The Skeleton Cupboard (14 page)

Chris stirred her sugar into her coffee with the end of a pen.

I went on to describe the whole session after Elise arrived. She had entered the room and I could see that she felt relieved to see Martin and me talking.

Chris took her pen out of the coffee. “Okay, she was relieved. But what else? Was she threatened?”

“Elise probably was a little bit threatened too—who wouldn't be wondering what had been said about her while she wasn't there?—but then she kissed the top of Martin's head and sat down. The thing is, it took me a while to stop feeling angry with him.”

Chris looked directly at me. “You are allowed to feel angry if a patient attacks you, but then you move on from it. It's their stuff, not yours.”

I wasn't sure about that, and I didn't like this part of me that was so quick to judge those I was working with.

Chris stirred her coffee again with the pen and then began to slurp at it; a trickle dribbled onto her chin. This woman really had a problem ingesting liquid, but this time I was so relieved to have her there that it didn't even bother me.

“Sensate focus really did seem like the way forward, but there was something getting in the way, so I had decided to let them tell me about themselves.” I handed Chris a tissue to wipe her mouth.

“And?”

“And then they told me about Mickey Mouse and Minnie Mouse.”

Chris looked up. I will never forget that moment: I had startled the Ice Queen. She composed herself quickly.

“Chris, they are Disney freaks.”

“Meaning?”

“They are going on their third Disney cruise for their honeymoon.”

Chris put her coffee cup down and looked straight at me.

My sensate focus couple couldn't get past first base because they hadn't got their vocabulary right. His was Mickey, and hers was Minnie.

A toe is a toe. An elbow is an elbow. If they were ever going to have a happy sex life, they were going to have to communicate like adults. A penis needed to be called a penis, not a Mickey, a vagina needed to be called a vagina, not a Minnie. That's where I would have to start. Vocabulary.

“And,” said Chris, “she needs to stop being his mother and be his lover so he can stop feeling emasculated.”

*   *   *

A week later Daisy came back.

She slapped the diary sheet down on my desk. “I can't do it.”

The diary told me what we already knew.

“See, he's right! I am a shit mother!”

I gathered my thoughts. “Daisy, is Jocasta toilet-trained?”

“Of course!”

“Does she feed herself? Can she read, write? Does she have friends? Can she talk to adults?”

Daisy laughed. “Yes. All of the above, very well!”

I screwed up the diary page and threw it into my bin. “So clearly she does not have a poor mother.”

Daisy stared at me.

“Look, I don't have children and so I am not going to pretend that I can get my head into how tough it must be being a parent at times. But what I can see is that you ‘know' how to parent, so the question is, why is sleep training so difficult for you?”

Daisy didn't say anything.

“I think you need Jocasta in your bed.”

And then it all came pouring out—she spent the next twenty minutes telling me the story of her unhappy marriage. She managed to get through half a box of tissues.

“I think you will be able to get Jocasta out of your bed when you feel ready for her father to join you there.”

Daisy wiped her eyes and nodded. “Then I think she'll be in my bed for a very long time.”

“Why do you say that?”

“Because he and I don't like each other very much anymore.”

“But how can you learn to like each other again if you have no intimate space together?”

Daisy sighed. “I think he has an intimate space with someone else.” She hugged her bag. “And besides, I don't like being alone in that huge bed.”

There was the loneliness.

We only had five minutes left of our session and I didn't want this poor woman to walk out feeling broken.

“Let's make a plan.”

Daisy rummaged in her bag and pulled out a small compact mirror. “Oh God! Look at my eyes.”

She started dabbing powder on her face, and as the mask went back on, we discussed the way forward.

*   *   *

I have always loved libraries. The university library was huge, beautiful and imposing, stuffed full of books, manuscripts and, one day, I hoped, my doctoral thesis—if I ever got around to doing it. Like a child in a sweetshop, I didn't know where first to run to in order to start stuffing myself full of all the delicious treats shelved around me.

However, that day I had a clear purpose for my visit, so no settling into a small nook and gorging on whatever I fancied; I had to deliver some case report write-ups to the university and so wanted to do research about loneliness, the theme that was coming up among a number of my patients.

As I walked toward the social sciences section, I thought about my favorite author, Sylvia Plath. Her book
The Bell Jar
, which I first read not long after my grandmother was killed, was the one that cemented my interest in mental health and my desire to work with vulnerable people.

Sylvia Plath once said, “How we need another soul to cling to,” someone to trust, confide in and share ourselves with.

Scrolling through the microfiched records of books related to
The Bell Jar
, I came across a story published in 1892 by Charlotte Perkins Gilman called
The Yellow Wallpaper
. It was a fictional journal account written by an unnamed woman with mental illness. It made me think of June.

Like June's, this woman's confinement and isolation started after she gave birth to a child. Suffering with what we would now recognize as postpartum depression, the woman was labeled as having a “temporary nervous depression—a slight hysterical tendency” by her physician husband, who locked her up in her bedroom in their summerhouse to recuperate. She could not leave the room, and the windows were barred. She was not allowed to read or do anything other than rest, and so she hid her journal from him.

The woman, vulnerable and alone, slowly began to hallucinate, seeing women creeping within the pattern of the yellow wallpaper on the walls of her prison. Over time she began to believe that she was one of them. As her isolation and loneliness increased, she slowly descended into her imaginary world with her companions, and her psychosis set in. The woman refused ever to leave the room again.

I needed to make my search more fact-based. Loneliness can lead to insanity, even to death, but how?

The obvious explanations were there: alcoholism, drug abuse, anxiety, stress, depression, suicide—all caused by loneliness, a psychological pain, a mental anguish that is powerful enough to break biological sleep rhythms, leading to problems with memory, understanding and learning. Loneliness leads to antisocial behavior: Children become delinquent as their lack of social connections makes them hostile and afraid. Lonely children—the thought made me shudder and then led me to reread material about the controversial Harry Harlow experiments of the 1960s.

Harlow, a man who died as a clinically depressed alcoholic, showed that attachment was fundamental to living. He did it by running cruel animal experiments with baby monkeys that he raised in isolation.

After separating the baby monkeys from their mothers within hours of their birth, he noticed that when put in isolation with the choice of a wire “surrogate” mother with an attached bottle of milk or one that had no food but was covered in soft terry cloth, the babies would spend significantly more time with their cloth-covered mother: Comfort contact was more important than being fed.

A baby monkey placed in a strange environment with its cloth surrogate mother would explore that environment, occasionally returning to cuddle up to its “mother,” to feel anchored and safe; however, if put in the room alone, without any form of surrogate, the baby monkey would rock, scream and cry.

Harlow watched his baby monkeys die of loneliness and then went on to do the same himself.

Loneliness kills via strokes and heart attacks: It increases blood pressure and stress hormones, elevates a blood chemical linked to cardiovascular disease and causes vasoconstriction. Social exclusion leads to a decrease in body temperature—literally, a chronically lonely person will feel “left out in the cold.”

We are designed for social contact, for connectedness. If we don't have that in our lives, our minds and bodies begin the slow process toward death.

Loneliness is lethal.

*   *   *

The placement continued through the increasingly cold, harsh winter. Having Chris back felt good and I was glad that she didn't indulge my need for a big chat about the blip in our relationship—she was boundaried; it was business as usual.

It took only a few sessions for Daisy to enable Jocasta to sleep in her own bed. We opted for the “gradual retreat” method, whereby Daisy began lying with Jocasta as she settled her off to sleep in her own bed and then over consecutive nights sat farther and farther away from her until the little girl felt secure enough to fall asleep without her mother being present.

A better-slept child and a confident mother meant that Jocasta was much less a monster, and Daisy was better able to set boundaries around all other behaviors designed to dominate and undermine her. At first Daisy's husband didn't like this new, more assertive wife setting boundaries for him.

“How are you both getting on?” I asked Daisy at our last session together.

“Gosh. Well, we are getting on better.”

I smiled. “So, like Jocasta, perhaps he is beginning to respect your voice, your needs.”

Daisy smiled back. “Let's hope so.”

“And is your husband back in your bed yet?”

“He was, but I have had to kick him out.”

I looked at the clock; we had only a few minutes left and now this revelation. “Why?”

Daisy smiled again. “His bloody snoring was keeping me awake. He can come back when he's lost weight.”

“Crikey!”

“Yes. So he's joined a gym.”

Daisy had to rush off to a charity fund-raiser. Before she left, she gave me an awkward hug. “Thank you.”

“I'm happy I could help.”

“No, I really mean it. Thank you. I feel so much better. I feel like I've got part of myself back.”

“Daisy, it was a pleasure.”

And it really was.

Meanwhile Marion kept canceling her appointments with me, and the practice policy was that three consecutive cancellations meant off the list.

I tried to persuade Mrs. C to offer just one more appointment, but she was not having it. “I'm sorry, but this is the policy—it is how we work.”

“I know, but I think this lady needs one more opportunity to see me, and this time I'll call her to make the appointment so I can talk to her, see if there's a problem.”

Mrs. C was not going to budge. “This is what I am telling you. There will be no more appointments for this person.”

I had to find another way. It was sweet Henrietta who pulled Marion's notes and got me her address and telephone number.

We spoke on the phone, and a few days later we met at her flat.

She opened the door nervously and ushered me into her small, tidy, cozy kitchen.

“Cup of tea?”

“Yes, please.” I blew on my cold fingers.

“I'm sorry I didn't come back to see you. I hope I didn't waste the appointments for someone else.”

“Don't worry about that, Marion. There's always something to catch up on.”

“Oh good. Sugar?”

“No, thanks.”

“I didn't like coming to the practice to talk about this whole business. It didn't feel right at all.”

“I can understand that.”

Marion opened a tin of biscuits and offered me one.

“Angela, my granddaughter, is not happy with me.”

“Why's that?”

“Well, I suppose that I haven't finished her project off for her.”

I sipped the lovely strong brew. “How?”

“You know. Genealogy. No big family reunion.” Marion opened a knitted spectacles case and pulled out a packet of cigarettes. “Smoke?”

“Not for me, thanks.”

“Mind if I do?”

“Of course not. This is your home.”

Marion smiled and lit up.

“So, Angela wants you to meet your biological mother.”

Marion nodded as she pulled long and hard on her cigarette.

“And what do you want, Marion?”

Marion sighed and rubbed her eyes. “I want that this had never happened.”

“What? Finding out about June?”

“Any of it.”

“Why, Marion?”

“Because beforehand everything was settled and I was happy.”

Marion topped up our teas and told me her story.

Marion was brought up in orphanages and children's homes until she started work at the age of fourteen, as the Second World War broke out, as a maid in a large house in Belgravia. Working there and living in the attic, Marion described happy times when she felt valued and useful and well cared for by the family she worked for.

“Life was simple and I was happy.”

Marion had a purpose and felt part of a family.

“And then he arrived.”

Reg was the delivery boy who would hang about chatting to Marion as she scrubbed the backstairs. He was handsome and funny, and soon they were courting.

“I loved dancing, and my Reg was a brilliant dancer.”

Reg and Marion fell in love doing the foxtrot and the waltz, and when she turned sixteen, they got married. After that life was filled with setting up a home, having their four daughters and running their successful fruit and vegetable market stall. The daughters were now all grown up and married with their own children, living nearby and running the stall in shifts for their elderly beloved parents. Reg and Marion ran the local barn-dance club.