All the Things We Never Knew (19 page)

Goff says with the right mix of circumstances that are toxic—physical or sexual abuse, neglect or a detached parent, early childhood trauma, environmental toxins—you are much more vulnerable to mental disorders. In an ACT approach, the focus is not on reducing the frequency or changing the content of inner experiences, but rather on changing the patient's relationship to the behavior. ACT is successful in the psychological treatment of a wide range of problems, including drug dependence, chronic pain, epilepsy, depression, social phobia, work stress, and borderline personality disorder.

Chapter Thirteen

The night of the party, October 8. The temperature inside the car had dropped. Colin and I were still parked outside the party, in the same parking place in northwest Portland, but the world and my view of it had made a cataclysmic shift. I had begun the evening of October 8 thinking that maybe David was stabilizing. The divorce papers were drawn up, tucked away in a drawer until he appeared well enough to make decisions for himself.

I'd begun the evening thinking that Colin and I might be right together. We'd seen one another several times since our first date, and with every coffee or quiet dinner, I'd come to realize Colin
was
one of the “good guys.” I would have preferred a carefree romance and to have been more settled when we met, but I also felt instinctively that I should not pass up the best thing that had happened to me in years. It was as if I'd been drowning, and Colin had revived me.

Now, according to the officer on the telephone, David had broken into a home and stolen a gun. It was completely clear now that David was psychotic. I could no longer deny how seriously ill he really was or believe that he would somehow, magically, get better. The party inside the restaurant was still rocking. I could see dancers bobbing through the windows, but it seemed like a world I'd never be able to rejoin. Not now.

Colin hadn't moved during the entire retelling of the story. I half expected him to drop me off in front of my home and wish me luck with my problems. Instead, he cradled me in his arms. “Sweetheart, you've been through so much,” he said. “Let me help you.”

I wiped the tears from my eyes and imagined what I must have looked like to him, with my mascara-smudged mug-shot face and my legs shivering with cold. Those girls inside the restaurant party were unburdened, many of them daughters of Portland's most wealthy philanthropists. I'd needed to escape the party immediately to go to David. But now, I realized, Colin deserved this time, this retelling of such an important part of what I'd been holding inside. Given the seriousness of the story, I expected him to call the date our last.

“What are you doing with me?” I said. “Go, have fun.”

“I don't have a say in whom my heart chooses,” Colin said. “And it's crazy for you. It was from the very moment I laid eyes on you.” He smiled and put his thumb on my chin.

I stopped talking. The tension in my throat broke, and I cried, “I've never been so scared in my life.” I had never shared this level of intimacy about my marriage with anyone in my family, or with any of my friends. I had been too ashamed to tell those closest to me what my life was really like, how difficult it had become. Somehow, I knew instinctively that Colin was safe territory.

“It will be okay. You'll be okay. So will Sophie. I promise you.”

Colin started the car. “I have the girls all weekend. If you'd like to drop Sophie by while you deal with things, I will entertain her like the so-called Disneyland dad that I am.” He squeezed my leg. “Okay?”

“Okay,” I said. “Thank you.”

“Now, let's get you to the police station,” he said, pulling carefully into traffic.

“No,” I said. “I've got to go home. David's mother should know.”

 

MINDFULNESS

Mindfulness helps people cope with mental illness. The origins of mindfulness meditation lie in a Buddhist tradition dating back more than 2,500 years, but many therapists are now seeing it used successfully to treat patients with a wide variety of problems, including chronic pain, depression, and suicidal ideation.

Mindfulness has been described as “a particular way of paying attention: on purpose, moment-by-moment, and without judgment.”

Early sessions of mindfulness therapy concentrate on learning to focus on sensations, such as the breath. Later, patients extend mindfulness to thoughts and emotions, especially as they are experienced in the body.

In group mindfulness therapy sessions, participants learn to tune in to small experiences and aspects of their surroundings that would usually pass unnoticed and to work toward increasing the presence of nourishing activities in their daily lives (activities that lift mood and increase energy). An important aim of the therapy is to improve positive well-being, not simply to reduce negative emotions. Finally, participants learn to identify patterns of emotional response and negative thinking that act as warning signals for potential relapse and to help one another develop crisis plans, incorporating actions to take in the event of future depression, hopelessness, and thoughts of suicide.

For patients with suicidal ideation, riding the wave of their thoughts can be liberating. “What's going on here? What is this? Do I recognize this? Is an old tape playing? Do I need to engage with it?”

Two controlled clinical trials have now demonstrated that mindfulness-based cognitive therapy (MBCT) can reduce the likelihood of relapse by about 40 to 50 percent in people who have suffered three or more previous episodes of depression. In the book
The Mindful Way Through Depression,
authors Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn outline
why mindfulness can be so helpful for people with depression and reveal that, by cultivating the awareness-of-being mode, we can:

               
•
  
get out of our heads and learn to experience the world directly, experientially, without the relentless commentary of our thoughts.

               
•
  
see our thoughts as mental events that come and go in the mind rather than taking them literally.

               
•
  
start living here, in each present moment.

               
•
  
disengage the autopilot in our heads.

               
•
  
sidestep the cascade of mental events that draws us down into depression.

               
•
  
stop trying to force life to be a certain way because we're uncomfortable right now.

Unfortunately, many people attempt to learn the skill of mindfulness while they are in the middle of a full-blown mental health crisis. That is why the most successful programs involve early intervention and treatment.

Chapter Fourteen

Alice seemed discombobulated when I woke her. She looked around the basement bedroom, trying to familiarize herself with the objects in the room.

“Alice, he's missing,” I said.

She sat up, suddenly alert and on duty again. “Who, David?” Her face was ashen, drawn. She shook her head, trying to assimilate everything happening around her.

“He has a gun.” I told her the story of the phone call, the police officer. “You'll have to get dressed. We need to drive to the Columbia Gorge, where they are looking for him. It's near Multnomah Falls. A forty-minute drive.”

“Of course, I know where that is.” She rose in a flannel nightgown. My heart ached for her—an old woman, terrified from losing her husband, and now, possibly her son.

“I'm sorry, Alice.” I handed her a robe. “I'm sorry it turned out this way.” She still didn't seem to quite realize where she was. She wobbled and then sat back down on the bed. The death of her husband had been a terrible blow.

“Well, we'll just, we'll just find him, then.” Something tripped in her voice, and the brisk, efficient Englishwoman was gone, replaced with hurt and vulnerability. “Won't we? Find him? I'm sorry, I had a glass of wine with dinner.” She sat on the side of the bed, her hands on either side of her temples. “I must not have heard him go out.”

I calculated how much time we had left to deal with this crisis before I would need to pick Sophie up from her sleepover the next morning. She usually liked to stay for a big breakfast. No need to tell her anything yet.

We were halfway to the sheriff's office when my cell phone rang. I answered it, hoping for a miracle.

It was the same officer who'd called before. He sounded tired. “Ms. Hamilton,” he said, “don't come to the sheriff's office. Go directly to the Mt. Hood Medical Center.” My hand clutched the steering wheel; this was it—they would tell me that David was dead, or that he shot someone. I braced myself for the worst.

“Is David okay?”

“For now. He went back to the house where he stole the gun. He turned on the gas and tried to kill himself there. Then he went to an abandoned house up the road, where he tried to cut himself. Somewhere during the night, he fired off two shots; maybe as a test, who knows? It appears he's taken a bunch of pills, too.”

He was talking fast; too many images were jumbling in my mind. David trying to light a stranger's stove? Firing shots into the sky? This wasn't making sense.

“How did you find him?”

“He went back to the original house again, and the owner brought him to the hospital. Apparently he knew the woman whose gun he stole.”

The officer had no idea how confusing the information was, how much of a mystery I'd found myself in. I stammered something nonsensical.

“She called the police. She's the one who took him to the hospital. Do you know where the hospital is, Ms. Hamilton?”

My reporting career had prepared me for this disaster in ways I never imagined. I'd been to the Mt. Hood hospital twice before: once to report on three climbers who had been plucked from a
crevasse on Mt. Hood, and the second time to report on a young snowboarder who had been rescued after getting caught in an avalanche. “Yes,” I told him, “we're almost at the exit.” I held the phone inches away from my ear, as if dampening the volume might help me avoid this reality. Alice's eyes were wide as she waited for me to fill her in.

“I don't even know if I've got this right,” I said to David's mother as I turned the car into the hospital. “David is here. He's okay. He knows the woman who brought him here.”

“Thank God,” Alice said, staring out into the darkness. There were two emergency room technicians sitting on the back bumper of an ambulance when we arrived. One was smoking; the other was staring off at the moon.

The ER was empty, except for a small woman with blonde hair sitting in the corner. She looked frazzled; her skin was nearly translucent under the fluorescent waiting room lights.

“We're here to see David Krol,” I said. “We're his family.”

The clerk checked her charts and then motioned toward the other woman sitting in the waiting room. “Yes, there's another family member already here. She checked him in.”

My startled look must have given away my shock. “Did she say she was family?” I asked, not keeping my voice down.

“Yes, she did,” the clerk said, “but she couldn't show proof of relation, and Officer Rodale said she was the person who phoned in the call, so we thought something might be up. We haven't allowed her to go back just yet.”

I stared at the woman in the waiting room, a mystery figure in a ninety-pound frame. She wore a coat that was way too large for her, one of those green barn jackets you see horse people wearing, and English riding pants and boots. Her blonde hair was long with touches of gray, frizzy and unkempt. She tapped her leg nervously as she waited in the corner. I exchanged glances with Alice and then walked to the corner where the woman sat.

“Hi, I'm David's wife, Sheila,” I said. “You are?”

“I'm Diedra Collins,” she said quietly. “I'm a good friend of David's.”

I sat down across from her. “I've never heard him mention you. How long have you two known one another?”