Trusting Her Voices: Trusting My Own By Lawrence Rubin, PhD, ABPP on 9/26/18 - 1:06 PM

There was something different about this seven-year-old who at such a tender age had already lost her father. And if that adversity was not enough, Christine was struggling to fit in and keep up. Yet, there was something about this lost and lonely girl, some palpable sense I had of her resilience. After a psychoeducational evaluation, carefully chosen recommendations, and consultation with her mother, it would be 15 years before I next saw this girl. She was now a woman who was, perhaps not unsurprisingly, still struggling to fit in and keep up, this time with a far-less accepting college crowd and the rigors of an academic curriculum that was really of little interest to her.

I was immediately struck by how she was at the same time both young for her age and an old soul- isolated, enigmatic. In her “backpack of wonders,” as I silently called it, she had a number of amulets drawn from characters of popular culture; wore T-shirts advertising her fascination with or perhaps identification with popular teen icons, and soon revealed to me that she had learned to populate the empty rooms of her life with what she called her ‘All-Girls Group.’ “Voices in her head, damn!”, I thought to myself. Could I have so badly wanted to see that struggling child in the most benign light all those years ago, denying the possibility of early onset schizophrenia? A rising sense of panic muddled my thoughts. Critical, self-questioning voices.

What to do? Query her mother more deeply? Do a thorough psychological evaluation? Refer her immediately to a psychiatrist? Consider the possibility of hospitalization? These were the voices in my head, and while I did not ignore them, I addressed each of them, ruled out immediate danger, and opened myself to Christine’s inner world. In the process, I got to know Laura, a “real” young woman who chronicled her lifelong battle with cystic fibrosis in the book Breathing for a Living. I met Lisa, the take-no-prisoners character from Susanna Kaysen's Girl, Interrupted. And after being granted membership as the “only boy” in Christine’s exclusive private club, went to work with her, following her lead, suspending my voices, getting to know hers, and following her lead in trying to plot a therapeutic path for us and for her.

That phase of therapy ended abruptly following a surgical procedure for Christine and loss of the family dog, which I imagine were very destabilizing for her. I later found out that she had joined the Army. “Of all places to go… They will eat her alive.” When she arrived several years later to reconnect and reinitiate our work, I found out that Christine’s group had abandoned her to the military thinking it the wrong decision. But with some creative re-framing, she accepted the notion that her support team thought the Army would be an important test for her and that she had to go it alone.

And, as to be expected, Christine experienced considerable adversity during her short stay with Uncle Sam-a belligerent drill instructor, unaccepting platoon-mates, brutal physical rigors and loneliness Broken and alone, Christine hobbled back into her life and somehow her “girls” found her, flocked to her side, lifted her on their backs and marched her back to school...and life. Along the way, their numbers increased to include a few new select members, this time a few male figures- all strong, all supportive, all with stories of survival and resilience, just what she needed.

Christine finished her college degree, tried a few different jobs in the computer field, and as of this writing, was still searching for the very same things she was looking for when I first met her as a child. I see her whenever she calls, trust that she is never alone, and long since separated myself out from the voices in my head that did not trust the voices in hers. I don’t believe that Christine ever dis-trusted her voices - that was me, although I never showed it to her. I think I was only able to accept hers when I was finally able to subdue my own.

File under: The Art of Psychotherapy, Child & Adolescent Therapy