August 24, 2022

Immolator – (noun)

One who offers in sacrifice (historical)

One of a sect of Russian fanatics who practised self-mutilation and sacrifice

He began his sessions closed off and seemingly emotionless. Guitar was his passion, but his depression overshadowed every ounce of joy. Not a drip of hope, eyes drooping because the weight of being awake and going about life was heavy. His relationship with his mom appeared to be the central issue–the need to be supported and the lack thereof, he perceived in his life.

Granted, for reasons that, in my clinical opinion, I did not blame him for coping the way he did for his developmental age. For the better part of the first two academic quarters, he engaged in a vicious dating pattern of girls who portrayed the maternal introject. From his perspective, the girls would be loving and affectionate, and “unreal.” Then, as time went on, the risk of emotional intimacy began to breach the capacity of the maternal introject, thus relating to the subsequent emotional distance. He progressively acted out more in classes, dancing all over the line. Then, it all fell apart. He began to wither away.

Alcohol and marijuana abuse. Abandonment of pastimes. Basically, negative sleep hygiene and codependency between him and his girlfriend. Angry outbursts at home increased maladaptive behaviors academically and socially. And a mindset of worthlessness wrapped up in a blanket of loneliness. Hope and interest in life diminished rapidly.

Mind you, as an intern, I’m not entirely sure how often this happens, epidemiologically speaking. The point I am trying to make is while this child is unraveling at the seams, my source of support originates from the questions I ask, the genuine reactions I let slip through the professional working relationship, and the damn breadcrumbs. I remember my life at fifteen going on sixteen, and it was not an easy time. In retrospect, I do not feel that pain during sessions. I can observe the emotional memory for what it was and use it as a backboard throughout the interactions.

And then, amongst the egregiously lengthy e-mail train, he divulged some health complications occurring outside school. A phone call to an outside therapist, branching off to his likely undiagnosed depressed mother, shifted to an e-mail I received of him on his way to the hospital in an ambulance. I promptly called his mother on my next day in the school–worried and supportive. The next step was partial hospitalization.

He requested to see me on Tuesday before he left for PHP for what played out to be about three weeks. It was a general check-in, and I let him know I would be in when he returned to school. After the first day, he shared that it was “so fucking boring,” to which I responded with, “I can imagine it isn’t your first choice of how to spend your days, but I look forward to hearing all about what your program has been like. You’ve mentioned wanting to stop smoking before, so we can work on that goal when you come back!” Radio silence for the next two weeks. Upon transition, he did not want any individualized treatment for his circumstances. The first step in a promising direction. He had repeatedly explored the themes of responsibility and independence before his medical leave. His dissonant actions to those values metaphorically castrated him on his trials toward integration.

A request for firmer deadlines on assignments utilizing the parameters of his educational accommodations: glimmer of hope number two. On his first day back to school, he was adorning a leather jacket from his girlfriend with the typical black-on-black ensemble paired with white high tops (either Nike or Vans) and a black bandana, of which it is unknown how often it is changed or washed. His individual session was in an alternative space than usual. It was in the comforting workspace of his previous counselor at the day school. In the fifty minutes of our session, we focused on the here-and-now and the direction he desires to take his therapy. The conversation bobbed into memory recounting, though it rarely had a lull. We departed from the session, light-hearted, smiling, satisfied.

As the day progressed, I fulfilled coverage for his math class. The hour-long period was with two male peers– one who was impulsive, hyperactive, and juvenile, and one who recently enrolled in the school and had internalized a violent, threatening paternal introject. Leading the class was a well-respected male staff, and the defiance and opposition ensued following collective work refusal. He fell into the triangle of inappropriate conversation topics topped off with abusive language. My countertransference leaked through as my frustration boiled over. The three students received incident reports as consequences of their behavior. I tolerate a lot because kids need space to find themselves, but in the name of John Bender in The Breakfast Club, “Hey, how come Andrew gets to get up? If he gets up, we’ll all get up; it’ll be anarchy.”

Our following session occurred two days later in our mutually established meeting spot. We got settled, and he took off his zip-up hoodie right away. He sat relaxed with his leg bouncing, an inferred testament to his comorbid ADHD combined-type diagnosis. We darted from topic to topic until listening to his death metal muses. The music encapsulated the adrenaline, worry, and strife of his inner world in a way that he could express. The desire to progress and commit to his passion suggested that the ego allowed for a multifaceted self-concept. We digressed into the world of his romantic relationship, which sustained throughout the waves of his redefinition.

When discussing a recent hardship his girlfriend is facing, he revealed that he left a message with her mom relaying that he is “proud of her.” When confronted about the twinge in his voice during his anecdote, he said it felt weird and embarrassing. To which I responded almost without pause,” You know that radical self-acceptance you learned in partial hospitalization? Try using that with your soft side as well. There’s nothing wrong with that.” I had no expectations about how that would sink in, absolutely no idea where it came from. I was doing therapy.

“The thing is,” he shared, “all death metal guitarists are soft as hell.”

While I disagree with his baseless statistical claim, this sentence indicated that something clicked. Was it the subtle hint at emotional self-awareness? Was it the underlying indication of personality integration, or was it the tone in which he said it–smiling, leaned back in his chair, shaking his head, and making direct eye contact?

Prognosis: Hopeful and alive. Off the record: Thank god.

Kailani NorwellKailani Norwell has a big mouth, a big heart, a big brain (metaphorically speaking), a big fucking ego, and an even bigger take on everything and anything. She has an unquenchable thirst for knowledge–to learn all that she can–and for personal development. While she dreams larger than life and encourages others to follow what puts sparks in their eyes, she typically plays incredibly small. She has indebted herself for America’s most expensive therapist–a bachelor’s and master’s degree in clinical psychology. Writing is her passion. It’s what ignites her soul. It is her most sincere form of expression. She doesn’t think she’s to write the next great American novel, but she’s to write something.

Featured Image by Raphael Nast on Unsplash