It isn't even the mirror, really, that drives me to therapy. I have my bit of injured pride, and it definitely has a place in all of this, but that's not it, really. I don't know, maybe it's the sense of always being disgusted with how much I hate my own body, how it sort of leads to me simply hating myself. I even stereotype myself!
I'm ashamed, every single time I eat, no matter what it is. I'm ashamed, every time I shop for clothes, because I need a special store that carries clothes for my body, because I am seen as unworthy to buy clothes in the "skinny" stores.
It's not really that other people feel that it's okay to be cruel to me, though as I've said, it does hit my vanity pretty hard. What really sends me into suicidal thoughts and makes me realize that I need help, is that I am no better, that I am being cruel to me. I have turned into this vile, nasty person, spending all of my time being horribly, emotionally abusive to myself.
This, I cannot live with. How can I ever expect anyone to love me, as I am, if I don't even like myself? How can I show anyone the good in me, if I can't see it?
So I've just hung up the phone; I called a therapist who does emergency appointments. He's agreed to see me today, and even as I go through the process of admitting that I'm messed up and I need help, I can't turn it off, my instinct to berate myself mercilessly.
Wow, you just can't get more screwed up than this, my inner evil cheerleader chants. Therapy? Now you need therapy? Poor little chubby lady, can't keep her big fat emotional breakdown in check.
Unfortunately, for me, my sweet and confident inner girlfriend is silent today. Maybe she's drowning herself in chocolate-covered chocolate ice cream.
Anyway, it's a long morning, getting ready for the appointment with the therapist and making the drive to the office, all with the constant broken record of self-abuse constantly playing in my head.
I walk in the door of the office and take a deep breath, looking over the waiting room. It is simply decorated, with a receptionist working behind a window, just as if this place is a regular office instead of a refuge for the mentally cracked. I walk close and clear my throat, drawing the attention of the receptionist, smiling in spite of myself as I am greeted by faded blue eyes in the midst of a sea of wrinkles.
She must be in her seventies, and as she pats her fluffy cloud of short gray hair, she smiles back at me welcomingly. She looks the way I imagine my grandmothers would have looked, had they been given the chance to grow really old.
"Uh, I'm here for an appointment. Cassaundra Keaton," I say, trying to force some volume through the nervous lump in my throat. I know my face is colored; I'm not sure I've ever felt more humiliated than I do right now, having to admit that I really have lost control over my life, and that my own emotions are my biggest fear. It's hard to admit to myself that I am my own worst source of emotional and physical danger.
"Dr. Caswell is expecting you, dear," she says, her short manicured fingernails clicking away on the keyboard. She's smiling to herself, and I can't help wondering why. She looks me over, and her smile grows wider; my hand rises up without my permission, my fingertips smoothing my hair. Her scrutiny makes me nervous, so I look behind her to the clock, her little wall calendar, and some pictures she has framed on her desk.
"Um, do I need to sign in or anything?"
"Nope, your work insurance has already been run," she says kindly. She can obviously tell how embarrassed I am. "I ran it myself after you called this morning, so all you'll need to do is fill out some paperwork. He wanted to see you right away though, and has instructed me to hold your paperwork until after the appointment. You can take it home, so you'll just need to bring it back before we can proceed with your next visit."
"Oh," I say, a little confused. "So, um -"
"You can just go on in." She smiles kindly and waves her hand, showing me which door to go through.
Nodding my understanding, I open the door and walk into a room that is dimly lit; somehow, I suddenly feel reassured. The office doesn't have any windows, but there are huge lighted paintings on the walls that give the small room an open feel. He's dressed his office with my comfort in mind; it looks like a small, intimate living room, and I am reminded of home, of Janet.
"Hi, I'm Mackenzie Caswell." He stands from his desk, and I am shocked to find myself rather suddenly attracted to him. Usually, I'm so caught up in my own concerns that I don't notice other people in detail, but this man is a shock to my senses.
He has dark hair, but I can't really place the color; the dim light of the room and the short military style of his haircut leaves me unable to label his hair as anything but "dark." Sharp, steely blue eyes look me over, fringed with thick lashes and framed by neat eyebrows. His jaw line is chiseled and defined, shaved but just slightly stubbled, and his shoulders are broad enough to make me wonder where he buys his shirts.
"And I'm assuming you are Cassaundra," he murmurs, stepping forward to take my hand in his. He bends slightly to look me in the eye, and I am shocked again by my reaction to him, suddenly aware of his height and size. I feel small, delicate. "Are you alright?"
Trying to clear my head and focus properly, I withdraw my hand and nod. "I'm ok," I force. "And yes, I'm Cass."
"Cass," he says, and I've never heard my name sound like that before. To him, I'm a patient, but to me, he's the first man I've ever been truly attracted to. Jackson's cute, and I've harbored a little crush on him for a long time, but I'm feeling my body come alive, right here in the office.
Oh my God, the doctor? You have to like your doctor? My inner cheerleader is at it again, the evil little twit.
"Why don't you have a seat," Dr. Caswell offers, sweeping his hand to indicate that I can sit wherever I choose. I choose the couch, of course, terrified that if the overstuffed chair is a tight fit, he'll notice. I lower myself gingerly, and tuck my purse beside me as Dr. Caswell drops comfortably into the chair across from me.
He doesn't have the psych clipboard that I expected him to take notes on, which is reassuring; instead, he places a small, non-intrusive recorder on the coffee table between us. Still, my nerves are a wreck; I'm terrified of what he might ask, or what he might say. Will he diagnose me as a certifiable crazy person? If I tell him the truth about my suicidal instinct, will he lock me up?
Sitting there, I'm so nervous I could throw up, and I don't know what to say; I've never done this before. Do I start? Should I say something? Or is he supposed to start?
"Okay," he says, softly. He's trying to make me feel safe, and it's working. "Since you're here as an emergency visit, we're going to gloss over the whole getting-to-know-you thing. I suppose, I'll get to know you fine in the coming weeks. So we're just going to gauge how severe your depression is right now, okay?"
"Okay." I feel small, insignificant and kind of stupid. What am I doing here?
"Let's start with something easy. Tell me about your hobbies." He leans back and settles into the chair, waiting to see what I will say.
"I don't really have any," I say, wrinkling my forehead in an attempt to magically call some enthusiasm to my mind. I don't craft, or do a lot of fitness stuff -- obviously -- or anything like that. I don't build, I don't write or sing or anything.
"I go to work, and then I go home. I talk on the phone with my sisters."
"You have sisters," he smiles. "That's a good start."
"Well, they aren't my sisters, really, they're foster sisters. I sort of grew up with them."
"They feel like family to you?" he asks. I nod, and he breaks into an easy grin, which makes dimples appear in his cheeks. To my sheer embarrassment this causes something inside of me to click over, like an engine suddenly starting that hasn't been run for a while. Goosebumps race over me, and I pray he can't see my reactions to him, that he can't see how attracted I am.
"They count then," he says, and I relax. If he notices my attraction, he has chosen to ignore it. I follow his lead.
"They've been good to me," I tell him. "Their mother, too. They, um,
they don't know I'm here. I can't tell them I'm crazy." My eyes are in my lap, my fingers helplessly twisting and smoothing the fabric of my dress, the only physical sign of my inner distress. I hadn't realized I was doing it.
"Crazy? Oh, you're crazy," he says, as if only noticing for the first time that I must be. "I didn't realize you were crazy, I just thought maybe you were having a hard time and needing some coaching. Crazy, though, is very serious."
"Thank you," I say to him. My voice is cool but my face is growing more heated by the second. "Did they teach you how to mock your patients in medical school? Or is that just a little freebie you throw in?"
"I didn't mean to mock," he chuckles, raising my temper another notch. Briefly, I wonder how much trouble I'll get in if I throw something at him. There's a nice, weighty candle in a glass jar, sitting lonesome on the end table beside me. I wonder if I could throw it far enough; it looks heavy. On the table at the other end of the couch, there is a vase of flowers; this is heavier than the candle. Candle it is, then.
Of course, I'm only entertaining a fantasy, I'd never do anything like that, but I just get so frustrated, feeling like the world is always making fun of me.
"Really, I didn't," he says. "I'm sorry, I promise. But you're not crazy, Cassaundra." As angry as I am, I still think he makes my name sound smooth and rich and sexy.
"Hmph. I feel pretty crazy."
"Okay, tell me this; how do you sleep? Well? Fitful? Do you feel rested in the mornings?"
"I sleep," I say, frowning some as I mentally review my sleep habits. "I usually wake up rested; I don't remember dreams. I don't think I move around much, but I sleep alone so I can't really say."
"I see," he says. "What about your appetite?"
My mouth falls open; I can't believe he's asking me about my appetite. Hasn't he looked at me? "My scale tells me my appetite is just fine. In fact, it's extra fine," I answer.
He laughs again. "Cute," he says. "That's cute."
The rest of the appointment is smooth, he asks basic questions and I give basic answers. Basically, he has tricked me into the getting-to-know-you session that he said we wouldn't have. He's good.
And wow, he thinks I'm cute.
Chapter Nine
I can't stop thinking about Dr. Caswell. Mackenzie. Even his name is sexy. Since the day I met him, he's wandered through my dreams, sometimes as my doctor, sometimes as something more. I don't remember the dreams in great detail, but I wake up frequently with the sense that he's been somewhere near.
I'm constantly chiding myself. He sees you as a patient. Only a patient.
It's disturbing, really. I have another appointment coming up, my fourth one. In the second appointment, we covered a lot of my childhood. We talked about the loss of my family, and how I've dealt with the grief over the years. We've touched briefly on my depression, insecurity, and anxiety.
I can't believe how hard it is to share those things with him, to make myself vulnerable in that way to someone I don't even know. I have to give him credit though; he makes it seem easier because he's really paying attention to me, really trying to understand me.
That's what he's paid for.
It's like he can tell when he's poking a sore spot in my memories, and he'll back away, drifting into other topics. He goes out of his way to put me as ease, but I keep waiting for him to say something off, something mean. Of course, he doesn't, but this is the extent of my cruelty to myself. I've grown to expect it from others.
At my last appointment, he told me he wanted us to work on my inner dialogue and he gave me a typical, day-to-day sort of scenario; I was instructed to tell him what my thoughts would be. He asked me what I'd be thinking if I found myself shopping completely alone with an unlimited budget in a lingerie store; it was meant to be an exercise in outward honesty, bringing my inner thoughts to the forefront and forcing me to voice them.
"What would I be thinking?" I'd asked. He'd nodded encouragingly, and I'd said, "I'd be thinking it's a damn shame everything here is too small."
Smiling to myself at the memory of his mouth dropping open at my honesty, I choose a grocery cart. Even grocery shopping is hard for me. For some people, they're just picking up something to eat, grabbing something for dinner, a bag of apples to make a pie for their families. I see mothers buying juice for their children, men buying beer and chips for game night.
I don't know why it happens; I'm walking through the store just like everyone else. Some people are smaller than I am, some are larger. Some look at me, some don't. Of those that do, some are admiring, some are not. Still, I feel like I've got a neon light shining out of me and an arrow over my head, like in a cartoon, flashing on and off, drawing every eye to my wiggling hips, my thighs, my breasts, my waist. My fat.
"I'd rather be dead than be fat."
It's like a running diatribe in my mind, this mix of self-abusive thoughts and memories from other times; I can't stop it, but I try hard to ignore it, to pretend I'm just normal like everyone else.
I choose bread to make sandwiches, remembering to squish slightly the way Janet taught me, to be sure the bread is soft. Uh-huh, that's right. You need more carbs on your chair-breaking butt. I choose salad supplies for my work lunches; lettuce and tomatoes, cucumbers, peppers in various colors, onions, cabbage, spinach. Rabbit food. Just what you need. Maybe if you only eat salad you can lose some weight. Besides, society says you can buy this. Okay, done now, go home.
But I'm not done; I walk down the aisle for salad dressing, and behind me is a shelf full of cookies, snack cakes, muffins. These are things I never allow myself to eat, out of fear that they will increase my weight problems. Might as well just fill the cart right up with them; that's what all these people think you live on anyway. Before I lose my cool and break down in the store, I make a quick dash down the meat aisle.
In the meat section, the brutality in my mind is silent. I eat mostly lean meat, and I can't really chastise myself for eating meat. I'm fully aware that the human body needs protein to survive, and I see chicken as a lifesaver. The only diet that's ever worked for me, even a little, was a low carb high protein diet. I lost fourteen water pounds, but then I found them back again and they brought friends to my waistline.
As I'm walking through the checkout lane, I can hear Dr. Caswell in my mind, like I'm reliving my last appointment in an effort to fend off grocery depression.
"So tell me why your confidence is so low," he'd said to me at my last appointment. I hadn't been expecting him to say that; it was actually his opening statement and I'd been pretty surprised. I'd sat there for so long, silently staring, that he'd felt obligated to explain himself.
"It shows in your body language. I can hear it when you talk. I can see it in your eyes, this belief that you are less than a woman. So, tell me, Cass. What do you believe is wrong with you? Other than the weight problems you've told me about, what is it that takes your self-worth from you?"
"It isn't just my weight," I'd whispered, watching him lean in to hear me better, leaning back in an effort to maintain my sense of being apart. "It's my whole life. I can't shop for clothes without hating myself for where I shop. I can't shop for food without hating myself for the things I believe others are thinking. I can't look in a mirror without finding something ugly, and I've lived my entire adult life by the dictates of the bathroom scale."
"Really? Why?"
"I don't know," I'd said to him, sliding a fingertip under my eyelashes before the pooling tears can wreck my makeup. I meet his eyes, waiting to see what he will say to me.
"Throw it away," he'd murmured, reaching across the coffee table to push a box of tissues my way. "You can tell if your body is bigger or smaller by the way your clothes fit, Cassaundra. You don't need to wake up every morning and ask your scale if you're worthy of breathing that day."
I remember how I'd stared at him when he told me that, shocked that he could even suggest it. Weighing every day is what keeps me in line, reminds me to drink water in
stead of soda, and eat salad instead of fries. He'd looked shocked too, when I'd told him that.
"You just have no faith in yourself at all, do you?" he'd asked, compassion softening his tone. "Okay, here's what we're going to do."
Dr. Caswell had insisted that I switch to weekly weighing, instead of daily. He said, that way, I could keep track of my weight without undue daily stress. I didn't have the heart to argue, to tell him that going an entire week wondering what my weight was would probably increase my daily stress.
He also said that I need to work more actively on building myself up. He'd prescribed a mild antidepressant and gave me a little book full of quotes to use as positive affirmations. Grinning at my confusion, he'd instructed me to take one of each, daily.
Today's affirmation, which floats to mind as I load my groceries into the car, is a quote from Elizabeth Gilbert. "Never forget that once upon a time, in an unguarded moment, you recognized yourself as a friend."
Fat Chance Page 5