Thursday, March 7, 2013

Surviving Life

Those of you who read my book will meet Alyce, the young woman whose five-year treatment was one of the most tumultuous of my career, filled with both rage and love. You will also meet me as I was at that time of my life, a relatively young clinician, married to the love of my life, living in an idyllic setting in the home my husband had remodeled.

I was immediately drawn to Alyce, hooked by her underlying fragility covered by a defensive and defiant toughness. Within two weeks of beginning treatment, Alyce decompensated into a florid psychosis. I saw her two and then three and sometimes four times a week. In addition, she often called me between sessions, sometimes pleading that I make her better, sometimes railing against my incompetence. 

Even after she improved Alyce, who was an adopted child, maintained the belief that I was her biological mother. 

“Why don’t you just admit it!” she would rage. “Why are you rejecting me again? Why did you reject me the first time? I hate you! I hate you! I hate you!!!”

Or she’d try a gentler approach. “Please just tell me you’re my mother. I won’t tell anyone. I understand. You don’t want anyone to know. I won’t tell. I promise. Just tell me you’re my mother.”

My reaction to these exhortations varied, both internally and verbally. There were times I wanted to yell, “Enough already, you know I’m not you’re mother.” At other times I wanted to take her in my arms and tell her that everything would be all right; that she didn’t need me to be her mother, that I would protect and take care of her as if she were my child. 

Alyce and I worked very hard. She struggled with the reality of my not being her biological mother, of my having a life outside of her, of my going on vacations. But through it all Alyce definitely knew that I cared deeply about her. She blossomed.

Even after Alyce left treatment we remained in occasional contact for many years. I knew that she had married and had a child. I knew she had two Master’s degrees, one in psychology and one in writing. Eventually we lost touch.

When I decided to write my book, Love and Loss In Life and In Treatment, I knew that I wanted to write about Alyce. I wrote two chapters and then went searching for Alyce to ask her permission to use her material. Although she is partially disguised, I felt there was too much information about her to publish without her consent. 

I emailed her, looked her up on Facebook, wrote to the last address I had for her. Nothing. No response. I tried again. Then, one night, there was a long message on my machine that I could barely decipher. A halting, drawn out, barely understandable voice said, “Li…n…da,… This is Al…yce.”

Although I couldn’t make out all that she said, I gathered that she had two accidents: the first some years ago which resulted in a long undiagnosed neck injury, the second a more recent car accident. The car accident resulted in a brain injury causing her speech problems, an inability to walk, difficulty in concentrating, and the need for twenty-four hour care. The message ended. I sobbed. My beautiful, accomplished Alyce! After all she had struggled through, this horrible tragedy befell her. I, who always tell patients life isn’t fair, wanted to rail against the unfairness of life. 

Sometime later I realized that I wasn’t crying only for Alyce, but also for myself. Alyce represented the time of my life I most cherished: the time before my husband’s illness, the time before I left the home I loved, and most importantly the time before my husband’s death. Life was now painfully different for both of us, although I in no way equated them. Alyce’s losses were tragic, mine, although terribly painful, were an expected part of life.     

I finally spoke with Alice, a painful conversation both because of my difficulty understanding her and the details of her injury and her life. Yet I could still hear Alyce’s grit and determination. She wasn’t giving up. She was suing the insurance company. She was in physical therapy, speech therapy, occupational therapy and psychotherapy.     

I have continued to follow the ups and downs of Alyce’s life. She lost the insurance case. She could no longer afford an aide. She was moved to a group home. Her daughter could no longer live with her and went to live with her father from whom Alyce was divorced. She rarely came to visit. And still Alyce persevered. Her speech improved. Her mind improved. She went back on the internet. She became more interested in life. 

After poor medical attention Alyce was hospitalized and almost placed in a nursing home. Instead, she now lives in her own apartment. There are many things she requires but cannot afford. And still she perseveres, determined to survive, determined to improve, determined to be present for her daughter. She is, after all, my beautiful, accomplished Alyce!