Touchstone Anthology of Contemporary Creative Nonfiction (91 page)

“Weird day yesterday,” I said. I spoke slowly, listening to my words, testing them on my tongue. So far so good.

I stood up. “You look weird,” he said, “unsteady.”

“I’m O.K.,” I said, and then, in that instant, a surge of anxiety. I had lied. I had not been O.K.
Say “God I’m sorry” fourteen times
, I ordered myself.
This is crazy
, I said to myself.
Fifteen times
, a voice from somewhere else seemed to command. “You really all right?” Adam asked. I closed my eyes, counted, blinked back open.

“O.K.,” I said. “I’m going to shower.”

But it wasn’t O.K. As soon as I was awake, obsessive thoughts returned. What before had been inconsequential behaviors, such as counting to three before I went through a doorway or checking the stove several times before bed, now became imperatives. There were a thousand and one of them to follow: rules about how to step, what it meant to touch my mouth, a hot consuming urge to fix the crooked angles of the universe. It was constant, a cruel nattering.
There, that tilted picture on the wall. Scratch your head with your left hand only
. It was noise, the beak of a woodpecker in the soft bark of my brain. But the worst by far were the dread thoughts about concentrating. I picked up a book but couldn’t read, so aware was I of myself reading, and the fear of that awareness, for it meant a cold disconnection from this world.

I began to avoid written language because of the anxiety associated with words. I stopped reading. Every sentence I wrote came out only half coherent. I became afraid of pens and paper, the red felt tip bleeding into white, a wound. What was it? What was I? I could not recognize myself spending hours counting, checking, avoiding. Gods seemed to hover in their air, inhabit me, blowing me full of their strange stellar breaths. I wanted my body back. Instead, I pulsed and stuttered and sparked with a glow not my own.

I spent the next several weeks mostly in my bedroom, door closed, shades drawn. I didn’t want to go out because any movement might set off a cycle of obsessions. I sat hunched and lost weight. My friend Adam, who had some anxiety problems of his own and was a real pooh-pooher of “talk therapy,” found me a behaviorist at McLean.

“These sorts of conditions,” the behavioral psychologist, Dr. Lipman, told me as I sat one day in his office, “are associated with people who have depressive temperaments, but unlike depression, they do not yield particularly well to more traditional modes of psychotherapy. We have, however, had some real success with cognitive/behavioral treatments.”

Outside it was a shining summer day. His office was dim, though, his blinds adjusted so only tiny gold chinks of light sprinkled through, illuminating him in patches. He was older, maybe fifty, and pudgy, and had tufts of hair in all the wrong places, in the whorls of his ears and his nostrils. I had a bad feeling about him.

Nevertheless, he was all I had right now. “What is this sort of condition exactly?” I asked. My voice, whenever I spoke these days, seemed slowed, stuck, words caught in my throat. I had to keep touching my throat, four times, five times, six times, or I would be punished by losing the power of speech altogether.

“Obsessive-compulsive disorder,” he announced. “Only you,” he said, and lifted his chin a little proudly, “have an especially difficult case of it.”

This, of course, was not what I wanted to hear. “What’s so especially difficult about my case?” I asked.

He tapped his chin with the eraser end of his pencil. He sat back in his leather seat. When the wind outside blew, the gold chinks scattered across his face and desk. Suddenly the world cleared a bit. The papers on his desk seemed animated, rustling, sheaves full of wings, books full of birds. I felt creepy, despondent, and excited all at once. Maybe he could help me. Maybe he had some special knowledge.

He then went on to explain to me how most people with obsessive thoughts —
my hands are filthy
, for instance — always follow those thoughts with a compulsive behavior, like hand washing. And while I did have some compulsive behaviors, Dr. Lipman explained, I had also reported that my most distressing obsession had to do with concentration, and that the concentration obsession had no clear-cut compulsion following in its wake.

“Therefore,” he said. His eyes sparkled as he spoke. He seemed excited by my case. He seemed so sure of himself that for a moment I was back with language again, only this time it was his language, his words forming me. “Therefore, you are what we call a primary ruminator!”

A cow, I thought, chewing and chewing on the floppy scum of its cud. I lowered my head.

He went on to tell me about treatment obstacles. Supposedly, primary ruminators are especially challenging because, while you can train people to cease compulsive behaviors, you can’t train them nearly as easily to tether their thoughts. His method, he told me, would be to use a certain instrument to desensitize me to the obsessive thought, to teach me not to be afraid of it, so when it entered my mind, I wouldn’t panic and thereby set off a whole cycle of anxiety and its partner, avoidance.

“How will we do it?” I asked.

And that is when he pulled “the instrument” from his desk drawer, a Walkman with a tiny tape in it. He told me he’d used it with people who were similar to me. He told me I was to record my voice saying “I can’t concentrate I can’t concentrate” and then wear the Walkman playing my own voice back to me for at least two hours a day. Soon, he said, I’d become so used to the thought it would no longer bother me.

He looked over at the clock. About half the session had gone by. “We still have twenty more minutes,” he said, pressing the red Record button, holding the miniature microphone up to my mouth. “Why don’t you start speaking now.”

I paid Dr. Lipman for the session, borrowed the Walkman and the tape, and left, stepping into the summer light. McLean is a huge, stately hospital, buildings with pillars, yawning lawns. The world outside looked lazy in the sweet heat of June. Tulips in the garden lapped at the pollen-rich air with black tongues. A squirrel chirped high in the tuft of a tree. For a moment the world seemed lovely. Then, from far across the lawn, I saw a shadow in a window. Drawn to it for a reason I could not articulate, I stepped closer, and closer still. The shadow resolved itself into lines — two dark brows, a nose. A girl, pressed against glass on a top-floor ward. Her hands were fisted on either side of her face, her curls in a ratty tangle. Her mouth was open, and though I could not hear her, I saw the red splash of her scream.

Behavior therapy is in some ways the antithesis of psychoanalysis. Psychoanalysis focuses on cause, behavior therapy on consequence. Although I’ve always been a critic of old-style psychoanalysis with its fetish for the past, I don’t completely discount the importance of origins. And I have always believed in the mind as an entity that at once subsumes the body and radiates beyond it, and therefore in need of interventions surpassing the mere technical — interventions that whisper to mystery, stroke the soul.

The Walkman, however, was a purely technical intervention. It had little red studs for buttons. The tape whirred efficiently in its center like a slick dark heart. My own voice echoed back to me, all blips and snaky static. I wondered what the obsession with concentration meant. Surely it had some significance beyond the quirks in my neuronal wiring. Surely the neuron itself — that tiny pulse of life embedded in the brain’s lush banks — was a God-given charge. When I was a girl, I had seen stalks of wheat filled with a strange red light. When I was a girl, I once peeled back the corn’s green clasps to find yellow pearls. With the Walkman on, I closed my eyes, saw again the prongs of corn, the wide world, and myself floating out of that world, in a place above all planets, severed even from my own mind. And I knew the obsession had something to do with deep disconnection and too much awe.

“There may be no real reasons,” Dr. Lipman repeated to me during my next visit. “OCD could well be the result of a nervous system that’s too sensitive. If the right medication is ever developed, we would use that.”

Because the right medication had not yet been found, I wore the Walkman. The earplugs felt spongy. Sometimes I wore it to bed, listening to my own voice repeat the obsessive fear. When I took the earphones off, the silence was complete. My sheets were damp from sweat. I waited. Shadows whirled around. Planets sent down their lights, laying them across the blue floor. Blue. Silver. Space.
I can’t concentrate
.

I did very little for the next year. Dr. Lipman kept insisting I wear the Walkman, turning up the volume, keeping it on for three, now four hours at a time. Fear and grief prevented me from eating much. When I was too terrified to get out of bed, Dr. Lipman checked me into the local hospital, where I lay amidst IV drips, bags of blood, murmuring heart machines that let me know someone somewhere near was still alive.

It was in the hospital that I was first introduced to psychiatric medications, which the doctors tried out on me, to no avail. The medications had poetic names and frequently rhymed with one another — nortriptyline, desipramine, amitriptyline. Nurses brought me capsules in miniature paper cups or oblong shapes of white that left a salty tingle on my tongue. None of them worked, except to make me drowsy and dull.

And then one day Dr. Lipman said to me, “There’s a new medication called Prozac, still in its trial period, but it’s seventy percent effective with OCD. I want to send you to a Dr. Stanley, here at McLean. He’s one of the physicians doing trial runs.”

I shrugged, willing to try. I’d tried so much, surely this couldn’t hurt. I didn’t expect much though. I certainly didn’t expect what I finally got.

In my memory, Stanley is the Prozac Doctor. He has an office high in the eaves of McLean. His desk gleams. His children smile out from frames lined up behind him. In the corner is a computer with a screen saver of hypnotic swirling stars. I watch the stars die and swell. I watch the simple gold band on Stanley’s hand. For a moment I think that maybe in here I’ll finally be able to escape the infected repetitions of my own mind. And then I hear a clock tick-tick-ticking. The sound begins to bother me; I cannot tune it out.
The clock is ruining my concentration,
I think, and turn toward it. The numbers on its face are not numbers but tiny painted pills, green and white. A chime hangs down, with another capsule, probably a plastic replica, swinging from the end of it. Back. Forth. Back. Back.

The pads of paper on Stanley’s desk are all edged in green and white, with the word “Prozac” scripted across the bottom. The pen has “Prozac” embossed in tiny letters. He asks me about my symptoms for a few minutes, and then uses the Prozac pen to write out a prescription.

“What about side effects?” I ask.

“Very few,” the Prozac Doctor answers. He smiles. “Maybe some queasiness. A headache in the beginning. Some short-term insomnia. All in all it’s a very good medication. The safest we have.”

“Behavior therapy hasn’t helped,” I say. I feel I’m speaking slowly, for the sound of that clock is consuming me. I put my hands over my ears.

“What is it?” he asks.

“Your — clock.”

He looks toward it.

“Would you mind putting it away?”

“Then I would be colluding with your disease,” he says. “If I put the clock away, you’ll just fixate on something else.”

“Disease,” I repeat. “I have a disease.”

“Without doubt,” he says. “OCD can be a crippling disease, but now, for the first time, we have the drugs to combat it.”

I take the prescription and leave. I will see him in one month for a follow-up. Disease. Combat. Collusions. My mind, it seems, is my enemy, my illness an absurdity that has to be exterminated. I believe this. The treatment I’m receiving, with its insistence upon cure — which means the abolition of hurt instead of its transformation — helps me to believe this. I have, indeed, been invaded by a virus, a germ I need to rid myself of.

Looking back on it now, I see this belief only added to my panic, shrunk my world still smaller.

On the first day of Prozac I felt nothing, on the second and third I felt nauseated, and for the rest of that week I had headaches so intense I wanted to groan and lower my face into a bowl of crushed ice. I had never had migraines before. In their own way they are beautiful, all pulsing suns and squeezing colors. When I closed my eyes, pink shapes flapped and angels’ halos spun. I was a girl again, lying in the snow. Slowly, one by one, the frozen forms lifted toward the light.

And then there really was an angel over me, pressing a cool cloth to my forehead. He held two snowy tablets out to me, and in a haze of pain I took them.

“You’ll be all right,” Adam said to me. When I cried it was a creek coming from my eyes.

I rubbed my eyes. The headache ebbed.

“How are you?” he asked.

“O.K.,” I said. And waited for a command.
Touch your nose, blink twelve times, try not to think about think about concentrating.

The imperatives came — I could hear them — but from far far away, like birds beyond a mountain, a sound nearly silent and easy to ignore.

“I’m…O.K.,” I repeated. I went out into the kitchen. The clock on the stove ticked. I pressed my ear against it and heard, this time, a steady, almost soothing pulse.

Most things, I think, diminish over time, rock and mountain, glacier and bone. But this wasn’t the nature of Prozac, or me on Prozac. One day I was ill, cramped up with fears, and the next day the ghosts were gone. Imagine having for years a raging fever, and then one day someone hands you a new kind of pill, and with in a matter of hours sweat dries, the scarlet swellings go down, your eyes no longer burn. The grass appears green again, the sky a gentle blue.
Hello hello. Remember me?
the planet whispers.