Her Story
Olivia arrived on an emergency basis, the friend of a friend of one of the psychologists in the office. The friend had called to ask if someone could see Olivia ASAP. I’ll never forget the first thing she said to me: “I think I’m crazy.” I had never seen anyone in a full-fledged anxiety attack before. It was not a pretty sight. Her body was shaking violently. I tried to hold her hands but they were moving so much they wouldn’t stay in mine. I put a hand on her leg and could feel her legs twitching uncontrollably. I simply scooted my chair up next to hers so we were knee to knee, and I held on to her as much as I could while she shook and tried to talk and cried and hiccoughed and coughed and sweated.
I assured her that she was having an anxiety attack and that she wasn’t crazy. I explained: “The folks who know these things always say that crazy people don’t know they’re crazy. So if you think you might be crazy, you’re not, because if you were, you wouldn’t realize it.” Whether that argument had any effect, I don’t know, but the shaking gradually subsided and the shudders spaced themselves farther and farther apart. One of the ironies of that first visit was that her father brought her. I was to learn, as the story unfolded, that it was her father who had abused Olivia, her older siblings and her mother. Of course, on that first day we didn’t talk about what had caused this onslaught of anxiety. We talked simply about coping skills for recognizing and reducing it.
Olivia is a bundle of unrealized potential. She is a beautiful woman with luxurious hair and flawless skin who has no idea she’s beautiful. She is model slender and walks like the dancer she always wanted to be. She is bright and resourceful and resilient but has had little opportunity to realize any of those possibilities. Born into another family, Olivia would probably have become a teacher in one of the arts or humanities. She is tied with my father as the most honest person I have ever met in my life. She is compassionate, intuitive and gradually coming to learn and accept that she is psychic. (We’ll come back to Olivia’s psychic ability later.) In her family there was zero support for realizing potential and seeking opportunities.
One of her childhood stories is about being sent around the neighborhood with an old doll carriage to collect food for the poor. She then brought the food home and her mom used it to feed her own children who were, indeed, impoverished. Olivia remembers breaking up the furniture to burn in the fireplace during the winter. She, like so many other abused and neglected children, had no dental care and only life-and-death medical care. The first time she went to the dentist she walked, carrying money she had earned herself in her after-school job at the drugstore.
This will sound familiar from Alan’s story, but the physical poverty which was present when her father was absent was much preferable to the physical abuse which filled their lives and minds when he was present. Dad had been the scrawniest of seven boys in his family and he, himself, grew up witnessing a lot of physical violence and being the recipient of an enormous amount of pent-up anger and hatred from his own father. He learned of cruelty from his father to his mother and witnessed cruelty from his father to each of his brothers who, in turn, came after the next youngest in the age-old enactment of the shit rolling down the hill. It piled up on the boy who became Olivia‘s father..
The cruelty in this family seems to have been generations old, as information about her grandparents can attest. Olivia’s grandparents probably would have had more than seven children but fate intervened. Grandma liked being pregnant. It was the only time that grandpa kept his hands off her, physically and sexually. Of course, he had a practical reason as well. Grandpa was hell-bent on having enough workers for the farm. It’s not surprising that a man who sees his children as free labor should hate to spend money. After grandma had three children with the help of the community doctor, grandpa decided the doctor was a waste. He, himself, would deliver the babies. Four, five and six were no problem. Number seven, Olivia’s dad, was premature. Even when it was abundantly clear that things weren’t going well, grandpa brought the baby into the world, took the cradle near the fireplace to warm up the little guy, patted grandma on the arm, told her to rest and left the room. Olivia’s uncles told Olivia’s father that they had heard their mother screaming, and then whimpering, and finally, moaning. Eventually everything was still. Their father forbade them from entering the room. In the morning, when grandpa went back into the bedroom with the squalling baby, grandma lay still and stiff. He called the boys in to say goodbye to their mother and then sent them out to dig a grave.
Grandpa reportedly tried diligently to find a replacement mom for this mob, but no one was willing to take on seven stepsons, including a scrawny, undernourished baby, much less take on grandpa, whose reputation had preceded him all over town. Olivia learned all this from a father who bragged about it, almost revering his father when he was sober, and cried about it with fathomless self-pity when he was drunk.
From this beginning, Olivia’s dad came into adulthood a belligerent, angry, raging man. A stint in the Army didn’t soften him any. He became a long-distance truck driver whose company demanded that he unload the trucks himself. This added a violent twist to his behavior as he frequently treated the children with as much brutality as he treated the boxes he was unloading from his trucks. Olivia, like him the littlest and lightest, went farther across the room and was hurt the most when he hurled and heaved the children around.
Her two older siblings left home as soon as they possibly could. Neither graduated from high school. Her older sister got pregnant and then got married and then got out of the house. Her older brother falsified papers somehow and got himself into the Navy. He became a submarine mechanic. In a rare moment of vulnerability with Olivia, he explained to her that he felt safe on a submarine. Their absconding left Olivia, at the age of nine, alone with an un-empowered mother and a cruel, controlling, abusive father.
Olivia calls her troubling childhood memories “Kodak moments.” She has flashes that don’t make much sense to her, but she sees each flash in her mind with the clarity of a photograph. She is crawling silently beside the sofa where her father is sleeping and his hand juts out and slaps her in the head. She is riding in the backseat of a car which her father is driving fast and erratically, knocking over trash cans and sideswiping mailboxes, when a woman’s gloved hand comes over the front seat and pushes Olivia down on the floor in the back and holds her there. Now, as an adult, she knows it was her mother’s hand trying to protect her from what she must have felt was an imminent accident. She has a clouded image of an oriental woman smiling at her as her father introduces them. She remembers getting into the car ostensibly to go get ice cream and ending up at the hospital to get her tonsils out instead. She has a memory of a doctor with bushy eyebrows and a mask and wonders if this is connected to the tonsillectomy.
She has another ice cream memory. They are driving to get ice cream, she and her parents and the two older ones, and her mom says something to her dad, she can’t hear what, and her dad slams on the brakes and turns around and without explanation drops everyone off at home and keeps going himself. These Kodak moments come without warning, flash in front of her mind, and drive her to distraction. “What is all this stuff?” she wants to know. “What does it mean? Why won’t it stop? What can I do? See, I’m crazy.”
Olivia has an album of memories which haunt her days and shatter her sleep.
One of the most upsetting happened when, she believes, she was eleven. Her father and mother had one of their many unbalanced fights. Her dad was more angry than usual and beat her mother with his fists. Olivia was in the house while this was happening, but her parents were in the bathroom and the door was locked. Her father finally flung open the door and flew down the steps and out of the house. She found her mother unconscious in the bathroom. She remembers dragging her into the bedroom and somehow getting her into bed. Had her mother not been moaning, she would have believed her to be dead.
Olivia cleaned her up and nursed her as well as any eleven year old could, and then she spent the night sitting behind the front door with a large butcher knife in her hands. He was not going to hurt her mother again.
The fighting was so bad that whenever possible her older sister would come and get her and take her to her house for the weekend. Olivia had a room to herself at her sister’s house. She would frequently wake up to find her brother-in-law standing silently in the room, and when she would say something, he would say he was just checking on her and walk away. Then one night she awakened to his hands rubbing her legs and removing her panties. She screamed and ran the mile home in her pajamas and bare feet in the middle of the night. Despite the fact that she told her story with outrage, the family version of that night was that Olivia had had a bad dream and, in her usual, super sensitive, overly reactive way, made a mountain out of a molehill. Nothing had taken place. This happens all too frequently to PTSD child victims. They are not believed. Insult is added to injury.
Finally her parents divorced and Olivia and her mother lived on scant child support but the joy of no violence and no fear. The abuse had taken a toll on her mother, though, and her incredibly mistreated and abused body was no match for the cancer that came. Olivia nursed her for the three years that it took the cancer to kill her. By this time Olivia was just graduating from high school and so, with her options an abusive father’s house, her sister’s house where her brother-in-law was free to molest her, or a stowaway on the submarines with her brother, Olivia chose her life path. Having completed a medical technology class in the vocational high school she attended, she took the first full-time job that was offered, in an obstetrician’s office, and found herself the cheapest apartment in town. She was never to escape the cycle of poverty known as the working poor.
Olivia married once. Her husband was so respectful that he told her he wanted to wait until after they were married to have sex. He was a musician and he was temporarily between gigs. He didn’t have a violent bone in his body. She dragged him with her to meet me. Neither of us imagined that he was gay. Three years later, with an unconsummated marriage and a couple thousand dollars of extra debt, she asked him to leave and the marriage was over. It had been a non-violent relationship and an affectionate one. Had Olivia not been so impeccably honest, she might have been able to tolerate the fraudulent nature of the non-marriage.
Single ever since, Olivia has gone through periods of great emotional contentment and periods of horrendous upheaval and loneliness. As her symptoms materialized, we tried to handle them.
Her Signs
Anxiety was and has always been Olivia’s primary and most disruptive symptom. It was anxiety, in fact, which proved to be the tipping point which brought Olivia into counseling. It is just so very hard for her to ever feel safe or relaxed. Her early childhood of pain has so tightened and constricted her body and her mind that she is a chronic jangle of nerves and tension. If she has something to worry about, she obsesses about it. If she has nothing to worry about, she worries that she’s missed something and she becomes more hyper-vigilant and wired.
She describes in her own written words what happens to her and how unexpectedly it happens:
I went to have breakfast with a friend. We sat and ate and talked about nothing in particular. I said, “I must have had too much coffee. I feel jittery.” When we were standing in the parking lot saying good-bye, I could feel a “rush” through my entire body. My throat became very tight, felt swollen, my hands were shaking, my legs shaky.
When I got in the car, I felt weak, sweaty, and nervous. Driving home I began to feel fearful, then scared to the point of crying. I stopped to get cigarettes. As I reached for the door of the store, there was another “rush.” I couldn’t help thinking, “Why are you afraid of a door?”
Then it occurred to me to try something. When I stood in line, I stayed still, touched nothing. Bam. Another “rush.” Panic, fear, shaking. However, I realized that my “rushes” occurred on their own. Doors do not trigger them. Lines of people do not trigger them. I came home, went to the bathroom, felt faint, then laid across my bed. My thinking was confused, fragmented. Bits and pieces of conversation popping in and out of my head. One-liners, so to speak. I sat up, afraid. The room looked slightly distorted. Judgment of distances slightly off. I looked at the clock and was aware that my perception of time was off. I thought maybe it had been an hour. It was ten minutes. Then the feeling of drunkenness mixed with nervousness. I could feel myself becoming “drunker.”
I slept for two hours. Awoke feeling shaky, hung over, jittery. It lasted another hour or so. Then I felt fine again. It’s much later now and it’s over. I’m not terrified and I don’t feel crazy. So how about a little humor. Maybe this is some kind of Scarlett O’Hara Syndrome. S.O.S. Didn’t all those southern belles occasionally come down with a case of the “vapors”?
Clearly you can tell from Olivia’s writing that her sense of humor was not one of the things she lost to PTSD. Her descriptions of being drunk on anxiety were eloquent and very helpful to her when she was able to make the perceptual leap from victim to observer. Stepping back to describe herself in a journal is one of the steps we took to work with Olivia’s symptoms. It makes more sense to talk about it here than to come back to it in the next section. This switch from being inside something--a participant or a victim--to being outside something--an observer or a survivor--can strengthen resiliency and move us from our emotional state to a thinking one.
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Take a half step back
And become an observer
Instead of a participant.
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Neurological research explains what actually happens inside the brain. Put simply, whatever parts and paths of the brain we use most are the ones that develop most completely. When a child is traumatized, the part of the brain that develops is the part which allows for an immediate response without thought or hesitation. This creates what is often seen as a hair-trigger reaction to insult or injury. There is no time for thought, and so, in fact, the brain doesn’t engage any thinking parts. It responds. The response is often not appropriate, but, then again, there are few appropriate responses to being beaten, battered or raped. So traumatized children learn to act and react without thinking about their actions or reactions because, bluntly, abusers don’t tend to negotiate.
In a dead heat with her anxiety as the hardest symptom she’s had to deal with comes Olivia’s depression. Again, her descriptions are poignant.
I hoped today I would wake up with a better feeling. I didn’t. I try to keep busy with cleaning and reading. But, I can’t seem to shake the feeling. I’m 36. I know that’s not old, but things haven’t turned out how I expected. Fifteen years ago I would have thought I’d be somewhere else. I thought financially things would be better. I thought maybe I’d be married and have a couple of kids, like everybody I know.
There’s just always this feeling of foreboding. Afraid of what’s to come. I don’t know any other way to explain it. I want to be happy. I want to be optimistic, enjoy things. I just can’t seem to shake these feelings.
I don’t understand myself anymore. That frightens me. I try to act like I used to act, thinking that if I “act it” I will become it. But deep down inside it’s all changed. I’m afraid. Somewhere I’m afraid I’m going to die soon. I know this doesn’t make sense. I’m fairly young. Up until recently my health has been pretty good. I’m just afraid I don’t have much time left. Isn’t this crazy? It doesn’t make sense to me. I don’t want to die. I don’t know what’s wrong with me. I never used to think crazy thoughts like this. Maybe I did go crazy. Maybe I just did it so quietly, no one noticed.
Many things in Olivia’s writing leap out at me as I read it over eighteen years later. Her sense of loss and grief, her regrets, her feelings of being different from others; her feelings of craziness because she has reactions and responses which make no sense in the non-traumatized present; her confusion about what PTSD is and how it affects so many aspects of her life; her pervasive fears; the constant looming of things dark and inexplicable and undeserved--even to the point of death; and her belief that she is invisible. No one would even notice if she died.
Her mental state of constant alarm has wreaked havoc with her body as well as her mind, altering her body chemistry. As expected, she has physical problems which also plague her day in and day out. It seems she no sooner gets one problem under control than another arises to keep her from feeling healthy physically. She has had serious thyroid problems. She has had constant gastro-intestinal problems. Her first memory of gastro-intestinal issues was when she was very young and she was crying because her stomach hurt. She remembers her mother rocking her and trying to soothe her, whispering, “It’s only hunger. It’ll go away soon.”
She has had a constant slew of gynecological problems, as well, which resulted in her meeting an incredibly important man in her life, her primary care physician, a compassionate man with strong, appropriate boundaries and an interesting twist on almost everything. This is another example to me of the way in which PTSD survivors often encounter people who are amazingly good and constant. It’s as though the universe wants to make up to them for the early awfulness of human mistreatment.
Another symptom I want to point out is her dissociation. This is very evident in her Kodak moments. Remember she sees herself crawling, sees herself being pushed down in the back seat of the car, just as she sees herself in the other flashes. In her flashes, she is outside her body, viewing herself in the picture. When these things happened in real time, Olivia dissociated. She left her body. This is a characteristic you’ll remember from Vicky’s story. Wikipedia provides a clear explanation: “Dissociation can be a response to trauma, and perhaps allows the mind to distance itself from experiences that are too much for the psyche to process at that time.” In a massive understatement, the blurb concludes that dissociative episodes “tend to be quite unsettling.”
Her Steps
Many of Olivia’s steps have been helpful, creative and resourceful. But, in my opinion, they have all been conducted with her hands tied behind her back. From the first day I saw her until last week, Olivia has vehemently and totally refused medication.
We have gone round and round about this, and finally she wore me down and I stopped arguing with her. Having seen enough of the vagaries of medication’s effectiveness for PTSD folks, the ways it reacts with stressed-out chemistry, the way it produces a quick tolerance, I have to reluctantly admit that she may have been very wise to proceed without medication. She was adamant. With her “rushes” and her “flashes” and her “drunkenness,” she was unwilling to fog up her mind in any other ways. I don’t believe that’s what anti-depressants and anti-anxiety medications do, but, perhaps for her, that is exactly what would have happened. So, contrary to the well-researched “talk therapy plus medication gets the best results,” we plowed ahead on our own.
Olivia has been absolutely constant in therapy. In the more than eighteen years, I have probably seen her forty-eight weeks a year. She has tried every suggestion, with the notable exception of medicine, and has read volumes of recommended books, written journal upon journal of memories and thoughts and doubts, exercised, drawn, taken yoga classes, challenged herself to go away overnight with girlfriends, gone to classes and groups and workshops. She, like so many others, has tried many different things to help herself heal.
Olivia said recently that she thinks the single thing which has helped her the most in her recovery was the contrast of my way of working with her and that of her general practitioner She would say to me, “Do you think I‘m crazy?” and I would reply definitely, “Absolutely not.” She’d say to him, “Do you think I‘m crazy?” and he’d reply quizzically, “So what if you are?” I’d send her to the library to find a book on creative journaling, and he’d send her out to the woods to collect bird feathers for him.
I’d suggest she get a part time job in a flower shop, and he’d suggest she plant a garden.
Now, if it were me and I had two health care professionals giving me such divergent advice, I think I’d have ditched one of them. Not Olivia. Somehow she finds it helpful and healing. Even funny, maybe. Crazy “experts.” Maybe that’s it. Maybe he and I are helping her to feel less crazy because we’re both sort of wacky.
My Story
I remember the day, about three years ago, when Olivia stormed into my office for her appointment and snarled at me, “I am so mad at you!” The why turned out to be that I had finally convinced her that she wasn’t crazy. A family that doesn’t believe a child, especially one who would run away in the middle of the night in her pajamas, is a crazy family. Olivia fumed, “It was much easier when I thought it was me. Then I could do something about it. What do I do about this?” I suggested Wyoming. She obligingly laughed.
Olivia has since retired from her first and only full-time job and has found some interesting and safe part-time jobs. She still struggles with finances, but she has never paid a bill late and is generous with those in worse shape than she. I remember the time she went to the warehouse store because she had heard on the radio they were selling blankets for $2 apiece. She bought ten and gave them to a shelter.
She has a few very good friends, including her two health providers, has set increasingly self-loyal boundaries with her family and friends, and continues to read voraciously, watch intelligent television, feed the animals in the woods behind her apartment, and content herself with her peaceful existence. She has some anxiety still, but she views it differently, and she has some depression, but that, too, she takes less seriously, knowing it so intimately that she now trusts both will go just as they come, here and there, but not always.
I recently came across a mental health test Olivia took in 1992. The results suggested that she might refuse to cooperate in therapy, was extremely defensive when talking about psychological material, would adapt poorly to environmental changes, was submissive, yielding and powerless, was likely to be with men who were sadistic and abusive, would most likely be a victim and a martyr, and was in gross denial and repression. I am thrilled to say that seventeen years later, not a thing that test projected is true. And all of this without medication.
I often tease with clients when they have an epiphany or make some great stride that I wish I had a bumper sticker announcing, “Most improved client of the month.” If I did, I’d give it to them. Olivia would be in the running for “Client who has worked the hardest and come the farthest.” What amazing courage she has demonstrated.
P.S. I mentioned her psychic abilities. I want to expand on that fleeting remark.
Those who find themselves in a traumatic situation once tend to be obsessively on the lookout for the danger signs that might indicate the trauma is about to happen again. This obsessive looking is a coping mechanism, a preventive form of paranoia. It is about to happen? There was no moon that night. Can I see the moon? It was raining. Is it raining? I could smell gasoline. Can I smell gasoline now? There were furtive sounds that made me think of a stalking tiger. What can I hear? Now, to complicate things a little more, this whole process of hyper-vigilance which scans the environment and surveys for danger is done unconsciously and fast, fast, fast. Those who have been repeatedly traumatized, or perhaps traumatized in different ways, learn to scan for everything. They constantly scan the radar. Trauma victims become very good at this. They often become so good at this that it becomes second nature. It becomes a constant habit. It becomes a way of life.
To have had to learn to be so compulsively observant, so obsessively watchful, is to be able to anticipate who people are and what they might do before they ever begin anything. Trauma survivors can smell danger; they can feel repressed anger in the hairs on the back of their necks. They can read people. Their lives have depended on it.
I remember the woman who taught me this. When I worked at Victim Assistance my job was to run a supervised visitation program which was court ordered when there were allegations that a child was unsafe with a parent or grandparent. Students from the social work and counseling programs at a near-by university did the actual supervision of the visits. I interviewed the parents or custodians of the child or children. I had to gather data and fears from the one parent and then interview the parent who would be supervised to explain the rules and to try to assess the level of danger the supervised parent might present for the child or children and the supervisor.
One of the student supervisors stood out from the rest. Her reports were more detailed, she observed more pertinent information, and she picked up small gestures or vocal cues the rest of the staff, me included, were likely to miss. I started asking her to come to the “accused” parent interviews. She was astonishing. She could tell from passing a person in the hall whether they were dangerous or benign. We had this one innocent-looking grandmother come in, wanting visits with her grandchildren. Barb, the student supervisor, leaned back in mock horror when the white haired seventy-year-old left my office. “She is so inappropriate with those children,” Barb told me later. “Are you psychic?” I asked her. “I guess so,” she shrugged. “PTSD survivors have to fine-tune every ability to read between the lines. I guess some of us cross over after we’ve practiced enough.”