If you are a new reader or only an occasional reader of this blog, you may not know that I used to be a psychotherapist.
In many ways, that career– not so thematically different from that of the writer, actually–seems so temporally distant, as if I’d been a therapist a lifetime ago rather than less than a decade ago.
In other ways, though, there are theories and practices, skills and strategies, experiences and people I carry with me; they are a constant presence even today, informing what I think and what I do.
One of those people is Alba Rosario.^
Alba was a client on my caseload; by the time I started working with her, she had been in therapy for most of her adult life, and as far as I could tell, it hadn’t helped her much. Perhaps it prevented her depression from tipping towards something more sinister, like suicide, but in most ways, therapy didn’t seem to be doing a whole lot for her. A good day for Alba was simply getting out of bed, getting dressed, and coming to the adult day treatment program (and since she slept in her clothes, “getting dressed” often involved just smoothing the wrinkles out of her skirt). She had tremendous difficulty just taking care of what therapists call “ADLs”- the basic “activities of daily living”: brushing one’s teeth, preparing meals, paying bills, and generally doing the mundane tasks we all have to do to get along in the world.
Week after week, for more than two years, Alba would show up for her session with me, inevitably replaying the same narrative over and over. She wanted to take a baby step so that the needle of depression would inch from total dysfunction to marginal dysfunction, but she was completely paralyzed. Just talking about an activity that seemed like the simplest of tasks for someone without depression stimulated visible anxiety that would literally set her trembling. Most sessions would end with Alba promising, feebly, that she would try to change her socks or remember to put a bill in her purse and bring it to therapy so we could talk about it (I also performed case management functions for her), and the subsequent session would begin with the same little shake of the head and a sad smile as she admitted that she hadn’t done any of the tiny tasks we talked about.
Alba was one of my most challenging clients because, as hard as I tried, I couldn’t understand her. I could empathize with her depression. I could define it. I could offer textbook clinical advice. But those things were particularly useful because I could not understand why Alba couldn’t, or wouldn’t, do what so many other patients with depression do–or try to do–to manage their illness: take the tiniest of steps so that they accumulate and become a pattern of successful “doing.”
After we had been working together for well over a year, my curiosity and impatience finally got the better of me. I was exasperated with Alba- why work with her at all? Why not just terminate therapy if it wasn’t “doing any good”? I asked her why she never did any of the tasks we discussed and that she’d agreed, each week, to try.
“Because,” she said, “I am afraid of not being depressed. Depression is terrible, but at least I know what it’s like and so I can cope with it. But I have no idea what not being depressed is like. The idea of knowing is terrifying.”
For those of us who have never personally struggled with depression or mental illness, Alba’s fear may seem, at first glance, irrational and incomprehensible. Why would someone not want to feel better?
But the fear of not knowing holds us back in many ways, and I’ve thought about Alba a lot recently as I listen to writer friends talk about their struggles with all sorts of fears and unknowns… and, if I’m honest, as I confront some of my own.
Many of us are hanging onto (or have hung onto) soul-strangling jobs that pay well but don’t light us up because we’re afraid–and legitimately so–about how we’ll survive on a freelance writer’s income. Others of us are accepting writing gigs for “exposure,” crap pay, or other ridiculous terms because we feel like we’ve got to be building up our bylines, even if it means the trade-off is a situation that fails to respect writers and creative products. There are a hundred variations, at least, on the theme, but ultimately, they all circle back, and uncomfortably so, to Alba’s refrain: “I’m afraid of what I don’t know, so I’ll just deal with what I know, even if it sucks.”
It would be easy to tell you (as people have done and made a boatload of money from saying): “Feel the fear and do it anyway.” And it would even be easy to give you a dozen examples from my own life of the times when I’ve felt the fear, done “it” anyway, and not only come out just fine, but come out way better than I had been before. I believe in taking leaps and hoping like hell that the net will appear.
But telling you that would also be overly facile.
We’ve each got to look at each of our fears–and there are many, aren’t there?– and confront them one by one. Today, maybe you change one sock. Or maybe you take off a sock, decide it’s too frigging scary to have that foot exposed, and you put it right back on. That’s ok. You’re probably not crippled by an acute, persistent, and severe mental illness like Alba, so you won’t wear your dirty socks for the next five years.
What is not ok, I think, is to not try, even tentatively, to face those fears or, at the very least, to articulate them. Even when Alba couldn’t or wouldn’t change her socks or bring in her bills, she was able to say what many of us are too afraid to speak aloud: “I’m afraid of the unknown. I’m afraid of change.” And “I don’t know how to take the first step.”
^Name changed to protect her identity.