She reaches for a handkerchief, and as she blows her nose she realizes the glamorous woman is looking at her and smiling. Karen blushes at being caught on the verge of weeping, but is relieved to have had some friendly contact. She smiles back as best she can.
Is she a film star? There must be famous people in here, thinks Karen, Moreland’s is renowned for it.
‘I’m Lillie.’ The young woman stretches out her hand. Her nails are beautifully manicured.
‘Karen,’ says Karen.
Then she notices Lillie’s fingers are shaking, and when she asks, ‘Is it your first day?’ her voice is tremulous and uncertain.
‘Yes.’
‘Ah.’
Karen isn’t sure what the ‘ah’ means, but gathers that the fact she is a newcomer is significant.
‘Have you been here before?’
‘No,’ Karen says. ‘Never.’
Again the man opposite glances up at her. She senses he’s about to say something but thinks better of it. He carries on filling in his form.
Next they are joined by an overweight young man with a ponytail who’s still in his slippers – looks like he’s staying here, concludes Karen – and a smartly dressed black guy who introduces himself as ‘Troy’ with an American accent.
Finally, at exactly eleven o’clock, a man with a spring in his step and a floppy fringe comes into the room wheeling a large whiteboard, and carrying a stack of papers and a box of magic markers.
‘Thanks, Sangeeta,’ he nods at the nurse. ‘You can leave now.’ He adjusts the whiteboard so they can see it, puts the box and papers on the coffee table and closes the door. Then he turns to the group and beams in a way that seems to light up the entire space. ‘I’m Johnnie.’
He looks about thirty, Karen decides, possibly even younger, though that might be because compared to the rest of us he seems so upbeat, full of energy.
‘I’m a therapist and I’m running the group this morning. Let’s start with a quick introduction as several of you are new today – Karen?’ He bounds over and shakes her hand forcefully. ‘Abby?’ He does the same to the woman with the shaggy blonde bob. ‘We met last night,’ he says to her, but Abby appears confused. ‘And Michael?’ The man filling in the form has been writing furiously all this while, but at last he puts down his pad and pen.
* * *
I can’t believe he’s properly trained, thinks Michael, as he shakes the young man’s hand. He barely seems older than Ryan. I bet he’s still a student. And imagine shutting the door on a room full of anxious and miserable people! That girl over there – her hands are quivering like jumping beans – can this really be a good idea? Locking us in, controlling what we can and can’t drink – reminds me of One Flew Over The Cuckoo’s Nest.
‘I’d like to invite all of you to start by saying a bit about how you’re feeling right now,’ Johnnie continues, pulling up a chair close to the whiteboard. ‘Who wants to go first?’
I’d rather stick pins in my eyes, thinks Michael.
‘Perhaps someone who’s been in group before could start,’ says Johnnie.
‘OK, I’ll go first.’ To his surprise, it’s the shaky young woman speaking. ‘I’m Lillie—’ She glances round at the group and smiles – he can tell she’s done this before, ‘ – and I’m a bit wobbly today.’
She’s mixed-race, Michael observes, and she’s local. That’s a proper Sussex accent there, if I’m not mistaken.
The therapist nods slowly. ‘And what do you think that wobbliness might be about?’
‘Well . . . They upped my lithium last night and I reckon I’m still getting used to it.’
Exactly, Michael says to himself. The psychiatrist I saw yesterday wants to put me on medication too, but see what it’s doing to her? She’s a nervous wreck.
‘Though I know the morning is always my most difficult time—’
She has the most amazing cleavage, he thinks, and as Lillie continues speaking he finds himself unable to take in much of what she says.
He’s roused from his reverie by an American, Troy, who speaks next: Michael gathers he is on sick leave from the army and due to return to service in Afghanistan at the end of the week. ‘I’m dreading it,’ he says.
A white-haired lady and a chap in slippers share a few words, then there’s a long silence. Expectation hangs in the air like a storm cloud.
Who is going to cave in? Michael wonders. The woman with the long reddish hair opposite, or the frail-looking one on the adjacent sofa? I’m damned if it’s going to be me.
The woman opposite shifts in her seat and opens her mouth to speak, but then bursts into tears.
Michael looks at the floor, mortified.
But Johnnie simply leans forward and nudges the box of tissues towards her. He seems unfazed. ‘Your feelings are welcome here, Karen.’
‘Gosh.’ Karen takes a tissue and blows her nose. ‘I’m sorry, I’m sorry, I don’t know where that came from . . .’
‘No need to be sorry,’ says Johnnie.
‘I can’t believe I’ve ended up here!’ she wails, and starts to cry again, more forcefully. ‘Oh no, I didn’t mean that to come out like that. How rude of me, when I don’t know any of you—’
‘I don’t know anyone either,’ says Abby. Her voice is a whisper.
Michael supposes this is his cue to echo that neither does he, but he’s too self-conscious to speak.
‘That’s how I felt when I arrived,’ Lillie says to Karen.
‘ – and you’ve all been so brave and honest, and here I am crying my eyes out—’ Karen gasps for breath.
‘But it does get better, I promise,’ says Lillie.
‘Really?’ Karen sounds deeply uncertain.
Michael wonders if he’s met her before. Maybe she’s a customer. Hove is only a few miles from Lewes; doubtless some patients are from there. He picks his cuticles as he tries to recall: he tends to be good with faces – or he used to be. Since he’s been sleeping badly, his memory is shot.
‘Yeah, you’re at rock bottom,’ says Troy. ‘Nothing can ever feel that bad again.’
‘Remember to speak in “I” statements if you can, Troy,’ says Johnnie.
What the hell does he mean by that? thinks Michael. All these rules! He feels more tongue-tied than ever.
‘Sorry.’ Troy nods. ‘I meant, when I arrived, post trauma, I was right at rock bottom.’
‘Thanks,’ says Johnnie.
‘And from there the only way is up,’ says Lillie.
Karen’s face relaxes into a tiny, appreciative smile.
14
Johnnie goes to the board, draws a large circle and stands back.
‘Today, as three of you are new, I thought we’d explore how the way we think can actually make our depression or anxiety worse,’ he says.
I wish he’d stop smiling, thinks Michael. What’s he got to be so happy about? I can’t think of anything worse than spending all day talking about depression.
‘This is one of the first steps in the therapeutic process – discovering your thoughts and behaviours and how they are linked. The second step is challenging that behaviour, but let’s begin by looking at how we think. One way of doing that is by using the Vicious Flower diagram.’
‘I’ve done this exercise before,’ mutters Troy.
‘Sorry about that,’ says Johnnie, ‘but every group is different because we’ve a different mix of people, which means I’m sure you’ll get something new from what they have to contribute. Perhaps you can kick off by saying what goes in the middle?’
‘“Depression”,’ says Troy, with a bored sigh, and Johnnie writes the word in the circle.
I don’t get what on earth this navel-gazing has to do with flowers, thinks Michael.
‘So, does someone want to tell me something they do when they get depressed?’ Johnnie looks round the group.
‘Stay in bed,’ says the man in slippers.
You don’t say, thinks Michael.
‘Perfect,’ says Johnnie, and draws an arc away from the circle captioned with the words ‘stay in bed’. ‘And then what happens when we don’t get up – how does that make us feel?’
‘Shit,’ says Troy.
‘Exactly,’ says Johnnie, and writes ‘self-loathing’ in another arc, leading back to the circle.
‘You should have written “shit”,’ says Michael. It pops out before he can stop himself.
‘Thank you, Michael. I think for our purposes the meaning is the same,’ says Johnnie.
Michael sees little pink spots rise in Johnnie’s cheeks. They should put someone tougher in charge, if he can’t deal with that, he thinks. Nonetheless, he feels a pang of remorse.
‘Can someone else suggest something they might do when they’re down?’ Johnnie asks.
‘Drink more alcohol?’ offers Michael in a moment of generosity, and Johnnie draws a fresh arc away from the circle, and captions it.
‘Thanks,’ he says, and the pink spots fade. ‘And what might this lead to?’
‘A hangover,’ says Lillie, and everyone laughs.
‘More anxiety,’ says Troy, and again Johnnie draws an arrow back to the circle.
Ah, thinks Michael, I get it. We’re forming petals. How ironic, when flowers landed me in here.
They continue in this vein: Rita, the white-haired lady in the sari, confesses she stays at home more, which leads her extended family to invite her out less; Karen says she’s stopped doing things she likes such as hosting parties and seeing friends, which makes her more miserable; Troy admits he gets angry and snarky then feels guilty; Colin, the young man in slippers, says he overeats and hates himself for doing so. Round and round they go, until they have a flower bursting with petals.
The only one who hasn’t contributed is Abby, Michael notices. She’s so pale and quiet, she’s not said a word other than at the very start. I wonder what her story is? He sneaks a better look. She appears exhausted; she keeps closing her eyes as if she’d like to go to sleep.
Michael can sympathize. Perhaps he should offer to go and get them both a coffee from reception, try and perk them both up.
Johnnie is still speaking. ‘So why do we do these things, if they’re so self-destructive?’
Rita is busy making notes. She lifts her head and says, ‘They’re comforting?’
‘In what way?’
‘Well, staying in is easier than the alternative – the last thing I feel like when I’m miserable is being sociable.’
‘Exactly,’ says Johnnie.
‘Johnnie?’ As Lillie leans forward, Michael tells himself not to gawp. ‘Are those what we call “safety behaviours” then?’
‘Yes.’
‘I don’t understand why they’re called safety behaviours if they actually do us harm.’
‘Because they’re things we do to feel safe,’ Johnnie explains. ‘And although it’s important to remember they might make us feel comforted, the relief is temporary. In the long run they can make the cycle perpetuate.’
‘Ah.’ Lillie sits back, evidently pleased she’s understood.
Oh dear, thinks Michael. He has just enough mental energy to work out the logic. As if giving up my business wasn’t tough enough, now it sounds like I should give up drinking too.
* * *
I’m worried about Callum, thinks Abby. Who’s got him ready, given him breakfast, helped him go to the loo? He should be at school by now, but I don’t trust Glenn to have taken time off work, and Eva will never manage on her own. I’ll bet no one here has a child who takes as much looking after as he does, or they’d never be able to chat like this. I’ve no idea what they’re all on about anyway. And who’s this young Hugh Grant lookalike with a floppy fringe? I believe he’s called Johnnie, but I can’t understand a word he’s saying. How come everyone else seems able to grasp the point and contribute?
She closes her eyes, trying to shut everyone – everything – out. If only it were that simple. No matter what she does, the thoughts are there, crowding, burning into her brain. However hard she tries to analyse them, to reason with herself, the cycle is the same. You’re a failure, a dreadful mother, a worthless human being. Unlovable, irresponsible, weak.
Earlier that morning she asked for some drugs to slow down her mind – begged, more like – pride had no part to play. She just wanted to stop the suffocating torrent of abuse. Lately it’s got so much worse – she can’t stand it. But the psychiatrist had said, ‘You’ll still have temazepam in your system,’ and given her such a low dose of sedative that the tablet barely touched the sides.
‘So, with depression something is out of kilter,’ Johnnie is saying. ‘And the first step towards adjusting the balance is wanting to change these patterns. A lot of the time people don’t want to change, but when we begin to understand how we’re contributing to our own negative mood, the motivation for doing so emerges—’
Never can Abby recall feeling so unsure of what she’s doing or why she is where she is. It’s as if there’s a glass wall separating her from the rest of the world, and she can’t get her bearings, or relate to anyone or anything.
All of a sudden she knows what she must do: go home. Yes, yes, that’s it. I need to leave, she thinks. Callum needs me. If I slip out quietly, no one will notice. The door’s just over there. Johnnie has got his back to us, he’s busy writing on the board . . .
She is halfway across the room when the therapist turns round.
‘Abby, do you need to go?’
‘Yes.’ She can hardly hear her own voice, it’s so subdued. ‘I do,’ she says, more forcefully, reaching for the door handle.
‘I would prefer it if you could stay for the whole session. We have only a few minutes left.’
She opens the door.
‘Um, well, hang on a moment—’
Abby ignores him and steps into the corridor.
‘Excuse me,’ she hears Johnnie say to the other group members. She starts to walk quickly but he comes after her and takes her gently by the shoulder. ‘Abby, are you OK?’
The self-lacerating thoughts are back again.
‘I have to go home,’ she says, trying to regain the clarity she had mere seconds ago. She sets off again towards the staircase but has only gone a few paces when Johnnie catches her.
‘Stop!’ His voice is sharp.
‘Is everything all right?’ says a woman. It’s that irritating nurse who was trailing round after Abby earlier. She’s hurrying towards them, up the stairs.
‘Ah, Sangeeta. Abby was just wanting to leave the group—’ Johnnie smiles at Abby, though why she can’t fathom.
‘I’ve got to look after my son,’ Abby explains. Surely once he understands this he will let her be?
‘I don’t think it’s a good idea for you to go home,’ says Johnnie. He jerks his head subtly at Sangeeta, but Abby sees it nonetheless.
‘I’ll handle this,’ says Sangeeta. ‘Abby, do you want to come and have a chat?’
‘No,’ says Abby. As if!
‘I’d better get back to the group,’ says Johnnie. ‘I’ll see you later, Abby.’
No, you won’t, she thinks.
* * *
‘Sorry about that,’ says Johnnie, coming back into the room.
Wonder what went on there, Michael wonders. Bit alarming. Still, she won’t get very far, that Abby, even if she wants to. Bet she doesn’t realize the door downstairs is locked and you need to know the code to get out.
Johnnie picks up his marker again. ‘Where was I?’
‘You were talking about motivation,’ says Troy, yawning.
I suppose I could do with some help with motivation, Michael thinks. Since the shop went bust, he’s spent most days in front of the telly; Chrissie has been nagging him about it. It was when she heard him muttering that he couldn’t see the point of doing anything any more that she insisted he go with her to the doctor.
‘Ah yes. Thanks, Troy.’ Johnnie wipes the Vicious Flower diagram off the bo
ard, and writes the words ‘Goal Planning’ at the top. ‘Next, we’re going to do an exercise that might help with motivation.’ He reaches for the A4 sheets he put on the table earlier. ‘I’ve brought some handouts.’ He walks over to Rita, who’s sitting nearest to him, and gives her the stack. ‘If you’d like to take a sheet and then pass the rest round, you can each have a go at completing the questions.’
Crikey, it’s like being back at school, thinks Michael. Next we’ll be allowed out to run around in the playground. With a teacher overseeing, of course.
15
‘So, how did you find group?’ asks Johnnie, as Karen takes a seat in the armchair opposite him. He invited her for a one-to-one chat after the session finished.
‘A bit strange,’ she says, glancing round the room he has led her to. It’s magnolia and beige, with net curtains at the window. Aside from their two chairs, the only furniture is a small table, on which rests another box of tissues, a jug of water and some plastic cups, and there’s also a clock on the wall. Apparently they have half an hour.
‘Sometimes people do find it a bit odd when they start here, and I heard you say you’ve never done anything like this before.’
‘No – I mean yes,’ says Karen. She still feels dazed from struggling to absorb so much information, and her stomach is rumbling. I was looking forward to lunch, she thinks, but I suppose I’ll have to wait.
‘I’m sorry to spring this on you, but I wanted to take advantage of the fact we both had the time and I thought it would be good to make a start.’
‘But why do I need this as well as the groups?’ she asks.
‘They’re for us to catch up on how things are going for you personally; I like to look upon them as providing a space where we can talk about things which might feel a bit difficult to discuss in front of other patients. It’ll be just me and you, and what you say here is confidential, unless I think you might harm yourself or someone else. I hope you find the sessions helpful.’