Friday, April 10, 2009

Why I Believe Psychotherapy Is An Integral Part of PTSD Treatment

To follow is an excerpt from my forthcoming memoir, Parasites of the Mind: A Memoir of Trauma, Survival, Identity and the Pursuit of Joy. This portion chronicles my beginning psychotherapy. It was 1998; 17 years after my trauma, 10 years into the extremely dark emotional pit of PTSD; the beginning of 10 years of extreme physical PTSD complications.

When I met Henry Grayson, PhD., for the first time in 1998 I immediately knew I had found a lifeline. Over the next 7 years he would become instrumental in helping me find a way to bridge the gap between what was in my head and letting it out. He didn’t lead me to complete healing, but he got the ball rolling (and sometimes gave it a necessary kick) and for that I’ll be forever grateful.


I agreed to meet Henry Grayson for this one reason: the name of the institute he founded is the Institute for the Psychotherapies and Spirituality. I wasn’t interested in therapy, but a man who understands and is interested in spirituality seemed like a man to whom I could relate. I had made a few large life decisions when I was released from the hospital and one of them was to become an atheist. At the age of thirteen I went against my parents’ wishes and gave up the idea of God and religion and my Jewish heritage in favor of developing some sort of personal transcendental focus that depends on my own self rather than some unproven entity. A therapist who believed in spirituality would, I thought, at least support those efforts.

I walked from my apartment on 64th and West End Avenue to Henry’s office, which is in a predominantly residential building on 58th and 8th. His office overlooks what used to be the Coliseum but is now the flashy new building that houses Jazz at Lincoln Center. Instead of taking the elevator, which would have been easier in my frail condition, I took the stairs because you don’t stay tough, ready for the next challenge, by taking the easy route anywhere. It was an extremely cold day and I was weak and out of breath after only four steps of the two flights to Henry’s floor. My fibromyalgic muscles screamed and burned. I sat down to rest before painfully climbing to the landing where I paused again before forcing myself up the second flight. By the time I reached Henry’s office I was exhausted and feeling faint.

I don’t remember the specifics of what we discussed that first day. The strongest impression that remains is of the dim lighting; the room glowed with an amber luster. And I remember Henry opening the office door to greet me. He is tall, six feet four, and trim with black-speckled gray hair neatly parted on the left side. His eyes, a sort of pewter color, are warm and friendly with a sparkle that hints at his deep sense of humor. He wore a simple, light blue oxford shirt with a tie and a pair of tan slacks.

“Hello,” he smiled and stood aside to let me pass through the door.

Immediately, I was hooked. Henry’s deep, smooth voice is incredibly mellow and seems to flow effortlessly from his mouth, as if he is merely exhaling a breath and there happen to be words floating on it. The way he says hello is not your usual blunt greeting. Instead, he utters the word with a sort of lilt on the second syllable so that he sounds both surprised and pleased to see me, as if he hasn’t been sitting in his office expecting me and preparing to walk beside me into my dark abyss.

In addition to this, Henry moves with effortless grace. He has an aura of such ease in his own skin that I immediately felt centered and grounded and safe just standing beside him. He indicated that I could either sit in a stuffed blue upholstered chair, or on a maroon, three-pillowed couch. I chose the chair and curled up in it, tucking my legs beneath me. Henry shut the door to the office and the room turned inward upon itself like a cocoon.

The first few weeks we focused on the events of the previous year and a half, which brought me to the admission that due to recent physical and medical events I felt completely, utterly, powerless.

A brief pause after I said this. Henry waited for me to speak again. When I didn’t, he said, “Are there other times in your life that you’ve felt powerless?”
“Yes.”
“When?”
“September, 1981.”
Slowly, I began to see how the past was so very much a part of my present.

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Those first months with Henry were very strange. Talking with him was like being released from the circus. I no longer had to perform. I no longer had to convince myself or anyone else that I was all right, that I was stable, happy or any of the other things that, when you’re ill and disgusted by pity, you try to fake. I could admit I was afraid. I could say out loud that I felt completely void of any medical safety and enormously without hope that I would ever feel at peace. With Henry I could be utterly candid because I felt secure in the knowledge that if I started to fall apart he would catch me. In the comfort of his office facing what I have always tried to deny didn’t destroy me as I expected it to, and it didn’t incapacitate my ability to cope. Instead, it brought a huge sense of relief.

In the end, therapy is nothing more than one person guiding another toward the possibility of seeing things differently. Henry is a pro at that. From the very beginning, my conversations with him illuminated the many dark places in my mind. Like a miner, he went with a lantern deep into the ore of my head and picked away in there, releasing chunks of information so that I could see how past experiences continued to inform present actions. Even when I was dead set on denying this, Henry guided the conversations along unpredictable paths until we came into a clearing and light filtered between the trees of my resistance. He was a guru instructing me in conscious meditation, and when my focus wandered, he gently steered it back.

But Henry turned out to be so much more than that. He has also been my Wu Li Master, the man who helps me discover essence and then, when I see it, leads me toward expanding the boundaries of my perceptions so that I understand even more. Beginning at the heart of the matter, he works outward toward the fringe details, allowing me to discover for myself the significant themes along the way. He begins, not with a big discussion of my history, but with my present, deep-seated emotions and then reflects their origins in images from my past. He helps me see myself without fear and with clarity.

Under Henry’s tutelage and through a forced devotion to a sort of cognitive consciousness I began to reconnect with myself in both physical and psychological realms. The pain in my muscles gradually began to diminish. I could walk without feeling I was using an insufficient amount of weary and weak ligaments to haul a heavy skeleton up the block. With Henry, I admitted how old fears were hanging around and (for lack of a more professional way of putting it) messing with my head. I could see how my fear of medicine made me act irrationally: either I was overly cautious about prescriptions, combing over definitions in the Physicians Desk Reference and grilling pharmacists, or I threw back medications without a second thought. Rather than recognize the constant yo-yo, I always only felt the powerlessness of a laywoman in a medical world; talking to Henry I understood how my trauma survival techniques had gotten a little out of hand.

Together, Henry and I forged an understanding and knowledge of the core issues so that I developed the ability to alter myself. We clarified topics grounded in the past and defined their repercussions in the present. I learned to redesign my reactions to new events by understanding the motivating principles of my responses. We brought light into the darkness of my fear, and we did it without overwhelming me so that, not only did I begin to function better outside of Henry’s office, but I became increasingly in control and adept within it. All of this seemed to happen without my really being aware of it. Henry is a genius, a sort of magician and changes occurred in me as a consequence of the knowledge he showed me how to pull out of my very own hat.

Which is not to say that I didn’t fight Henry and the whole process from day one.

“I don’t want to go back there!” I’d say whenever he probed the memories of my illness. “Talking makes me sad and melancholy. I don’t want to go so far into it that I can’t come out. I don’t want to spend the days between our visits in a fog of depression and despair. Although,” and here I am struck by that unwitting second of clarity that good therapy brings about, “that’s not really so different from how I already spend each day.”

With this realization my attitude began to change. I started to go back closer to 1981 than Henry’s questions even suggested. Once I got going, I gave more detail than Henry may have wished, but I couldn’t stop myself. For so many years these memories had been kept behind a curtain in my mind and when I was finally brave enough to pull the curtain aside it felt good, like flexing atrophied muscles that shrieked at movement but became warm and flexible and strong with repetitive use.

Precisely because Henry and I were unknown to each other our work together gained strength. I had nothing invested in his reactions to me. I had nothing to lose by baring all to him, showing him that beneath my veneer of stoic strength I was cowering, and beyond that: I found a sort of solace in knowing it.

“When I’m happy and not worrying, things get out of control. I don’t take good care. I feel safe when I don’t feel safe,” I admit one afternoon. “As if not feeling safe is important. As if feeling fear will keep me alert and will ultimately keep me from harm. It doesn’t make any sense. I can’t explain it, but not feeling safe makes me feel like I’m not totally powerless. It reminds me to be aware and to remember who I am. I’m a survivor and if I don’t remember what happened, it could happen again. Fear feels familiar.”
“That’s not uncommon for people who have suffered trauma.,” Henry replied. “But by holding on to that feeling of powerlessness, how do you ever expect to be free of it?”
“I don’t want to be free of it. It reminds me who I am. Sometimes I feel so lost. I can’t see myself at all, except as a woman who survived this horrific thing. In the context of that tragedy is the only time I know exactly who I am. The past is what feels most real. The rest is only a fantasy.”
“You can choose your own reality, Michele.”
“I choose the truth.”
“The truth is, you were strong enough to survive. There’s nothing powerless about that.”

And just like that my whole perspective changed. From talking.

2 comments:

Mike H said...

wow!

Michele Rosenthal said...

@Mike - Amazing, isn't it -- the incredible healing power of words never ceases to surprise me.