CW: Pregnancy loss, suicidal ideation
I’ve never been in a waiting room this fancy before – I guess that’s what £100 an hour gets you. It’s bright and lovely, the muted yellow of the walls implying health and good cheer. The credentials on the wall tell me that this man is someone who thinks he should be trusted with people’s innermost thoughts. He has multiple certificates, all displayed in shiny oak frames. I wonder if they protect him from the stories he hears, if he uses them like a talisman in the night when he cannot sleep, if he still believes that objects can keep him safe. Like a child.
Lucy, lovely to meet you. He takes me down a short, cheerful corridor and into his office, all unkillable plastic plants and unbreakable plastic coffee cups. I sit on the chair to his left, weaving my fingers through a thick blanket he has placed over the arm of it. False comfort.
How are you today? What an unoriginal starting question. I take another look at him from beneath my eyelashes, having resolved to focus on the blanket and not much else. He’s frowning gently at me, concerned, and I realise that not making eye contact might be a bad idea, might paint me as someone who has things to hide. I raise my head and meet his gaze full-on. I’m not too bad, doctor. I know you might think that’s a strange answer, that I wouldn’t be here if I was okay, but today I’m honestly not too bad.
He smiles warmly, but it doesn’t quite reach the depths of his muddy green eyes and I realise that I need to be a bit more careful, a bit more circumspect, if I want to leave this encounter unscathed. As if I ever really leave any encounter unscathed. I smile to myself, but he isn’t watching me now. He’s shuffling a stack of papers on top of a clipboard on his knee. He has a pen, and for a moment, I think he’s going to give it to me, but at the last second he seems to decide to keep the power of the written word to himself, to make me speak rather than write. That’s fine. I’m used to men holding onto the power they think they have over me.
Before we begin today, there’s a questionnaire I want us to fill in together. It’s about different things that can affect your mood, and it’s called the Patient Health Questionnaire. I’m only asking about the last two weeks, so it’s a snapshot of how you’ve been feeling. I’m going to give you a statement, and you’ll give me a number between zero and three – zero being “not at all” and three being “nearly every day.” Is that okay?
I suppose so. Nobody mentioned a questionnaire to me when my husband booked this appointment, but I suppose he wants as much information as possible to make an informed decision about whether I’m mad or not. Yes, doctor.
Please, it’s David. Call me David, I insist. Now – first question: over the last two weeks, how much have you been bothered by having little interest or pleasure in doing things?
Define “doing things.” For that matter, define “little interest or pleasure.” If there’s a cup of tea involved (oat milk, no sugar) or a good book (not that trash that my sister reads), I’m fairly interested. I get pleasure from watching the birds feeding their young outside the kitchen window and probably get overly invested in the chicks surviving into the summer. But if you’re asking me about spending time with my friends or having sex with my husband – no interest, no pleasure. And that’s why we’re here, isn’t it? Erm…probably a one. I hedge my bets. His face tells me I’ve given the right answer – a bit down, but not a completely hopeless case yet. Yet.
Okay. How about feeling down, depressed, or hopeless?
Well, over the last two weeks I’ve been increasingly down, depressed, and hopeless since my husband, who I always thought was a reasonable man, decided that I needed to see a psychiatrist for my “mental health.” Meaning, that he found out about my plan and exercised every last bit of his power over me to make me come to see a man who is going to make a judgement on whether I’m sane or not. So, I guess you could say so. No, doctor – David. I’d say zero for that one. I have a good life, for the most part.
Good. Trouble falling or staying asleep, or sleeping too much?
Ah. Now that I do have difficulties with. Trouble falling asleep, when my husband comes home from the bar with his friends right at the time that I’m getting comfortable and ready to drop off. Trouble staying asleep when he gets into bed and paws at me after he’s had a few drinks. Falling asleep during the day due to my inability to get a decent night’s rest, between him and the crying babies, wailing for their mother – for me – every few minutes, especially when my back is turned, especially from a different room. And yes, I do know that they’re in my head now. I’ve figured that much out at least, but my husband’s behaviour towards me very much is not. Probably a two there, I do struggle with sleep. His face tells me that I’ve given the wrong answer this time, and I make a mental note to lie later that this is due to me staying up late cleaning or cooking and then collapsing due to exhaustion rather than any internal process.
Okay, then I’m guessing this one might also apply – feeling tired, or having little energy?
Damn it, now I’m going to have to say yes to this one and increase my score on his stupid questionnaire. I suppose it’s true – the babies do keep me awake, and then during the day I’m so tired I imagine that I can see them, always crawling around the next corner or running – some of the older ones – away from the windows when the sunlight catches them. I didn’t expect the miscarriages to have such a lasting effect on me, never really wanted children to start with, but my body is obviously aware of what I’ve lost, and the older ones call out to me in the night, asking me to come with them, wanting to take me away from where I am. The younger ones just scream, slowly eroding any last bit of resolve I might have had to deny them what they want. Yes, you’re right – but only a little. One for that question, I think.
Great. How about poor appetite, or overeating?
I don’t have any appetite these days. I know that if I want to grow a new life I need to eat well and often, but as I said, I’m not really interested in having children. I’ve already got four, the babies and the older ones, and as they’re aged between five and three months old, they do keep me busy. It’s my husband who tries to encourage me to eat, makes me whatever food I fancy every night and doesn’t even flinch as I pick listlessly at it. He can’t hear the babies, I know that now. I thought it was something we shared, but when I mentioned it to him it got me a one-way ticket into this office, so. Something to keep to myself in future, and definitely not something to tell David. My appetite is fine. Zero for that one. He frowns, and I wonder what my husband told him when he booked this appointment. I’d probably better make my next answer more convincing.
Okay. Feeling bad about yourself, or that you are a failure or have let yourself or your family down?
Finally, one I can answer sincerely, as everyone knows about it anyway. Yes, I do feel bad about myself. As you’ll be aware, I’ve had four miscarriages, and at times I can’t help but feel that they were my fault. So, a three for that one. He smiles benevolently at me and I return his expression tentatively, trying to mask my relief. That was clearly the correct answer and fits with what he thinks he already knows about me.
Oh Lucy, please don’t think that. None of that is your fault, at all. But let’s finish this questionnaire, and we can discuss it in more detail. I warm towards David slightly. He is trying, and he doesn’t blame me. But I need to make sure I get what I need from this, and that’s going to mean lying to him a bit. Listen, Lucy, he’s asking you the next question. Trouble concentrating on things, such as reading the newspaper or watching television?
My concentration would be fine if the babies would stop crying, if the older ones would stop their whispering, but I decide that doesn’t count. One. My concentration is fine, but obviously I’m tired sometimes and that can affect it. A call back to earlier questions – risky, but I think I’ve pulled it off.
Good. How about this one – moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or restless that you have been moving around more than usual?
I have absolutely no idea what he’s getting at here. Some days my whole body is slowed down, and it’s like moving through treacle just to answer my husband’s questions when he gets home from work. Sometimes I’m a ball of energy, designing new curtains for the nursery room and alarming my friends and family with my assertions about what we’ll call the new baby when he arrives. Knowing all the while, though, that he’s never going to arrive. That my hopes for children are all buried with my mother in the graveyard, and that it’s so stupid because I was on the fence about them to start with, but now I can’t get away from them and their crying and their whispering about how the soft earth is so comfortable and quiet. I have to admit, it sounds inviting. No, I don’t think I’m like that. Maybe a one, I’m sometimes a bit slow.
And the last question – thoughts that you would be better off dead or of hurting yourself in some way?
Every single second. No, not at all. Zero. He smiles again, prejudicing a process that I’m sure he thinks is neutral, and I know this was definitely the right answer.
Okay, so you’ve scored nine out of twenty-seven on that questionnaire. That indicates mild depressive symptoms, which is good. That means I don’t have to be too worried about you. So, tell me what’s brought you to me today.
My husband found out that I was planning to join my dead children and I can’t stop hearing their cries. Well, my husband thought that it would be good to get my mental health checked after the miscarriages, which I completely understand. I don’t feel that I need any therapy, but I do feel a bit down and bad about myself at times. David smiles and writes this down on his notepad, and I start to feel another plan forming as the words pour out of me, unbidden. This is clearly a man who likes to know, who likes to diagnose and pin and treat, a lepidopterist of the human variety, a feelings collector. I can use that to my advantage.
***
I leave David’s office an hour later, £100 lighter and with a prescription for antidepressants in my pocket. I have just enough time to go and pick them up from the pharmacy before my husband arrives to take me home. I won’t tell him that I have them, of course, but I will claim that the meeting was helpful, and to show my appreciation I’ll make us a lovely meal tonight, so stunning that I’ll surprise him by eating most of my portion too, so richly spiced and flavoured that he won’t taste anything bitter or wrong. And then we’ll go to see the children.
Together.
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