“Give me your sharps,” she said.
I stared at my new therapist. She was a blond athlete. She could have easily beaten me up.
She reached her hand out. “Give me your sharps. Now.”
“Why?” I protested.
“You have two choices,” she said. “Either you give me the glucose kit, or we don’t do this.”
I held the kit in my hand. “But what if it’s actually a blood-sugar issue? What if I die because you took this kit away from me?”
“I’m willing to take that risk,” she said.
“Well of course you are!” I fought back. “You’re not the one who might die!”
“You’re not hypoglycemic. Now, give me your sharps.”
“You don’t know that! You’re just a psychologist and not even a real psychologist. You’re just a grad student. You’re not even a real doctor!”
She adjusted her glasses. “Do you know what I majored in undergrad? Sports medicine, specializing in diabetics who play sports. I’m completely prepared to assess what a blood sugar crash looks like.”
Out of every fucking therapist-in-training I could have gotten, of course, I would have gotten the one who was a diabetes expert.
I hadn’t been able to tell my parents that I was in therapy because, if I did, think of the other questions they’d start to ask. The entire Jenga tower of lies I had so carefully crafted would crumble. There was only one way to be in therapy that they would never know about. I went to the University of Toledo’s psychology department, where they have one of those free-for-the-public therapy schemes, where you receive therapy from a grad student aspiring to be a therapist.
I handed her my sharps. “I’m gonna die. You have to know that I’m gonna die.”
“No, you’re not,” she said, snatching the glucose kit from my hand before I had a chance to change my mind.
“I spent money on that you know, you’re literally stealing my property that I worked hard for.” I tried going for pity.
“Hmmm,” she said. “Great point. Let me ask you, in the twelve to fourteen months that you’ve been using these every day, how much money do you think you’ve spent? And remember, I’m well aware of how much those strips cost.”
She was right. I had spent hundreds, maybe even a thousand dollars within the last year. But at the time, a thousand dollars seemed like a small price to pay for my freedom.
She stared at the bruised and purple tips of each of my fingers. “How many times a day do you prick your fingers?”
“I don’t know, maybe four?” (I was lying.)
She inhaled, annoyed. “I’ll ask again. How many times a day do you prick your fingers?”
“Um… ten?” (I lied again.)
“Your fingertips are completely swollen and purple.” She rubbed her eye, becoming increasingly irritated. “How many times a day do you prick your fingers?”
“I don’t know!” I finally shouted. “I don’t count (a lie), maybe like twenty or something?” (There we go.)
She handed me some papers. “Time’s up. Take these home, fill them out, bring them in next week.”
I looked at the papers. The first one was about Exposure Therapy, and what it meant to engage in it. The second was a questionnaire with questions like, Do you sometimes hear voices that nobody else hears? The other was a consent form, acknowledging that I was going to be partaking in physical activities and that I wouldn’t sue the university if I got hurt or died.
Exposure therapy, for those wondering, is, “therapy that involves exposing the patient to the anxiety source or its context without the intention to cause any danger. Doing so is thought to help them overcome their anxiety or distress.” In short, exposure therapy is a bitch. It forces you to do all the things you don’t want to do. And non-stop exposure therapy started the minute I left that office. I was out in the world, forced to live without the one thing that made me feel safe. I was now a crack addict without his bump. I was antsy, easily agitated, and mad at everything around me.
I had considered buying a new glucose kit the second I left her office. But I was completely broke, and my entire life had been destroyed by anxiety. As terrified as I was, I was willing to do anything to overcome the panic attacks. Even if that meant facing death head-on.
A week had gone by and I was back in the therapist’s office. I had spent much of that time avoiding the world. I went to work with candy in my back pocket for moments when I felt a blood sugar crash coming. After work, I went home and hid in my room. I felt like I was agoraphobic again.
“You were agoraphobic this entire time,” she said, crossing her arms.
“How am I agoraphobic?” I argued. “I was going outside and living a somewhat normal-ish life before you took my damn kit away!”
“Were you stressed and anxious while outside of your house?” she asked.
“Sort of,” I replied, losing confidence.
“And did you need to test your blood every hour, sometimes more, to make sure you were ok?”
“Well, I mean… yeah.”
“That’s because you’re agoraphobic. You never overcame your problem, you just found a coping mechanism that turned into an addictive ritual.”
“Listen, Sarah…” I said, trying to take control of the conversation.
“It’s Samantha,” she replied.
She was playing hardball. “Ok… Samantha. I’m trying really hard here. I mean, I’m the one who initiated therapy. I get that I’m fucked up. But you gotta understand that I’m doing my best.” I tried playing the sympathy card again to little effect.
“You’re what, twenty-five years old?” she asked.
“Twenty-four.”
“Okay, twenty-four,” she said, leaning in, “you’re a young man in the prime of your life, and yet you’ve let panic and anxiety control you. I know you’re trying and so I’m doing my part as well. You’re young, healthy, and in shape. I’m not going to treat you like a sick old man.”
She went through my questionnaire and made sure I signed the release form in the right spots.
“Great!” she said, giving the first glimpse of actual interest. “Looks good. We can start doing exposure exercises next session!”
Yay.
EXPOSURE EXERCISE 1
Toledo, Ohio is a weird little place. It was once an industrial town that was destined to be the Chicago of Lake Erie, but after its economy collapsed in the 70s, that never happened. Ever since then, Toledo had been losing jobs and population, and has had a steady rise in crime and drugs.
A great example of this contrast is the train track that runs straight through the campus of the University, a relic of Toledo’s glory days. Our first exercise was to walk the tracks. No shade, no shelter. I was to feel the wide openness and the brightness of the spring sun beaming down on me. I wasn’t allowed to bring any snacks or water. Samantha would say those are just crutches.
“So, how are you feeling?” she asked as we walked aimlessly.
“How long do I have to be out here for?” I asked, hoping this little jaunt would come to a quick end.
“Depends,” she said. “How are you feeling?”
I thought maybe I could make this end quicker if I pretended this was giving me more anxiety than it was. I feared that if I stayed out there too long, I would have a panic attack. I was still worried that maybe I had an actual illness.
“I’m um, not doing well actually. I’m, feeling kind of like, a panic attack or something…”
Before I even had time to react, she lifted my shirt and started rubbing her hand on my back.
“Whoa!” I shouted. “What the fuck!”
“Your back isn’t sweating,” she said in disappointment. “Let me see your hands.”
I was shocked. This bitch just lifted my shirt up. Who the hell did she think she was?
“I said, ‘let me see your palms,’” she said in a way that I haven’t heard since kindergarten.
I reached out my hands and turned them over so my palms were showing. She started rubbing her hands around my palms.
“Your back and your palms are dry,” she said, looking down at me. “When you start panicking, the first signs are almost always a sweaty back and sweaty palms. You’re lying to me.”
I tried justifying my lie to her. “I’m just scared,” I said, sounding pathetic. Even I was annoyed with myself. “I don’t want to die on some train track in Toledo.”
Samantha set down her notebook and put her hair in a ponytail. “Well, now we’re gonna make you sweat. We’re going to run until I say stop.”
Now I was sweating. Running, in the heat without water or chocolate? If I was ever going to have my epic hypoglycemic crash, this was it.
“What? No!” I yelled. “This can’t be allowed. Aren’t there rules for my safety or something?”
“You signed the form,” she said. “Now, run. Or, we stop therapy.”
That constant threat of ending therapy. God damn that woman.
We ran the train track. I tried doing more of a jog than a run. My goal was to be as slow as possible to avoid depleting my sugar levels. Samantha wasn’t having it.
“Speed up!” she said, almost effortlessly, as if she wasn’t using up any energy at all.
I sped up. We ran until I started to get panicky. My fears got to me. My legs started feeling like Jello. All I could envision was myself dying on the train tracks of the University of Toledo, a college I never even applied to because I felt it was so far beneath me. My heart raced. It was hard to breathe.
“Oh my God! Stop!” I yelled as I fell, gasping for breath.
Samantha sat down on the tracks next to me as I struggled to catch my breath. She watched me silently. My breathing started to stabilize. My heartbeat slowed. Then came that post-panic attack coma, where nothing matters anymore.
“Are you finished?” Samantha said.
I looked at her, stunned. “Am I finished?”
She ran her hands through her blond hair, enjoying the spring air. I had never met such a heartless asshole in my entire life.
We walked back to her office mostly in silence. I took it slow, still feeling drained. She gave me some space, allowing me to walk as slow as I wanted. I kept telling myself I wasn’t going to die. I was terrified that the exhaustion I felt wasn’t the result of a panic attack, but was my sugar levels running on empty.
When we arrived at the office, I sat down in a big plushy chair. I felt myself sink into it. It felt great. I wanted my entire body to sink away into a deep sleep that could restore my energy and reboot my system. Samantha opened up a bag and gave me a bottle of water.
“Nice job today,” she said. “Next time, don’t lie to me.”
I left her office and couldn’t wait to get to my car where I had stashed a bar of chocolate. I knew that, without it, I’d have another panic attack on the drive home.
EXPOSURE EXERCISE 2
A few weeks had gone by since the last exercise. The previous weeks’ sessions had been me and Samantha bickering back and forth about hypoglycemia. What it was, who could get it, the signs of a blood sugar crash, and so forth. She kept reminding me that if I wanted to devote my life to researching an illness, I should at least focus on one that I had. She reinforced the idea of agoraphobia over and over again.
Her main argument: if it’s blood sugar crashes, why do they only happen when you’re outside of your house?
My main argument: I hate you. You don’t know me. You’re mean and evil.
She made it her goal to not only get me reacquainted with the outside world but to do everything she could to challenge my belief about the blood sugar crashes.
It was almost the end of the semester at the University. The campus was bustling with students eager for their summer break. Samantha and I took to our normal routine and walked the campus. It felt nice to be around all the students. They all seemed so innocent and naïve, completely unaware of how awful the world could be. It made me wish that I could go back to my life before anxiety. I wanted to be nineteen again. I had always hated my life, but nothing in my past compared to becoming afraid of the outside world.
“So,” Samantha said, “you’ve gone about a month without the glucose kit. How are you feeling?”
I didn’t tell her that I had replaced the glucose kit with a stash of chocolate and candy. “It’s been okay.” Keep it light. Keep it simple. Avoid further questions.
“Have you been anyplace?” she asked. “Do you ever walk around the mall? Or a park? Do you ever explore?” She didn’t care if I was trying to avoid the topic.
I watched as a hot guy walked past. He was in an electric-blue tank top with green shorts. His biceps were flawless. His calves flexed with every step he took. He was tanned. He was the guy I wished I could have been. He was also the kind of guy I was extremely attracted to. It made me both horny and sad to look at him. Horny because he was hot. Sad because he was living the life I never would.
Samantha nudged my side. “I asked if you’ve been getting out in public or not.”
“Um, yeah, sort of,” I said halfheartedly.
She could tell I was lying. “Alright then, let’s amp this up a bit.”
We walked to one of the main buildings, University Hall. Next to it is a hill. College kids were lying on the grass, reading in the warm sun. Some were playing Frisbee. Guys were talking and laughing, girls were tanning. It was exactly what colleges look like in 90s movies.
“Alright,” Samantha said,“here’s what you’re going to do: you’re going to run up the hill and then roll down it. And then you’re going to run back up the hill and then roll back down it. You’ll do that until I say stop.”
I looked at all the college kids, so full of youth and virility. And then there was me, about to be making a complete fool of myself in front of all of them.
“This has to be a joke. There are people everywhere,” I tried pleading.
“Do you want to get better?” Samantha said. “Now, get up that hill.”
I sighed, ran up the hill, then rolled down. I was a little dizzy but felt better than I thought I would. I ran up again and rolled down a second time. I noticed I had started attracting some attention from the college kids.
“Dude, people are staring at me. Can we please stop?” I tried reasoning.
“Up the hill,” she said, putting her hands on her hips. “Now.”
I rolled my eyes and ran up the hill. Aside from the fact that this was humiliating as fuck, I noticed it was a beautiful day out. The grass was a bright emerald green, the sky, a welcoming blue. I think that was probably one of the first times I had noticed and appreciated my surroundings for a long time.
I rolled down the hill and stood up. I was starting to get dizzy. Then, a really hot college guy walked up to us.
“Dude!” he said as he approached. “Is this, like, some kind of workout or something? I bet it’s a killer full-body exercise, huh?”
I just stared at him, mouth dropped. He had amazing blond hair and the sharpest jaw-line ever. He looked like those hot guys from 80s slasher movies. I had no idea what to say. I couldn’t have been more embarrassed. I looked at Samantha, and she looked back at me.
“Ugh, yeah,” she said. “I’m helping him train for track and field.”
I was impressed that she jumped in to help.
The guy seemed impressed as well. “Damn, that’s awesome!” he said, nodding his head. “Hey, my frat is going to have a party this weekend. We’re calling it pancakes and booze. We’re gonna, like, make a bunch of pancakes and drink beer. It’s gonna be sweet! You both should totally come!”
Was I seriously just invited to a party? The first party I’d ever been invited to in my entire life? While I was in the middle of a therapy session?
“Sounds great!” Samantha said, patting my back. “We have to get back to training, but we’ll be there this weekend. Hey, buddy,” she said to me cheerfully. “Do another run up the hill for me.”
I glared at her. She knew damn well I couldn’t fight her about running up the hill when there was a cute boy standing there. She knew I’d play the part. She was a crafty bitch. I ran up the hill. As I got to the top and turned to roll down, I could see the frat guy had begun walking away. Thank god. I couldn’t keep doing this for much longer. I rolled down the hill and stood up next to Samantha.
“We’re not going to that party,” she said. “That would be inappropriate.”
I brushed the grass off my elbows. “I figured.”
“How are you feeling?” she asked. “You seem to be holding up pretty well.”
And she was right. I was so busy focusing on a pancake-eating frat boy that I had somehow forgotten about the normal anxieties that swirled around inside the walls of my inner-world.
“I’m kind of dizzy, and I sort of feel like I could throw up,” I said.
Samantha shook her head. “Well, I guess we’ll just have to keep running this hill until you get more exhausted. Up the hill!”
I had learned by this point that fighting her was pointless. I went to go run up the hill, but before I did I slipped in a little “Bitch” under my breath.
I could hear Samantha yell, “I heard that!”
Because of my insubordination, she made me run the hill another few times. Finally, I rolled to the bottom and collapsed. I was going to throw up. I could feel the bile rising.
I laid on the grass, facing the sky. “I’m done! I can’t do it another time! I’m gonna throw up.”
Samantha stood over me. “It’s pretty hard rolling around on a full stomach isn’t it?” she said, pointing to the chocolate bar poking out of my pocket. “Have we been using a new safety mechanism?”
I rolled on my side. “I’m gonna throw up. Don’t yell at me.”
Samantha sat down in the grass. “You’ve been making good progress. Even if you have been cheating with sugar. You’re actually making quicker progress than almost anyone who comes into our office. I need you to believe in yourself. I need you to see that you can easily overcome this.”
It felt good when she was nice to me.
She picked a blade of grass and started making knots with it. “Next time we do an exercise, you can’t eat beforehand. Not even breakfast. I want you to come on an empty stomach. I’ll be checking your pockets.”
She said these things as if they were easy. But, I was starting to feel better. Being out in public was slowly becoming less daunting. Getting through the day at work was getting easier, and getting out of the house didn’t feel so awful anymore. I noticed the changes but didn’t want to give her any credit.
EXPOSURE EXERCISE 3
Another month passed. Samantha and I had spent the past few sessions talking about anxiety and depression, and how the two fed into each other. It was now late June and time for another session of exposure therapy. It was a beautiful, warm, and sunny morning. Toledo is a shithole, but we have some amazing summer weather. Sam had called me the night before and told me this was the day, so come without having breakfast or snacking on anything. I had a banana on the drive over.
I sat down in her office. She was smiling. I should have been immediately alarmed.
“I have something special planned for today,” she said.
I gulped.
“Let’s walk,” she said.
We started walking through campus and I could hear loud music blasting from somewhere. It was Ozzy Osbourne, “Crazy Train.”
The University of Toledo has a shitty football team. But even though the team sucks, the school is still Division One, so the campus has a huge football stadium, the very stadium we were now walking towards. A stadium that I soon learned was responsible for blasting Ozzy.
As we walked closer to UT’s stadium, known as the Glass Bowl, I started getting nervous. There was something nefarious in the air, made obvious by Sam’s giant smile.
“Sam,” I asked sheepishly, “what are we doing?” If she had chosen to feel my palms, she would have noticed that they were drenched.
“You’ll see,” she said with summery cheer.
We entered the stadium through the team entrance. As we made our way through the building, I could see the bright light of the outside world ahead of us. It was the football field. We were about to walk directly onto the field. I could hear a commotion from outside, the yells and grunts of hyper-masculinity. “Crazy Train” ended and AC/DC’s “Thunderstruck” began.
We walked out onto the turf, and I could see what was happening. The football team was in the middle of summer training.
“Sam, what the fuck? Are we even allowed to be here?”
We walked right up to the team as they practiced in their navy and yellow uniforms. I could smell Under Armour, sweat, and manhood. I was horny and I was scared. Sam knew from our therapy sessions that I had a fear of straight men. She knew how ugly I felt around them. How small, how insecure, how intimidated they made me feel. Especially the alpha-male jocks.
She walked up to the coach and started speaking to him. She was an athlete and she studied sports medicine. She must have known both the coach and the team. That must have been how we were able to get access to the stadium during training.
As she spoke to the coach, I stood awkwardly off to the side. The team was having a huddle. I stared at them, sweating. They stared at me, drinking Gatorade. Sam walked over to me after shaking the coach’s hand and laughing with him. She was having a blast.
“Alright, so here’s the deal,” she said, pulling her hair back into a ponytail. “You’re going to run up the bleachers, then down the bleachers, and onto the field. When you get to the field, you’ll spin in circles until I tell you to stop, then you’ll run back up the bleachers. We’ll do that until you feel like you might collapse.”
I wanted the ISS to explode and de-orbit, slamming into her at terminal velocity. I wanted a school shooting. I wanted anything that could keep this from happening.
“You want me to run onto the football field while the team practices?” I was frantic.
“Yes!” she said with glee. “Come on, this will be fun!”
“You fucking planned this. This entire moment was planned out. I fucking hate you!” I was done being nice.
Sam smiled. “The more you yell at me, the more energy you’re going to waste. You wouldn’t want a blood sugar crash would you?”
That’s when I said it. I looked her in the eye and said, “Fuck you, cunt.”
She was unfazed. “Run the bleachers, now.”
I bolted up the bleachers. I was over it. I wanted to collapse and get this over with as quickly as possible. I was running in the blaring sun, without being able to have breakfast, as a D1 football team watched. I would have preferred death.
I ran down the bleachers and onto the field.
“Alright, now spin!” Samantha cheered on.
I started twirling around, screaming “Fuck you!”
“Alright, stop!” Sam ordered. “Now, back up the bleachers! Go! Go! Go!”
I bolted back up the bleachers, stood at the top, and took a deep breath. Then, I ran back down onto the football field. Sam had me spin in circles again before sending me back up the bleachers. When I reached the top, I looked out over the field and noticed I had attracted the attention of the entire football team and the coaches. I ran back down onto the field.
“Sam, they’re all staring at me! Can we please go somewhere else?”
She ignored me completely. “Okay, spin!”
I spun around until I was dizzy.
“Now, back up the bleachers!” She loved every moment of it.
As I started running back towards the bleachers, I turned around and screamed, “I hope someone fucking murders you!” Then up the bleachers, I went.
Sam yelled at me from the field, “I’m sorry what did you say?”
I was at the top of the bleachers now, and I no longer had any fucks to give. So I screamed at the top of my lungs, “I said, I hope someone MURDERS you!”
I ran back down the bleachers onto the field, where Sam had me spin again.
“You know, it’s weird,” she said as I spun in circles. “I thought you were convinced you’d have a blood sugar crash? And yet you have the energy to keep yelling at me. How interesting.”
I stopped spinning. “Burn in hell!”
“Does it make you feel better when you say bad things to me?”
“Yes!” I shouted.
“Whatever gets the job done. Carry on.” She couldn’t have cared less.
I started up the bleachers again. “Bastard! Bitch! You’re a fucking bastard bitch dick whore! You dick whore!” I was incoherently stringing together any bad word I could. “Slut! Cock shit bitch!”
Thank god the football team wasn’t able to have cell phones in their uniforms. Because, if they did, there would be some very surreal viral videos on YouTube right now titled “Kid With Tourette’s Goes Crazy At Stadium.“
I was so pumped up with rage and adrenaline, I hadn’t even noticed how tired I was getting. I ran back onto the field. My legs were wobbling so bad it was hard to stand. I was breathing hard.
Sam looked at me, then handed me one of the Gatorades from the team’s cooler. “Alright, take a seat.”
I fell onto the grass and chugged the Gatorade. Sam sat down next to me. The football team kept practicing as if we weren’t even there.
“I want you to think back to a few months ago,” Sam said, “when we first started. Do you think you would have been able to run the bleachers in front of the football team?”
I answered honestly. “There’s no way in hell I would have been able to.” I hadn’t even noticed how much progress I had made until I looked back. Running bleachers without breakfast is something that actual athletes do, not fucked up gay boys with agoraphobia. It was pretty unbelievable to think that I had just done that.
“Alright, let’s go back to the office. I have something to give you,” she said.
We walked back to the office. My legs slowly stabilized on the walk back. My breathing calmed. I was starting to learn that your body can recover on its own. Wobbly legs can stop wobbling. It doesn’t mean that you’re going to collapse. I felt free from something. I had just accomplished a task I didn’t think possible. I felt strong and brave.
Back at her office, Sam handed me my sharps back. “Here,” she said, handing me the glucose kit.
I looked at her confused. “You’re giving this back to me?”
She nodded her head. “The next step is for you to keep these, but to have the confidence that you don’t need them.”
I looked at the glucose kit. That kit had both liberated me, allowing me to go outside, and enslaved me, forcing me to depend on it. I didn’t want it anymore. I didn’t even want to think about going back to that life. I held it in my hand. Unsure of how to feel.
“Alright,” Sam said, “that’s it for this week. I want you to know you did a really great job. Remember this until we meet next week: you don’t need that kit, and you never did. The next time you think you’re going to have a panic attack, just remember screaming that you hoped someone would murder me… in front of an entire football team.”
I laughed. “Yeah, sorry about that.”
Sam smiled. “Don’t worry about it. I’ll see you next week.”
I walked out of her office, still holding the glucose kit in my hand. I made my way down the hallway, fiddling with it, refamiliarizing myself with its feel. Near the exit, there was a trashcan. I looked at the glucose kit. I took a few seconds, wondering what might happen without it. But then I remembered those hot football players. They probably aren’t slaves to glucose kits. They probably don’t even comprehend the idea of death yet. They’re too young, too healthy.
I wanted to be young and healthy too.
I opened the trashcan and threw the kit in.
I walked out into the bright summer sun.