“Do you still have space in your program?” I ask instead of answering her question. “The one you mentioned when we first started working together?”
She can’t hide her surprise, her eyebrows jumping slightly up as she looks back at me. “You’re considering inpatient treatment? Has something happened?”
“I want to try it,” I answer, my fingers fidgeting with the hem of my sweater nervously. “I think I need to.”
Tiffany blinks, trying to read me but apparently coming up empty. “I once told you that you were always welcome into my program. Of course that hasn’t changed. I’m just surprised to hear this interest coming from you, especially since you’ve been steadily making progress.”
“Slowly,” I correct, wrinkling my nose. “I’ve beenslowlymaking progress and I need something more challenging. Do you not think it will help me anymore?”
“That’s not what I said,” she tells me carefully. “I think you would thrive in the program, actually. Especially if you’re as determined to go through with it as you seem. I only mean that I didn’t expect this today. Your fear of leaving your home has been a large barrier in making the program a good fit for you. But as we’ve seen, you’ve been making great strides in tackling that fear.”
I huff, shaking my head. “You call leaving the house twice in three years great progress?”
Her face does a poor job of masking her sympathy. “Anya, you may have only made a couple big trips away, but you go outside nearly every day. You feel safest here, so you enjoy your safe space, but you aren’t incapable of leaving. That is great progress, whether you believe it or not. Plenty of people withlittle to no trauma also enjoy the safety and comfort that a home offers.”
We’ll have to agree to disagree.
“If I do the program, though, do you think I’ll show more progress?”
“I think it’s very likely, yes,” she confirms, not willing to make a promise for obvious reasons. “Is there something specific you’re looking to improve upon? Anything you can tell me will help me cater to your care.”
“I want to stop being so terrified of everything,” I say, the words coming out half-angry, half-exhausted. “I want to be able to think about a future, about falling in love and growing old with a family of my own without considering it impossible. I want to be normal again. I don’t care if normal is the wrong word, or if I’ll never be the same girl I was before. I want it, so I don’t care if it’s not achievable or realistic. I stillwantit.”
“It’s okay to want that, Anya,” Tiffany tells me softly. “And you’re right, you may never be that same girl again. But we never are. You’re nearly four years older than that girl now. You’d be different from her if nothing bad ever happened to you. You’d have grown differently, but grown all the same. And still, you’re allowed to desire normalcy. To wish for easier days with less struggle and more happiness. I don’t think normal is impossible, because normal is defined in a multitude of ways. I would be very happy to help you createyournormal, Anya.”
“How long will it take?” I ask, swallowing with anticipation.
“I think you would benefit from even a couple of weeks, but if you want to be all in?—”
“I do,” I interrupt in a rush. “I’m all in.”
“Then I would recommend the full stay. I would keep you for sixty days. I know it seems like a long time, but I assure you it will go by faster than you expect. Your days will be filledwith different therapies, group activities, outside time, and new techniques to advance your progress as you go.”
Two whole months.
The amount of time is daunting, and still my determination doesn’t fade.
“And I would remind you that your stay might be much easier on you than other patients you may meet. You’ve already adjusted to your medication, and you’ve been doing one-on-one therapy for quite some time. I think you will settle in quicker than you imagine possible for those two reasons alone.”
“Okay. Can you tell me more?”
“Of course.”
Tiffany goes on for several minutes describing her program. How I’ll have my own room, and a curated routine meant to fit my needs best. I’ll see other specialists she employs and even try more unfamiliar therapies, like water and animal-based interactions meant to increase relaxation through reduced stress. Apparently, they have a whole horse barn for equine-assisted therapy.
She explains how she thinks I’ll benefit from group therapy especially. By hearing others open up about similar traumas they have experienced, I may eventually be able to share my own without shame. Somehow, I doubt anything I share will come out without shame or embarrassment or some other God-awful misplaced feeling, but it’s a nice thought.
“And these treatments and therapies…you think they can help me with everything? The PTSD, the anxiety, my fears, my OCD? You don’t think I’ll regress without my routine?”
“You may experience some discomfort, but no, I don’t believe you’ll regress.” She offers a half-lifted smile. “Using your routines and your comforting actions are what sets your PTSD-induced OCD apart from a typical anxiety case. Anxious thoughts are obsessions, and your routines and sortof rituals you’ve created to soothe thought obsessions are your compulsions. There are healthy ways to use your routines, of course. But I will note that you’ve been driven by fear to push your compulsions and habits into a more disordered way of living.”
“What do you mean by that?” I ask, suddenly worried. “You’ve never said this before.”
“Because you are still making progress, like I said. A step back but three steps forward is still moving. And sometimes, a little bit of disordered action can keep the mind comfortable. ‘Bad’habits aren’t detrimental. I would have stepped in sooner, had I known you wanted to advance sooner. You’ve been adjusting, and I’ve been letting you do what feels best.”
I blink, trying to digest her meaning, and she decides to clarify further.
“Your checking, for instance. I know you feel comforted checking your window locks before bed several times, despite the fact that you never touch them to unlock them. You still fight the urge to google food interactions with your medication, even though you know what’s safe in your diet. And your diet…while I understand your draw to the routine and the mental ease of having the same meals weekly, it’s been quite some time since you began eating this way. I think you might want to branch out again, but you’re scared of what might happen if you do?”
