Cath Staincliffe - Witness

Fiona

The therapy wasn’t quite what she’d expected. No digging into her childhood or searching questions about her relationships or how she expressed her emotions. Instead Hazel Fuller began by taking an account of the circumstances surrounding her first panic attack.

As soon as Fiona began to speak, her mind flying back to that hot summer day, the boy on the ground, she found herself growing tense, her muscles retracting, her breath out of synch, words tangling.

‘I’m sorry,’ she said, ‘it’s still so-’ She stopped, wrestling tears. ‘I’m frightened it’s starting again.’ She was stupid, a child in the dark. How had she grown so weak?

‘A natural fear,’ Hazel reassured her. ‘Relax your hands.’

Fiona looked down at her fists, clenched, the knuckles white. Consciously she opened them, palms up.

‘And your feet.’

Fiona laughed, spread her toes, turned her ankles.

‘Breathe out.’

Fiona obeyed.

‘Wait,’ Hazel cautioned. ‘Drop your shoulders.’ She nodded. ‘Now, a steady breath in and draw it down into your diaphragm. And hold, and release.’

Once the breathing had calmed Fiona, Hazel explained that all their sessions would be looking at practical techniques that Fiona could use.

‘What do you know about CBT?’ Hazel asked.

‘I’ve read a bit online,’ Fiona told her.

‘Then you’ve probably seen that there are two elements to CBT – changing how you think and changing how you behave. We enable you to accept that however unpleasant the symptoms are they will pass, that you will not die or have a heart attack, that nothing is physically wrong. And we look at the physiology of what is happening – understanding that helps put it in perspective. As far as behaviour goes, we examine patterns that aren’t helping your condition and teach you ways of controlling your anxiety and rehearsing responses to hopefully minimize the number of attacks.’

Fiona nodded. Grateful.

‘You’re on antidepressants?’

‘Yes.’

‘Those combined with CBT offer the greatest chance of improvement according to the latest studies.’

‘Good.’

‘You’re a midwife,’ Hazel observed.

‘Yes.’

‘Think about your work, times when something unpredictable happens, when the mother or baby is at risk and you need to act quickly. Can you give me an example?’

‘A C-section, emergency Caesarean.’

‘Go on.’

‘If we see signs that the baby is in distress, or we lose the heartbeat, then we have to get the mother into theatre as soon as possible.’

‘A lot of adrenalin?’

‘God, yes.’

‘What’s that like for you?’ She seemed genuinely interested.

‘A bit hairy at times but it’s important to reassure the mum, not to frighten her.’

‘And while you’re doing this what’s happening to you, physiologically?’

Fiona thought. ‘Pulse speeds up, heart too, my mind seems sharper. I think I read somewhere the adrenalin helps you remember things, concentrate better. A survival mechanism?’

Hazel nodded. ‘Now think of something else. Think of losing your temper. Big time.’

Fiona thought of shouting at Owen about the apples and cream.

‘What’s the physiology there?’ Hazel asked.

‘Hot. Sweating, my head buzzing, pulse quicker, everything brighter. It’s the same,’ she concluded.

‘The same response,’ Hazel acknowledged. ‘Fight, flight and fornication.’

Fiona laughed. ‘I knew this – my training.’

‘Of course. But it’s hard to hold on to when you’re so anxious. A panic attack is a flood of adrenalin; it brings all the same changes as you’d find if you were having a blazing row with someone. Or a passionate encounter.’

Chance’d be a fine thing, Fiona thought.

‘The lack of context makes the panic attack both disabling and traumatic but fundamentally there is nothing happening in your body, in your muscles and your central nervous system, that doesn’t happen at other times in response to particular situations – like the emergency Caesarean.’

‘But it feels so different.’

‘Exactly. And our goal over the next few weeks will be to repattern your thoughts about it and re-educate you.’

Fiona left with a set of daily exercises to do. She felt buoyed up by the session, especially at Hazel’s optimistic view of the likely outcome of the therapy.

That afternoon Fiona bought a home hair-colour kit from the chemist’s. She really needed a haircut as well. She was blessed with straight hair but as it had grown longer she’d taken to snagging it back in an elastic band. Until she felt ready to make an appointment at least she could banish the grey hairs salted through it.

She was waiting for the colour to take when Owen got in.

‘Can you do mine?’ he asked her.

‘Have you got a kit?’

He groaned. ‘Didn’t you get one?’

‘No. It doesn’t seem five minutes since last time.’

‘The brown’s showing.’

‘Well, go and buy a kit and I’ll help you. They’ll still be open.’

He didn’t reply but slumped noisily into the kitchen while she went upstairs to rinse the mixture off. She left it down and let it dry naturally while she started tea. Owen loved curry so she’d bought some lamb at the butcher’s and a huge bunch of fresh coriander from the Asian grocer’s. She sealed the lamb and fried the onions and spices, added tomatoes and lemon juice and put the dish in the oven to cook slowly. It was dark by six when she drew the curtains and set the table.

Owen appreciated the meal, cleared his plate of seconds, grunted his thanks and left.

‘Dishwasher,’ she reminded him on his way out of the room.

‘I know!’ he shot back at her.

After walking the dog, she watched a film. She woke feeling disoriented, befuddled. It was eleven thirty, the house was quiet. Owen must be in bed. He never came in to kiss her goodnight any more. She missed that, the physical connection, however brief. She knew he had to grow up, grow apart from her, but hadn’t anticipated how much it would hurt. She was lonely. Lonely for love and physical affection. Aware of the sentiment of self-pity she scolded herself – she’d somuch to be thankful for: a healthy son, good friends, the house. The money she’d inherited from her parents together with a contribution from Jeff, by way of payment towards Owen’s upkeep, meant she’d paid off the mortgage years ago. Since then they had managed on her modest income.

Fiona wondered if she should push Owen to get in touch with Jeff again. Maybe reviving his relationship with his dad would help him in the messy business of growing up. Contact between father and son had dwindled over time. Jeff had a second family now, much younger, and lived in Jersey. Jeff was punctilious about birthday and Christmas presents. He and Owen had exchanged emails regularly at first but that had trailed off. By the time he was twelve Owen was refusing invitations to spend the holidays with Jeff. But it would be so much easier, she thought, to be sharing all this, the animosity and teenage tantrums, with another parent.

In the bathroom there were dark splashes on the sink and the clothes basket and the floor by the toilet. Fiona reeled, grabbed the sink and felt the blood pound in her neck. Owen was hurt, blood everywhere, what had he done?! Cut himself, slit his wrists?! Blink , his blood on her hands, blink , his eyes rolling back, blink , the spasm that shook him. No! She remembered Hazel. Took a slow breath, took it deep. Stared at the black stains and smears and realized it was hair dye not blood. He must have done it himself while she was watching TV. She shuddered with relief. She rubbed the blot from the sink but the marks on the basket and the floor were permanent. Still shaken, but hugely relieved she hadn’t had a full-blown attack, she didn’t trust herself to tackle her son about it yet. Tomorrow would be better.