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When I was so severely ill, my illness became my identity, the only way I had to distinguish myself from the rest of the world.
During my late teens and early twenties, whatever sense of myself that I had remained shaky; I was a serious athlete and I was ambivalent about my sexual orientation. I was shy and introverted — the cocaine (to which I became addicted) —- possessed a magic quality which drew me out and enabled me to flirt and move easily among the small groups of people. After I graduated from college, the only job I could get was as a secretary in an advertising agency which I was sure disappointed my parents and further cemented my perception of myself as a failure.
The anorexia was the first thing at which I was truly successful. I became better at losing weight than anyone I knew. The eating disorder sucked me in, it swallowed me, it consumed me. Losing weight became my focus, it was more important than my career (by now I had been promoted to a management position), it was more important than my relationships with my family and friends, and it was more important than my life.
Thoroughly absorbed into the mental health system, labeled as "severely and persistently mentally ill," I played out the part to perfection. My goal became to be the sickest patient, the one with the worst set of symptoms, the one who needed the most attention. This was the only way I knew how to be special; that was the only way I knew to feel that someone cared about me.
There was an absence to any obvious meaning or sense to my life. I was hopping from the hospital to partial programs to group therapy to halfway houses, much the way a child hops from one painted horse to another on a carnival carousel, without ever getting off the ride that keeps going in circles. I was afraid to make a change, take a risk, assume responsibility,
Change is scary. So is the possibility of freedom. It requires a leap of faith in oneself and an act of will. I see it in many of my patients. While I can't tell them that I also once clung to the safety of Social Security Disability and Medicaid, I can let them know that I realize how frightening it can be to even conceive of giving up these entitlements and venturing out. "Start slowly," I suggest. "Begin with a volunteer job a couple of hours a week."
I can suggest, advise, encourage, cajole, wheedle, coax, persuade with my best intentions, but it comes down to terror versus willingness. There is a war raging inside the patient's psyche which causes him or her a great deal of anxiety.
Decisions are difficult and some patients ultimately decide not to act. As a therapist I accept this and continue to be patient for I know how long it took me to take the first step. I am familiar with the internal struggle, with the colliding of wills.
As I grew out of my patient role, I remained the eternal child. After my mother passed away, I parentified my younger brother, leaning on him for support, looking to him to make decisions for me. Then he had a child of his own and I made a conscious decision to try to step back and become more independent. I made a lot of mistakes, but in doing so I was forced to find what I had lost so long ago.
I started working again as a therapist and I began to write. Becoming a sister to my brother and not a child, my brother and I became friends. I became an aunt for the first time and I now I have the pleasure of watching my niece grow and flourish with true childish exuberance. Developing a small but tight circle of close friends, I discovered I didn't have to be sick to be cared about and feel special.
My unique identity gradually emerged, cementing its distinctiveness in my mind. Now I have my own personality, identifiable by all the aspects that make up my life. I feel inspired, passionate about living for the first time that I can remember.
My identity will always remain exclusive to me but I also will continue to work towards shaping it, molding it, and growing it. I've already had too much backsliding, too much stagnation.
I've had my fill of being the (sickest) patient. My satisfaction is derived from working with my patients and facilitating their recovery. Helping them to find their identity is remarkably fulfilling for the longing to find a misplaced identity is like waiting for the sun to emerge from behind the clouds.
