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knew from our first session that Mary’s treatment was going to be slow and long. She’d been weakened by years of chronic disability, and I feared that her chequered history with mental health services would also hold her back. But as time went on, she grew stronger and stronger in therapy. Step by step she slowly advanced. I taught her that the treatment of anxiety was like trench warfare: ‘Just move the trench forward ten paces, bunker down, and don’t let the enemy break through your defences. Small gains are all we need between sessions, Mary — that’s the way we’ll win the war’.
As weeks turned into months, the gains grew larger. I could see Mary becoming empowered in her recovery. She became more positive, optimistic and animated in sessions. She was increasingly engaged and attentive — an ideal patient who was eager to learn and even more eager to recover.
At the time of this interview, Mary had seen me 54 times over three years and she had dramatically improved. Through daily exposure to feared foods and fluid she had slowly mastered meal times. Her first steps were small — merely changing the brand of her bottled water was a cause for significant celebration in the opening weeks of treatment. Slowly she added more foods, and gradually she eliminated all her safety behaviours and magical rituals. She stopped eating near hospitals and slowly reclaimed her life.
Mary is now eating freely, coming to sessions on her own, and travelling with much greater ease. Her mood has been stable for many months and she is completing a course in Fine Arts. She recently married and is enthusiastically building a life with her new husband. To say that she is free of anxiety would be an overstatement, but she is an entirely different person to the woman I first met.
Our interview with Mary
| Ross: | Thank you so much for talking to me today, Mary. Could you begin by telling me about your family and life at home as you grew up? |
| Mary: | I didn’t have a very normal childhood, I guess. My father left when I was about two. My mother left when I was about three. So I grew up with my grandparents until I was five or six. My mum came in and out of the picture at various points in time. I don’t blame them really. They were both quite young. I think my dad was 19 and mum was 25. So initially I grew up without them. |
| Ross: | But your mum would re-appear. Tell me about your relationship with her in those early years. |
| Mary: | Very co-dependent, I think. My mother made the world around me a very unsafe place. She frequently told me, from a very young age, how dangerous the world was. So I clung to her whenever she was around. This created its own problems because she suffered with psychotic episodes, even back then. She would see things and hear things and have outbursts of paranoia when I was young. I distinctly remember them. They were like small traumatic episodes in which I came to see danger in things that were quite safe. |
| Ross: | I see. And your father? Did he also re-appear? |
| Mary: | When I was very young, he wasn’t there at all, and then he came back when I was five. He’s been a figure in my life ever since. |
| Ross: | And what’s been your experience of the man? How would you describe this relationship? |
| Mary: | He’s not on my birth certificate, which I always find really amusing. I think it’s because my mum is indigenous and my dad is white. I think she was too scared to put him on the birth certificate because there was some irrational thought that maybe I’d get taken away. The shadows of the stolen generation were never far from her mind. |
| Ross: | That must have been very difficult for her. Can I ask, when your mum and dad returned to you, what role did your grandparents continue to play in your life? |
| Mary: | Not too much for many years, because my mum took me away. I was around five years of age. I remember the day distinctly. We were at the train station in our country town. I kept looking at my grandmother — I was terribly scared that she was going to die. I’m not sure why I believed this — perhaps because she was old in my mind. We got on the train, and as it pulled away, I saw her fading in the distance. We didn’t return to the town for another three or four years. So I went a few years without seeing either of my grandparents. I missed them. |
| Ross: | I see. I was going to ask you about any early losses that you experienced in your life, and you’ve already mentioned one — the loss of grandparents — of being pulled away from your grandparents. What, if any, was the impact of this event? And of any other losses in your early life? |
| Mary: | I didn’t have a lot of losses, but death was talked about a lot in my family. Right across my childhood, death was a regular topic within my home and within the circles of my extended family. Tales were told of the people who had died. Sometimes I even thought, (and at times I still do), that they were imaginary people that my family made up because they were always such traumatic stories. They talked about an uncle that got tragically and mysteriously hit by a car, and an aunt who got killed by the hospital because they wanted her organs. These are the kind of stories I grew up with from a really young age. I started to fear any symbols of death or loss or departures. |
| Ross: | Can you give me an example? |
| Mary: | Sure. I remember the hit song Leaving on a Jet Plane. It always triggered fear in me. I’d cry and cry when it came on the radio because I came to believe that it either meant my grandmother was going to die or my mum was going to leave me again. |
| Ross: | I see. |
| Mary: | Yes, so I always had that fear, even after I left my grandparents. Since that day on the train station when they faded into the distance, I’ve always been waiting for them to die. It’s now 23 years later, and they’re still not dead. (Mary smiled quietly to herself and shook her head). |
| Ross: | Mary, I was going to ask you about losses or traumas in your parents’ lives, perhaps occurring before you were born. You’ve mentioned that they talked about uncles. They talked about other people that had died. If I’m understanding you, they talked about these happenings a lot. As time went on, did that continue? Was it clear that these events had had a big impact on them; the people in their lives that weren’t with them anymore? |
| Mary: | (Mary hesitated). It’s a weird thing. They talk about death a lot — death has clearly haunted them. I don’t think they’ve ever really processed the big losses in their lives. My mum was Indigenous, and so her trauma has always been there. My grandmother was part of the stolen generation. She lost a sister who was taken away. And she lost others to early death. All her other brothers and sisters died, except for one that’s still alive. She was one of nine, but she lost them all, one way or another. Death was such a big part of her life, and the world has always been a very unsafe place for her. |
| And the trauma was passed down — it infected my mum. She lost her favourite uncle and her favourite aunt, and a few other important people. My mum also had several other distinct traumas. I’ve always believed that she was molested when she was younger too. She’s very fixated on molestation and rape, something that she’s never talked about. She was there when her sister’s son got badly burned in a fire and lost his leg. So she’s had all these incidents — such a traumatic life. And then there’s the imaginary traumas of her world of psychosis. Her life has been so very difficult. | |
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My dad’s life was similarly painful — his existence has
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