Image: Nancy Fouts
Phase 1
PHQ 9
to audience
This letter is to confirm that we have agreed to undertake Cognitive Behavioural Therapy to help you address your current difficulties
difficulties
depression inventory depression inventory – four
anxiety anxiety anxiety anxiety anxiety – twelve
Goals for your therapy:
- To stop over thinking
- To think in a more positive way
- To deal with everyday stress/anxiety
anxiety anxiety anxiety
Clare sits down and opens letter
Over the last 2 weeks, how often have you been bothered by any of the following problems?
- Little interest or pleasure in doing things
- Feeling down, depressed, or hopeless
- Trouble falling or staying asleep, or sleeping too much
- Feeling tired or having little energy
- Poor appetite or overeating
- Feeling bad about yourself – or that you are a failure or have let yourself or your family down
- Trouble concentrating on things, such as reading the newspaper or watching television
- Moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or restless that you have been moving around a lot more than usual?
- (slows speech down gradually – significantly) Thoughts that you would be better off dead or of hurting yourself in some way
Clare passes letter to member of audience and picks up netball – holds it under her arm – strong, assured
Phase 2
Letter to body 1 marked changed of tone
I love you body
I love the way the skin is strong on me
I love you body –
you’ve been so good
I’ve been so sure of you,
so sure-footed – hopscotching rocks at a beach,
so sure
I love you body
I love how your brain hones in
on ball and body
calculating distance/trajectory/speed
needed for the certain intercept
A spell – exact recipe:
legs – launch
torso – smooth turns
arms – stretch
fingers – breach the Centre’s attack:
frustrate, set back and
the ball’s yours all yours
Start of first quarter umpire’s whistle is blown
Clare runs quickly to get in position for the match
Phase 3
GAD 7
(in a sing-song tone and after every ball bounce states an item from the list) Over the last 2 weeks, how often have you been bothered by any of the following problems?
- Feeling nervous, anxious or on edge
- Not being able to stop or control worrying
- Worrying too much about different things
- Trouble relaxing
- Being so restless that it is hard to sit still
- Becoming easily annoyed or irritable
- (again slows speech down gradually – significantly) Feeling afraid as if something awful might happen…
she rolls the ball away slowly
Phase 4
Fun with Kids 1 Goobledegook child’s recording plays C3:1 silly noises – again huge contrast to seriousness of before
They are crazy. Are they all this crazy? A shifting heat that pushes back at the cold snap. Why is it so difficult to be in a dark place when they’re here… and they’re always here? The funnies I wanna love and protect more than anything are always here. Here when I just want to be dark, here when I’m the best, most fun mum and I can be dark and I can be such a massively fun mum, I know I’m a good mum. Am I a good mum? You’ve told me and told me and you’ve written it to me, just like I could write you – endless.
Clare looks back at the chair, then retrieves the letter and sits down with it
Phase 5
Birthday Cake 5 Aspects conversation with therapist
Clare: It was before a birthday party. I always thought I would love birthday parties. I love what they give. I do not love birthday parties. I’m good at birthday parties. I can do a good one. I am good at them. I’m not bad. I was making the birthday cake, just making it and it was a bit messy and there was noise – quite a bit of noise…
Therapist: And what did you notice – what did you notice in your body, what did you feel?
Clare: I felt fidgety, fidgety and tense, y’know on edge. I could feel it, feel it starting and getting worse – the breathing
Therapist: Where did you feel it?
Clare: Here. (signals to chest – shoulders – head – outside) It’s in me – in here and its outside, outside too, in, in the (pauses, struggles then speaks) noise. In the breathing and in the noise.
Therapist: How intense were the feelings – between zero and a hundred percent?
Clare: (iffy, approximating – gesticulates whilst answering)
feeling tense – eighty percent
irritability – eighty five
Therapist: What were your automatic reactions? What would other people have seen you doing?
Clare as herself: I’d be banging cupboard doors, getting louder – really banging them and clattering in the sink and all the time saying nothing. Or, or doing the opposite – saying something – ranting, a circle of ranting that can’t seem to stop. And I step out of it, I listen to it and I say ‘Who is that person going on and on – It’s not me. I don’t want it to be me.
God, don’t let it be me.
Phase 6
Acrobatics with 4-yr-old as Clare says the first two lines she twists the chair around
Clare: Hey my boy-oh – do you want to go flying?
Clare as Gil: Yearrrhhhhh
Clare kneels on the chair
Clare: I throw him on to the bed and jump on next to him – laughing, guffawing, tickling and kissing the least cherubic of all cherubs all over his little spotless face and golden hair. He is crazy – some have said wild – it makes for some difficult situations, I struggle, I love it.
Clare jumps up into crouching position
Clare: ‘Jump on boy-oh!’ – He launches himself as usual, then grapples shakily – hands holding hands. Feet positioned under his tummy and raising him into the superman position. We perform several acrobatic moves – each time collapsing on to the bed, each time he squeals, shrieks and wriggles seemingly oblivious of the fact that falling in the wrong direction could mean disaster. But I hold him, the knee is holding him up. Even though it often aches around the joint now – sometimes when I’m just sitting still.
I watch him on the school run, its morning – charging, leaping, invading everybody’s personal space as he passes – not caring. I enjoy watching other adults’ reactions – usually bemused or chuckling to themselves (Oh what
I’d do to not care like that!) Hurtling forwards – with his usual determined frown and his arms flapping. ‘What are you doing love, what are you doing lovely boy?’
‘I’m trying to fly, I’m flying.’
Laughs when replying ‘Yes, that’s it – try it again, keep flying. Keep going, even when I’m not here to prop you up.’
Umpire’s whistle blows in particular way to signal end of the quarter.
Phase 7
Diagnosis section on Therapy Blueprint Soundtrack marks contrast/change
How did the problem develop? What things led to the problem?
Tendencies towards orderliness and perfectionism, intensified through having a third child and moving home.
Social anxiety – caring too much about what others think.
Phase 8
Doctor’s opinion / Ben’s opinion
I saw the doctor yesterday. It was a particularly bad half term so I did it, I spoke to him – told him about the tenseness. I always thought I’d love having my children around me in the holidays, perhaps my standards are just too high. Within five minutes I was clutching a prescription, he hardly took time to talk or speak about the alternatives.
Eyes come, go:
screen, hands, screen, face, screen, me?
You ask for the potted history:
fifty second film-wrapped setback on a plate.
It is outside, separate. It is not yours.
No, it’s not yours.
You would have to mangle a whole body
into a head, into a shoulder, into a lung –
stretching down with pinky toe,
ring toe, until every toe
and membrane mimicked mine.
Until your calves – caught,
knees – translated onto knees
(torn cruciate ligament on the right.)
Until your flanks deciphered soft grazes
on the lodes,
on the hair-wisps of thighs.
Midriff overlapping midriff, touching
every episode, exposure on the soft,
Linea belly Negra line.
This line is my line.
This face is my line.
You can’t transpose a middle – every cell: event imprint
A chest – circled and sucked clean of milk,
like the milk: infusing growth / feeling into bellies, bones.
You can’t map a muscle memory of arms, hands –
warred in sport and
loss-circled in grief.
Or an ecstasy that rockets in the throat, announces to the head
to be moved by art, a one-off action,
or by uncomplicated, childlike joy.
And you can’t become a body –
lying on a dark bed. When everything is out of reach
and can’t quite be grappled with either.
And you can’t become a body –
lying on a bed. Become a body, when everything is out of reach
lying on a bed. Become a body, when everything is out of reach. Become a body that can’t
quite be grappled with either.
You can’t, you can’t, you can’t.
So you prescribe these pills instead.
I take the prescription, fold it neatly in my wallet (where it will stay for months) and walk home.
Good old Ben. Always says the right thing…always has to say the right thing. Said it was all normal. I don’t need to do anything about it – never have needed to really have I? No. I mean it’s only been a few half terms when it’s got overwhelming. Just a few half terms. Pretty normal really. He says. He does say that. What if I think I do need it? What will he say then? If he says I shouldn’t do it, but I think I need to, should I just do it? I’m sure he just wants to help – to tell me it’s normal. He knows he needs to tell me it’s normal. Sometimes I’m sure he’s itching to… to have something that will help in those times.
Phase 9
Work and Social Adjustment
Please look at the questions below and give a number between 0 and 8 to describe how much your problems affect you in each area:
- Work
- Home Management
- Social Leisure Activities Clare picks up ball and bag and takes to stage right
- Private Leisure Activities
- Family and Relationships
Phase 10
Letter to knee
Talking to knee, whilst crouching with netball
Hey knee, don’t let me down. You’ve served me well old thingumajig, been knocked about, battered, picked apart and sewn up by surgeons.
Clare unpacks sports bag with kit for match, then puts up hair and adjusts trainers
And they treated me fast, cos they knew I was a sportswoman and I was unusually pushy and I was proud. They knew I played all over the place and it was important, important I get back to it. Even when I’ll never do it at any level higher than this – too old, too many babies, too many injuries. It is important, it is.
Pause and continue re adjusting trainers – leaving last statement in the air, then starts putting knee support on
Knee – keep it together, I know you – you’ve come this far. Just watch it when you coming down from a height, when I land from that jump – hold it together, don’t buckle. I’m not ready for that yet. You’re still important,
Netball moves in following section, finishing with sprinting at full pelt
Sometimes I daydream about going further. Dream about playing for a top team, the time I tried out and didn’t do things by halves. (When I’m motivated, I don’t do things by halves.) The time when I took the super-league team’s training schedule and stuck at it, right down to the small print. And I was fast then, the fastest I’ve ever been. I was running everywhere, circuit training, interval training, weight-lifting (even took the weights camping!) Training, training in a field, on a court, right-handed, left-handed – me and my friend Hannah – we trialled, I was thirty. Maybe it was too much for you – not long after you gave up. Had to have you unpicked and mended. Perhaps I went at it too hard for a thirty-year-old? I know I was too old and had too many other commitments, but it was good to know that I was as fit as them – that was the feedback. I matched them for fitness – those players – Camilla Buchanan, some of them England players – Naida Hutchinson. I matched them.
Phase 11
Ruining Christmas Clare is completely out of breath and panting, takes steps to recover breath and drinks during next scene
Mum says, ‘We’ll come to you this Christmas. We’ll come to you. I can bake and bring Christmas cake, mince pies, yule log. Would you like a yule log? What would you like? Let’s make it easy!’ She says.
Is it normal for the idea of hosting to fill you with utter dread? I convinced myself it would be ok, I could do it. I can’t expect Mum to do it every year. The timings would all have to be precise though. Everything would need to be planned, so it was ordered, not chaos. The food prepped the night before…
In fact it would be best if I didn’t have to go in the kitchen, makes me on edge – pressured situation – bad insulation, cooking, steam – wet kitchen, stressed me, Christmas dinner. No.
Ben loves to cook, but his timings are bad, can I deal with bad timings? He can cook…The time I ruined Christmas.
Clare gets party popper out of bag then pops it sarcastically and picks up the streamers and shoves them in her hair
Phase 12
Fun with Kids 2 moving to hiding position, pretending to be Flora
I love her quirky ways, like spending time – just us two. My girl ninja – the stealth specialist who makes a habit of creeping up on people, laughs and jumps at me as if she’s pulled off the ultimate deception. I pretend to be shocked, amused.
Clare sits cross-legged
She’s standing in front of me as I sit on the bed, requesting I video her as she rolls her eyes in separate directions at the same time – very proud – then dissolves into giggles and bows repetitively to an imaginary audience, ‘Thank you, thank you, thank you!’
What will you remember when you’re further away from me? Will you remember these things – the eyes-rolling video, or the times when things were a bit too much for Mummy to cope with, the tears in the bedroom?
God, I don’t want that to be how it is.
Clare crawls to chair, whilst beginning to say the next section
Phase 13
Perfectionism, OCD, Social Anxiety
I like to do things well. I feel a strong feeling of fear in social situations that won’t go away.
Heart racing and pounding.
I get pleasure of achieving what others can’t do. It makes me feel special.
Tense muscles.
I get satisfaction knowing I’ve tried my hardest.
Sweating.
I think others are judging me.
Breathing changes.
I like being prepared for every event. Sometimes I’m so afraid of failing that I never get started.
Feeling jumpy or restless.
If I can’t do something perfectly then there is no point even trying.
Stomach churning or butterflies.
People will think I’m boring or strange because I can’t make every-day chit chat.
If things and objects in my life are not in the correct order, or out of alignment I feel distressed.
I can write, but I can’t talk. I can write, but I can’t talk. I can’t talk. I can’t talk. I don’t like noise…
The perfect Christmas host!
Phase 14
Benefits
Stands up and moves forward to address audience
Don’t get me wrong, most of the time we’re all just plodding along as usual. Usual, ‘normal’ usual. There are good times, there are really great times.