The part-time treatment began with a psychological assessment: several conversations with therapists and psychiatrist. But about a week before these talks were to take place, things got out of hand at home. I was annoyed with my mother, and my father defended my mother, giving me an aggressive reaction, which made me extremely angry with him and led to mutual insults, at which my mother said to me: “Timeout, timeout”, which made me feel like I was being punished like a little child for my anger, and my father could do anything to me with impunity. In the end, I cried for a long time. The clever ones among you may find that the first sentences of this event remind them of the piece I wrote earlier, about my sexual fantasies. I quote myself: Every time I thought about my girlfriend, sexually, a man came around the corner in my head, taking away all lust and scaring me. … Later this turns out to be a blueprint for what I went through in the relationship with my parents.’ The parallels are, of course, striking. I will return to this later.
Eelco de Smet, who had referred me to the clinic at the time, could still remember me from the previous year. He especially remembered that I constantly corrected myself when I said something wrong. He thought I had changed a lot, and it felt good that someone saw that, because, after all, I had worked very hard at it. I told him very openly about my therapy at the clinic, that I had mainly talked about my sister and the trauma I had suffered towards her. We also talked about sex and love. He suggested that maybe those were two of the same things to me. I disagreed, but later I came back from this. I did indeed see it as two of the same things. And what also came up was that I was having many sexual fantasies about women (which he found SM-like), but I found the intimate part of sex gross. It was a very nice conversation, and I felt very seen.
Also, before the therapy actually started, I was supposed to write a short life story, so that the therapists knew something of my history. In this short life story I tell about how I was as a child, and what development I went through in the clinic. At the end I tell how important it is for me to be independent, to be able to view the other person in contact correctly, and to view positive and negative feelings unified in one person. And Eelco was able to help me with this. So I had a lot of confidence in the therapy. I also had a conversation with one of the sociotherapists, Karin, about my daily activities. With her I also had the feeling that I was very much seen. I also had a talk with psychiatrist Lieve. What I remember most is that she asked me if I had been spanked in the past. This was a bit of a shock for me, because in the clinic nobody had ever asked me that directly before, apart from Desmond. I answered in the affirmative, and when asked who did it the most, I answered that I did not know. I found it very scary to think about this. I also told her about my aggressive fantasies, which made me feel very powerful, and which I was also very proud of. Some people wonder why I was proud of aggressive fantasies, “that’s not something to be proud of”, but for me it was totally new to feel these feelings, which could never exist before, and for me it was a big step in my development, because every person needs his aggression, admittedly for most in a controlled form (but I didn’t know that yet), but still! It ensures that you are able to withstand attacks, it is your defense. It is your feeling, your personal strength, the passion in your body, you can fall back on it when you feel bad, and it makes you stay upright when someone attacks you. It allows you to be excited about something, or sexually. And of course we were able to see earlier in my life story, what happens when these feelings are not allowed to exist.
Finally, I had a systemic conversation with my parents and Tineke, another therapist. Keeping in mind the out-of-control event from a week earlier, I said, “I’m afraid of my dad, and he’s afraid of me.” Tineke came to the subject of boundaries. Whether there had been any in our home, and how my parents felt about pointing these out to me. My parents replied that they had always found that difficult. I broke in and said, “There certainly were boundaries!” to which Tineke said, “Yes, I can understand you saying that!” I then got the feeling that my parents were seen as helpless victims, and I as the guy who terrorized the place with his supposedly unbounded personality. I didn’t taste any awareness from her about what therapy I had done in the clinic for the past year, and what trauma(s) I had dealt with.
In the time that followed, I would begin to feel more and more fear of the therapists there, who came across to me as very fake, incompetent, and narrow-minded. I started my therapy in the intake group, which lasted several weeks. I got used to my therapy companions, and to the therapists. But to my mind, everyone was much closer together, than was the case in the clinic. In one of the first weeks I expressed to the sociotherapists that their behavior made me anxious. They were very controlling, unlike the therapists at the clinic. They remained controlling towards me, and also towards others, but I felt supported in a way, because they knew how to reassure me, even though I had no idea what was going to happen.
There was a nice girl in the intake group, though, and I tried to impress her. She was aware of this and she sometimes hinted that she did notice that I was flirtatious. This felt like an attack to me, even though she did not mean it at all, but I had the feeling, partly because of the controlling attitude of the therapists, that she was very dissatisfied with me. But fortunately I was reassured by Brenda, the psychomotor therapist.
After a few weeks I moved on to the present & past group, the group best suited to work on your identity, according to Eelco. What I kept in mind from this first period was that the therapists occasionally indicated the direction I should take. Miranda, the creative therapist, wondered why I was fighting my fear so much: “Why don’t you just let it come over you?” She also told me that I was now overreacting and obessively going in the opposite direction, and that the idea was that I would go take a middle path, while maintaining my qualities. At least, that’s what I understand now, looking back on it. But at that moment I thought she meant something else and that felt like rejection. But I didn’t ask any questions because I was going to stand my ground anyway. Nobody could hurt me: I had my aggression by my side. I would feel much more rejected in the time to come. One time at psychomotor therapy we had to pick a spot in the hall and I had sat on top of a closet, with some pillows around me. Then a group member asked if she could have a pillow from me, to which I said “no”! Then the therapist said that I was not nice (is that required?) and that I had purposely chosen a high place to feel safe (logical, cause I am not yet comfortable). If this had happened in the clinic, I would have received a compliment that I had chosen for myself by not giving away the pillows and looking for a safe place, but apparently you were not allowed to feel safe here and you always had to be nice, at least this was my interpretation. When I discussed events like this in sociotherapy, and said I felt disrespected, it was said, “I don’t think you feel disrespected, I think it’s just confronting what we’re saying,” to which I then felt disrespected again. I tried to let all the anxiety, which was getting pretty intense, just come over me.
In the first evaluation I describe that I was confronted a lot, and that I was terribly afraid to be angry. I describe how I have felt trapped between my sister and brother. And I describe that I hardly ever destructively vent my tensions at home anymore, and that I am working very hard to build up activities. And I tell that I no longer see ‘control’ as a bad thing (but that was mainly to justify the controlling behaviour of the therapists). Eelco describes that my behavior can be summarized in a symbolic medal with two sides: on the one hand I can idealize people enormously, and on the other hand I can devalue them (not appreciate them). And I did recognize that. I am also told that I must be especially naughty in the coming period and that sounds like music to my ears. But I would hardly be able to do that….
What I remember about the second period is that there was an enormous confrontation. Eelco confronted me with the fact that I was throwing myself obsessively into activities and that I was exceeding my limits, whereupon I went in one fell swoop from doing everything to doing nothing. I was afraid of not being adequate enough, so I stopped with the activities, I became passive again, despite attempts by a sociotherapist to get me active again: “But it will make you feel so proud!!! Do it anyway!” But for me there was nothing between everything and nothing, that was just the way I was. Moreover, at that moment I could only cry, whereupon Eelco urged me that my boundaries would be taken seriously. In the group sessions I mentioned that I was very afraid of Eelco. I made contributions about identity and spontaneity and told that when being angry with my mother and my father saying something about this, I would then direct everything at my father! In the time that followed, I discovered even more about how I was at the inside.
After the therapy I regularly walked to the center of the city to have a drink in a café. This was always nice. One time there was a woman with twins sitting one table away from me. We started talking. At one point she asked me what I was doing in daily life and I told her about my therapies. I told her I was also a twin. And she was very nice. At one point I wanted to elaborate, and I told her that being a twin had caused me trauma. What she said shocked me and made me think. She said, “But then maybe your parents have been at fault.” This was about the worst thing you could say to me. Because saying that someone did something wrong was worse than hating someone terribly, in my experience. I hated my parents at that moment, but I kept telling myself that they hadn’t made any more mistakes than other parents. After all, that was what Anke from Brunssum said in the systemic interview with my family and me. Moreover, in the clinic therapy I had learned from Gerna, the music therapist, not to talk in terms of “you did this wrong” and “you are to blame for this” but rather in terms like: “what was this like for you?” And “this is what it was like for me!”. This event in the café was actually the stepping stone for me to look clearly at my parents (despite all the hatred), and to put into words what I thought they had done wrong, and believe me: that image did not correspond with what Anke and Desmond had thought about my family all this time, and what made her decide to refer me to the part-time therapy. One evening, I was angry with my parents again and then I verbalized it to them; my brother was there too. I told them that I was angry that my father always reacted very aggressively when I was angry, and I was angry at my mother for always standing by and not intervening when my father reacted aggressively. This was very courageous of me, but I did not get the desired reaction, and my brother even stood up for my parents. In therapy I did not talk about it, because I had not gotten the impression that it was rewarded in this therapy if you said something negative about your parents. After all, I was that guy who could get so angry, and I had to restrain myself from saying anything negative. If only I had told what I knew, but I just couldn’t, the pressure of the group and the therapists was just too great for my liking, so I hid it away and forgot about it.
Throughout the second period, my aggressive fantasies ran rampant, especially toward Eelco, but so little attention was paid to that that it kept building up. I was very suspicious. I couldn’t express it, because this part of me was totally ignored, and this caused my head to almost explode at my second evaluation. On the outside, however, I behaved nicely. And just at this moment Eelco told me that I desperately want to feel real contact, and my aggressive fantasies are destroying this contact. I went home surprised, I had not heard this before, and before I got home something strange started to happen in me. I felt myself weakening… Instead of the fantasies, Eelco came into my head who I kept hearing saying: “your aggressive fantasies are destroying intimate contact!” And intimate contact was precisely my greatest desire at that moment. My aggression started to subside, I felt the enormously increased forces slowly move downwards in my body. I tried to fight it, but I just couldn’t, because Eelco was there, in my head. I thought it was terrible. I felt weaker and weaker and felt my sexual identity changing, against my will. Because in my aggression I could identify with men, but now that I was obviously letting go of my aggression, out of survival, it seemed as if I was becoming more and more feminine. I was totally confused and made many contributions in the therapy sessions about my sexuality and how my parents reacted to me at home when I was angry. I also mentioned that my father could get aggressive towards me, to which Eelco said something like, “He was a bit clumsy!” At that moment I was also afraid that my for me very valuable ability to get excited by women would disappear more and more because of the therapy, on which Eelco said: “Women can get very angry too!” on which I felt that I wasn’t safe anywhere anymore and became even more confused. I no longer had the feeling that I had any control over others, the fear increased, and the compulsion slowly returned. Was I going to feel the same as I did before I started the therapies…? This frightened me so much that I scraped together all my fighting spirit in my body and tried to push it up as hard as I could. I blew myself up terribly, but I couldn’t manage to fantasize aggressively. I was raging!!! But I didn’t feel this rage in my head anymore, but instead through my whole body. But didn’t know what to do with it. My head was completely filled with aggression, but it was not the usual boundless rage, no, it was controlled aggression. And then all of a sudden the therapists at the therapy session said, “Now you are allowed to be angry! Then I became even more furious inside, because they had completely fooled me, by totally ignoring my anger in the past period and not affirming it at all. If I would express my anger now, I would be judged by the therapists whether I did right, I thought! I could get a reaction, and that was exactly what I was afraid of. Because it would have no effect, they would not take me seriously, because it felt as if THEY were controlling me, as if they were playing with me, like predators with their prey. I felt like a figurative plaything!!! I didn’t want to be angry anymore and kept everything inside. Eelco said at that moment that I was dangerous! Several times he urged me to share what I felt, but I refused.
But the longer I kept my anger inside and the more that happened in therapy, the more weird feelings I started to have. It was then summer 2005, and my sister had set up the tent in the garden, to sleep in it, just for fun. I would also sleep in the tent, just for fun. It was more fun for a time than lying in your bed. And that night, among others, I had delusional thoughts. I had the delusion that I had a woman’s body again, very overwhelming, and I was convinced that I had to undergo the sex change operation, then I would surely feel better. It even turned me on when I thought about that. And when I brought this up in therapy, I cried a lot again and Eelco said that I was becoming almost psychotic, but apparently he was still hopeful that I would be able to cope. I had fears of merging (as if I was merging with some of my “internal objects” that I had previously tried to keep at bay with my rage, (I don’t know the proper English term for it, maybe ‘fusion’ anxiety)), and he also said that he wanted to make clear the difference between my sister Lauren and me, that we were two different people, and that I shouldn’t have slept in the tent with her. As if it was fucking my fault that I had these fears! Besides, to my mind it wasn’t my sister I was merging with in my head, it was my mother as well! I had to be like her according to the therapists supposedly. I also had homosexual feelings that I didn’t want, because at the same time I didn’t find men interesting at all. I had the feeling I was forced to be gay, and female, by those therapists. I still tried to trust the therapy: if I continued it would automatically get better, because quitting was not an option: then everyone would be on my back saying it was unwise. In my third evaluation I described what was happening in a very adaptive way, and I wrote about what I thought Eelco wanted to hear: that I can admit those feminine and homosexual feelings more and more (although I did not want to, and it felt as if the therapists were responsible for this). But I also described that I felt very bad and that I suffered a lot from anxiety and compulsion. But I didn’t get any support for my feelings. I felt so worthless and the only thing Eelco de Smet said was, “The compulsions have increased, but those are immature mechanisms!” He also said, “The idea is for you to start doing lots of things, otherwise you’ll still be here next year!” I felt abused and I didn’t dare say it, that’s how incredibly powerful those therapists felt. “You making us up to be very powerful,” they sometimes said, but I couldn’t help it, it was just in my ‘blueprint’, my system. I felt they were trying to push me to express my anger. Eelco said, “You’re not afraid of being controlled now anymore!” In other words, what’s stopping you from expressing your anger…. On the one hand, I now looked down on them in dismay, on the other hand, I still had hope. So I went on. I was really overflowing with anger, but I was also very much in touch with the reaction that followed each time. As a result, at one point in the group session I described how my father used to repeatedly hit me in the face and shake me furiously, when I was angry. This was incredibly brave, but all Eelco said was, “Did it ever happen?” to which I thought he thought I was trying to escape therapy by saying that. The pressure was so great for me, that I lost my own feelings, and could only express myself destructively to the therapists, or very adjusted. And that sweet adaptive behavior was very much rewarded and seen each time, but it did not feel as if it was me. So I remembered that at that time I sometimes felt I was doing everything on autopilot. And meanwhile I felt alienated from what I was saying and doing, a kind of depersonalization. I felt so much hatred, but couldn’t listen to it, because then I wouldn’t survive for my feelings. I was torn apart!!! I splitted internally. And every time I tried to bring out my anger, it was always in a clumsy way, and I felt I was being controlled again, which made me cry a lot (“the crying will remain for a while”, Eelco once said), so that piece of power disappeared from my head forever. And they controlled (and manipulate) me very cleverly: Eelco told me again and again that I wanted nothing more than intimate contact and I had to think of the moment I spoke to him at the second evaluation, when he told me that my aggressive fantasies were destroying intimate contact. Then I had to cry a lot, because I had just such a need for intimate contact, and it made me feel further controlled again. Eelco then interpreted my grief as if I was mourning for what had not been present in my family, but in my head a completely different story was playing: I was crying because I felt belittled again! But I didn’t have the strength to express it.
One time I thought back to what Anke had once said. Someone in the clinic had been very angry. And Anke understood that well, and saw it in perspective. She said: “Sometimes damaged people test whether they can still express their anger in contact with the therapists!” Once when Eelco asked why I had been angry during that tumultuous time, I said, “It was like a test!” Eelco had absolutely no understanding for this, and he came back with the usual line that I wanted intimate contact so badly.
At one point I was so desperate and destructive that even my therapy mates turned against me, and I cried a lot. At one point I was completely silenced. I had no defense at all and I was catching heat from everyone, loyal to the therapist they all were. From that moment on I felt totally alone. Dead. Broken. Alienated. I walked to the bus station on autopilot, without it looking like it was me who was walking. I felt that this was going completely wrong. I was on the bus, and I no longer recognized the places I was going through. I mentally knew where I was, but the feeling of recognition was totally gone. Total derealization. I also no longer had any emotional memory of the past, everything was gone. At home the first thing I did was to hug my mother and look for support. And she supported me as she always could do so well! But I went crazy. I thought I was going to die. I thought, I have to go back to the clinic! This is not possible! I suddenly thought of Dick, a therapy mate in the clinic, who had been psychotic, and had finally ended up in the clinic. His therapy was abruptly terminated while I was still in the thick of it. It was said he had some kind of a defense mechanism, which prevented them to get his aggression to ascend. And as a result, he would have to live the rest of his life in a very structured way, to prevent deterioration. I remember very well that he told me he would have to live the rest of his life like a vegetable. This was terrible. And I was convinced that this was now also true for me! This added to the fear! And it was unstoppable!
The next day I had to go back to therapy but I was terrified of returning. My mother drove me by car to the therapy location, and we went in together. I wanted to ask the desk clerk if Eelco could come down, but immediately burst into tears. Eelco came and we had a talk. I told him that I was so frightened and felt so alone. He said, “It’s good that you are pointing this out.” Such an annoying therapy oneliner, to which I said that he could really go to hell! He said: “The aggression is in your system” and: “You are estranged from contact inside.” He asked if I wanted a time-out and I agreed. I would stay home for a few days. These few days at home I spent mostly with doses of Oxazepam, lots of sleep, but mostly staying busy, because that was the last pointless handle I had been given by the therapists, which again I tried very hard to comply with. It did not make me feel better.
I felt awful: terribly depressed, anxious, angry and desperate, but I didn’t want to believe that the therapists would let me leave in this state. If I continued the therapy, it would get better gradually, I told myself again. I was unstoppable! So after a few days I called again to find out when I could start again. Eelco told me that he wanted to discuss this in person and that I could bring my parents. At the meeting he told me that he didn’t think it was a good idea for me to continue with therapy. He said that in therapy they put/had put a lot of pressure on me, and that I had a vulnerability, which made it better to stop, and say goodbye. I thought, who created this vulnerability? You!!! Who exposed that vulnerability: You!!! Bastard! But I was very adjusted again. I felt cast aside, as if I had failed in therapy. As if two years of intensive therapy had been for nothing. I told him that I felt worse now than before I started all the therapies, to which Eelco assured me that I was no worse off. After all, I was no longer compulsive, but to be honest I just didn’t dare to do that anymore, because he had said that is immature. And what did I still dare to do? Nothing really. I had become a patient for life.
In one of the last conversations with Lieve Deruyter, the psychiatrist, she told me that I was never really allowed to express my anger at home and that I was allowed to be angry, even though I now had the feeling that I wasn’t. And she assured me that the process I had gone through during the past year was not irreversible. And then I totally looked down on her, because I thought of Dick, the vegetable, and knew that Lieve was wrong.
Since I had been diagnosed in the regular hospital (2003), my antidepressants had been significantly increased. After the clinical therapy in the psychiatric hospital, when I felt so well, I had even reduced them partially, but in the last periods in the part-time therapy, when I was having such a hard time, they had been increased again, even doubled, “just as a helping hand! So not as a regression” Lieve and Eelco assured me. But when this almost maximum dose did not help sufficiently against the anxiety, I was also given an antipsychotic for the first time in my life, which was constantly increased to a fairly high dose, “just as a helping hand!” But the expected progress that would make me no longer need my medication, did not materialize and has not materialized to this day. I was damaged too far.
The worst part is that it was a puzzle for me what had actually happened, and what part the therapists had in it. At the farewell they behaved as infallibly as ever, as if nothing had happened. That was terrible. They just went on with their ways and techniques, and they let me go in this state, without looking critically at themselves, and admitting their own mistakes, although Eelco said that it was their responsibility, but what that meant exactly, I did not know. I had to find out for myself what went wrong, where it went wrong, where the mistakes were made, how it all works psychologically and so on. That is hard! They unfairly had so much faith in their therapy and nothing came of it. They assured me at one point in the therapy, when I could no longer fantasize aggressively, that I was allowed to exist the way I was, but I did not go home with that feeling. I felt the conditional love, which I had experienced in the past within my family, and which now, with this event, came crashing down again. Because I was not like they thought I was: I was like I came out of the clinic, that was the real Jesse, back then I was still standing. Back then I had the extra space in my head that I always needed so much, to keep my great fear (of real and actual danger!) manageable. This was unbearable. And I was furious, but kept this all inside.
By applying a lot of pressure on me, not affirming me, and challenging my boundaries, the therapists hoped that I would bring out my dire anger, defend my boundaries, so that I would gain self-confidence, and then be able to release my anger and push my boundaries! And at first glance, they thought that’s what was happening to me. But that was not what was going on in my head, I have already made that clear. The therapy had a completely different effect than what had been intended. If their estimations had been correct, and I had no serious trauma towards my parents anymore, I would have been free of diagnosis after this therapy. Unfortunately, things turned out differently for me, and I was brought fully into contact with a serious trauma, from which you can actually only run away or fight if you want to remain intact. And it was precisely those ‘flight and fight’ ways (black and white thinking (splitting), aggressive fantasies, going out of contact), that were taken from me. And when they saw what effect that had, they also admitted that fleeing was justified. Now I know that Anke and Desmond, the therapists at the clinic, should not have referred me to the part-time-therapy. The stakes were too high. Apparently they were willing to take the risk, and perhaps I had unwittingly misled them. After all, they had raised this issue several times: the time I had knocked on Desmond’s door at various times after the therapy, because I wanted to talk to him about it in person. And the time Anke asked me about what exactly I was afraid of when I was living out my aggression internally. It is the function of a therapist to confront his or her patients with the trauma they have suffered, and to make it known to the patient’s conscious mind. This was done well with the trauma to my sister, but not with the trauma to my father. I have, out of great fear and shame, subconsciously avoided talking about it. I denied that part of myself. Sometimes I feel very guilty about that, but I can’t handle it to look at the damage this all has caused with guilt, so I try not to listen to it…
