Losing the Atmosphere, A Memoir: A Baffling Disorder, a Search for Help, and the Therapist Who Understood

Losing the Atmosphere, A Memoir: A Baffling Disorder, a Search for Help, and the Therapist Who Understood

by Vivian Conan
In a poignant memoir chronicling her return to wholeness, Vivian Conan, with the help of her therapist, Jeffery Smith, shares her tortuous yet liberating journey. 
Filed Under: Severe Mental Illness


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[Editor’s Note: The following article begins with an excerpt from the author’s book, Losing the Atmosphere, A Memoir: A Baffling Disorder, a Search for Help, and the Therapist Who Understood, followed by a portion of the Afterword by her therapist, Jeffery Smith.]

The Saddest Present

“Do you got anything to tell me?” Wendy asked, her custom at the start of a session. It was late October, 1998. I looked at Jeffery trustingly, expecting his usual No.

“Yes,” he said softly, reluctantly.

“What is it?” Not Wendy’s confident voice, but someone’s who felt she was about to be dropped.

“I’m going to be away from December sixteenth to January fifth.”

you know dose doll-babies I cut up with scissors a few years ago? I need to see them
Three weeks. A long moment of silence. Then Wendy again. “You know dose doll-babies I cut up with scissors a few years ago? I need to see them.”  

Jeffery lifted the couch seat and rummaged through the storage chest beneath. That was where he kept my blanket and pillow, crayons, and drawing pad, what made his office my special place for four hours — two double sessions — each week. I looked away, not wanting to see what else he stored there.

Hearing the lid close, I faced him. He handed me a small paper bag. I turned it upside down and tiny plastic body parts fell to the floor.

AlmostVivian had bought the dolls several years before, when I was still seeing both Sarah and Jeffery. It was during the time the babies on the bottom level were coming out often in sessions, alternately moaning and screaming. I listened and was amazed because I didn’t feel any torment. Sometimes, I tried to stop the sounds by choking the babies in me, putting my hands around my neck and squeezing so tightly I coughed. Jeffery would pry my hands off so I could breathe, telling me to let the sounds happen, that even though I didn’t know what they were about, someone in me did, and eventually I would, too.

But outside of session, I felt their neediness coursing through my veins, a hunger and yearning that could never be satisfied. I was sure that monster neediness would repel Sarah and Jeffery and I would lose them forever. I hated the babies and wanted to bash them out of me. I needed Sarah and Jeffery to know about the hate. It was too big for me to handle alone. On the walk home from work one evening, AlmostVivian got the idea of using dolls instead. She stopped at a toy store and bought their entire stock of miniature plastic babies, 12 of them. Each was about four inches tall, sealed in its own cellophane package, with dimples and blue eyes.

laughing diabolically, I held the closed blades like a dagger and plunged them into a doll’s stomach
In my next session, which was with Sarah, I took the dolls and a pair of sharp scissors from my backpack. Laughing diabolically, I held the closed blades like a dagger and plunged them into a doll’s stomach. “I’m going to kill you!” I said, as I began cutting through the waist. It was a voice like that of TheOneWhoCursesCars but raging at the Inside babies instead of Outside people. The plastic was hard, and the scissor loops dug into my fingers. I kept cutting. When the doll’s body was severed, I pulled on her head. It came off with a popping sound. I tossed the three pieces aside and attacked the next doll.

At the same time, that one part of me was gleefully plunging scissors into the guts of the dolls, another part was aware of Sarah, sitting silently on the floor with me. As if I were in her head, I knew she was uncomfortable. I also knew it troubled her to be uncomfortable, because she felt that as a therapist, she should understand and accept what I was doing. I didn’t want her to be uncomfortable. I needed her to talk in her gentle Mommy voice and look at me with the soft eyes that were ordinarily filled with love for me. I needed her to understand the desperation behind my lunatic laughter. But the more I butchered the dolls, the more uncomfortable she seemed.

Suddenly I felt dirty. Unacceptable. Sarah was good and pure. She believed in God and went to church. I stopped cutting, threw everything back into the paper bag — the three dolls I had mutilated, the nine still sealed in cellophane, the scissors — and stuffed the bag into my backpack. For a minute I looked at Sarah, not saying anything, trying to win her back with my eyes. She regarded me dubiously.

I felt my face get soft and my body relax. Then I heard Emily’s whisper. Young, trusting, shy. “Sarah?”

Sarah cocked her head and looked at me from a different angle.

“Sarah?” I whispered again.

The warmth came back into her eyes. “Emily?”

I slid my hand toward her along the floor. She took it in hers, and we locked eyes. “Hi, Sarah,” I said.

“Hi, Emily.” She smiled kindly at me. All was well again.

The next day, in my session with Jeffery, I continued the massacre.

“Somebody’s really angry at the babies,” he said.

Once I saw I didn’t repulse him, I let go, stabbing and cutting. “Now you’re going to die!" I growled.

theoretically, I knew this killing spree wouldn’t free me from the babies
Theoretically, I knew this killing spree wouldn’t free me from the babies. I also knew I was supposed to embrace and care for them, because they were part of me and needed to heal. But I didn’t want them to be part of me. Shrieking and giggling, I dismembered all but one, then stopped. If I destroyed the whole lot, how would I get them back when I was ready for them to heal? I tossed the last cellophane-wrapped doll to safety on the other side of the room, then snatched one of the severed heads off the floor and cut it into tiny slivers.

Several years had passed since then. The bottom level was less dominant, and I less needy. I had forgotten about the dolls until now, with Jeffery’s three-week absence looming. Looking at the body parts on the floor, I knew I had to fix the most broken baby — the one with her head in slivers — before he left, so I could take her home and care for her myself while he was away.

“Do you got any glue?” Wendy asked.

So began our routine for the next few weeks. At the beginning, middle, and end of each session, I glued one sliver of the baby’s face in place, allowing time for it to set, all the while joking about my pediatric trauma unit. It was painstaking work. I wouldn’t let Jeffery help but was glad he was there, watching each piece make the baby more whole.

I also asked questions.

“Are you going to be in another time zone?”


“What airline are you taking?”

“I think it’s Tower.”

I had been expecting something like United or American. Those flew to many places in the United States. Tower went mostly across the Atlantic Ocean. Best not to ask where. “Make sure you’re careful.”

“I’ll be very careful.”

Things could happen even if he was careful. Dr. Welch died while he was on vacation in Europe. “Are you going to come back?”


in our last session, before Jeffery left, I worried that I wouldn’t be able to hold onto the reality of his existence for three weeks
He said some of us knew he existed when I couldn’t see him. Others didn’t. “You need to set up a bucket brigade, so the ones of you who do know can pass the information to the ones who don’t.”

I liked that idea and sprawled on my stomach, crayons in hand, to draw 21 tiny buckets. I cut them out, wrote one date on each, and heaped them, like a pile of multicolored confetti, on top of the mended baby. She had scars on her face that would never go away, but she was whole.

Jeffery drew me a coupon: two stick figures, big and little, him and me, holding hands. There was a dotted line connecting their hearts, and a border around the whole picture.

“Is dat border because you and me are in the same world together, even if you can’t see me and I can’t see you?”

“That’s exactly right.”

“And even if you’re in a different place, you’re still the same person?”

“That’s exactly right. I’m me, and I never change on the inside even if I wear different clothes, or my voice sounds different, or I’m in a different place.”

When it was time to leave, I put everything into my backpack: mended baby, paper buckets, coupon. As I stood in the doorway, I realized Jeffery’s office would be empty for three weeks. That was scary. I hoped he wouldn’t die.

Atmosphere people never died. People in bodies did.

“Be very careful,” I whispered.

He nodded and waved.

We said goodbye three times and I backed out, holding him with my eyes until I closed the door.

For the first time since Jeffery started becoming more of a flesh-and-blood person than an Atmosphere person, all of us believed he existed, even though he was away. Every few days, we mailed a letter to his office, along with the cutout paper buckets for the days that had passed since the previous letter.

On the day he was scheduled to fly back — three days before my session — I visualized him in his body. He orders a drink when the flight attendant comes down the aisle. He rests it on his tray table while he reads a magazine. He gets in line for the bathroom. All day, I listened to the radio — for plane crashes. I worried that he wouldn’t be able to land because of the snow, even though most of it was in the Midwest.   

The phone rang late that evening.

“Hi, Vivian. It’s Jeffery. I’m back.” We had prearranged that he would call.

“Thank you for telling me,” I said, and we hung up.

I played his words over and over in my head. Was his voice different? Was he the same person?

Tuesday came at last. To avoid seeing the patient before me leave, I walked through the waiting room to hide in the kitchen, as had long been my custom. Soon I heard the first in the usual sequence of sounds. The door to his office. Next, the hall door. He or she was gone. Now the noise of the sliding-door closet in the waiting room. I peeked out he was standing in front of the closet. In a body-shape; Jeffery, yet not Jeffery. He took off his shoes and put on another pair. So that’s where he hid the new ones that upset me. I knew I should step back, because he would pass the kitchen door on his way to the next sound: the bathroom. But I ran into the waiting room.

“I saw you!” I laughed, jumping up and down. “I saw you go into the closet and change your shoes.”

Jeffery looked momentarily surprised. Then he smiled, a wide smile that deepened the crinkles in the corners of his eyes “Hi, Vivian.”

“Are you really back?”

“Yup. It’s me.” His smile got bigger.

He’s obviously happy to see me. I’m glad he’s happy. I’m devastated he’s happy. His happiness is proof that he wasn’t with me in the atmosphere all along. I hate him. I love him. I hate him. I punched him in the arm.

Still, he smiled.

“So, how are you?” I said, a little girl trying out sophisticated talk. It sounded funny. I giggled and tried another phrase. “Nice to see you.” Oh my god. That’s what you say to someone who has been away. The scary words kept tumbling out of me. “How was your trip? It’s been a long time.” He smiled. I wanted to cry. I punched him again and giggled some more.  

he wasn’t the Atmosphere Jeffery because he didn’t know everything I thought and felt and did while he was gone
I tried to frame him in a familiar context, but nothing fit. He wasn’t the Atmosphere Jeffery because he didn’t know everything I thought and felt and did while he was gone. Yet he connected eyes with me in the old way. But he was in a physical body and his body had probably been across an ocean. Could the Jeffery who smiled at me now be continuous with the Jeffery who had waved goodbye three weeks ago?

I spent the entire session trying to merge them before and after Jefferys; I looked for the mole he used to have on his forehead. It was still there. Most of all, I kept checking his voice and eyes. The old Jeffery was in both. Yet I couldn’t settle and never got to tell him all the things I had saved up. I left feeling empty and cheated.

When I got home, I wrote a letter that I mailed the following day.

You think you came back, but you didn’t. Your smile came back, but not your insides to our insides... You can’t expect to take up from where we left off....  

Over the next few months, as Jeffery’s presence in the Atmosphere continued to fade, the entire Atmosphere began to lose potency. Though Sarah and Marybeth were still in it, their essences were weak, not enough to sustain me. There were major upsets over minor events. Jeffery forgot to call when he said he would, or he remembered to call but his voice was ever-so-slightly hurried; either way, I was sure he hated me, and I had lost him forever. Jeffery wore a new sweater; this evidence that he went to a store or received a gift meant he was gone from the Atmosphere, and I had lost him forever. Jeffery changed my session from Fridays to Thursdays so his weekends could begin earlier; it was clear I was a burden to him and had lost him forever.

With each incident, I felt betrayed anew. “I HATE YOU!” the angry ones screamed. The hurt ones whined. “You said you would call, and you forgot You shouldn’t say something if you can’t do it.” The abandoned ones became paralyzed and mute. Each time, Jeffery reassured me that I hadn’t lost him, and he hadn’t changed. Only my perception of him had changed. Each time, I would feel better. Until the next time.    

the more Jeffery became real as a flesh-and-blood person, the more self-conscious I was about the nonsense syllables and noises
The more Jeffery became real as a flesh-and-blood person, the more self-conscious I was about the nonsense syllables and noises that had seemed natural and acceptable before. But I was unable to talk about Inside concerns in regular English words, so I filled long stretches of my sessions with prattle about Outside happenings: my boss was being fired; the traffic on the way to his office had been horrendous. All the while, Inside yearned for the kind of connection I used to have with the old Jeffery.

I brought a computer to a session and found I could type what I couldn’t say out loud. Jeffery answered either by typing back or talking, depending on what I indicated I wanted. This became our new method of communication. Often, I didn’t know what I was going to say until I saw the words appear on the screen. It was as if they flowed from my fingertips, bypassing my brain.

One day I wrote about what I considered Jeffery’s shortcomings as a skin-container person, and how much I missed his Atmosphere version. I finished typing and handed him the computer. When he lowered his eyes to the screen to read, I took the opportunity to scrutinize his body. Who was this person trying so hard to reach me? I looked for things that would make him real and found them in comforting imperfections: a small hole in his sock, one unruly gray hair sticking out of his thick black eyebrows, an ink spot on his shirt pocket. He typed something, then held out the computer to me.

I’m a skin person, but I’m a lot more like an atmosphere person than what you think of as a skin person. Because you think of a skin person as somebody who drops you. Somebody who breaks the connection with you. I’m not the kind of skin person who does that.   

I looked up to see a sincere face that matched the words. His eyes met mine and held them, and I felt a tiny bit of the connection I used to feel with the Atmosphere-like Jeffery. At the same time, I was aware that he was not in the Atmosphere. The eyebrow hair was still sticking out.

Only Wendy could report in out loud words about anything that mattered to Inside. Before I had this new conception of Jeffery, she used to appear just at the beginning of sessions, a scout checking for potentially dangerous skin-world manifestations in the otherwise Atmosphere-like Jeffery. But with Jeffery rarely in the Atmosphere anymore, Wendy now stayed out for most of the session, a lone soldier on the front line, and no one else got a chance to be with him. At first, because Wendy was perky and chatted freely, Jeffery thought I was adapting well to my new perception of him.

“Wanna hear a joke I heard on the radio?” Wendy asked one day in her saucy little-girl voice.

“Sure,” Jeffery said.

“What’s the difference between an HMO and the PLO?”

“I give up.”

“You can negotiate with the PLO.”

Wendy was delighted when Jeffery laughed.

“I know a joke, too,” he said.

Jeffery had never told us a joke before. Atmosphere people didn’t joke. “What is it?” she asked, trying to maintain a cheerful voice

“How can you recognize a happy motorcyclist?”

“I give up.”

“He’s the one with dead bugs on his teeth.”

Wendy managed the required giggle, but there was an earthquake Inside. Jeffery had violated a boundary, crossed further into skin territory than Wendy could protect us against. Her giggle stopped abruptly, and she punched him in the arm. “You’re not supposed to tell jokes,” she said angrily. “Only we’re allowed to tell jokes.”  

His face turned serious. “I’m sorry. I won’t do it again.”

“And don’t smile! Don’t act glad to see us when you first come in.” She punched him in the other arm. “That’s just to make it even,” she said in a more gentle voice, “so your arms will be balanced.”

We had had the conversation about smiles many times. Jeffery knew we saw his smile as proof that he was seeing us for the first time after a break. If he had been in the Atmosphere, there wouldn’t have been any breaks. “It’s good to remind me,” he said.

I did keep reminding him — about his smile, his tone of voice, his mannerisms — in an attempt to preserve what little remained of the Atmosphere.
I did keep reminding him — about his smile, his tone of voice, his mannerisms — in an attempt to preserve what little remained of the Atmosphere. I still needed it for time-outs from the real world, though it wasn’t as soothing as it used to be.

Atmosphere people were no longer pure essences, so completely mingled with mine that I never felt self-conscious about anything I did. Now they were separate, looking down on me from someplace near the ceiling, where they hovered in invisible bodies. “Alone” in my apartment, I was embarrassed when I pulled my pants down to sit on the toilet, because they could see me. Once, when I was cooking fish, I opened the window to get rid of the smell — not for me, but for them. I felt foolish whenever I did things like that, yet I kept doing them.

The only times I felt satisfyingly connected to Jeffery were when we had toast, my ultimate comfort food. He let me keep supplies in his kitchen: a toaster on the counter, a loaf of artisanal white bread and a stick of butter in the refrigerator. We developed a ritual of having toast at the beginning and end of each session “Breaking bread together,” Wendy called it. She was usually the one who ate with him, chatting, using big words, playfully comparing the designs his bites and hers made in our slices. Jeffery and I may have been separate people, but we were having the same sensations of taste, smell, and crunch.

Four months after his Tower Air Christmas vacation, in the last week of April 1999, Jeffery and I were sitting on the floor in the kitchen at the start of a session.

“Do you got anything to tell me?” Wendy asked.


I stiffened and waited.

“I won’t be here next Thursday.”

I felt a stab. “Did you forget it was my birthday Friday?” We had planned to celebrate during our Thursday session. The stab went so deep, I couldn’t even punch him. I inched backward until I felt the wall behind me, then slumped forward, head between my knees.

“I’m sorry,” Jeffery said.

He did sound sorry. I looked up to see him sitting cross-legged on the mat.

“I hate you!” screamed an angry voice. “You forgot my birthday,” whispered a devastated one. I punched his arm several times. He pressed his arms into his sides but didn’t flinch.

It suddenly struck me that all this was ridiculous. My body would be 57 next week and I was carrying on like a three-year-old having a tantrum. Jeffery wasn’t an Atmosphere that had deserted me. He was an ordinary human being, the kind you might see in the supermarket, but a very wonderful human being. It was rare that he missed a session. He must have something he really needed to do, and I was making it so difficult. Part of me was still upset. Another part felt a surge of love for him.

While one voice was whining, “It was gonna be my birthday,” another voice, grownup and calm, interrupted with, “Wait. I think it’s time to give you a present.”   

Jeffery looked at me quizzically. I reached for my computer and began typing.

when you are a baby, you would never think of giving your mother a present, because your mother just IS
...When you are a baby, you would never think of giving your mother a present, because your mother just IS. She is part of you, and you are part of her. But when you get a little bigger, you realize your mommy is a separate person, and she can get glad at you, and she can get mad at you. That is very scary. Now you have to do things to make her like you, or you will use her up. When you realize, you are supposed to buy your mother a present for Mother’s Day, you cross into a whole different dimension. You lost something you will never get back.

I passed the computer to Jeffery. He read. But before he could type an answer, I took it again and continued writing.

We never thought of you as someone we needed to give a present to. But last weekend, something made us know that now we did. We remembered when you used to say you needed to be seen. And we knew you would be seen if we gave you a present. So, we walked up and down the booths of the Columbus Avenue crafts fair, and then we saw a very special puzzle box with a secret compartment... When we were packing up the shopping bag to come here tonight, we put the box in, and we were very depressed about it. Then we forgot it was there — until we just got so upset when you asked us to change the session next week when it is our birthday. We realized we were right. It’s time to give you a present. It’s the saddest present we ever gave. But it’s also a very nice present.

I handed the computer to Jeffery. This time, when he finished reading, I reached inside the shopping bag and passed him a small package wrapped in white tissue paper. Jeffery held it in his hand and looked at me, as if he didn’t know what to do.

“Open it!” I commanded.

Rigid with anticipation, I watched him unwrap the layers of tissue. When at last he held the round box in his hand, he still didn’t say anything. He just turned it over slowly examining the top, the bottom, the side. But I saw that he was admiring the graceful streaks of dark brown grain running through the blonde wood, polished as smooth as satin.

“Take it apart,” I instructed. “The side piece first.”

He fingered the side, then slid it up. It came off in the shape of a crescent moon. He slid the top off sideways to reveal another cutout piece underneath. I watched his face and was thrilled to see his appreciation deepen as he lifted the last piece and discovered the hidden compartment, lined with dark brown felt. It was a truly magical box, small enough to fit in the palm of your hand, large enough to hold a secret.

“Thank you,” he said, looking up. “It’s a very beautiful box.”

I felt powerful — and grownup. I had given Jeffery a present that made him happy
I felt powerful — and grownup. I had given Jeffery a present that made him happy. I had let him know I saw him. But underneath, a deep sadness started to roll over me. Before it completely engulfed me, Wendy, always close to the surface, popped out. “I think it’s time to have some toast,” she said gaily.

“Good idea,” Jeffery agreed.

Retracing the Human Journey of Attachment

from the Afterword by Jeffery Smith, MD- Vivian's Therapist   

in telling her story, Vivian opens a window into the drama of early attachment
Losing the Atmosphere is more than an account of living with multiple personalities. In telling her story, Vivian opens a window into the drama of early attachment: how, during our first three years, we become connected to our caregivers and, through those connections, gain awareness of ourselves and begin to forge the capacity to cope with strong emotions.  

The best way I have of understanding Vivian’s Atmosphere is to think about the experience of birth. After existing in the insulated, warm, muffled environment of the womb, humans are suddenly ejected into a world with loud sounds, sharp sensations on the skin, and cold air. The shock must be enormous. Now imagine a protected childlike Vivian facing the emotional equivalent of birth. The Atmosphere was ever-present, existing in the form of molecules intermingled with hers, so there was total, immersive contact. This womblike protection kept her from ever experiencing aloneness. Any fear was met with a reassuring presence; emotional pain was instantly understood and thus barely felt. After years of being surrounded by this protective Atmosphere of benevolent beings with no needs of their own, constantly attuned to the feelings of one small girl, she is suddenly subjected to the harshness of raw emotions.

Losing the Atmosphere is about encountering, for the first time, fear, pain, and separateness. We have all gone through these very experiences but so long ago that they lie beyond the reach of memory. Because Vivian’s self was split into separate parts, and because some parts were shielded from these universal experiences until adulthood, she is able to give a firsthand account of a journey we all make on the way to becoming attached and emerging as social beings.   

This material is excerpted from Losing the Atmosphere, A Memoir: A Baffling Disorder, a Search for Help, and the Therapist Who Understood, by Vivian Conan, and re-printed here with explicit permission of the publisher, Greenpoint Press.  

©2024, Psychotherapy.net
Vivian Conan Vivian Conan is a writer, librarian, and IT business analyst who lives in Manhattan. Her work has appeared in The New York Times, New York, Lilith (award-winning essay), Narratively, Cleaver, and Dorothy Parker’s Ashes. She received a 2007 fellowship in Nonfiction Literature from the New York Foundation for the Arts and a 2019 Simon Rockower Award from the American Jewish Press Association. Her memoir about healing from mental illness is Losing the Atmosphere. The audiobook was a finalist for the 2021 Independent Press Award and the 2021 Independent Audiobook Awards. Learn more at VivianConan.com