So now she knows the truth about “Not okay”

On Monday, I sent Bea an email. In it, I very bluntly told her that I was “not okay” and that she needed to stop telling me I was okay; that I needed her to see past my act of being fine, that I needed to her believe me that I wasn’t okay. And then I told her I wasn’t eating, I was cutting daily. I told her I was cutting before therapy. I told her I had an all out bulimic episode last week– something I am terribly ashamed of.

I was so afraid to send this email, but I sent it. I know I need help. I don’t want to be self destructing this way. Not anymore. I want to have energy to play with my daughter. I want to sit down and eat dinner with my husband. I don’t want to feel an urgent need to run off and cut myself every time I get overwhelmed.

Bea responded kindly, and in her non-judgmental way, that we really needed to go back to symptom management and safety this week. So, when I showed up to therapy on Tuesday, it was with dread. I do not like talking about my behaviors. I don’t like picking them apart, and I don’t like talking about why. I didn’t want to hear that I should just eat, or a lecture on the damage I was doing, or listen to theories on why I cut. Nope. I didn’t want to be doing this. I wanted to keep starving, keep cutting, keep pretending I was fine. Except……I really didn’t want to do that, either.

I walked into Bea’s office feeling like a kid that is in trouble. How I hate that feeling. It’s not a good feeling. I couldn’t even get a “hello” out. I sat down, and just hid my face. I wanted to run out of there, and just go and go and go. What was I thinking? Telling her I wasn’t okay? Telling her exactly how bad things had gotten? Maybe I really was crazy.

“Hi,” Bea says, “this is going to be hard today for you, isn’t it?”

From my spot on the couch, I nod my head without looking up.

“I think it’s really important that you told me. I’m really glad you sent that email, thank you for telling me. We need to go back to working on being safe, keeping you safe.”

I don’t say anything. I can’t. I don’t want to be here. I know we need to talk about these things, I know I should pick my head up and start talking, start behaving like an adult. I’m just too tired, though. And she knows now, anyway, so what’s they point in trying to pretend?

“I do need to be able to trust that you will tell me if you have worsening symptoms. We are stirring up a lot of stuff, and we are staying on the edge of safety here, that’s a given, considering you have behaviors you have never given up or have been willing to give up. And that’s okay. But you have to communicate with me, I can’t see what is being stirred up, or what is happening on the inside. That’s why I was so glad that you reached out with your email. We can work on these things, together, okay?”

I nod again. I’m still not talking.

“I want us to make a list of behaviors that you are using the most to escape, or to feel better when things are overwhelming,” she says.

I cringe. I don’t want a list. That requires my participation. Crap.

After a while, Bea asks me what I think the number one thing I use to avoid feeling or dealing with stuff is right now. It’s an easy answer. “Not eating,” I mumble it, embarrassed and mad at myself.

“I don’t think this is rooted in a need for being a certain weight, or being a perfect size,” she tells me, “I really, really believe that this is you being in complete control of your body. You weren’t in control of your body during the abuse, and now, I think you get the feeling of you can be— ‘oh no, body, you aren’t hungry, I will not feed you, I am the one in comtrol. And we know that’s fine and well, until it doesn’t work anymore, because one day it will make you sick. I’m not going to lecture you on that, or tell you to eat. It’s not that simple. But I do think, for you, it’s the ultimate control over what you had no control over.”

I don’t say a word. I don’t react, I won’t react. Bea’s words hit me deep; maybe because she is the first therapist who knows what happened, maybe because she is the first therapist I have really ever begun to trust, whatever the reason, she seems to get it, to put into words what I can not, what I have never really been able to explain or express. I won’t tell her, I can’t tell. It seems imperative that she not know how close to home her words have hit, or true they ring in my heart.

We sit in silence for a while, again. I am struggling to get words out, to say the second thing that should go on the list.

Bea is laughing at herself. “You should be encouraged; the most disorganized therapist in the world is making a list! You love lists….maybe you are rubbing off on me……”

Finally she asks if I would rather write the list at home and bring it to her on Thursday.

I sigh. “No. Either way, you want the list, so you’ll know what’s on it.”

“I can’t help you if I don’t know, that’s all,” she tells me, “you did this before. I already know all the things you do, and about them, too. It’s okay. But if I don’t know what’s being used the most often, how can I even try to help you? That’s the only reason I want to know.”

I try to remind myself that this is Bea, who does not think I’m crazy, who usually convinces me I’m normal (for a person with a trauma history), who has never judged me, who already knows all the crap I do to myself, and all the other “crazy” things I do to try to be okay.

“Cutting.”

I can hear her pen on paper, and then she asks me if my experience is like other people who cut, “I’ve had people tell me that it almost feels good to hurt themselves, either because they feel numb, or because it makes them numb, but then there is a second part to it, almost a self care part….like you are being kind to yourself, bandaging the wound, cleaning it—”

I’m shaking my head no, because she’s wrong. This is not my experience. This might be what other cutters say, or maybe is the typical cutter experience. I don’t know. But I have heard this all before, and Bea is heading into the dangerous “shrinky things” territory. But, maybe, this is why no one has ever been able to help me before. I’ve never tried to explain it, or correct their assumptions. So, I shake my head no.

“Not your experience?” Bea asks.

I gather my courage, and then I blurt out, as fast as I can, “it’s like throwing up, without haveing to eat or puke, so it’s better.”

“Oh, oh!” She sounds like something just clicked for her, “it’s about relief, then. It’s release, for you.”

And with that, I feel like a weight is gone. I’m still hiding my face, still curled up, still tense but not as much. She got it. She understood.

“Is this why not eating and cutting go together for you?” She asks me, and I nod. “So…..don’t eat, and you have control. Cut and you have release,” she says. I nod again.

She gets it. She understands the twisted way my head works, and why I self destruct.

The list is easier after that. Bulimic behavior, running/over exercising (which I don’t really do anymore thanks to my fibro). Then I say swimming can make me feel better, but not the same as the other stuff. We add sewing, reading, playing with Kat, cooking, baking, taking care of others.

Bea wants me to spend time outdoors. I tell her I’m not an outdoors kind of girl. I used to like to sit outside and read, or take relaxing boat rides, things like that. The type of outdoors stuff you do without kids. So, no, I’m not a go for a walk outdoors kind of girl. She’s surprised by this. I get the feeling I surprise her a lot.

We talk about yoga. Bea has wanted me to try yoga for quite a while now. I’m not against the idea, but it has taken me a while to warm up to it. She suggested it, and has gently reminded me since then how much yoga could help me to be grounded and connected to my body.

“I just really want you to think about yoga. It could be another tool for you to use instead of hurting yourself,” Bea says.

I nod. I’ve talked a little this session, but not very much. Poor Bea. She doesn’t really like to talk, but somehow, with me, she gets stuck talking an awful lot.

“I really want us to try the container exercise today,” Bea says.

“Ok. But I already have a box,” I remind her.

“Right, so this should be an easy one for you. But remember, you said your lock was broken. So I want to make a new container. And fix the lock.”

I nod.

“Okay, close your eyes if it feels safe, if you like, I usually do, and take some good deep belly breathes,” Bea starts walking me through the exersise. I hate belly breathes, but they don’t trigger me like they used to. I don’t focus on them though I can’t. I focus on her voice, on the noises outside, on the fact that I am picking at my fingers. “Okay. We are going to build a container……” And so we start. In my mind, I picture a big box, dark and shadowy, strong enough to hold all the ugly inside. Bea continues, guiding though how to build the container, and then putting the ugly, the memories inside.

That’s when the anxiety kicks in. I start to feel like I have to get everything, all the ugly in the box right now. I feel like a scared little girl. I want to cry, I feel so overwhelmed, but I have to get all the memories picked up, so I can smile and be okay or nothing will ever be okay again. I have to do this right now. I’m shaking, and I’m fighting back tears. I can’t even listen to Bea, but at some point the exercise is over. I’m still lost in the anxiety and scared and the trying not to cry.

“Did that work for you? Could you follow it through? Did you make a box and lock everything inside?” Bea asks me.

I nod, it’s all I can do, because if I open my mouth to talk, I know the tears will fall, and then how will I ever explain that?

Bea is quiet for a minute. She finally says, “Did you really do it, or are you telling me you did because you think that’s the right answer? Because this doesn’t work for everyone. And that’s okay.”

The part of me that is “here” and not stuck in the scared anxious place is so thankful she knows to ask now, that she realizes I will always give what I perceive to be the “right” answer, that I can’t stop myself from pretending to be okay. It gives me the courage to think about telling the truth.

It takes me almost 5 minutes, and then I say, “I didn’t do it.” I whisper it, barely getting it out. I’m still stuck in the scared anxious place.

“Did you go somewhere? I feel like you are in a scary place,” Bea says very softy.

I shake my head no….then yes. Finally, “I don’t know, it’s a feeling. I’m anxious, scared. I want to cry. I’ve been trying not to cry.”

Bea helps me calm down, come back, get grounded. She asks me to email her later about where I was, what happened. She also says that we won’t do any more imaginative exercises; that sometimes childhood sexual abuse survivors are already too good at going away. So it’s back to working on grounding. And, as I head out the door, she tells me to really think about yoga.