detective appeared impressed. “I was thinking three would be a good number.”
“Fair enough. Three sessions it is. But you have to take your visits with me seriously; that’s my condition. You don’t have to believe in everything I say. But as long as we have three appointments together, you might as well listen. And do your homework.”
“Homework?”
“Absolutely. Your first assignment is to name your pain.”
“What?” I had the good detective’s full attention again, most likely because she thought I was nuts.
“Give your pain a name. And next time you wake up in the middle of the night, instead of telling yourself to go back to sleep, I want you to address your pain by name. Talk to it. Then listen for what it might have to say.”
“You mean, like, ‘Give me Percocet’?” D.D. muttered.
I smiled. “Speaking of which, are you taking anything?”
“No.”
“Why not?”
That seminod, or maybe it was a half shrug. “Just say no to drugs, yada, yada, yada. Prescription, nonprescription, it’s a fine line out there with narcotics, and I’d prefer not to cross it.”
“Are you afraid of drugs?”
“Say what?”
“Some people are. They’re afraid of how the drugs may make them feel; they’re afraid of becoming addicted. I’m not saying there’s anything wrong with that. I’m just asking.”
“I don’t like meds. Plain and simple. They’re not for me.”
“You consider yourself tougher than that?”
“You’re stereotyping me.”
“And you’re avoiding my question.”
“Is it true you can’t feel pain?”
I smiled, sat back fully and glanced at the clock. “Twenty-two minutes,” I said.
The detective wasn’t dumb. She glanced at the wall clock hanging beside my desk, then scowled.
“You’re a detective,” I continued. “Of course you ran a background on me. And since the Boston Herald, not to mention numerous science publications, have found my condition fascinating, you learned quite a bit. Then it was simply a matter of waiting until you needed to distract, evade. The best defense is a good offense, yes?” I kept my voice even. “For the record, Detective, I can’t feel any physical pain. Which means I have nothing better to do than focus on yours. And you still haven’t answered my question. Do you consider yourself tough?”
“Yes,” she bit out.
“So tough, your back, your shoulder, shouldn’t be slowing you down like this?”
“I can’t wash my hair!”
I waited.
“I can’t lift my son. My three-year-old son. And last night, he went to hug me and I stepped away because I knew it would hurt. I couldn’t take the pain!”
I waited.
“And the docs all say it’ll get better. Do this, take that, but in the meantime, I can’t sleep, I can’t move and I can’t even enjoy lounging around in bed, because I fucking hate my bed. It hurts too much to get in and out of it. I’m old, I’m broken and I’m basically unemployed. Shit!”
Then: “Goddamn, shit on a stick, bite me, fuckety fuck fuck. Shit!”
“Melvin,” I said.
“What?” D.D. looked up, a semiferal gleam in her eye. A look I’d seen many times in my practice; the gaze of an animal in pain.
“Melvin,” I repeated calmly. “I think you should name your pain Melvin. Shit on a stick, fuckety fuck fuck Melvin. And every time he bothers you, yell at him. Curse him out. Why not? You might actually feel better. Discover that putting your Self in charge of Melvin makes him smaller and your Self more powerful. And isn’t that really what you miss? Feeling powerful?”
“Melvin,” D.D. said.
“Just a suggestion. Obviously, you want a name that resonates for you.”
“How much do you charge an hour again?”
“Well, I am a doctor. Have initials after my name and everything.”
“Melvin. Good God, my pain is called Melvin.”
“The Internal Family Systems model subdivides the mind into four main parts. At the core is your Self, the natural leader of the system. Then there is the section called the Exiles, which include pain and trauma you’re not ready to process yet so you have cast aside. Unfortunately, the Exiles need to share their stories. They will continue to act out, in the form of rage, terror, grief and shame, until they are heard.
“When the Exiles act up, the next group, the Firefighters, kick into gear. Classic firefighting techniques include drug or alcohol abuse, binge eating, other short-term cover-ups for long-term pain. Finally there are the Managers. This section also tries to keep the Exiles at bay through hypercontrolling every situation. Striving, judging, self-criticizing, all come from the Managers. Basically your exiled pain/trauma causes emotional distress, which in turn goads the Firefighters into various self-destructive