I showed up at my therapist’s office in January pulsing with big news. Normally, I’d take my time settling in, checking my phone one last time for texts from my children’s teachers and making small talk about the parking lot renovations. But that day, I had barely situated in my usual spot on her blue couch when I announced that I wanted to stop talking about my anxiety. We could use our time to talk about other things, I said, because I had decided how to address the anxiety thing once and for all.
“I am going to do ketamine,” I said.
I thought I saw skepticism on her ever-neutral face, but I pressed on, sharing what I had learned about Ketamine-Assisted Psychotherapy, a medically supervised “trip” to heal my psyche.
I’d read about patients who took the drug and reported dissociation, or a sense of disconnection from one’s ordinary reality and usual self. This happened as a direct result of ketamine journeys, or “trips” as they are called. Although that term made me squeamish ― I was never one for club drugs or raves, which is where ketamine is often taken recreationally, and took pride in my rule-abiding nature ― the studies I researched pointed to an improvement in outlook and mood following ketamine treatment. And often, it happened fast.
My sister is a Yale-trained psychiatrist who has spent years in conferences, training and planning sessions with her peers to understand the mechanisms and benefits of ketamine. She thought my plan had merit. “It’s worth a shot, Nik,” she said.
I used my sister’s background as fodder for the case I made to my therapist that day.
“Okay,” she said when I paused long enough for her to speak, “let me know how I can help.”
Part of me wanted something more from her. Pushback? An alternative? But mostly I was grateful for her support, and knew I’d always have her blue couch to fall back on if ketamine wasn’t the answer.
Plus, by that point, I was desperate. I had come to believe over several years that my anxiety wasn’t going to be talked or meditated away. I’d spent the dark hours of early mornings while my kids were still asleep trying to focus on quieting my mind. I’d tried and failed to be present. I’d spent countless hours in therapy.
Nothing was working.
“As a kid, I trembled from my shoulders to my knees any time I felt nauseous, sometimes for hours on end. My mom called it 'the shakes,' and she would sit next to me and stroke my hair until it passed.”
Anxiety comes in many forms. Mine is a fear of sickness. There is no rational explanation for it, no formative experience that I can recall. But for as long as I can remember, I have been terrified to be sick, and to be around anyone who is.
As a kid, I trembled from my shoulders to my knees any time I felt nauseous, sometimes for hours on end. My mom called it “the shakes,” and she would sit next to me and stroke my hair until it passed. In high school, I learned the name for one of my fears: emetophobia, or the fear of vomiting.
During and after college, I turned down offers to try bites of meals and sips of drinks. I never touched communal cheese trays. I often scrubbed my hands until my knuckles cracked and bled.
When I became a parent, I kept my distance from sick friends for weeks after their illnesses ended. The year my son was born, I cut a Thanksgiving weekend with family short because my two-year-old nephew threw up in the bathtub.
“I think he just ran around too much after dinner,” my sister said, a look of sympathy on her face.
“I’m not risking it,” I said, “I’m sorry.” I stuffed my infant son’s diapers into my suitcase and left. My husband held my hand the whole drive home.
My sister understood, too. She’d known me better than anyone else, and as a psychiatrist, she understood the mechanisms in my brain pushing flight over fight wherever illness was concerned. She’d had a front-row seat to my anxiety for our whole lives.
My anxiety worsened with my second and third children. I reluctantly agreed when my husband suggested breakfast out on weekends, but panicked every time one of the kids touched the floor. It wasn’t unusual for me to cart them off to the restroom sink tucked under my arm several times before the food even arrived. My husband knew better than to suggest a little floor licking was good for their immune systems. The thing was, logic never played a role in my anxiety. Does it ever?
Out and about, I caved to dread daily. I exploded when my kids put their chins on the conveyor belt in check-out lines. I schlepped them straight to the Purell after they crossed monkey bars at the park. I’d stormed out of more than one preschool birthday party early because of the inevitable barrage of germs, vowing to myself this party would be the last.
“My anxiety worsened with my second and third children. I reluctantly agreed when my husband suggested breakfast out on weekends, but panicked every time one of the kids touched the floor. It wasn’t unusual for me to cart them off to the restroom sink tucked under my arm several times before the food even arrived.”
My life seemed forever to hang in the balance of letting my kids be kids and preventing them from getting sick.
Perhaps worst of all: I kissed my children on the tops of their heads, not their faces, to avoid contact with invisible germs.
My husband wasn’t immune either. I’d demand he wash his hands the moment he got home. “Longer,” I’d say, “and don’t forget to scrub under your fingernails.”
My diligence seemed to pay off. When the flu took out most of our street one year, we stayed clear. I attributed this to my insistence on hygiene. I stockpiled latex gloves, face masks, and plastic drop cloths. I prided myself on effective quarantining, long before the word became part of the zeitgeist.
Initially, my therapist helped me to accept my behaviors. She explained how fear is a primal human condition designed to keep us alive. I practiced the plan: acknowledging my fear, and then dismissing it when it was interfering with my life. But no matter how many times I regurgitated my mental mantra ― I’m scared. What’s in my control? What’s the worst that can happen? Breathe. ― I never really calmed.
Then my six-year-old son started covering his finger with his shirt sleeve to itch his face. He worried that litter on the playground and drinking from the same cup after his younger sisters would make him sick. I sensed I was encouraging his worry, and although my husband could act as a countervailing force on the weekends, the kids spent most of their time with me.
Renowned psychologist and author Dr. Harriet Lerner says, “Anxiety is extremely contagious, but so is calm.” I knew my kids were picking up on my fear and I wanted to learn how to spread more calm.
Health gurus, best-selling authors, and celebrities all seemed to be singing the praises of psychedelic medicine. And when my sister suggested I consider it for my anxiety, I listened. I came to long for a journey. I wanted to see and feel what I intuitively understood: that mine was a small place in a vast universe ― that my relatively fluid state of existence was tethered to life as I knew it only by the barest of mystic threads. I believed I could arrive on the other side of the journey less crippled by anxiety ― more able, finally, to live.
The medicines were safe and the chance of overdose was miniscule in a controlled setting. This wasn’t a prescription pill I would have to take every day. It was a three-hour, in-person appointment. I might only need one. After an encounter with the medicine, a doctor trained in this type of therapy would talk me through ― or “integrate” ― the experience to explore whatever came up during the journey. That part, I understood, was where the true healing came.
I saw my decision as an arrival at a last resort. I was determined to carve out a weekend away from my family to have my ketamine experience. “Whatever you think it’s going to take,” my husband had said. My default state of fear had likely exhausted him too. I was a little nervous about the trip itself, but I had become nearly 100% convinced of my plan.
Until the coronavirus hit.
Early on, the pandemic didn’t scare me as much as I might have thought. I’d read early reports that the virus mostly spared children, and that half of the world was likely to get it. Some people wouldn’t even know they had it. We can handle a mild respiratory illness, I thought. But as data about younger people falling ill emerged, along with news of the medical system’s harrowing shortages, my anxiety quickly swelled to a fever pitch.
For a few nights after lockdown started, I barely slept. I dreamed of illness and hospitals and death. I shouted a lot during the day. I told my kids about the “bad” and scary things that can happen to people who get the virus. I stood behind them at the sink, my hands guiding theirs in a very slow 20-count wash.
The difference between COVID-19 and the other sicknesses I’ve managed to prevent or curtail is that I cannot control this one. This isn’t a stomach virus contained in the preschool classroom of my youngest child. It’s not another strain of seasonal influenza to be added to this year’s vaccine (not without a miracle, anyway). On some days, the anxiety I feel consumes me from the moment I wake.
But underneath it all, there is also calm. With my whole family at home, in my control, I can relax. A little. It’s been months since my stomach has churned because someone starts crying in the middle of the night. I kiss my kids on the cheek every day.
It’s also the first time in my life I’ve felt normal. In a way, you could say the pandemic granted me permission for my precautions.
Last month, it dawned on me. This could be my journey. If there were ever a semi-mystical, completely surreal and mind-altering experience that proves undeniably how little control I have and yet delivers me on the other side more whole, coronavirus is it.
“It’s also the first time in my life I’ve felt normal. In a way, you could say the pandemic granted me permission for my precautions.”
No one knows what will happen next, and the best I can do is remain focused on this moment. The notion of “being present” is everywhere. But now, maybe for the first time, I’m finally getting it. Maybe my being present with my family during quarantine will act as its own balm?
Now, I notice a strand of my daughter’s hair sticking to her face while she blows bubbles. I study my son’s eyelashes while he erases and redraws the beak of a cartoon pigeon. I sauté garlic in a pan and make soup for dinner, knowing my husband will be at the table with us because he never left the house.
I have today.
I reached out to my therapist for a Zoom session. I also texted my sister and told her maybe I didn’t need a ketamine journey after all, that coronavirus might be the ticket. It might even be the “drug” I’d been seeking all along.
“You might be right,” she replied.
Part of me will mourn the end of social distancing and quarantine, which seems like the very protection I’ve been seeking all along. But soon enough, we will reenter the world and I will have to see if my newfound calmness holds strong. I may still choose a psychedelic journey to help me with anxiety one day, but I’m starting to think maybe, just maybe, it won’t be necessary.
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