Tales from the Valley of Death. Rachel E. Menzies

Mary: Maybe. But I don’t think it did. It was fairly traumatic though. I was always excluded and sometimes it got fairly violent and volatile. It got exceedingly worse as I got older. During puberty, when I was around 13 or 14, the violence increased because a lot of the older girls saw me as a threat to their boyfriend. But that never seemed to phase me — I always thought there were more important things like purpose and death, so everything else was kind of irrelevant. Ross: Okay. Mary, I’d like to change topics again. How did you first come to treatment? Tell me about your first experience of treatment? Mary: Well, I can tell you when I first got properly diagnosed. I was about 15 and I had the thought that I had a brain tumour. I flew to Melbourne to see a specialist. I flew down by myself and was feeling okay. But when I got there I swallowed a fingernail and it terrified me. You see, when I was six years old I ate some popcorn and nearly choked on it. It got lodged in my throat and my throat swelled up. I lived on fluid for a week because of my swollen throat. It hurt when I ate and I was scared I’d choke on solid food. So here I was at 15 and I swallowed a fingernail and I was scared that the same thing would happen. I was terrified that my throat would swell, so I wouldn’t eat solids for weeks. I was terrified that I’d choke and die. Ross: Sorry to cut across you, Mary, but that happening with the popcorn at six is very interesting because so many of the fears in later life have been around choking. Mary: My family’s fixated on choking. Ross: I see. Mary: Like you don’t eat that, don’t run with that. You’ll choke. Sit down. Choking is a big thing in my family. Ross: You heard a lot of that talk as you grew up. Mary: Oh, yes. Constantly. Everything was a choking hazard. Ross: I see. Let’s get back to Melbourne. You swallowed a fingernail and became terrified about choking. Did that bring you into treatment with a psychologist or a psychiatrist? Mary: No, but it was how I first got diagnosed. You see, I wouldn’t eat at all. I ended up quite disoriented and had a massive panic attack — one of the biggest attacks I’ve ever had. The ambulance came. I went into hospital. I was quite weak because I hadn’t eaten in weeks. The only thing I’d had was fluids like Sustagen. The doctor in emergency diagnosed me with panic disorder and told me I needed to see someone. But my family don’t like dealing with psychologists and psychiatrists, and so they didn’t really encourage me to see one. So I went back home and I stayed in Dubbo, moving back in with my dad and my mum. We all lived together again. My boyfriend at the time came and lived with us as well. It’s at this time that I became agoraphobic. All my friends were still at school. I wasn’t because I’d dropped out. I was painting. And I was smoking a lot. I was smoking and painting, and I wouldn’t leave the house. At times I tried, but things seemed to go badly. I tried to get my driver’s license. I thought that would help. I got my learner’s permit and started to drive in my street. I knew I had to go further, so one day I tried to drive to the local shops to get a chocolate milk. But on the way there a car crashed into the back of us. Ross: How old were you? Mary: I was 16. It was just after I came back from Melbourne. It was like a three-car pile-up, and we were at the front. I got out and I had a massive panic attack. The ambulance came and they suggested I follow up with the GP immediately. I really couldn’t calm down. When I got to the GP, I was freaking out. He was really kind and very caring. He became my primary source of help. He was at the Indigenous Medical Centre. He was the one who put me on the path to seeing a psychologist. Ross: I see. Mary: The first psychologist was awful — just awful. She kept calling me Emily. She wasn’t helpful. She gave me her mobile number and she told me to use paper bags for hyperventilating because I was hyperventilating a lot at that point. I didn’t really know how to stop the sensations. I left her after three months. Ross: Did you move on to another psychologist? Mary: I saw many over the years because I moved around so much. We didn’t stay in Dubbo for very long. My life was very unstable. I moved from Dubbo to Brisbane, Darwin, Port Brisbane, Melbourne, back to Dubbo, and Sydney. Ross: A lot of movement. And did you engage with different therapists in each of those places? Mary: Yes, I’ve seen a lot of psychologists. I would say … six or so that I can distinctly think of, but there would be more. There were many that I saw for just a few sessions because they weren’t helpful. Some of them caused me harm! I remember one psychologist told me that ‘There’s people who think that they’re having a heart attack so much that it actually happens.’ Ross: Right. He actually heightened your fears! Is it fair to say that you found psychological and psychiatric care over the years to be inconsistent in quality? Mary: Because I was so poor — my family had no money — I couldn’t afford to see private practitioners when I was young. And once the agoraphobia began I couldn’t get to a lot of services anyway. I relied on the GP at the Aboriginal Medical Service — he helped me a little bit. He tried to get me involved in online programs which was a good thing. Also, we moved to Brisbane, and then my anxiety improved a little. I went on medication at that point, and I think that did help me. Ross: Medication has played a useful role? Mary: I felt like it helped me function in short-term bursts, but that was it. I don’t think it necessarily helped with therapy. On medication I could do stuff, but it wasn’t actually progressing anywhere if that makes sense. Ross: Yes, I see what you mean. In all the therapy that you’ve had, and you’ve had a lot with various people, what do you think have been the most effective components? What procedures or tasks have most moved you forward? Mary: To be honest, for me, the very first thing was talking to someone who wasn’t an idiot. Ross: Right. Mary: It was so important to talk to someone who understood what they were talking about. Mostly I’ve felt that mental health professionals didn’t actually understand what was going on with me at all. And then they’d fumble around and try to get me to do exposure and it was all too extreme. It was all too traumatising. Ross: I see. Mary: I did learn about breathing from some early psychologists. And about not fearing sensations — learning the difference between sensations and symptoms. I think all of this was really helpful for my panic disorder because it meant that when I had a panic attack I could control my symptoms. One psychologist