Dear Cary,

Over the past few months, I have written this letter a dozen times. At moments, I would give anything for someone to wave a wand and let me know what I should do, but at the same time, I cannot bring myself to believe there is an easy solution to my issue.

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Apparently, I am unlovable on certain levels. When I write this, I do not just mean as a person, but also the efforts of my hands.

My parents were both pedophiles, and I grew up feeling less real than that life-sized doll my mother bought me at age seven so I could have a "friend." When puberty finally rendered me into a monster to them, I was relieved -- but the abuse never stopped. It just changed character. Suddenly I became irredeemable and disgusting. My older brother spent most of my childhood tormenting me, which typically made my parents laugh or chastise me for not fighting back. Even though it pained me beyond words, his uncontrolled anger made me cut off contact with him when I did the same with my parents. My ex-husband spent 12 years of our 14-year marriage encouraging me to be on fertility meds while he knew he had taken measures to never have children (measures about which I knew nothing) because "God told him that He wanted me to be alone." I only found out what he had done when I hit menopause early. God's hatred was how he rationalized his actions when asking me for the divorce. For six months between that request and the marriage ending, he told me nearly every day that he had never loved me or wanted me or even liked me. He had married me out of pity. Given my family, no one else would ever be able to want me. It has been four years since then, and I have only now begun to date again. Finally, I thought I had found someone with whom I could at the very least enjoy physical contact and to whom I could give some delight, and yet he broke up with me so he could go back to the woman who had pureed his heart.

I am blessed to have some good friends -- although one just got demoted because she suggested I commit suicide rather than continue to try to find success as a writer and artist. Her rationale is that my ex has remarried a woman with children (making her more worthy than me), and the agreement that he and I made during the divorce should be made null and void. She swore my ex had convinced her of this and said I would do it if I were "honorable." This is because he actually has useful people that could use the help promised to me. After all, I am only an artist. I am only a writer. I barely make enough from my craft to keep working at it and feed myself.

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Other of my friends seem to pity me, although they are usually tactful enough to not say it out loud. One in particular has demanded that I never speak of my past or of how I might feel or if I am lonely, because they love me "despite those things" but "should not have to hear about it." Most know how hard I worked to make my PTSD non-symptomatic; they can see how much time I put into trying to make my work financially sustaining; they utter praise about my determination. All of them have opinions on what I should do to magically become a success -- write differently, try more marketable types of painting, go to this gallery or submit to that magazine or this agent. I always take what they say seriously, but sometimes what is requested of me is not something I can creatively do or manage psychologically. I have lingering social anxiety, so telling me to cold-call 100 galleries and talk about how awesome I am is not something I can actually do. At least not without laughing or crying.

Once more, I have created a very long letter to you and I don't even quite know how to approach what I'm asking. Whatever it is in me that made my parents act the way they did toward me; that made my brother see me as a punching bag; that encouraged my husband to keep me from having children because there was nothing in me worth continuing on for another generation; that made what had been a good friend decide my suicide is preferable to my living the life of an artist; that encourages people to tell me that I ought not to share my past, thoughts or emotions; and that made this last attempt at connection decide his heart-stomping ex was better than taking a chance with me may be too deeply ingrained in my being to be fixed. No matter how much navel-gazing I do, I cannot point to a specific thing in me that causes this reaction in people. Granted, I am not a supermodel. In truth, I am flawed and damaged and strange -- but so are most of the people I know, and they do not suffer this persistent isolation and rejection.

Art and words pour out of me every single day, to my great delight and comfort, but I feel powerless to throw them out into the world at a faster pace or in a more determined manner than I already do. While I cannot take everyone's well-meaning advice, I still surely need help.

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Maybe this is what I need to know: How do I keep going when I am the only one that finds value in what I do and who I am? I cannot force people to like my artwork, or my words or my self -- and yet, without such things, how can I gird my loins enough to keep going?

Art and writing seem to be all I'm good for -- and I am blessed beyond words to have this outlet -- but how on Earth do I get out of this vacuum and into the world?

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Thank you for reading this,

Art or Death?

Dear Art or Death,

At first I thought this would be a letter from someone thinking about killing herself, but it is not that. It is a letter from someone asking how to continue living. The first thing that comes to mind is that if you had a technique that let you banish certain things people have said and certain past events from your present consciousness, that might make life more comfortable. You mentioned PTSD. If you could decouple these memories from your limbic system, perhaps life would be more comfortable. I don't know too much about, this but I have read and talked with professionals about EMDR -- eye movement desensitization and reprocessing. My sense is that it works. Also conventional talk therapy works. Having a safe space in which to consider these questions you raise here seems to work. Anything that can give you a buffer zone will be helpful. Also cognitive therapy could be helpful by allowing you to reframe some of the verbal messages you are entertaining in your mind. So there is much hope for you. I view some of this as fairly mechanical. That is, your brain is accustomed to doing certain things, but its patterns can be changed. As I said in yesterday's column, however, we are still stuck with us. That is, my telling you that EMDR, conventional talk therapy, interpersonal therapy and cognitive therapy can all be helpful does not mean that you will have the resources and planning ability to avail yourself of them. So you might have to start first on getting well in some more fundamental ways. How organized is your life? If you are producing paintings and writing, then you must be fairly good at planning, taking steps, making agreements, showing up at appointments. I sense that you are fairly good at what I guess would be called organizational and "executive" functions.

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I am getting this feeling, or this memory now, of what it feels like to have reached the limit of conventional functioning; that is, I am remembering what it feels like to hit the wall and have to approach the world anew, with baby steps. I would say that in a moment of spiritual crisis, which is what you are in, it can become suddenly difficult and yet profoundly important to simply make an appointment somewhere and show up. And if you are an adult who is used to functioning well in the world of showing up to work and greeting clerks and taking the right seat on the bus, it can come as a shock. But this is the spiritual breaking point. This is how we know that we are at the spiritual breaking point because routine actions are suddenly alien; we are not sure what shoe to put on; we must look at our ticket over and over to make sure it is the right one. For instance, I will have periods where I do not seem to be able to look at my calendar or read my email. Something else is calling me. I don't feel good about this. I wish my "executive capacity" were greater and more in tune with the requirements of the world. I am trying to suggest that you may be in a similar state, and that the reason this happens is that when we reach a turning point, it takes everything we've got. Emotionally and spiritually we are called upon to exert everything. There is not much left for polite conversation and showing up on time. This state, which I think most people reach occasionally, may be expressed in anger or in leaving, in drinking and acting out sexually, or in making sudden extravagant purchases. It may be expressed in many ways. It may be expressed as depression if the decision is made to do nothing or to turn it inward and voice despair. What we must do is learn to hear this voice of spiritual or emotional need and tend to it. For instance last night I found myself irritable and shut off and for the first time in maybe 30 years instead of knocking around the house like an angry, depressed figure, I inquired what was going on, what was I worrying about, what was I fearful of, and this had positive results.

It has taken a long time to learn to do this. But since I have learned to do this it seems reasonable that others can as well. I am no different from you. It is no easier for me to learn to do this than it is for anyone else. Some people are much, much healthier emotionally than you and I are. I guess they were lucky. It doesn't mean you and I can't learn to do the things we need to do. So this is what I say to you: I know what it is like to be beset with painful memories and have certain thoughts repeat themselves, and to carry a feeling of anger and woundedness and betrayal and sheer befuddlement at the unfathomably rude and clueless things people will say and do. I know what that is like, and I know that it is often more attractive to go there than to truly try to change. It is more attractive sometimes to burrow into the sorrow and stay there waiting for rescue. The awful thing is that we will never be rescued when we burrow into our sorrow. No one is coming for us. If as a child we are hurt and we go in the closet and cry, eventually an adult will come for us, or we will eventually open the door, red-faced and ashamed, and there will be some comfort somewhere. But these days, as adults, when we sink into our woundedness and victimhood, perhaps doing it metaphorically and invisibly or perhaps doing it quite openly, there will be no rescue. There is no rescue from this; there is only determined improvement. We are alone in the universe. There are no parents either cruel or kind. There are no parents of any sort. We are on our own and must seek whatever remedies exist and take them in the manner in which they are available. We must show up whenever an appointment can be made. We must keep doing whatever has even the smallest chance of success.

My role is to say that this is doable: There are therapies that will lessen the intensity of these feelings and give you some detachment, some breathing room and some techniques for self-care and self-nurturing. It is up to you to seek these things out and accept that they might seem strange at first but still to give them a try and be a beginner again and just give modern medicine and psychotherapy a try. Believe me, I say this with all my heart: The pain of trauma survivors is great, but there are many techniques that can work to lessen it. One must only do the footwork.

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All that is required of you is that you ask for help and do the footwork. You don't even have to act grateful for the help. You just have to receive it.