Institutionalized

After twenty more awkward, semi-silent minutes, a knocking was heard at Dr. Woodson’s door. He got up to answer, and an aide mentioned that she was here for me. I stood up, eager to get out of the uncomfortable chair and Woodson’s lifeless office. Before I left, however, Woodson shook my hand.

“It was nice meeting you,” he told me. “I look forward to working with you some more.”

“Err…me too,” I replied, trying to extricate my hand from his. Eventually, he let go, and the aide and I were off to my next therapy session. I had managed to glean from my schedule that I would only have Woodson for private therapy, but I had no idea who would be leading the group therapy sessions.

Eventually, the aide and I had arrived at a relatively large room with chairs set up in an oval shape. Kids were milling about, chatting with one another before the session started. I spotted Rachelle and Mikhail standing off to the side. I managed to catch Rachelle’s eye and she waved and smiled at me. Mikhail scowled at me, but I expected that from him.

I decided that, since they had been so kind as to welcome me to their table that morning, I would go over and make some conversation. As soon as I approached, Rachelle’s smile widened and she gave me a quick hug.

“Hi! I didn’t know you were scheduled for the same group session as me!” she exclaimed.

“Yeah, I can’t say I was expecting this either,” I replied. “Hi, Mikhail.” He gave another one of his trademark uninterested grunts. Rachelle rolled her eyes and smiled apologetically.

“Sorry about him,” she whispered. “He doesn’t like talking about his problems with self-harming.”

“I can imagine. Who’s running this session?”

Rachelle brightened. “Dr. Nakamura. You’ll like her. Everyone likes her, except Jacob Byrd; but he’s not in this session, so we’re all good.” As soon as Rachelle finished her statement, a petite Asian woman strode into the room, carrying a clipboard.

“All right people, take your seats so we can begin,” she called. Everyone sat down quickly and watched her with rapt attention. I took a seat between Rachelle and a guy who was blushing uncontrollably.

The woman stood at one side of the circle of chairs and cleared her throat. “Hi everyone, my name is Dr. Eileen Nakamura. The reason I’m introducing myself is because we have a new patient joining us.” She nodded at me. “Lilly, why don’t you introduce yourself?”

I squirmed a bit in my chair and gulped. “Uh, hi. My name’s Lilly Finnegan.” My shaky introduction was met with some ‘Hello’s, ‘Hi’s and ‘Welcome’s.

Dr. Nakamura beamed and clapped her hands together. “All right, let’s get started, shall we? First order of business, Roseanne has some good news to share. Roseanne, take it away.”

A short, chubby girl with a messy red pixie cut stood up. “I haven’t burned myself in almost a month,” she stated proudly. Her announcement warranted a loud burst of applause, and one guy shouted ‘Way to go, Roseanne!’. She grinned and sat back down.

Dr. Nakamura clapped along with everyone else. “Wonderful! You’re doing great, Roseanne. Keep up the awesome work. Okay, next order of business. Today we’re going to talk about triggers. Who can tell me what a trigger is?” A frail-looking girl sitting next to the blushing guy raised her hand. “Yes, Nicole.”

Nicole lowered her hand. “Something that makes you want to do something.”

Dr. N nodded. “Exactly. A trigger could be anything—certain places, certain people, certain situations—it could even be something as simple as a certain smell. Triggers can apply to anything, not just self-harm. They are a conditioned response to a situation. For example, if you eat twelve brownies whenever you smell them freshly-baked, the smell is a trigger. Who can name some triggers?” Roseanne raised her hand. “Yes, Roseanne.”

She scrunched her face up before answering. “Stress.”

Dr. Nakamura nodded again. “Yes. Stress is a big trigger for a lot of things.” She walked over to the whiteboard and wrote ‘stress’ in big letters at the top. “Stress can trigger self-harm, overeating, and even panic attacks.” She spun around. “Others?” She called on a boy sitting in the back. “Peter.”

“Boredom,” he replied quickly.

‘Boredom’ was written on the board. “That’s another big one. This one can often lead to more dangerous behaviors, such as drinking or doing drugs. Alright, let’s hear another one. Yes, Rachelle.”

I hadn’t even noticed Rachelle had her hand raised until I turned and looked at her. “Anger.”

“Anger. Very good. That can lead to some really destructive stuff. Any others?”

After a while, the board was filled with triggers. Some of them were ones I could relate to—sadness, anger, stress, and failure. Others were ones that I thought were really bizarre—one kid said that he cut because he was panicked over a dream he had, another said she self-harmed whenever she got horny.

“All right,” Dr. Nakamura began, “now that we know what our triggers are, and what they lead us to do, we can work on substitution behaviors—things that are constructive rather than damaging. Who can name a good substitution behavior?” I raised my hand and she beamed at me. “Yes, Lilly.”

“Um…exercising?” I guessed.

She clapped her hands together. “That’s great! Exercise is a good substitution behavior because, not only is it good for you, it gets your endorphins moving throughout the bloodstream, which increases feelings of well-being. All right, who’s got some others?”

The rest of the session passed quickly—all of the people in the room openly talked about what kind of self-harming they had done, what made them do it, and how they were avoiding it. When there was silence, it wasn’t awkward like it was in Dr. Woodson’s office; it was just a natural pause in conversation. Kevin was right—Dr. Nakamura really did know her job well. She could talk to the patients without talking down to them, she had everyone in the room paying attention without even trying, and she was open about the fact that she had self-harmed in the past.

The last one was the one that made the biggest impression on me. At the end of the session, she rolled up the sleeve of her shirt to show us the scars she had given herself from cutting.

“Remember,” she had said, “you can overcome this. That’s what I’m here for. If you ever have any difficulties, you can talk to me or anyone else here.”

At the end of the session, as everyone was walking out, Dr. Nakamura stopped me at the door and smiled at me.

“I’m really glad that you’re in my session,” she told me. “From what I heard about you, you’ve had a pretty tough go of it. But just remember that we’re all here to help you. I hope you’re adjusting well to life here, and if you ever need to talk, there are people who will listen.”

“Thank you,” I replied. I quickly left the room to catch up with Rachelle and Mikhail and head to lunch.