Hidden Valley Road - Inside the Mind of an American Family - Robert Kolker Page 0,97

Louise Silvern remembered meeting Lindsay for the first time in 1984, listening to the pretty, self-possessed nineteen-year-old talk about her family and what had happened to her. Lindsay’s description of her family, and of the minute-to-minute experience of growing up in that house, was far and away the most traumatic story, certainly, that she had ever heard from a patient. And when Lindsay got to the part about the college health services therapist not believing her, she remembered being outraged. Job one, Silvern had always thought, was to not shut a patient down.

There is a narrative, or a myth, that our society indulges in about trauma and therapy, particularly in the wake of unspeakable childhood abuse. The myth starts with a child unable to speak, and takes flight when the right therapist is sensitive and kind enough to coax the child into a breakthrough. This is the mold established by Dr. Fried, the Frieda Fromm-Reichmann surrogate in I Never Promised You a Rose Garden. Once the child lets it all out, the trauma disappears like a bad dream. The patient is as good as cured—relieved and unburdened and ready to embrace the world again. In books and movies, the breakthrough happens in one fraught, angry, tearful session, perhaps late at night, after a small crisis triggers something in the patient that they’ve tried to keep bottled up for years.

In Lindsay’s case, the myth was barely half true. In Silvern—Lindsay’s second therapist, based in Boulder and referred by Nancy Gary—Lindsay found a professional listener who, yes, through sensitivity and kindness, created the safe, accepting space that was necessary for Lindsay to take control of her own story.

Where the myth breaks apart is with the idea of a breakthrough. For Lindsay, the breakthrough was more like a seep-through, coming gradually, over twenty-five years, the product of steady, intense work in sessions that sometimes were as frequent as three times a week. While Lindsay was going to classes and getting straight As and having boyfriends and going skiing and climbing, she was dashing away for an hour a week, sometimes two or three, to tell her therapist her family secrets. And while this took a very long time, Silvern made sure the pace remained unrushed. Unlike the movie therapists, she did not want to seem overly invested in the outcome of each session. That kind of pressure can turn a patient into a performing seal, just doing whatever she feels the therapist expects. At its worst, that pressure can be retraumatizing.

As a first step, she did very little but listen to Lindsay carefully for several sessions, paying attention to which subjects were overwhelming, or “fragmenting,” to her, and which closed her down entirely. To become fragmented, she explained, was to be so walled off from difficult elements of yourself that those difficulties would only grow stronger, more insistent, more destructive. The solution, or the goal, was to help Lindsay find her own strengths and then develop them to help herself cope with these challenging subjects—to “integrate,” as Silvern put it, the difficult parts of her psyche into the rest of her life, rather than cordon them off.

Lindsay wanted to move faster, of course. She wanted to get the problem solved—for someone, anyone, to send the worry away. But for her brothers’ and her own sake, she also wanted answers from Silvern about the nature of mental illness—the causes. Could trauma or abuse cause insanity? Is it possible that Peter or Joe or Matt were at Pueblo because of something Jim did to them?

It seemed like a tidy enough explanation. But if that were true—and to be sure, no studies have ever suggested that abuse does cause schizophrenia—that would mean that Lindsay was at risk.

After all this time, she still was terrified of becoming mentally ill. Silvern made it clear to Lindsay how much bravery it would take for her to get past this fear.

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LINDSAY PAID FOR the sessions herself. Silvern would put whatever she couldn’t pay on a tab. Lindsay continued to pay it off for years after graduation, settling it finally after starting her own business in her late twenties.

She never asked her parents to pay. Both Mimi and Don rejected the whole idea of therapy. Why dig all that up again?