“I was so excited when I read your email about the dentist!” Bea says to me, after I’ve pulled off my coat and settled myself onto the couch. Hagrid had been running around the room, but after stopping by Bea’s chair for some attention, he jumps up next to me.
“Me, too. I really couldn’t have found a better dentist.” I’m smiling, because this is such a big deal for me.
We talk about the dentist, and when I tell Bea what Dr. R had said about medications, she nods. “It makes sense. It’s the same idea as building resilience when talking about and feeling emotions. If you aren’t present when we talk about things, you can not really integrate that experience. I think she’s right. Each positive experience you have can be built upon to build resilience and tolerate dental appointments better.”
I nod my head, agreeing with her. “I’m going to try just taking an anti-anxiety medicine for the next appointment, I think.”
“I think that’s a great idea. And she is clearly familiar with PTSD. Having you orient to the room was very good.” She takes a drink of her tea, and seems to consider something. “Did it feel validating to have a dentist know some of the challenges with PTSD? To have hubby see that, and to have it confirmed that you aren’t crazy, that in fact, enough other people struggle with this that she spent two years working with just PTSD dental patients?”
I shrug. “I don’t know. I guess.” I hadn’t even thought about it, really. But in hindsight, it was validating.
As we wrap up talking about the dentist, Bea asks me if I want to talk about the bad night, or if I want to go through the email she had said she would talk to me about today. I cover my face, and after a moment, sit up and shake my head. “I don’t know. Both? I’m not sure…..I did a lot of writing this week. I was…..well, I made a list of progress. Maybe that first? And then the rest of the email?”
“That sounds good.” She smiles as she takes my iPad mini from me. (You can see that list here https://fallingdowmtherabbithole.wordpress.com/progress/)
“You might not agree with those….I don’t know. You might just think I’m way off….but ….I started writing and the list was longer than I thought. So….I don’t know.” I rush to…..I’m not sure, exactly,maybe to explain what I’d written, maybe to make sure she knew it wasn’t that important. I am afraid she is going to disagree or think I’ve written down such tiny, insignificant things that it was a waste to do so.
“If you feel a change, then it’s a change. And if you feel like it’s progress, then it is. That’s the real test, not whether I or anyone else thinks you have made progress. It’s how you feel about it.” She says gently.
I bury my face in my knees as she reads, feeling embarrassed.
“Right here….you say that you still like routines and schedules, but you are able to handle it if they change. That is progress! Progress doesn’t mean everything is all better, all ‘fixed’. It means a change that has made your life easier, more enjoyable. This is good….this is really good.” She says. And then, after a moment, “Wow. I knew how hard it was for you to say no to your mom, how much you felt like you had to be the good daughter. I didn’t realize that it went all the way back like this, though. You write it out so well, ‘I could never say no to my mom, or disappoint her, for fear of making her sick again.’ It was really hard for you to tell her no, wasn’t it?”
I lift my head, peek at her from the corner of my eye. “Do you remember when…..?”
“I do remember. We really worked on that a lot. I just didn’t link the fear of telling her no with the fear of making her sick again. You felt so responsible for her.”
“We talked about it for weeks. Are you sure you didn’t know what a big deal it was? Because it felt like you did.” I tell her.
“Honestly, I remember the party issue, and you feeling like you had to go, even though you were scared. And I do remember it being a very big deal, and a hard thing for so many, many reasons, I just don’t think I linked the fear of disappointing her all the way back to the fear of making her sick again. I was seeing it more as the need to be a good girl, to be perfect so she would continue accepting you.” Bea is talking in that gentle tone. I think she is afraid she is going to upset me.
I nod. I think a year ago, my feelings would be hurt. But today? I’m okay. I remember how Bea was so there for me, how supportive she was, how she saw me for extra sessions, and was emailing daily. I remember how she felt like she wanted to protect me from going to that party and seeing Kenny. I remember feeling that protectiveness, when I showed up to an appointment with the little girl running the ship, and so terrified that it had taken everything in me to leave my house and get to her office. I remember feeling like she was on my side. “Well, I remember feeling like you were in it with me and on my side.”
I see her smile out of the corner of my eye. “I was absolutely on your side. I just didn’t realize how far back that went, and I’m thinking how hard it was for you to say no to her. This is a big deal. This is huge that you feel able to say no, and let her be responsible for herself.”
She continues reading the list. It really is a lot longer than I thought it would be. “Here. You’ve just written a perfect treatment plan for the insurance. They always want quantifiable goals, progress. You were sleeping only 3 hours a night, and now some nights you sleep 5 or even 6 hours. That is a big deal.”
I laugh. It is a big deal. Getting more sleep, even just 2 nights a week, means I can function better and handle triggers better. “You can send them that. I don’t mind.” And I truly don’t. I know how ridiculous insurance companies can be. We have to deal with them all the time for Kat’s ABA.
Bea goes back to reading, commenting on other things I’d listed out. She is really excited about me dealing better with messes; she tells me this is a very big deal and huge progress. She finishes reading and says, “I agree with all of this. This is major progress. I want to cry over this.”
I shake my head. “No, don’t cry, I wasn’t trying to upset you.” I feel….odd. I’m confused, because this list is not a bad thing. But I’m feeling guilty because it’s upset Bea for some reason.
“I am not upset at all. Not at all. I feel like crying happy tears. I’m feeling a lot of happy feelings right now, and they are so big they needs a way to come out. That’s happy tears.” I can hear the emotion in her voice.
“Oh.” I feel like an idiot. “It’s okay then. You can cry.”
“Then I’m going to let myself feel my feelings. Tears are just our emotions coming out, and in this case, I have happy emotions coming out,” she says to me. “This is such a great list. We did all of this without sensorimotor therapy. I’ve been so focused on what I felt I did wrong in your therapy, and pushing for this other way. But this is a lot that we accomplished. This is a good reminder that the sensorimotor stuff is an ‘and’ not an ‘or’. It’s a big deal that you can see these changes and name them. That’s progress, too. I feel like we should print this out and have it it refer to, so that we can remind ourselves how much has changed, when you are having a hard day.”
“I can email a copy to you,” I offer shyly.
“That would be really great. Thank you!” She says.
I want to ask her what would have been on her list as progress, if it would have been different than mine, but I don’t. Instead, I motion her to hand the iPad back, and I pull up my coping skills/resources page. “Did you want to see my coping skills list?” (You can find that here…https://fallingdowmtherabbithole.wordpress.com/coping-skills-and-resources/)
“This is great, so good,” she tells me. We talk about the coping skills I’ve added to the list. She asks me where I’d found this picture of ways to take a break, stating that she really likes it.
“I think I just googled it. I don’t know. It was a long time ago.”
“Could you send me this, too? I think it would be helpful for this teen boy I’ve been seeing. He really has a hard time finding any resource, and when he is feeling bad, he can’t work his way out of it. I’ve been using the grounding resources that have worked with you in the past for him, and those do help. So this picture would be awesome.”
“Sure. You’ll end up with the whole document though, is that okay?”
“Yes, that’s perfect. I’d like to keep a list of your personal resources, if it’s all right. It would be good to have it to refer back to when we need it.” She says.
“Okay,” I tell her. We talk a bit more about resources, and different people’s ways of using them. (I want to add here that I’m not bothered by hearing Bea mention other people she sees, or even by seeing her other clients as I am arriving or leaving. I know that she sees other people– this is her job, after all– and when she talks about others (never with a name or with any identifying details), and I can hear the care and compassion in her voice, and see how much she wants to help them, I’m a little awed, and in some way, it affirms for me that she cares that much about me, too. She’s often told me stories about abused and traumatized kids she has worked with, usually as a way to drive home the point I’m not crazy, or my experience isn’t wrong, or I’m not alone, or my reaction is the same as other children’s. It helps me, but I realize that it could be upsetting for some.)
She glances at the clock and asks me, “Should we look at your email now? Go through the rest of it?”
I grimace, but pull it up and hand it to her. Then, I quickly bury my face in my knees.
She skims through it, and then stops. “So, knowing that coloring helped bring you back, that is a good thing to know. It’s good for you to have a sense of control over being far away, and it’s good for us to have a way to bring you back.”
“Yeah……” I mumble.
“We can build on that, now, maybe trying to orient to the room. When you are ready.” There is no judgement or annoyance in her voice over my still not being ready.
“Even though….well, even though I could sit up, I don’t usually want to. So that is hard. Maybe if you didn’t ask me to sit up or to find a certain color in the room, you just asked what I can see? Like right now, I see the blue rug, and the wooden floor, and the bucket of puppets, and the bin of blocks. I can see the purple blanket on the couch, and Hagrid’s tail and your shoes.”
“That’s a great idea! We can do that. I’m glad to know what will feel safer to you.” Again Bea sounds like she really is glad, and not annoyed at all. I so don’t get her sometimes.
“It’s still uncomfortable,” I say.
“It is uncomfortable, yes, but I think you nailed it when you said it’s new, and feels weird because it’s new. This is a resource we need to have, to help you stay safe. If we are going to talk more about details and the actual trauma, and work on integrating that one day– and I think we can, and that it is important– we need ways to help you stay in the window. So, when you are going too far away, we know that coloring has worked to bring you back, and that it feels safe to orient to the room of you can keep your head down. Now we need to find something that works for you, and feels comfortable to help bring you back when you are going the other direction; when you are maybe far away, but hyperaroused.”
I sigh. “Can’t I just go far away, then? Wouldn’t that be okay?”
“Well……we don’t want to send you back the other way and back out the window that way, we just want to pull you back into the window. And the window isn’t comfortable, it’s on the edge of the trauma memories, and enough into the past that you can access the memories, and feel the feelings. It’s not that you should be comfortable in the window. But if we can stay in the window, it is easier to be grounded when you leave here and go on to have a good day at home. And things really do become more integrated when you are in the window.”
“No….I mean, if I’m on the upside of the window, why couldn’t I just go to the far away that feels safe?” I’m feeling frustrated, because I think what I’m saying makes sense, and she’s not getting it.
“Yes, that would bring you back from the hyperarousal, but my worry would be if you could do it on command like that, and then you would be in the far away, and we would have to bring you back from that.” She explains calmly.
“So? Why couldn’t that work?”
“It could work. It absolutely could work,” she tells me. After a pause, she says, “I know you don’t like visualization exercises. I know in the past they have triggered you and been uncomfortable. I wonder if now that you have more resources to use, if the safe space exercise would be a good one for us to do. It is visualizing, but it is about creating a safe space in your mind. It’s a very detailed exercise, and it is a tool that orients you to the internal. It’s also maybe similar to your safe far away.”
I think about it before I nod my head. I’m surprised that she is able to tell that I’ve nodded, because with my face buried in my knees, and my arms wrapped around my head, the movement is small.
“So, maybe one day next week, we will have a safe space day.” She tells me. She talks a little more about it, and I’m wondering if I don’t already have a safe space on my head. But I’m not sure, because the room in my head puts me far away and not very present. However, in the room, I’m present enough to function. So I don’t know.
“This, here, about the after and how it seems to you now,” Bea says, tapping the iPad’s screen as she reads. “This is our goal, what we want to be able to do with the actual trauma event. I believe the after, for this memory, is integrated. The way that you say you remember what it feels like to be scared, but you don’t feel that fear now, that is an integrated memory. You remember the feelings and what was going on, but it doesn’t take over anymore.”
I nod my head. I can’t speak, because there really are no words for the awe I am feeling right now. It took me almost two years of therapy, but I’ve turned one memory– albeit a small one and it’s only the after part of the actual trauma memory– from a living, overwhelming thing into just something awful that happened, into an event where I know, and remember the fear was huge and terrible, but it’s no longer an event where the fear is real, and present and something that is going to drown me. Even though I had realized this at home, and realized it again as I wrote to Bea, attempting to describe how I was feeling, how this memory seemed different to me, it’s only when Bea says it, that the impact hits me: one day, all these memories that overwhelm me and ruin my life and send me running to my closet to hide, will be nothing more than horrifying memories, and the feelings, the sensations, the emotional wreckage that they bring with them right now, will just be something I remember feeling. I won’t have to feel these things for the rest of my life. I honestly can not fully wrap my mind around the idea.
I won’t be in this cage of flashbacks and nightmares and feelings, memories, emotions forever. I suddenly have this feeling that I can have a real life. How awesome is that? I can have a real life. I’m not sure I have ever thought about my future in any way besides doing what I’m supposed to do, but suddenly I feel full of hope for the future, as if I could do anything.
To be continued…………