His Story
His father was a millionaire businessman. His mother was an executive secretary who collected shoes and fine art. No one ever molested him, whipped him or tortured him. Instead, they verbally, mentally and emotionally leveled him. They made certain he knew he was in the way. They treated him as though he were an idiot. They criticized the way he looked. They taunted him for the way he walked. They belittled him for way he “was,” which evolved from no extra-curricular endeavors, no sports groups, no friends overnight. Most telling of all was his parents’ disregard for the fact that Roger had no medical or dental care until he was in college and could go to the infirmary for free.
Such isolation produced disastrous social skills. Since no one ever listened to him, Roger talked too loudly when he did get a chance to talk. Since no one ever talked with him, he didn’t learn how to listen. He interrupted, talked over people and, when he got an opportunity to talk, talked for much too long at any one time. He never learned how to ask questions, show approval, or validate another. Roger simply knew nothing about living in society, functioning in a group or bonding with others.
Roger dropped out of college and became a welder. But, he was unable to join a union. He didn’t know how to follow rules or bend to the wishes of the majority. So what should have been a secure, financially stable life, became a constant struggle, not only financially but also in terms of being wanted and valued as an employee. And he was no one’s idea of the perfect employee. He didn’t take teasing, couldn’t accept it or give it, had no idea how to banter with the other men, and rarely so much as nodded at another worker. He was sure, without even experimenting, that none of the guys would have liked him.
Roger, however, was flashy. He had jet-black hair and dressed only in shirts with horses on the front. His shoes were always polished and his scowl was often misread as a sexy, aloof, stare-down. That was what his wife thought when she met him. She, herself, had grown up with a critical father and, since Roger barely spoke, he seemingly wasn’t going to be critical. Since he rarely interacted with people, he had no friends, and, therefore, she had no competition. She chased him, and he was thrilled. For the first time in his life, someone wanted him.
Francie was a nurse. She was accustomed to calling the shots, and to say that she was a control freak would not be overstating it. She told Roger when to work and when to stay home. When she was pregnant, he was sent to work. She found him jobs. When they had their babies, he was ordered to stay home. He later reported that the favorite times of his life were the months he spent staying home with the newborns. Newborns, as you may realize, don’t care if you talk too loudly or if you talk too much. Bottles and dry diapers. He could handle it. He felt successful for the first time in his life.
Francie, however, as time went on, tired of being the designated adult in the family. When they entered counseling, one of the first stories I remember was a fight about how to make peanut butter and jelly sandwiches for the kids. According to Francie, Roger made them incorrectly. I forget what his mistake was, but I remember feeling great sympathy for him. To be criticized for making PB&J incorrectly was a new level of control in my book. She added that he did everything else wrong, too. He didn’t work enough. He didn’t cook enough. He didn’t get the lines in the carpet straight when he vacuumed. And once he had the audacity to use a potholder to remove a pizza from the oven, and pizza sauce got on the potholder. In other words, Roger was back living with his parents. I used to get furious with him when he’d shape his thumb and forefinger into the letter “L” and put it on his forehead and repeat, “Loser, loser, loser.” Of course, he had a point. That had certainly been his life experience.
As the children went through their early years and started school, Roger lost his connection with them. Mom’s very negative and condemning attitude toward Dad was highly contagious. Dad began his most dependable adult coping mechanism: sleeping. He would get up when everyone went off to work or school and then go back to bed for the day. It was clear when Francie got home that nothing on the “to do” list had been touched. As she got more vocal about what a bum he was, he became more of a bum and, not surprisingly, slid into a deep depression.
The tipping point came one New Year’s Eve when the kids were invited to a neighbor’s house and Francie went out with some friends. When she came home, around one, Roger had taken every pill in the house and was lying across the bed, unconscious. His stomach was pumped and when he came home from the hospital, Francie and the kids went to stay with her family. The marriage was over, and Roger was on his own. More abandonment, more rejection, more neglect and more failure. It was at this point, after the suicide attempt, that Roger dragged his reluctant self into individual therapy.
His Signs
Roger was depressed.There were many days when he didn’t get out of bed, didn’t eat, didn’t shower, didn’t go anywhere, and had no break from his own negative, heavy thinking. The first thing we started working on in therapy was his own self-image and his own negative, self-defeating perceptions.
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PERCEPTION IS REALITY
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Perception is the individual way each of us looks at ourselves and understands reality. A loved child will look at himself as loveable and wonder what’s wrong with people who don’t like him. It will be their problem, because he knows he’s okay. An unloved child will look at himself and know there is something fundamentally wrong with him. He expects people not to like him. He therefore meets and greets everyone with a belligerent attitude: “I know you don’t like me.” There’s a scowl and a frown, not a smile or a nod. You don’t get a chance with the Rogers of the world. They already know you don’t like them, so why should they like you? They’ll beat you to it. They’ll dislike you first!
Now, all of this is the mind reading so common to PTSD survivors. But, here’s what happens. If we mind read positively, believing ourselves to be loveable, likeable, competent and good, we’ll be, most of the time, loveable, likeable, competent and good. And because we are what we believe ourselves to be, we’ll face the world with authenticity, confidence and energy. And the world loves authenticity, confidence and energy. The world rewards loveable, likeable, competent and good people. There’s a song from The King and I that talks about this very phenomenon. Anna and her son are about to land in Siam and everything is starting to look strange and frightening. So she sings to him--it is a musical, after all: “Make believe you’re brave, and the trick will take you far. You may be as brave as you make believe you are.” Psychology has a buzz phrase for this, too: Fake it ‘til you make it.
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Fake it ‘til you make it!!!!!!
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This is not about being inauthentic, believe me. This is about creating a self-fulfilling prophesy. Well, all prophesies are self-fulfilling. However, this is about creating a positive, helpful, self-fulfilling prophesy. This is not about being a cocky, glad-handing schmoozer. This is about giving the world a chance. This is about making them tell you that you can’t have the job--not making them convince you that you can. This requires changing our perceptions of the universe, God, others, karma, ourselves, the cop on the corner and the lady in the post office.
Is the process difficult? You bet. As traumatized children and adults, we have learned that the world is a dangerous place, that bad things happen, and people can be mean and nasty and cruel and crazy. But, what happens to us is that we extrapolate from our experiences a perception of the whole world. We assume typically that the events of our lives accurately portray the events of all lives. To alter this assumption requires an acceptance of ourselves as posttraumatic stress survivors. The current statistic is that about 10% of the population has PTSD. We are different. We have gotten a bum deal, but it is not a constant, consistent deal the universe hands out to everyone all the time. Just because we can’t see any joy in the future, doesn’t mean it isn’t there and doesn’t exist. We’ll have to work with the universe to co-create it. This is a process which begins with changing our perceptions. Because PERCEPTION IS REALITY.
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Just because we don’t see any joy in the future,
Doesn’t mean it isn’t there
Or that it doesn’t exist. We can create it!
We take charge of our own lives by taking charge of our perceptions.
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Now, I hear you thinking, as Roger did and does sometimes still, this is just setting myself up to be knocked down. Sometimes, yes. Everybody gets knocked down sometimes. But nobody gets knocked down all the time. One of the things that brought Roger’s perceptions into clarity for me was the difference between the ways Roger describes his divorce and the way I describe mine. I say, “He left.” Or I might use a nasty word in place of the ‘he.’ Or I might even say, “I’m divorced,” admitting some accountability in the split up and not blaming the whole thing on ‘He.’
Roger, however, always describes his divorce the same way: “I was RAPED,” he begins, “gagged, bound and flung head first into the concrete.” The casual listener would definitely not realize that this is a divorce between two consenting adults. Roger is one of those people who says, “If I didn’t have bad luck, I’d have no luck.” And when his house refinancing ends up costing him more than the original offer, and when he gets rear-ended on the way to work, and when his water heater breaks, and his roof leaks, and a check bounces, and a teenager talks back, Roger is sure these things happen only to him. I don’t know about everyone else, but they have certainly all happened to me.
Roger is convinced that the black cloud hangs over his head and that he alone has to experience the negatives and pitfalls of life. This attitude just helps bring more and more negativity into his awareness. Perception is reality. Once again, contrast my childhood friend, Karen, who cared for an abusive father-in-law, lived with an unemotional, unsupportive, uncommunicative husband and, most devastatingly, lost a child. Yet, she describes herself as being blessed and living a happy life.
Roger believes himself to be cursed and living an unhappy life. Roger’s most difficult and persistent symptom was his ongoing obsession with suicide. He had suicidal thoughts and suicidal ideation, and he threatened suicide for most of the first fourteen years in therapy. Roger had one actual attempt and probably twenty-some threats over the years. With the threats he frequently had a plan, either pills or razors, and he always had a day and time. His plan was predicated on making someone, usually his ex-wife, and one time his children, feel a guilt and a remorse they would have to carry forever.
His passive/aggressive need for revenge is the cry of an under-empowered person against the person he or she perceives has all the power or control. The suicide, in other words, is a way to get even. Roger’s plans always reminded me of the words my grandfather hurled at my grandmother on the way to the hospital where he would die three days later: “Good luck forgetting this, Martha.”
Roger’s impetuousness was another recalcitrant symptom. He constantly reacted before he thought about what he was doing. Someone would tease him, and he’d react with vile curses. Someone would cut him off on the road, and he’d pound on the horn and ride their bumper. One of his children would talk back to him, and he’d lose his temper.
He constantly overreacted. Those reactions came from his deep well of personal inadequacy and they were intense and extravagant. When he was attacked in even the mildest ways, his payback was poorly timed and ill-conceived. The punishment he received might have been a one on the scale, but the punishment he returned was at least a seven.
Roger was an expert at taking everything personally. If I was late, I didn’t want to see him. If I was sick, it was just so I could cancel his session. If the boss at work had a suggestion or guidance of any kind, only Roger was called on the carpet. His car was singled out for parking tickets. His children were the only ones ever to tell a parent, “I hate you!”
Roger was financially irresponsible. He would shop at only the finest stores and buy only the highest quality items. Birthdays and holidays he shopped like a wild man.
The children had more of everything than they could need or even want. The house was decorated to the nines and landscaped so as to be the prettiest on the block. And Roger had numerous collections. He bought old license plates and model ships for himself. This need for the unnecessary extended to his children. The girls had collectable dolls. The boys had collectable action figures.
Another of Roger’s symptoms is the result of fifty years of tension and stress in his body. Physically, he is a wreck. He has high blood pressure, high cholesterol, borderline diabetes, and severe back problems which have led to hip, leg, knee and foot problems.
His Steps
Step one with Roger was to refer him to a psychiatrist. This step was met with Roger’s usual personalization: “You think I‘m crazy.” I explained that psychiatrists are trained to understand the brain chemistry and are the best doctors to prescribe medication, and that actually, very few of the patients any psychiatrist sees are crazy. Then he tried, “You’re trying to get rid of me.” I explained that a therapist and a psychiatrist work together. The research is abundant that medication and talk therapy together are much more successful than one or the other. Only a psychiatrist (or a talented and willing general practitioner or internist) can intuit and prescribe medication. Only a therapist has hour-long appointments designed for listening, re-parenting, cajoling, supporting, prodding and modeling a healthy, therapeutic relationship.
However reluctant Roger was to comply, he agreed to see the psychiatrist who immediately started him on medication. I believe the first medication he tried was Effexor. It’s an anti-depressant which generally has an energizing component. It immediately worked. I have observed that the more a person needs an anti-depressant, the more quickly it seems to work. Unfortunately, for Roger (Remember, if he didn’t have bad luck he wouldn’t have any) it had side-effects which to him were intolerable. Multiple medications were tried. Some worked; some didn’t. The psychiatrist was amazingly patient and determinedly creative. He designed anti-depressant/anti-anxiety cocktails for Roger which lost their effectiveness after about six months. Most people build up a tolerance to an anti-depressant after about ten years. Six months for Roger.
The difficulty with finding medication which worked and was tolerable for him was not surprising. We talked previously about the long-term effects of tension and stress on the body and mind of a PTSD survivor. Many medications don’t work or work differently for PTSD survivors due to the way the body chemistry has been over stimulated and unable to rest and recover from episodes of hyper-alertness and overdrive. Roger’s psychiatrist, for example, in an attempt to get him out of bed and moving, prescribed Ritalin. For a person who does not have attention deficit disorder, for which Ritalin was long the drug of choice, Ritalin acts like speed. It had no effect on Roger... No effect whatsoever. We were all stunned. What an unforgettable lesson in how PTSD shocks and changes the body and mind chemistry.
In therapy, work on Roger’s depression began with identifying, understanding and changing perceptions. This was about as speedy as building the pyramids one stone at a time. We set about identifying and working on altering his negative self image, his negative self-talk and his negative projections on others. One of the ways we worked on this was that for about six months I wrote out and gave Roger flash cards at every session. His assignment was to read them over first thing every morning and last thing every night before bed. This assignment was predicated on my encouragement that he actually get out of bed every day. Here are some of the messages on the more than 100 cards:
Perception is reality.
What have I learned from this?
I don’t have to compare myself to anyone else.
No one can treat me like crap without my cooperation.
Status quo is the way Roger wants it to go--
But not the way Roger will grow.
When no one calls me back or responds to my needs--
I will dig inside myself and know that
An answer is available if I just listen.
I hold a high moral standard and am ethically accountable for my behavior.
The wisdom is inside my head and heart.
I’ll feel whatever I feel without judgment.
The children will teach me all I need to know about joy.
I’m a good person.
I deserve happiness.
These flash cards differ from affirmations. Affirmations are written according to various guidelines which work with the mind on positive messages. Affirmations are a helpful way to pull ourselves out of the doldrums and spiff up our self images. They, I thought, were too divergent for Roger--too far from his reality. We had to start closer to home. Typical affirmations include wording such as: “I am a beautiful person.” “I enjoy life.” “I find the best in every situation.” Roger wasn’t quite ready to start there. So we specially designed cards which were palatable for him.
A great deal of therapy with Roger would have seemed to a casual observer like superficial chit-chat, and in many ways it was. Roger had no template for normalcy. He didn’t know what a normal parent/child relationship was like. He had never had a friend, and was awkward in attempts made both by others and himself. He had boundaries which varied from the overly rigid, allowing no one near, to the overly loose, which amounted to scaring people away because he seemed so needy. Therefore, a lot of what we talked about over the years dealt with the definition of normal. I have often wished there was a book about normal. Perhaps that could be my next writing project. People who grow up in abuse, neglect, criticism, condemnation, total permissiveness or total denial, grow up with no idea of the wide and flexible middle ground that makes up “the normal.” For example, never giving a child any idea of what he or she is doing well is not normal. But where are the limits? Never reprimanding or guiding a child is equally harmful. One of the things Roger and I talked about is the distinction between approving of the child as a person and approving of the child’s behavior. The child has to be valued for himself or herself but also has to know that not everything he does is acceptable. I remember friends telling about the man who had season tickets to the symphony in seats directly in front of them. He apparently made distracting noises and produced toxic odors during every concert. He may have been a perfectly acceptable human being, but his behavior made my friends grow to dislike symphony music.
Remember the Robert Fulghum book, All I Really Need to Know I Learned in Kindergarten? That may be one of the only books ever written which talks about normalcy: Share. Rest. Take turns. Hold hands and stick together. What wonderful nuggets of basic human behavior. They seem, well, obvious, but Roger was missing a lot of the basics which most of us learn by osmosis from our parents and families. As I said earlier, Roger talked too long at any one time. Such behavior isn’t normal. And the world is very hard on people who don’t act normal. You can be as screwy as a fruitcake in this world of ours, as long as you know how to act within the normal range.
Roger filled many a journal in those early years. First he spilled out story after story of long-ago hurts and heartaches mixed in with present-day pain. Then he started using his journal to capture his feelings and behaviors so we could talk about them. Was this oversensitive? Was that overly harsh? Had he, indeed, been mistreated here? Was he out of line there?
Along with such self-analysis, Roger took another step to help in his PTSD recovery. He filed bankruptcy and gave himself a fresh start financially. He came to understand that he was an emotional spender as well as an emotional eater. He works to keep both under control.
My Story
Probably the least therapeutic reaction I ever had in my life was to Roger’s suicide threats. He would say, “I’m going to off myself.” I would say, “You can’t.” I used unabashed guilt to try to keep him from killing himself. “You chose to have children,” I reasoned. “Once a person makes that choice, they invalidate the choice for suicide.” I told him about my grandfather killing himself and about the consequences through the generations that the one act of desperation caused. Again, he would say, “I’m going to.” Again, I would say, “No, you’re not. You are not leaving your children with that legacy.” Round and round we would go.
What finally stopped that merry-go-round of Roger’s stubborn desperation and my equally stubborn desperation was a deal we cut. He was determined to commit suicide on the day after Thanksgiving. I managed to get him an appointment with an internist on the Saturday after Thanksgiving, and he agreed to wait twenty-four hours before proceeding. This amazing doctor spent two hours with him on that Saturday afternoon and I have not heard the “s” word since. This physician looked at him with fresh eyes and started treating the physical and the mental issues Roger presented. That physician has been tireless ever since. It’s almost two years, and the difference in Roger is incredible. He has hope. For the first time, he has hope.
Roger and I have had a turbulent decade and a half as client and therapist. He has taught me more about patience and temperance than any other client. He comes in on rants and it’s all I can do to keep my mouth shut. He rails against those who have hurt him and his narcissism drives me to distraction. He is convinced he is the one person in the world who has received the worst treatment the world has to offer. He has threatened to leave and never come back if I mention the starving Armenians again. He has also threatened to make sure my license is taken away, to call me at home in the middle of the night, to . . . You name it. Then, another day, he tells me he’s a “lifer” and he’ll be my last appointment on the last day I practice. It has been a wild ride. But, after all these years, I think we have come to trust each other. I sometimes think it is even more amazing that I trust him than that he trusts me. Perhaps both are remarkable and perhaps they could only happen in tandem one with the other.
A last symptom of Roger’s which was too personal to me to put in the symptom section and had to be reserved for my story was Roger’s expressed hatred of God. Roger grew up with no religious training at all but in college found a church he loved. When he met Francie, they were both devout, practicing Catholics. They were married in the Catholic Church and attended mass regularly. Roger considered himself a faithful follower.
With the divorce and the resultant devastation of his adult life, Roger decided God was a punitive, miserly God who withheld and taunted and turned his back on the likes of Roger. Probably the one issue Roger and I talked about more than any other was God.
Free will was a new concept to Roger, an age-old one to a catholic like me. The catholics who go by the lower case ‘c,’ I remember learning in catechism, were those believers of the ancient, undivided, universal Christian church. So his Catholic and my catholic have had an ongoing dialogue about God.
The last time I saw Roger he was telling me about one of his children who has been debating whether or not he wished to be confirmed in the Catholic Church. Roger’s teenager was really disgusted that God let bad things happen and he wasn’t sure he wanted any part of it. Roger listened to the concerns with respect and patience. Then he started a dialogue with his child on free will. After a few days of thought the decision was made to go ahead with the confirmation. Roger is glad. He handled a difficult situation with tact and diplomacy. Whew. I have to enjoy this baby step while I can. I’m sure Roger and I will be back on the roller coaster the next time I see him. I feel like I’m the “lifer.”