by Torey Hayden
Maddened, I reached across the table and slammed the thing off.
This had not been an edifying session. Once the awful jobs of cleaning Drake up, arranging to get the therapy room cleaned up, and sponging down poor old Friend were over, I returned him to the ward and retreated to my office, where I collapsed into the chair at my desk and covered my eyes with my hand.
Helen was there, and she had no trouble reading my distress. “Want me to look at the tape with you?” she offered.
No. No, I didn’t want anyone else looking at the tape. I didn’t want to look at the tape myself. I’d gone too far. I’d pushed too hard. I’d overstepped what I should be doing with that little boy and I knew it. I’d known it even as I was doing it, but desperation to get results had allowed me to override common sense. It was going to be a hard tape to watch. I’d be mortified for someone else to see it. So I declined her offer and just sat.
What were we going to do? We couldn’t keep Drake for weeks and weeks. He was too young. The separation and, to put it bluntly, the institutionalization inherent in being on the unit would only create greater psychological problems in the long run, to say nothing of the stress of experiences like our session today. Yet it was obvious he did have something serious going on. What? How had the mutism become so intractable at such an early age? Why? For what reason was he refusing to cooperate now? How come?
If I was brutally honest with myself, not only had I made absolutely no progress with Drake, despite intensive daily therapy, but I literally knew no more about what was causing his problems now than when I’d first met him. This was a scary thought, not only in terms of having spent so much time with the boy and yet having learned so little about him, but also for what it said about the focus of the sessions. Out to do a job, confident of how to do it, I’d given the boy very little chance to direct any of the sessions himself. I’d gone into this like a mechanic, setting about repairing a faulty car engine.
And yet … it wasn’t as calloused as that. I’d done it because I had wanted Drake in and out of the hospital as quickly as possible, because I hadn’t wanted to disrupt his life any longer than absolutely necessary, because I’d known that even if he did require long-term therapy, it would need to be carried out somewhere other than here and by someone other than me; so my job was, in fact, largely mechanical. Help him speak so that these other things could happen.
And yet …
Very tentatively, I turned my mind back to the one other thing not yet addressed with Drake. If this mutism was so intractable, the odds were high that something seriously wrong was happening in the family. We were going to have to address that. Up until this point, I’d been holding out hope either that Drake would speak and this would make any such questions about child abuse or other serious family dysfunction easier to pursue, or else that some clue as to the nature of the problem would become evident from Drake’s behavior on the unit, and we would then know more which way to go. As it was, he still didn’t speak, and he hadn’t been anything but cheery, cooperative, and sociable on the unit. So I was stuck with the prospect of figuring out how to deal with a dysfunctional family when I didn’t know what the trouble was, who was causing it, or in what manner it was impacting Drake—and they all lived two hundred miles away.
Chapter
21
The breakfast tray had already been cleared from Gerda’s room by the time I arrived, and she had lain down again, her back to the door. She didn’t respond immediately to my presence. My sense was that she had expected it to be one of the rehabilitation center staff and so just ignored the noise, but when I said her name, she then turned her head quite quickly. More laboriously, her body followed.
“Would you like help to sit up?” I asked.
She reached a hand out in a gesture I didn’t immediately understand. It looked as if she were patting a nonexistent dog beside the bed. Then she made eye contact with me and patted the air again.
“Ah. The little boy? Are you wondering about the little boy I had with me the other day?”
She nodded.
“He’s a patient at the hospital where I work. That was just a treat, taking him out while I ran some errands.”
Her brow wrinkled in an expression that said to me, “Tell me more.” Or possibly, “Why is he there?”
“He’s at the hospital because he doesn’t speak. He talks at home but only to his mother. No one else. Not even his father. And, of course, this is causing him problems. So I’m trying to help him.”
A pause.
“Unfortunately, I’m not doing such a good job, I’m afraid. He still isn’t talking.”
Gerda made a sad, sympathetic face.
I was touched to see her so concerned, especially as she had registered almost no emotion during previous visits. I settled into the chair beside the bed.
“I think I told you, his name is Drake. And I feel so sorry for him. He’s only four. There are a lot of expectations in his family. They’re very prominent in their community. The grandfather is a real patriarch—demanding, domineering, bossing everyone. He gets so distressed thinking something is ‘wrong’ with Drake. Whereas, if the boy just had a chance to be himself …”
Gerda nodded faintly.
A small silence came then. I knew I shouldn’t be talking about one client with another client, even if it was very unlikely Gerda would ever pass any of the information on. But it was unethical, so I searched for another direction to take the conversation.
“Twilight child,” she said, her voice soft. “Twilight child, twilight child.”
Surprised, I looked at her, because here was the elusive spontaneous speech I had been brought in to find.
Unfortunately, poetic as they were, the words didn’t make much sense to me. She regarded me intently with her blue, blue eyes, but her expression remained quite unreadable.
I nodded slowly, hoping that was an adequate response.
Gerda looked away. She seemed to study a blank part of the wall beside the bed and then looked back, saying in a very quiet voice, “Tim come west in the boxcar, so he had part thoroughbred in him. Should have been a saddler, but Papa hitched him to the wagon.”
I scrambled madly to figure out what we were talking about, how we had gotten from Drake to the topic of boxcars and Tim, whom I took to be a horse.
“Gone down along the breaks to hunt chokecherries. Mama put all the buckets on the wagon and a big picnic lunch. Papa hitched Tim and they all went. Louisa and me, we always got left home. Boys could go. ‘No place for girls,’ Mama would say. I’d say, ‘Mama, boys are no good picking chokecherries. Let me and Louisa come.’ Mama says, ‘You’ll get your dresses dirty down along the breaks.’
“The boys’d come home, their hands, their lips, their tongues, even their teeth stained red with chokecherry juice. Could eat as much as you want of chokecherries because no one can eat many. You get choky in the back of your throat from the juice. Got to have a drink of water. But you always try again.”
I was still bewildered by this unexpected burst of speech. Nonetheless, as Gerda spoke, I was transported back to the countryside of my Montana childhood, to the world of sagebrush, buffalo grass, and wild gray-green chokecherry bushes hung heavy in early autumn with fruit. My generation was probably among the last to experience chokecherry picking as a regular autumn event in most people’s homes. I recalled well the annual outings with family and friends in warm fall sunshine, the taste, like bitter cherries, and the unexpected choking sensation that followed. How distant that world and those times seemed. It’d been ages since chokecherries had even crossed my mind.
“I went chokecherry picking as a child,” I said to Gerda. “My grandmother used to make it into syrup for our pancakes. I liked it better than maple syrup.”
“My brother Willie, he went in the cow field once. The bull took after him. He ran right up the apple tree that was by the creek and when he was caught up there, that bull came and stuck his face up and licked Willie rig
ht on the cheek. You could hear Willie howling clear in the house. Clear upstairs where Louisa and me were mending. He thought he’d been bit. Said, ‘That bull took a taste of me, Mama!’ and he was crying. Alfred thought it was funny. When Mama caught me looking through the fence, I got the belt to me. She says, ‘No place for girls.’ So unfair. Willie’s so much littler. And I like cows. I wasn’t scared of the bull one bit.”
Nothing Gerda said made real sense. Or, rather, it did in its own little universe, but it made no sense there in the rehabilitation center. I assumed she was recounting memories, but they came out haphazardly, and they did not include me in the conversational way most people relate memories. Indeed, if I attempted to join the topic, Gerda didn’t respond to me. She kept talking randomly, not as if I weren’t there precisely, because I very much had the sense she was talking to me; but her words didn’t have the give-and-take of a conversation, so I didn’t know how to interpret them. Nonetheless, I left the rehabilitation center in good spirits. She could speak spontaneously.
I wanted an in-depth meeting with Dave Menotti over Cassandra. Despite the high profile in the media, dissociative disorders—and more specifically, multiple personality disorder—are not well understood, particularly in children. In my early professional years, multiple personality disorder was considered very rare and, indeed, was not believed to occur in children at all, so no child with that diagnosis had ever come my way. Then in the 1980s, multiple personalities suddenly became the plat du jour. Mysterious and fascinating, it was a fashionable, even desirable, diagnosis to have. And, indeed, everyone seemed to have it. While still regarded as uncommon in children, several of the children I had previously worked with who were now adults were rediagnosed as having multiple personalities. Indeed, so were some of my colleagues.
Overexposure eventually dampened the allure. The disorder was wrested back from the popular media. Serious research was undertaken and a body of knowledge was developed based on objective data rather than sensationalized personal stories. It was found to be not as rare as we had believed in the 1970s, but neither was it common. And it remained a complex, enigmatic psychological disorder.
The problem with dissociation as a disorder is that dissociation itself is a continuum behavior from mild on one end to severe on the other, and every single person is on this continuum. Dissociation is normal, and everyone dissociates. Any time we become so absorbed in an activity that we lose track of what’s happening around us, that is dissociation. Most adults experience it regularly while driving—they become involved thinking about supper or their job or their family or even something so mundane as what to buy at the grocery store and lose awareness of driving their vehicle. They don’t lose control of the vehicle. They just stop seeing the road and the surrounding environment and see instead what is in their heads. They are able to drive perfectly well on “automatic pilot” and will snap out of their thoughts at the first indication of needing to give more attention to the road, but during the time they are “lost in thought,” they have no cognitive awareness of the stretch of road they’ve just driven. This is normal behavior. Everyone does it. And like all behavior, there is a huge variation in “normal.” Some people dissociate hardly at all; others dissociate easily and frequently. Both can be effective adults and perfectly normal.
It is also normal to dissociate in stressful situations, to try to subvert pain or a negative situation by “thinking of something else.” Indeed, this is generally considered a good thing; self-help books show us ways to do it effectively; parents often encourage children to cope in this manner; and people who show such abilities are often regarded as creative, adaptive, or intelligent. So the question is not, do you dissociate or not? Or even, how much do you dissociate? Rather it is, at what point on the continuum does it move from being resourceful and helpful to maladaptive and damaging? This is a difficult question to answer, not the least because that point isn’t in the same place for all people, and not all dissociated states, even on the far end of the spectrum, are bad.
Multiple personality disorder in childhood is an even more complicated issue. As part of normal imaginative play, most children dissociate easily and, indeed, quite completely, to try out different identities as police officers, astronauts, cowboys, parents. Likewise, many healthy, well-adapted children have imaginary companions who show a different personality from the child. Some construct whole imaginary worlds, elaborately detailed and peopled with a diversity of characters. These creations can last throughout childhood, adolescence, and even adulthood without any implication of psychological disturbance. On the other hand, there are completely unrelated organic factors—drugs, allergies, physical illnesses—that can also cause dramatic behavior changes that mimic dissociation, such as the inability to recall recent events, abrupt changes in attention span, or “cloudy” thinking. So multiple personality disorder isn’t a straightforward diagnosis to make.
As a consequence, I very much needed Dave Menotti’s input, because my own background was inadequate for such a diagnosis. He’d been away for much of the previous week or I probably would have snagged him to look at the tape at the point when I first became suspicious of this possibility. Now, after my most recent session with Cassandra, I definitely needed his opinion.
Dave watched the tape with great interest. It was a dreary afternoon, quite late in the day, and darkness came sooner than it should have because of a heavily overcast sky and icy rain. Our video cameras filmed in black and white only, and the tape I’d used to record this session was an old, much-used one, so it was full of snow and flickers. This only added to the gritty, rather bleak ambiance.
Left arm across his belly, right elbow braced on it, Dave absently twisted his lower lip as he watched. His brow furrowed as Cassandra began talking about Minister Snake and Cowboy Snake.
“Even when a child has a diagnosis of MPD, it isn’t very common to have clearly defined alter egos,” Dave said. “That is more of an adult phenomenon. The alters tend to become more complex and significant as the individual matures. I’m not sure why, whether it is simply part of the maturational process and reaching abstract thinking levels, or whether it is because the behavior becomes entrenched. In my experience, however, the alters are quite nebulous in most children. Not really ‘personalities’ per se. Which makes them harder to track down, harder to recognize. But it also usually makes them easier to reintegrate with the main personality, because they haven’t become so detached.” He let out a long breath. “But yeah, I certainly get the feeling this is what we are dealing with here.”
“There’s a very high correlation between MPD and severe trauma, isn’t there?” I asked.
Dave nodded. “More than just severe trauma. It usually implies repeated severe trauma. Trauma of the sort the child perceives as life-threatening. And that the kid can’t get away from. That keeps happening over and over again with no real opportunity to heal in between. Yeah. I think it’s in the nineties—96, 98 percent of kids with MPD have suffered that level of abuse.”
He sighed. “So even if she never reveals what happened to her during her abduction, we need to assume Cassandra has been a severely and repeatedly abused girl.”
Chapter
22
While these insights into Cassandra’s perplexing behavior were a diagnostic breakthrough, they were, sadly, a breakthrough only in terms of our perceptions of her, but not in terms of what she was doing. I’d hoped that she and I had at last started to form a positive relationship, that our quiet conversation and my deeper comprehension of what was going on would provide the much-needed connection and we could start to move forward. Not so. Cassandra remained as challenging and hard to like as before.
As seemed to be the norm these days, she was in lock-down when I came to get her for our session together. Once again it was over Selma. Selma’s vulnerability made her a magnet for Cassandra, who, on the one hand, seemed genuinely to like the younger girl, and on the other hand, seemed completely unable to
stop from bullying her. This wasn’t helped any by the fact Selma wasn’t very bright, and, as a consequence, was hopelessly gullible, taking everything said to her as literal truth. This gullibility itself simply fascinated Cassandra, who then became even more outrageous in her lies, as if to see just how ridiculous she could become before Selma would call her on it.
Even more fascinating to Cassandra, however, were Selma’s hallucinations. I was quite certain Cassandra was identifying with all this—identifying not only Selma’s hallucinations as the same kind of voices she herself had with Minister Snake or Cowboy Snake, but also identifying Selma’s overtly psychotic behavior as evidence that voices in one’s head did mean one was crazy. Thus, she too was in this category.
In reality, Selma’s hallucinations were of a much different nature. They focused almost exclusively on demons, vampires, ghosts, and other supernatural evils. Being around her was like being trapped in the world of Buffy the Vampire Slayer. Selma genuinely saw and heard these things. In addition, the voices continually whispered to her about who among the rest of us were demons or vampires in disguise. As a consequence, Selma had to perform countless rituals to keep the world safe from the activities of all of us secretly evil entities. Indeed, Selma seemed unable to say or do anything that did not revolve around the paranormal. This made her a disconcerting partner in any conversation, because she was inclined to inject complete non sequiturs about vampires or witches into even the most mundane exchanges.
Until meeting Cassandra on the ward, Selma had had no particular sexual content to her vampire obsession. Consequently, it was initially easy to tell what images Cassandra had planted, because Selma simply parroted back Cassandra’s tales of abusive and sadistic sexual activity verbatim, except she usually inserted “ghost” or “vampire” for a person’s name. Things quickly started getting scarier, however. Perceiving that molestation was a really nasty thing, Selma began to incorporate it into her general concept of ghosts and vampires, even though she seemed to have no real idea what the actual words meant beyond “something scary.” Thus now, along with vampires jumping out at you, biting you, and making you undead, they might anally penetrate you or “suck you off” as well. Selma began to say these things earnestly to anyone at any time and in any conversation.
