Thursday, April 12, 2018
It’s 10:45 a.m. on a sunny April Thursday, and a girl is sitting in the dining hall, trying to eat something before she goes to her counseling session. She feels nauseous and isn’t sure if it’s because she nervous or if it’s because she needs to eat something. After eating about three spoonfuls of soup, as that’s all she can take, she sits there for a few minutes.
“There’s so many people in here, and I need to leave right now. There are people near me that are too much to handle, including the girl who rejected me as a roommate after she agreed to rooming together. This is not okay. I need to leave right now. Just leave. Get up and leave. Come on. Go. Leave. Just get up and leave. You are going to be late.”
After a few minutes, she is able to collect herself enough to make her way downstairs to wait. Once she finds an empty chair in a corner, she takes out the folder with the letter she wrote about herself and a piece of paper. She opens it and goes over the paper with her list of things she hopes to talk about in session.
“You need to calm the fuck down already. It’s not that big of a deal. You have gone to sessions so many times before, so you just need to stop all this nonsense. Just calm down. Ground yourself. See your feet are still on the floor in your shoes. Your body is still in the chair. Your hands are holding the folder and the papers. Just breathe. Not breathing does nothing to help, so come on. Just breathe.”
Then she examines her letter that contains her struggles and sufferings that she wishes she could share with her mother. She has decided that she wants to share it in session after several months of revision and contemplation.
It’s 10:58 a.m., and she walks across the room to the counseling center and passes through the doors. As she walks in, she sees two other students sitting and waiting. Seeing other students in there, waiting, makes her anxious, and she tries to ignore those feelings. She walks to the front desk to check in, then back to a chair to sit and wait. While holding her folder, she notices her hands trembling, her heart racing, and her breath getting quicker. She tries to ground while she waits for a few minutes before being taken back into the counselor’s office.
It’s 11:03 a.m., and she’s sitting in the chair across from the counselor. She has her folder and phone next to her in the chair. She feels on edge and uncomfortable in the chair as the pillow behind her is in an awkward position, but she is too nervous to move it or lean back on it. The chair makes a weird squeaking sound when one moves in it, and she is too anxious and doesn’t want to hear or make that noise. As she is sitting there with her hands shaking and her anxiety rising, her counselor greets her.
“Good morning,” he says with a smile.
She tries to respond back and manages to weakly say, “Good morning.”
She notices that he noticed the folder she brought. Her anxiety rises because she feels like she should have spoken louder and clearer.
Her mind tells her, “Wow. Good job. You can’t even say a decent hello.”
“How are you doing today?”
“I’m okay.” She can barely speak as she is fighting with her thoughts. “Wow. Really? Again? You can’t speak properly, can you?”
“Is there anything you want to specifically talk about today?” he questions.
She thinks he is wondering about the folder she has brought in, so she opens the folder and takes out a paper with her list.
“Um, yes, there are some things that I wanted to talk about today,” she responds in a somewhat shaky voice and looks at the paper.
“Don’t do it. You can’t do it. You shouldn’t be doing this because you’re not going to be able to. You can’t do it. You don’t matter enough to bring this up. If you can barely even say hello,you most definitely can’t talk about this stuff.”
Her mind is telling her these lies over and over again.
“Alright, go ahead.”
As she holds the paper, her hands are shaking, and her thoughts are becoming louder. She stares at the page trying to decide what she wants to talk about first. Her mind is racing, and she can’t make a decision. She stares for awhile longer, with her anxiety rising to severely high levels. As she continues to look at the page, her thoughts are interrupted for a moment by a voice. She hears what he is saying, but her thoughts are trying to drown him out. She is stuck in her mind and is starting to panic because she doesn’t think she will be able to speak. She wants to talk about these topics on her paper but is too afraid. She isn’t sure why she’s so afraid. It might be because it contains hard and painful things. She continues to stare at the page until she is no longer able to look at it, so she folds it back up. She tries not to dissociate and to keep herself in the room. Her counselor starts talking again and telling her some things she doesn’t quite remember.
A few minutes pass that are now a blur to her. She dissociates and is now trapped in her mind trying to calm herself, but it’s not working. Her breathing is getting quicker, and her hands are shaking more. She doesn’t quite know what is going on now, and everything is a blur. After a little while, she is finally able to calm herself enough. As she stares at her paper, her counselor tells her she can put the paper down. She can’t let it go because of the anxiety, and she is stuck here not knowing what to do. Eventually, she can’t take the anxiety anymore, so she puts the paper down. After a few more minutes of a blur, she is finally able to collect herself enough to tell him what she wanted to talk about. She decides she is just going to do it and get it over with otherwise she will regret it later. She hesitates, then somehow manages to summon enough courage to speak.
“So last semester, I wrote this letter sort of thing that I wanted to send to my mom, but it was really harsh, so I revised it, but I thought it was still too harsh, so I revised it again. The first two revisions were in second person,but this revision is in third person, so like now it’s about this girl I know.”
He gives some advice, and she doesn’t quite remember exactly what happened, but she knows he said something to the effect that he doesn’t know the answer because he doesn’t know her mother or what the letter says. He asks a few questions that she did her best to answer. Her anxiety continues to rise, but she knows that it was going to be okay because she was able to speak about what she wanted to talk about.
“Do you want me to read it?”
“No, don’t let him read it. We don’t need to be understood. This is too personal and too deep. You’re too messed up to let anyone read this. Why did you even have the thought to let anyone read this piece of shit? Why did you even write it? No one cares about your letter or anything you have to say. Nothing you say or write matters. You don’t even matter.”
She hesitates and looks away then down at the folder.
“Um, yes, I think I do.”
She feels a wave of relief because she didn’t want to outright say she needed him to read it. To understand her better, he needed to read this letter because she feels like she can’t properly articulate her thoughts and feelings aloud. She had the intention before she got there to let him read it because she knew it would give him a better understanding of her mind and her pain.
She hands him the folder with the seven and a half pages of her mind. He takes it and holds it for a few seconds.
“Is there anything I should know before I read this?”
“No, I don’t think so.”
He opens the folder and takes out the paper. (click here for the paper)
“I’m a very slow reader so it might take me a little while. If you want to, you can take out your phone or just relax or whatever.”
She thinks to herself, “I too am a slow reader, so it doesn’t bother me at all.”
She sits there as he reads each page. Her heart and breathing have calmed down some, but she is still nervous of what he is going to think about her writing. She believes her writing is terrible, but she still felt some sort of accomplishment and pride for being able to complete this letter and express her mind.
As he continues to read the letter, she sees which page he is on and is now getting nervous because she knows the paragraphs he is getting to are the ones that contain the darkest parts of her mind. Her heart is now racing because she’s not sure how he is going to react. Then her mind is out of this room thinking about the times she was writing this letter and all the thoughts she had as she was writing. She’s dissociating and trying to come back into the room but is struggling. Finally, she manages to center and ground herself. Now, she sees that he is on the last page and is now panicking.
“Why did you give this to him to read? This is too much, and you’re too vulnerable. This was a bad idea, and you shouldn’t even be here right now. You should be dead. Now he knows your pain,and you’re just going to hurt him like you hurt all the rest of those around you with your stupid, pathetic problems. Good job. You’re such a failure.”
“No, it’s okay, he needs to know my pain in order to help. It’s too late now anyways. It’s okay. This is what I really wanted. You have just kept me from doing this, so you’re the problem here.”
It’s 11:42 a.m., and he finishes the last page of the paper, then stacks them up and puts them with the folder. She sees the time as he finishes the last sentence and worries that they are going to go over time making him late for the next client.
“Great. You made this letter too long and now you’re going to go over your time. Good job. You’re such a failure and a burden. Why are you even here? Why are you even alive? You’re just a burden to everyone you interact with, and this is just one more instance as proof.”
He hands the letter and folder back to her. As her hands are shaking, she takes the stack. She is too nervous to look up at him, so she looks down at the floor. Somehow, after a couple seconds, she manages to look up. He looks like he is hurt and like he cares. She thinks she sees emotion in his eyes but isn’t sure. She can tell that he understands her pain now. Tears begin to make their way to her eyes, but she tries to push them away. She is starting to feel relief because she has finally shared everything with someone. She feels like she can trust him more now.
“Thank you for sharing this with me.”
He starts talking about other things, but her mind is fighting her, so she is having trouble focusing on what he is saying. She knows what he is saying and is trying to understand, but her mind is trying to distract her. He talks about how she should wait to send this to her mother. She is relieved that he said this because after seeing his reaction, she can’t imagine how hurt her own mother would be if she knew all these things about her.
He asks about some of the things that stood out to him like the suicidal and self-injurious paragraphs. He says something about how he didn’t know how bad things are with the self-harm and that if she is that dependent on it without anything else, he doesn’t want to take it away just yet.
“I am relieved that I don’t have to give up cutting yet because I will have a little less guilt about it, but I really don’t want to keep cutting as I don’t want any more scars as evidence. I’m afraid that when I have to see a doctor for a physical, they will see my scars and cuts on my thigh, and they will ask about them. I don’t want to have to explain it to them or to my mother in person if she were to see them or hear about them from the doctor. Several weeks ago, before the Florida trip, I tried to give up cutting my wrist because I didn’t want any more scars and I wanted my other cuts to heal so I could put concealer over them to hide them. I wasn’t going to be able to wear long sleeves because it was so warm, and we had specific short sleeve shirts we had to wear, so I couldn’t hide them with clothing. Instead, I cut my thigh, and on the trip, I’m pretty sure when we were at the pool, someone saw the fading cuts even though I thought they had faded enough so that they weren’t noticeable.”
As he asks about the suicidal and self-injurious parts, she feels ashamed for even thinking about them, but is still honest about them.
“Are you suicidal?”
“No. You are not talking about this. No. We are not doing this.”
“But I need to be honest. I have to tell the truth.”
She nods yes because she can’t find her voice.
“Hm.” He looks sympathetic and sad for her. “Okay. On a scale of one to ten, with one being that you think about death, and ten being that you would actually do it, where are you?
“I think about a three or a four.”
“About a three or a four, okay. And where are you when you’re at your worst?” He asks in a soft tone and waits for her to answer.
She hesitates before speaking and thinks about the times where she’s been at her worst.
“About an eight.”
“Okay. Have you thought about how you would do it?”
She nods as her voice is lost again.
“Can you tell me how you would do it?”
She still can’t find her voice because she feels like she may start crying. Her voice ends up non-existent when she gets emotional. Her mind is off again.
“Seriously, no. No way. This is where I draw the line. This is too vulnerable and too uncomfortable. You are not sharing those thoughts anymore. Sharing your thoughts about how you want to kill yourself is way too much.”
Her mind then goes through the ways she would do it.
“She would slit the arteries in her wrists with a blade and let them bleed out. Or she would overdose on multiple different meds at the same time, step out in front of a car in the street, or jump from the top of a tall building. Although, she doesn’t think that stepping out in front of a car would most definitely kill her; it would probably just hurt her. Then she would just be a burden to the people she stepped out in front of, causing them the pain of hitting a person as well as the burden she would be to her family for all the medical bills. And she can’t get to the roof any building around here that would most definitely kill her if she jumped. As for overdosing, she almost overdosed on the Zoloft she was taking and got so scared about it. She also wanted to stop taking it one because she didn’t think it was working and two because she felt more suicidal. She feels that slitting her wrists or overdosing would be the easiest way to go out. Sometimes she feels like she needs to be hospitalized because of the times she has been so bad that she thought she might actually do it, but she’s scared of all the hospital bills and how her parents would react, so she just suffered alone in silence.”
She shakes her head to imply that she can’t.
He continues to talk, and her mind wanders to think about how she should be saying what she is thinking.
“Why can’t you just tell him. Like seriously he already knows that you’re suicidal. It’s not that much more painful and uncomfortable to share how you want to kill yourself. Like seriously why can’t you just do it? It’s not that hard. Just do it. Come on. You can’t do it, can you? Wow. You’re so pathetic. You’re such a failure.”
He talks to her about letting him know when she gets to an eight and that she can email him to let him know. He also tells her that if she ever gets too bad and is scared about it, there are always helplines and the hospital.
“I don’t think I could ever call a helpline and I would be to nervous to email you because I wouldn’t want to bother you out of sessions. I don’t really think that I bother you, but there’s still that nagging thought that I do. I also do wish I could be hospitalized because then I would be safe. Honestly, I’m getting tired of not feeling safe. Often, I don’t feel safe enough by myself, so I try to surround myself with people, so I don’t do anything. But I would be so scared about it because I’m terrified of hospitals and am afraid to go there and admit myself. I would also be scared of what my parents would think and how it would hurt them both emotionally and mentally as well as financially. We could never afford hospital bills or even medication or seeing a clinician.”
He continues to talk and brings up the topic of medication again. He thinks that she should try it again to make their work together more impactful. Although they have made some progress, its been slow and gradual. She knows she needs to make more progress quickly though because she needs to feel better to keep surviving. She wants to try meds again because she’s tired of fighting on her own. She needs help to remain strong before she breaks completely. But she’s hesitant because she knows her mother won’t want her to take them. She’s so scared of going back on them because of what happened the last time, and she’s afraid of her mother’s opinion as well as what might happen with the side effects of the meds. She didn’t like the effects of the last one and is scared of others that she might experience with a new one.
He also suggests she sees a clinician or someone over the summer as she has had difficulties not meeting for an extended period of time. She has thought about this over the week before their session and actually found someone she might be okay with seeing. But she is also scared about because she doesn’t think she will be able to afford it or have her mother agree. Originally, she thought about this because she had a seriously hard time being home and not meeting for sessions. She started thinking about the summer and how she might not make it through the break if she didn’t have some support or help.
In the end, she feels like the session went well and she feels good knowing that she has finally shared everything. She feels accomplished knowing that she has been able to communicate and express everything that is going on in her mind even if it wasn’t through speaking. During the session, she knew what was going on, but now doesn’t remember completely what happened. She remembers the comforting things said that, surprisingly, she believed. Having someone express that they truly care, gives her some hope to keep fighting. After she left her session, she starts thinking and overthinking about everything that happened during their meeting, trying to remember everything detail.