Bent But Not Broken (15 page)

So I had this in my mind when I saw Beth. She looked absolutely terrified, and totally unable to move. I got up and went over to her, to ask her what was wrong. That's when I saw what she had been looking at. She'd chosen a craft magazine. It was about how to make stuff out of paper. Unfortunately it had a Halloween theme. The page in front of Beth was how to make black spiders to hang from the ceiling or something. It had flipped her switch. I kept saying 'It's all right, Beth. It's only paper,' when Dianne and the nurse cottoned on. Talk about slow on the uptake! They're supposed to be the professionals! They should have noticed Beth before I did! The nurse leaned across and took the magazine away. Beth was as still as a statue. It was like she had been turned to stone. She was definitely somewhere else. The nurse kept speaking quietly to Beth, but I don't think Beth could hear her – let alone understand what was being said. It scared the shit out of me, Crystal. I've seen Beth go off, but not for ages now. I thought she must be nearly fixed. I was so upset as the nurse led Beth out that I Ieft the room too, and spent the rest of the morning flopped in a beanbag.

I didn't see Beth again until group in the afternoon. I was glad that she looked like her usual self. But I was not happy that Mad Rachel was there. At least she was sitting next to Doctor Harry. I hoped she'd go off and he would have to spear tackle her down. Bitchy, I know. But the thought of chubby Doctor Harry slamming her to the floor made me smile. There's so little to laugh about in here.

When Jenny saw her there, she seemed to shrink. She raced across the circle and stood in front of me and Suzy. We were sitting together, as usual. Jenny's fear was so strong I could taste it. I moved one chair around so that she could sit between us. But that put her directly opposite Mad Rachel. As Jenny sat down she turned her doll's face so that it was against her tiny chest. She wrapped her arms around its head, like she was protecting it. She'll probably make a good mother. Hope it's not too soon, though!

Doctor Harry did his eyes around the circle thing (as usual) and then said that Beth wanted to talk to us. This was not usual. We all looked expectantly at Beth. She was obviously feeling nervous. She was looking at her hands, and her fingers were knotting and unknotting. I wondered if this was her idea, or if Doctor Harry had forced her into it. I saw her take a deep breath, as though she was trying to find her courage. Then she looked up, but didn't make eye contact with any of us. She was looking at a spot on the floor somewhere near the centre of the circle.

'This morning you all saw me have a panic attack,' she started quietly. She hesitated. 'I want to tell you what it's like for me,' she stammered. I could tell that this was really difficult for her. I couldn't understand why Doctor Harry was making her do this. I was starting to get angry when she continued, a little more confidently.

'Doctor Harry is helping me to realise that I don't have to be so afraid of spiders,' she said. 'Now I know that they can't really hurt me. And I thought I had that fixed in my head – until this morning,' she continued sadly. We all kept quiet. Even Mad Rachel. Though she might still be drug fucked. I hoped so.

'I know it with my mind. But I can't stop the fear,' Beth said. With that she did look up at us. We were nodding and smiling our encouragement. She took another deep breath. This was costing her a lot.

'I know that this fear is way too much for the threat that a spider really will hurt me,' she explained. 'Doctor Harry says it's disproportionate fear to threat. It took me a while to understand what he meant. But I do now,' she added. She looked so sad. I think she was hoping that we wouldn't think she's bonkers. Or maybe she was hoping that we understood what she meant. Either way, no-one was going to interrupt her. We know pain when we see it.

'When I have a panic attack I freeze,' she went on. 'My heart races like it's trying to burst out of me. The first few times I thought I was going to have a heart attack! So I got even more scared,' she said, so sadly. We all kept quiet, but were trying to reassure her to go on by nodding and smiling.

'I know that I'm not going to have a heart attack, but it's still really scary,' she explained. 'Doctor Harry has drummed this into my head. But I still feel afraid. I know it's stupid, but I can't stop the fear,' she whispered. She had stopped looking at us, and was watching her fingers knotting together again. We were silently urging her on. It seemed important to her to describe what happens to her. If that's what she wanted to do, none of us was going to interrupt her.

'Then I freeze. I can't help it. It's like my brain stops, so my body can't move,' she explained thoughtfully. With this, she glanced up quickly to check how we were reacting to what she was saying. I've never seen Beth so lacking in confidence. I wanted to tell her it was all right. But for once I kept my big mouth shut. I felt that if anyone had said anything, the spell would be broken and Beth would not be able to keep going. Obviously the others read it the same way.

'I become so afraid that I break out in a sweat, but I feel cold at the same time,' she said. 'I can hear what people are saying to me, but it's like they're speaking from under water. I can't do anything. And I am afraid that I will wet myself,' she whispered. 'That hasn't ever happened, but I am terrified that I will. Stupid, huh?' she begged for understanding.

Again she quickly glanced up from her hands. Even Mad Rachel seemed to be interested in what Beth was saying. There was a lot of good will. We know Beth. We like her. I was trying to send this message with my face. I hope she saw it. She went back to looking at the floor.

'The absolute worst thing is if someone touches me while I'm having a panic attack,' she said. 'It flips me out. I totally lose my shit. That's when I start screaming and can't stop. It's like someone else is doing it. I can hear the screaming, but I don't realise that I am the one doing it,' she said. Her face had gone bright red. I think she was remembering all the times she had been so embarrassed. I felt like hugging her, and telling her it was okay. It was completely silent for a few minutes. I was trying to imagine what it would be like to have a panic attack. Maybe the others were too.

Doctor Harry did what he always does when someone speaks in group. 'Thank you for explaining this to us, Beth,' he said as he smiled at her. 'You have been very brave.' I think he meant it.

There was a general release of tension. Beth looked up at us, her eyes pleading for acceptance. It broke my heart to see such vulnerability. She's a great girl who has one problem. She doesn't deserve to think she's crazy for just one problem. I was wondering how she would get fixed, when Doctor Harry started to explain exactly that. He freaks me out sometimes!

'The challenge of treating a person who suffers from panic attacks comes from the duality of the condition,' he said. Even before Suzy could ask, he continued, 'The underlying fear is compounded by a secondary fear. What I mean is that because someone is afraid of say, sharks – this fear can build in their minds until it becomes a very real terror. So even though they know with their intellect that the chances of facing a shark are quite remote, the fear takes over emotionally. The person now is deeply afraid, and this fear is disproportionate to the risk,' he explained.

He paused, and looked around the group to see if we were with him. I think we were, even Jenny. What surprised me was the look of intelligent interest on Mad Rachel's face.

'If this fear is strong enough to stop a person from going about their usual day, then it becomes an unreasonable anxiety,' he said.

Suzy jumped in at this. 'We all get anxious,' she said. 'So where's the problem?'

As usual, Doctor Harry answered a question with a question. Boring!

'Why does anxiety exist?' he asked the group. I didn't know. Looking around, it seemed like no-one else did either. Then I nearly fell off my chair!

'Anxiety exists as our early warning system,' Mad Rachel answered. 'It exists so we can recognise threats to our wellbeing,' she added.

'Spot on Rachel!' Doctor Harry responded with a smile. 'And what happens to our bodies when we feel anxious?' he asked.

Not to be outdone, Suzy leapt in. 'I did this in Health Science,' she announced with satisfaction. 'Our brains get us ready to either fight or run away,' she announced. 'Fight or flight response,' she added.

'And what does the body do to get us ready for fight or flight?' Doctor Harry asked.

'Our brains shut down thinking by flooding us with chemicals like adrenaline,' she said. 'Our hearts beat faster so that we are ready for action.'

'Really good, Suzy!' Doctor Harry praised her. She looked pretty pumped with this compliment.

'A person suffering from a panic attack is in an acute state of anxiety. Their body has prepared them for fight or flight, but to such an extreme that they can do neither,' he explained. 'So they are stuck with this terrible fear, and can't do anything about it. Can you imagine how this would feel?'

I was thinking about it. I wondered if it would be like when you're watching a really scary movie. I mean, terrifying. You want to stop watching it, but have to keep going with it. You have to know how it works out. I don't know, Crystal. That was the best I could come up with. It didn't come close to what Beth was describing, though.

'Remember that I said panic attacks work on two levels?' he asked. 'A person can experience one panic attack, or even several,' Doctor Harry said. 'Now it gets really difficult because the person is so scared of having a panic attack, they panic about that too,' he expanded.

I was a bit lost here, but Suzy was all over it, as usual. 'So they start to avoid places because they might have a panic attack?' she asked.

'Yes. If someone is terrified of sharks, they would be afraid to go to the beach. That may not be too difficult an environment to avoid. But what if the person is afraid of being afraid – where can they possibly go?' he asked.

I was starting to get a handle on this afraid of things. Now he was complicating it by saying you could be afraid of being afraid? I was getting lost.

'They carry their fear with them, all the time,' Doctor Harry explained. 'So they are not just afraid of sharks, as in our example, but now are also afraid of having a panic attack. This is where the person's anxiety has reached such proportions that they cannot function as they should,' he said. 'We call this a panic disorder,' he finished.

I was getting a grip on this. I reckon it's like when you do those waxy crayon drawings. First you put the colours. Then you cover it with black. Then you scratch a picture through the black to show the colours. Well, that's how I was thinking about it. We were all quiet, trying to work it out in our own ways, I suppose. The silence was broken by Mad Rachel. She didn't flip her shit. She wasn't even rude. She swiveled in her chair so that she was full-on facing Doctor Harry. I felt Jenny flinch as though she had been slapped.

'So how can you fix both levels of fear?' Mad Rachel asked. I thought it was a pretty good question.

'Excellent question, Rachel. Thank you for asking it,' Doctor Harry responded with a smile. This wasn't unusual. It's what he always did. But Rachel is new, so she looked like she'd been given a present. I was wondering why he was being so nice to her. Hadn't he been told about Mad Rachel?

'We have first to convince the person that they are not going to die,' he answered. 'You would be surprised how often people who suffer from a panic disorder really do think that they will die,' he added.

Okay, I'm thinking, no-one's going to die. That's a good start. The way Beth described it, you probably would think you're having a heart attack.

'Then you have to teach the person to recognise their panic attack symptoms, and learn how to manage them,' he said.

'How can you do that?' Mad Rachel asked. Got in by a short nose ahead of Suzy, I reckon.

'We do breathing exercises; meditation; visualisation – whatever the person likes and, ultimately, can do for themselves,' he said.

Suzy got in first with the next one. 'But that hasn't fixed the fear that kicked the whole thing off, has it?' she stated.

'Right again, Suzy!' Doctor Harry smiled at her challenge. It was like he enjoyed batting ideas around. For a minute I think he forgot we're a bunch of crazy girls!

'It varies because people can be afraid of so many things. Fear of clowns is a popular one!' he said.

'Seriously? How can you be afraid of clowns?' I was thinking.

Kayla said in a very small voice, 'I am afraid of clowns. And balloons,' she added. We all looked at her, and she blushed. She's one of the mousy ones who never say anything in the group sessions.

'So what could you do to fix that?' Suzy demanded.

'Cognitive behaviour therapy is the cornerstone of the treatment,' Doctor Harry said.

'That's talking and listening,' I said smugly. 'Counselling, basically,' I explained. I wasn't going to let Suzy and Mad Rachel get all the attention. Yeah, out of character. Totally.

'Great, Abigail!' Doctor Harry enthused. I was wondering if he'd had lollies for lunch.

'The person has to be helped to understand that their fear is out of proportion to the actual threat,' he said. 'The longer the person has been afraid, usually the longer it takes to undo the damage,' he explained.

'Like what you said about first aid!' Suzy threw in. Definitely sugar highs going on here. Maybe they had red cordial?

'And if the person agrees, we slowly introduce the object of their fear into the treatment. This is called exposure or behavioural therapy,' he said.

I giggled. I couldn't help it. I had this image of everyone sitting around with no clothes on! Sick, but there you go. I am in here. I looked down to signal that I was out of it for a bit.

'With this behavioural therapy gradually the person realises that they can control their fear responses. So eventually they can recognise that they feel the fear and anxiety, but are not stopped cold by it,' he finished.

He worked his way around the circle, lingering on each face.