid that your anxiety level might sometimes reach a stage that you won’t be able to breathe your way out of yourself.” He pauses, breathes, and continues very slowly. Each word seems to take an entire minute for him to say. “When that happens, I want to be able to help bring you out of it. I want to try one last technique that might stop you from running away.”
Okay…
“I promise we’ll only try this in extreme circumstances, and only if you want to do it. If you want to drop this part right now, we can.” He breaks our eye contact and starts pacing again. UGH. Gotta pull more information from him. Who is the therapist
here?
“Tell me.” Pause. Nothing. “Now, Aiden.”
That stops his pacing. His eyes fly right back to mine. I nod gently.
He opens his mouth to talk. Good counseling, Callie.
“It’s a massage technique,” he mumbles while lowering his eyes, “for your shoulders. Something I can do to take away some of your tension when you don’t have the strength to do it on your own.” He keeps his eyes and head down, almost as though he is waiting for me to throw my chair at him or something.
Oh. More touching. That explains the sad eyes. He thinks he’s going to get me all freaked out.
He’s wrong. I’m starting to realize that he doesn’t actually know everything about me. He doesn’t know that I do allow some people to touch me. Mandy, Melanie, Mom, Abby. Jared and Dad on occasion. And it’s okay. Not something that really takes any special effort on my part.
He doesn’t know that some people are clean to me. Okay to touch. And he can’t possibly know what I am just now realizing. He is clean to me. Somehow.
Well, I know how. He’s earned it. The tissues, the chair, the special instruments, the hand washing, his mom…I do trust him.
Now to explain that without being gushy or creepy. It would be easier to refuse the massage. Besides that, he may be clean to me, but the thought of him massaging my shoulders still gets me all nervous.
He is still looking down, but I know his eyes are upset, concerned, distraught. I can’t be responsible for that.
One. Two. Three. Here goes… “Let’s do it.”
His head snaps up. Eyes on eyes. “Really?” More hope than sad in his eyes now. Some relief too. Good.
“Yes.”
He starts to explain the massage technique he’ll use, but all I hear is, “I’m going to touch you, I’m going to touch you, I’m going to…”
Well, at least I won’t have to fake tension in my body for our little practice session. {Another quick change. Rice to Finger Eleven with “Paralyzer.”}
“Are you ready?”
Why not? Deep breath. Nod number 9,306.
He slowly walks away from his desk and around me to the back of my chair. I resist the urge to turn and watch him as he passes, instead keeping my tense body rigid and facing straight ahead.
“Move slightly forward on your chair, Calista. Just a little so I can, uh, get my hands behind you.” I adjust myself. “Now, try to recreate some of the tension from our earlier exercise.”
Already tense, Dr. Blake.
I close my eyes and go through some of the motions from earlier, pretending to make some new tension.
“Good, Calista.” Glad he appreciates my efforts. “Are you ready?”
At least when I nod this time, he gets to see a new view of the move.
No more nodding. I feel the heat of his hands as they crawl to my shoulders. Closer. Closer. Contact. A warm, slow ache begins in my shoulders.
His hands. Strong. Searing. Moving now.
Oh my God.
The slow ache begins to spread throughout my entire body, scorching and paralyzing as it moves. As he moves. Fingers making circles. Pressing into my skin slowly and cautiously. Infusing heat throughout me.
As I sink further into my chair, my eyes close and my mouth falls slightly open. I feel my neck lose all strength and start to drop back…back…back…
I snap forward just in time, managing not to crush his hands with my dead weight. My movement startles him, and he tears his hands from my shoulders.
“Is it too much?” he asks quickly. Quietly.
Too much? Too much heat? Too much aching?
“No, it isn’t,” I say softly, without turning around. I don’t know how to explain the whole neck jerk thing without embarrassing myself so I try to ignore it instead.
“So you think it might work? If you’re in a tough spot, it might help you with relaxation?”
Relaxation. I don’t think that is the right word for it. Definitely not relaxing. Definitely not helping me breathe. A distraction, though, for sure. I didn’t think about Tuberculosis or Meningitis or even Chicken Pox once during his massage.
So I’m speaking honestly when I say, “Yes. I think it could help me change my course of thinking in a rough situation.” Or at any time whatsoever.
“Really?” There is relief in his voice. I can hear it.
“Really.”
He starts to move around me. “All right then. Okay.”
All right, okay, all right, okay, okay, all right…
“Let’s go over our general procedure then.” He sits on the corner of his desk as he begins to explain. I listen, trying to move my eyes slightly every ten seconds or so, working hard not to get trapped by his eyes. I nod here and there to show I’m listening. Hoping it all seems natural.
Doubtful, Callie.
“When we initially get you into an uncomfortable position, I want you to let yourself feel your fear. Don’t try to ignore it. Face it. Allow your stomach to get tense, your body to get nervous. As soon as that nervousness begins, which I assume will be rather immediately, you and I will engage in conversation.”
Seriously? He’s going to make me all nervous and then expect me to be able to carry on a normal discussion? About what? The rainy weather? Upcoming sporting events?
I wait for him to say more, trying to appear ambivalent about this conversation idea, but he must see confusion or disbelief on my face.
“Calista, we are only going to have this conversation once you feel you can talk. If you are absolutely too worked up to talk, I will ask you to begin your relaxation exercises. Hopefully, you will succeed in relaxing yourself enough to talk…”
And if I don’t, he’ll try to relax me.
“When we have our conversation, we will make a game plan—a worst case scenario game plan. You won’t be just worrying about your fear anymore or doing little rituals or routines to avoid it. Instead, you will be dropped right into a situation where your fear is your reality.
“What will you do? How will you handle it when it really happens? What concrete actions will your gut tell you to take to try to make it better?” He pauses. “You cannot really answer these questions honestly until you are actually in the feared situation.”
This doesn’t sound too awful, I guess. As long as he is helping me through it. I’m still not convinced that I’ll be able to keep myself from running though.
“That is the first thing we’ll discuss.” There’s more? Great. “We will also discuss what specific events would have to fall into place for the feared outcome to occur in your undesirable situation.”
What the hell? Gonna have to break that sentence down for me, Doc. A lot. Once again, my face must express that sentiment. Mental note: Sign up for acting classes.
“Okay, Calista. Let me explain that better.”
Good plan.
“You are only scared of going to certain places—public restrooms, crowded restaurants, bars, etcetera, because you think they hold some danger for you. Right?” I nod slowly.
“The danger is what you are really afraid of, not the places themselves.” I nod again. “And the danger is what this condition, this disease, has created in your mind. Within your mind, you have determined certain horrible consequences for going to each of these places. You’ve determined that you’ll contract unavoidable, specific diseases or that you’ll cause definite harm to others or yourself. You associate these places with these diseases or harmful events, convincing yourself that going to these places will automatically result in you acquiring diseases or provoking harm.”
I nod slowly again. While this all makes sense, I still don’t quite get his point. I also don’t get why he had to say “these places” so many times.
“While perhaps there have been times in the past where people have truly experienced these feared outcomes, the likelihood of this is very rare.”
Still confused.
“For example, somewhere in the world, on some date, yes, a person might have
picked up some rare disease in a public restroom or at a bar. However, ninety-nine times out of one hundred, this doesn’t actually happen. You and other people with this condition are worried about that one percent of the time. Many times, you are even worried about something that has never happened before.”
That’s true. I do know that.
“So we will discuss what conditions would have to fall perfectly into place for your worst fear, your frightening outcome, to really happen. Oftentimes, five to ten specific events would have to occur before that outcome could ever be a true possibility.
“Thinking about how many things would have to fall into place may help you to see your fears in a new light, to understand how unlikely it is that your feared outcomes will ever occur.”
I nod again. This sounds reasonable.
He goes on. “One of the most unbelievable aspects of this condition is the fact that most people with OCD realize that their fears are ridiculous. I can tell from your emails and our few meetings that you feel this way.”
Of course you can.
“We will simply use that feeling, that knowledge, to help you get through some of these situations. Perhaps we’ll even be able to make you see some fears in an even more ridiculous light.”
Not a bad plan. Definitely worth trying anyway.
He stands up and begins to push his chair back to its spot behind his desk. I guess we are done for today. I probably should be getting home to get ready for Girls’ Night anyway.
Standing behind his desk now, he begins to speak again. Cautiously, but sincerely. “This isn’t going to be easy for you, Calista. I do want you to push yourself to work as hard as you can during our sessions, but I also want you to relax when we aren’t in session.
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