All in the Mind (6 page)

Once, about six months ago, they’d had a longer than usual session, during which David had attempted to describe the mental tortures he inflicted upon himself as he tried to lift his head from his pillow, then his body from the bed, then go through the seemingly endless processes of cleaning and clothing that have to be done before a ‘normal’ person can begin to live a ‘normal’ day.

He’d talked about what it was like to experience a plunge, a sustained period of unrelenting agony, which then ended as quickly as it had begun. ‘I felt like I had lived through a storm,’ he said, ‘and not a blade of grass had moved.’

Sturrock was so struck by the beauty of the words, and how they spoke to his own condition, that he wrote them down. When David left, he stood by the window, staring at those words, reading them again and again. Then he let his head fall against the glass, and started sobbing. He was feeling close to physical collapse, about to fall to the floor, when Phyllis came in to tell him he was running late for his next patient. She saw he was distressed, saw also the zeal with which he sought to recover himself, and neither of them ever mentioned it again. He hoped she assumed he had been given some bad news by his wife who had been particularly persistent in her calls.

When David had been referred to him, the diagnosis had been that his condition was chemical and he had been prescribed a variety of drugs. Sturrock hadn’t been so convinced and had lowered the doses, cutting out some of the drugs completely. In one of their first sessions he’d talked to David about the demons and angels inside everyone, and how on some days demons could get the upper hand,
making
a person think bad thoughts, feel bad feelings and occasionally do bad things.

‘But why do my demons always have the upper hand?’ David had asked him. ‘And what are they?’

‘I don’t know if you don’t know,’ replied Sturrock. ‘That’s what we’re here to try to find out.’

Deep down, though, he was pretty sure that David’s demons lurked somewhere in his relationship with his father. When they talked about Leonard Temple, David’s recollections were minimal and fluid, details large and small changing with each account. Sturrock believed David felt somehow responsible for his father’s departure and his mother’s subsequent misery, though on the one occasion he talked to Mrs Temple, he discovered that after the shock of her husband’s leaving subsided, she began to prefer life without Mr Temple to life with him, which had included persistent verbal and occasional physical abuse. David could remember none of it.

Today Sturrock wanted to focus on David’s ‘best–worst’ list, a new piece of homework he had introduced a few weeks ago. The idea was that David should record, at the end of every day, the best thing and the worst thing that had happened to him. It didn’t have to be an event as such. It could be a thought or a memory. Nor did he have to do it literally at the end of the day. Any time he felt like noting down these moments and thoughts, he should do so. The basic purpose was to try to show David that even on bad days, good things could happen, and he should recognise them, and try to build them into a pattern.

‘How are you getting on with the best–worst exercise?’ Sturrock asked, once David had settled himself into the leather armchair. ‘Do you find it useful?’

David looked a little suspicious of the question. He didn’t answer immediately, but after a few seconds he answered firmly, ‘Yes, I do.’

‘Because?’

‘Because if I am kind of OK, not on a downward curve, just OK, average, it makes me look around for the good things, and maybe appreciate them. Something like that.’

Sturrock smiled. He felt pleased. At least one of his patients was benefiting from the homework exercises he was setting. ‘Good. Well, let’s keep it up as part of the weekly rhythm, shall we? Every day, let’s try to record it, one of each at least, more on the good side if you want to, and then every week send it in for me to have a look at before we meet. That OK?’

‘Yeah,’ said David. Then he paused, and the suspicious, hesitant look returned. ‘It’s hard when the “worsts” are really bad, though. Like yesterday.’

Sturrock glanced down at the piece of paper resting on top of the file, angry with himself that he hadn’t had time to look at it properly before David arrived. He had clearly missed something. He decided to play for time, and give himself the chance for another look.

‘Let’s read through what you’ve written, shall we? And you can talk me through it.’

He picked up the printout and read:

Friday
. Best – warm sunshine when I was walking to the tube from the hospital. Really nice chat with Amanda at work. Worst – got bollocked again for not responding to tannoy message at work. Argument with Mum when I told her.

Saturday
. Best – thinking a lot about Amanda. Worst – really empty at start of day because of last night. Mum hyper. Rhythm kicking in, slipping down. Key trigger Mum turning on radio and responding to something on a phone-in, then asking my views.

Sunday
. Best – walk by canal. Forgot myself. Worst – couldn’t sleep.

Monday
. Best – felt confident. Had planned to ask Amanda to go for a drink after work. Worst – decided against, and felt a bit low.

Tuesday
. Best – slept OK. Felt OK. Worst – bit of a fall as walked home from work.

Wednesday
. Best – good conversation with Amanda. Worst – some guy giving me a really funny look, sort of contempt but worse than that because it said ‘you don’t count’. Rhythm down.

Thursday
. Best – woke up thinking today was going to be a great day. Worst – really bad conversation with Amanda.

Sturrock wanted to probe first on the trigger points that had set off a clear downward curve from last Friday into Saturday. Did the curve down begin when he was told off at work, when his mum reacted in a way he didn’t like, during the night, in his dreams, or when he woke up the next day? David thought it was probably a combination of all of them. But if he had to pick out a particular moment, it would be when his mother reacted as she did.

Alongside David’s best–worst printout, Sturrock also had a copy of David’s account of his dreams for the week. He asked most of his patients to keep a ‘dream register’. He urged them to get into the habit, as soon as they woke up, of recording as much as they could remember. It was an article of faith for Sturrock that dreams were a nightly conversation between the conscious and the subconscious. There was, in his opinion, no detail too small to be of interest. But, for David, there were too many mornings in which he woke up in what he called his full-on catatonic state, and even committing thoughts and memories to print was beyond him. He also claimed he had never been much of a dreamer. Sturrock had heard this from dozens of patients down the years, but he knew that, once they acquired the discipline of noting down their dreams, first they realised how much they dreamed, and then they became more adept at remembering them. There came a point with most patients required to keep a register where they suddenly realised that even as they were dreaming, part of their conscious mind was trying to store away details
to
record as soon as they woke up. One patient complained that it led to her becoming a virtual insomniac. She was so keen to commit her dreams to memory that as soon as one began, she woke up and reached for her pen.

The only dream David had noted from Friday, the night of his plunge, was of him and his mother in a cafe. He couldn’t decide what to order and his mother was getting more and more agitated, not on her own account, but for the waitress who was standing there waiting to write down what he wanted. David thought the waitress seemed content to wait for as long as it took, and he went back to the beginning of the menu and began to read slowly through the list of starters. His mother shifted about on her chair, the waitress remained impassive and David was resolutely indifferent to both. He ended up ordering a glass of water and salt in a pepper cellar, which the waitress took at face value, but which agitated his mother even more. She wanted him to have some vegetables too.

‘What do you make of that?’ Sturrock asked.

‘Dunno,’ said David. ‘Just Mum and her food again, isn’t it?’

Sturrock noted that the woman called Amanda figured several times, and was clearly responsible for a second downward curve. David had never mentioned her before, yet it was clear they saw a good deal of each other.

‘Who’s Amanda?’ he asked. ‘This is the first I’ve heard of her.’

David looked pained. ‘We’re all allowed secrets,’ he said.

Sturrock nodded. ‘We are indeed. But she’s not secret any more, is she? She is on your best–worst list, prominently.’

David looked over at the window. He seemed unsure how to respond. Sturrock asked him whether she worked in the same department at the packaging warehouse, where David was a porter. His job was low-paid, not particularly challenging, but it suited the rhythms of his depressions. When he felt OK, he could join in as part of a team, and it was clear that at times he even quite enjoyed himself. When he was down, the routine work allowed him to avoid being drawn into other people’s lives or conversations.

‘She started out as a porter,’ said David, ‘but she’s so much better than me that she got promoted fast.’

Apparently Amanda was now in overall charge of one of the most important packing stations, which handled women’s fashionwear. At first David hadn’t thought she was any different from all the other employees who spent their time chatting about telly and fashion and football, tracking who was going out with who, and complaining about how stupid the bosses were. She would tease him about his scruffy clothes, or ask if he had his eye on any of the girls at work. But then one day she’d asked him if he suffered from depression.

‘I don’t know why,’ said David, ‘but I kind of trusted her. The other packers and porters just think I’m weird, and mostly avoid talking to me. But Amanda has always been friendly. It turns out her dad was bipolar, so she knows all about depression. She even went to my line manager to ask him about me, whether I was bipolar and stuff.’

‘How did you feel about that?’ asked Sturrock.

‘About what?’

‘About her asking your boss personal questions about you.’

‘I felt quite touched that she bothered to,’ said David.

After she had told him of her father’s illness, David said, Amanda had stuck up for him if anyone gave him a hard time.

‘A couple of weeks ago, there was a forklift-truck driver waiting for a container of packages that I was supposed to have put in his next batch for moving. I wasn’t feeling great and I was late getting round to where this guy was waiting and when I got there he starts mouthing off at me, really going for me, and Amanda is standing there watching, and she lets it go, but then this guy calls me a “nutter” and she just goes for him, marches right up to him and says, “You just leave him alone or else you’ve got me and the rest to answer to.”’

‘The rest?’

‘I don’t know what she meant by that. Most of the time the rest of them just ignore me, but she’s a bit of a leader at work, and it shut the guy up big time. I just chucked the packages in and off he went.’

‘She sounds quite a character,’ said Sturrock, smiling.

‘Like I say, a leader. She’s special.’

Sturrock noticed that David’s face changed when he talked about Amanda. The lines around his mouth relaxed a little, and he no longer narrowed his eyes. He began to open up, and his account became a melange of his words and hers as he explained how he tried to thank her for what she did.

‘I didn’t say anything for a few days, but then I dug in a bit, and I got up the courage to go up to her in the tea break to say thanks, thanks, Amanda, for what you did the other day. And she’s like smiling, and probably wondering why it took me so long, but she says, “No worries,” and how she hates bullies and she could tell I was having a bad day, and I say, “Yeah, most of my days are bad days, but that day was worse than most, so thanks.”

‘And then she goes into a big thing about her dad and how I remind her of him, how one minute he could be warm and loving, the next he’d go all withdrawn, sometimes unable to speak or even hear what she was saying to him. She said he could go for days on end, locked away in his room, and her mum would pretend everything was fine, how he was just tired and needed a rest, and she and her sisters had to be quiet and good, but she says even when she was little she knew it was bad, and then she said how horrible it was sometimes, having a dad there who wasn’t really there at all, just this big bad cloud hanging over the place.’

‘Did that make you think of your own father?’

‘No, it made me think of my mum, and how she must feel about me. No wonder Amanda wants nothing to do with me.’

Sturrock glanced down at David’s homework and his ‘worst’ entry for Thursday: ‘
really bad conversation with Amanda
.’ He was angry with himself. How had he managed to miss picking up on that?

‘How do you know she wants nothing more to do with you?’

David’s narrow-eyed, troubled look returned. He was staring down at his hands, and running them over his knees again and again.

‘No point.’

‘No point what?’

‘No point talking about it.’

‘Are you sure?’

‘Hmm …’

Sturrock realised he was going to have to come at it from another angle.

‘So from what you’ve told me, she stands up for you, and she understands you, and she sympathises with you, so you like her, yes?’

‘What I liked was having someone to talk to who had this incredible feel for the mood I was in. It was uncanny really, how she would always know when I was up for a chat, and when I just wanted to be left alone. One day I said to her, “Do you know that apart from my mum and my shrink, you’re the only person I really talk to?”’

‘How did she react to that?’

‘Good. Big smile. Said she was glad. And I wanted to say something nice to her. And I had the words coming up through my mind – “You’re really nice.” I can feel them coming up into my head and they’re almost at my lips but then I’m getting different messages from my inner voice. First, it’s telling me to say it, tell her she’s really nice and see if she’s still smiling, and then it comes in again and it says, “No, play safe, sit tight, it’ll come out wrong.”’