The part-time treatment was to begin with a psychological examination: various interviews with therapists and a psychiatrist. But about a week before these interviews were to take place, things at home were getting out of hand. I was annoyed with my mother, and my father defended my mother by reacting aggressively to me, which made me very angry with him and we started swearing at each other, whereupon my mother said to me: “Timeout, timeout”, which made me feel like I was being punished for my anger like a small child, and that my father could do anything to me with impunity. In the end, I cried for a long time.
Eelco de Smet, who had referred me to the clinic at the time, could still remember me from the previous year. He especially remembered that I constantly corrected myself when I said something wrong. He thought I had changed a lot, and it felt good that someone had noticed, because after all, I had worked very hard on that. I spoke very openly about my therapy at the clinic, that I had mainly talked about my sister and the trauma I had suffered because of her. We also talked about sex and love. He suggested that at that moment, those might be the same for me. I did not agree, but later I came around to this view. At that moment, I did indeed see them as the same. And something else that came up was that I had many sexual fantasies about women (which he considered SM-like), but that I found the intimacy of sex repulsive. It was a very pleasant conversation, and I felt very much seen.
I was also supposed to write a short life story before the therapy really started, so that the therapists would know something of my history. In this short life story, I talk about what I was like as a child, and what development I went through in the clinic, with the knowledge of myself that I had then. At the end, I said that it is important to me that I am independent, that I’m able to see the other person, and that I see positive and negative feelings united in one person. And Eelco was able to help me with this. So I had a lot of faith in the therapy. I also had a conversation with one of the sociotherapists, Karin, about my daily activities. I also had the sense that I was well understood there. I also had a conversation with the psychiatrist Lieve, who was affiliated with the center on a part-time basis. What I remember most about that conversation is that she asked me if I had been beaten as a child. This was a bit of a shock to me, because no one at the clinic had ever asked me that question so directly. I answered in the affirmative, and when asked who did it the most, I replied that I did not know. I found it very scary to think about this. I also told her about my aggressive fantasies, which made me feel very powerful, and of which I was also very proud. Some people wonder why I was proud of aggressive fantasies, ”that’s nothing to be proud of”, but for me it was totally new to feel these feelings that were never supposed to be there, and so it was a big step in my development, because every person needs their aggression, albeit in a controlled way for most people (but I didn’t know that then), but still! It ensures that you can withstand attacks, it is your defense. It is your ‘own feeling’, your ‘own power’, the passion in your body, you can fall back on it when you feel bad, and it ensures that you remain standing if someone attacks you. It allows you to get excited about something, for instance sexually. And of course we have seen earlier in my life story what happens when these feelings are not allowed to exist and you direct them destructively at yourself!
Finally, I had a systemic conversation with my parents and Tineke, another therapist. With the event from the week before that had gotten out of hand in the back of my mind, I said: “I am afraid of my father, and he is afraid of me.” Tineke brought up the subject of boundaries. Whether there had been any in our home, and how my parents felt about setting boundaries for me. My parents replied that they had always found that difficult. I interjected and said: “There certainly were boundaries!” to which Tineke said: “Yes, I understand why you would say that!” I then got the feeling that my parents were seen as helpless parents, and I as the boy who terrorized the place with his supposedly unlimited personality. I sensed that she had no idea what kind of therapy I had undergone in the clinic over the past year, or what trauma or traumas I had dealt with. It was as if they were simply trying to determine which of us had the most severe disorder, and that person was then to blame for everything and couldn’t be right about anything else. Very amateurish. Angry people can also be right and justified in their anger.
In the time that followed, I would increasingly feel fear for the therapists there, who seemed very fake, ignorant and narrow-minded to me. I started my therapy in the intake group, which lasted a few weeks. I got used to my therapy group members and to the therapists. But I felt that everyone was much closer to each other than was the case in the clinic. In one of the first weeks, I already told the sociotherapists that their behavior made me anxious. They were very controlling, unlike the therapists at the clinic. They continued to control me and others, but I felt supported because they knew how to reassure me, even though I had no idea what was going to happen.
There was a nice girl in the intake group and I tried to impress her. She was aware of this and she sometimes hinted that she had noticed that I was flirting. I felt like I was under attack, even though she didn’t mean it that way at all, but partly due to the controlling attitude of the therapists, I had the sense that she was very dissatisfied with me. Fortunately, I was reassured by Brenda, the psychomotor therapist, who said that after all, I was still working on it.
After a few weeks, I moved on to the past & present group, the group best suited to working on your identity, according to Eelco. What I remember from this first period was that the therapists did occasionally indicate the direction I should take. Miranda, the creative therapist, wondered why I fought so hard against my fear: “Why don’t you just let it wash over you?!” She also said that I tended to overreact, and that I was supposed to find a middle ground, while still maintaining my qualities. At least, that is what I understand now, looking back. But at the time, I thought she meant something else and it felt like rejection. But I didn’t ask any questions because I still could fall back on my aggressive fantasies, every time someone insulted me. I would feel much more rejected in the time to come. Once, during psychomotor therapy, we had to choose a spot in the hall and I had sat on top of a cupboard, with some cushions around me. Then a group member asked if she could have one of my cushions, to which I said ‘no’. Then the therapist told me I had been unkind (is that what is expected?) and that I had deliberately chosen a high place to feel safe (understandable if I did not feel at ease). If this had happened in the clinic, I would have received a compliment for having stayed in control by not handing over the cushions and seeking a safe place, but apparently you weren’t allowed to feel safe here and you always had to be nice. At least, that was my interpretation. When I discussed events like these in sociotherapy and said that I felt unappreciated, they would say: “I don’t think you feel unappreciated, I think it’s just confronting what we say,” which would then make me feel unappreciated again. I tried to let all the fear, which was building up nicely, just wash over me.
In the first evaluation, I describe how I have been confronted a lot and that I have been incredibly afraid of being angry. I describe how I have felt stuck between my sister and brother. And I describe that I hardly ever act out my tensions at home in a destructive way and that I am working very hard to build up activities. And I tell him that I no longer see ‘control’ as a mistake (but that was mainly to justify the controlling behavior of the therapists). Eelco describes that my behavior can be summarized in a symbolic medal with two sides: on the one hand, I can idealize people tremendously, and on the other hand, I can devalue them considerably (not appreciate them), the psychological splitting. And I recognized that. I am also told that I should be especially naughty in the coming period, and that sounds like music to my ears. However, I wasn’t gonna be very successful…
A nice break was a vacation to Barcelona, where I celebrated my 21st birthday with Theo, Kim (Theo’s girlfriend), my sister Lauren, and two other girls we also regularly visited in their student house, Mariëlle and Lieke. We got along very well in this group and it was the best vacation ever for me, because I still felt very good back then. Everyone laughed at me because I was still taking analog SLR photos at the time, while everyone else already had a digital camera. But we have many photos from back then, and it’s fantastic to look back, because everyone is radiating very positively.
After the vacation, by which time I was 21, it was back to therapy. I was in the second period, and what I remember is that there was an enormous confrontation. Eelco confronted me with the fact that I was obsessively throwing myself into activities and that I was going beyond my limits, which caused me to go from doing everything to doing nothing in one fell swoop. I was afraid of not being good enough, so I stopped doing the activities and became passive again, despite the attempts of a sociotherapist to get me active again: “But it will make you feel so proud! Do it anyway!” But for me there was no in-between, that was just how I was made. Furthermore, at that moment all I could do was cry, whereupon Eelco emphasized to me that my boundaries would be taken seriously. I told the group sessions that I was very afraid of Eelco. I contributed about identity and spontaneity and told them that when I was angry with my mother and my father said something, I would then direct everything at my father! In the time that followed, I discovered even more about myself.
After therapy, I regularly walked to the city center to have a drink at a department store café. I always enjoyed this. One time, there was a woman with twins sitting at a table a few feet away from me. We got to talking. At one point, she asked me what I did in daily life and I told her about my therapies. I told her that I was also a twin. And she was very nice. At a certain point I wanted to tell her more, and I told her that being a twin had caused me trauma. And what she said next shocked me and made me think. She said: “But then maybe your parents made a mistake.” This was about the worst thing you could say to me. Because saying that someone had done something wrong was worse than hating someone terribly, in my experience. I hated my parents at that moment, but I pretended that they hadn’t made more mistakes than other parents. After all, that was what Anke van Brunssum said in the systemic conversation with my family and me. What’s more, in the clinic I had learned therapy from Gerna, the music therapist, to not talk in terms of “you did this wrong” and “you are to blame for this”, but rather in terms like: “how was this for you?!” And “this is how it was for me!”. This incident in the café was actually the stepping stone for me to take a clear look at my parents (despite all the hate), and to articulate what I thought they did wrong, and believe me: that image did not correspond with what Anke and Desmond had thought all that time about my family, and what made her decide to send me to part-time education. One evening, I was angry with my parents again and I told them so; my brother was there too. I told them I was angry that my father always reacted very aggressively when I was angry, and I was angry with my mother because she always stood by and watched and never intervened when my father went too far. This was incredibly brave of me, but I did not get the desired reaction, and my brother even stood up for my parents. I did not talk about it in therapy because recently I had not gotten the impression that it was rewarded in this therapy if you said something negative about your parents. After all, I was that boy who could get so angry, and I had to restrain myself and not say anything negative. If only I had told what I knew back then, but I just couldn’t. I felt the pressure from the group and the therapists was just too great, so I kept it to myself and forgot about it.
My aggressive fantasies increased throughout the second period, especially towards Eelco, but so little attention was paid to this that it only got worse. I was very suspicious. I couldn’t express it there because this part of me was completely ignored, and this caused my head to almost explode during my second evaluation. On the outside, however, I behaved decently. Eelco said that my sexuality would change in the next period, and that I could talk about that subject in therapy. This made me even more suspicious, and just at that moment he told me that I so badly want to feel real contact, and that my aggressive fantasies destroy this intimate contact. I went home surprised, I had never heard this before, and before I got home something strange started to happen to me. I felt myself relax… Instead of the fantasies, Eelco came into my head and I kept hearing him say: “your aggressive fantasies destroy intimate contact!” And intimate contact was my greatest wish at that moment. With women, at least. My aggression began to subside, I felt the enormously accumulated forces slowly sinking down into my body. I tried to fight it, but I just couldn’t, because Eelco was there, in my head. I hated it. I started to feel weaker and weaker and felt my sexual identity changing, against my will. Because in my aggression I could identify with men, but now that I was apparently letting go of my aggression out of survival, it seemed as if I was starting to feel more and more feminine. There was a reversal between who I want to be and who I became. I was totally confused and shared a lot about my sexuality and how my parents reacted to me at home when I was angry. I also told them that my father could become aggressive towards me, to which Eelco said something like: “He was clumsy!” At that moment I was also afraid that my ability to get aroused by women, which was very valuable to me, would disappear even more through the therapy, to which Eelco said: “Women can also get very angry!” After which I had the feeling that I was no longer safe anywhere and became even more confused. Eelco thought and believed that I was gay. I did not agree with him, because I did not feel any romantic attraction to men. I only wanted friendly contact with men. I also did not feel any sexual arousal towards men, although I could appreciate their bodies. I said that I loved women, but Eelco said that I was not capable of a mature relationship with a woman (probably because I could not accept their anger). And that if I did start a relationship with a woman, it would be a “lesbian” relationship. WTF! At that moment, I no longer had the feeling that I had any control over others, and that I could be satisfied with myself. The fear increased, and the compulsion slowly returned. Would it get even worse? Would I start to feel the same way as before I started the therapies? This startled me so much that I summoned all the fight left in my body and tried to push it to the surface with all my might. I got myself terribly worked up, but I couldn’t manage to fantasize aggressively. I was furious! And I felt the excitement not in my head this time, but throughout my entire body. But I had no idea what to do with it. My head was completely filled with aggression, but it wasn’t the usual boundless fury, no, it was controlled aggression. And then the therapists at the therapy session suddenly said: “Now you are allowed to be angry!!”. Then I became even more furious inside, because they had completely fooled me, by totally ignoring my anger in the past period and not confirming it at all. If I were to express my anger now, I would be judged by the therapists if I was doing it right, I thought! I might get a reaction, and that was exactly what I was so afraid of. Because it wouldn’t have any effect, they wouldn’t take me seriously, because it felt like THEY were controlling me, like they were playing with me, like predators with their prey. I felt like a figurative play toy! I couldn’t take it anymore and kept everything inside. At that moment, Eelco said I was dangerous! Several times he urged me to share what I was feeling, but I refused, because I subconsciously knew it would only lead to loss.
But the longer I kept my anger inside and the more that happened in therapy, the more strange feelings I started to have. It was the summer of 2005, and my sister had set up a tent in the garden to sleep in for fun. I would also sleep in the tent for the fun of it. It was something different than lying in bed feeling bored. And that night, among other things, I had delusional ideas. I again had the delusion that I had a woman’s body, very overwhelming, and I was convinced that I should undergo this sex-change operation, that I would surely feel better then. It even turned me on when I thought about it, which I found absolutely awful at the same time. And when I brought this up in therapy, I had to cry a lot again and Eelco said that I was becoming almost psychotic, but apparently he was still hopeful that I would work through it. I had fears of merging (as if I would merge with some of my “internal objects” (inner representations of important people in your past) that I had previously wanted to keep at a distance with my rage), and he also said that he clearly wanted to point out the difference between Lauren and me, that we were two different people, and that I shouldn’t have slept in the tent with her. As if it was my fault that I had those fears! Moreover, I felt that it wasn’t my sister that I merged with in my head, but my mother! I felt like I had to be like her, the therapists said. I also felt like I had to be gay, even though I wasn’t interested in men at all, but everyone kept trying to convince me that I was gay. Even a gorgeous girl I had a crush on. That felt awful. You should have seen how those women enjoyed emasculating and dismissing a boy. I still tried to trust the therapy: if I continued, it would get better on its own, because quitting was not an option: then everyone would be telling me that it wasn’t wise. In my third evaluation, I described in detail what was happening and I wrote about what I thought Eelco wanted to hear: that I was getting better at accepting my feminine and homosexual feelings (although I didn’t want to and it felt like the therapists were responsible for this). But I also described that I felt very bad and that I suffered a lot from anxiety and compulsion. But I did not get any support for my feelings. I felt so worthless and the only thing Eelco de Smet said was: “The compulsion has increased, but those are immature mechanisms!” He also said: “You are supposed to go do lots of things, otherwise you will still be here next year!” I felt abused and I didn’t dare to say it, those therapists felt so incredibly powerful. “You portray us as very powerful!” they sometimes said, but there was nothing I could do about it, it was just part of my ‘blueprint’, my system. I felt that they were trying to push me to express my anger. Eelco said: “You are no longer afraid of being controlled!” In other words: what’s stopping you from expressing your anger? On the one hand, I now looked down on them intensely, but on the other hand, I still had hope. So I continued. I was overflowing with anger, but I was also very much aware of the reaction that followed every time. As a result, at a certain point in the group session, I described how my father used to repeatedly hit me in the face and shake me furiously when I was angry. This was incredibly brave, but the only thing Eelco said was: “Did it ever happen?” At which point I thought he thought I wanted to escape therapy by saying that. I felt the pressure was so great that I lost touch with my own feelings and could only express myself destructively towards the therapists, or in a very well-behaved way. And that sweet, well-adjusted behavior was rewarded and noticed every time, but it didn’t feel like it was me. I remember that at the time I would sometimes feel like everything was happening on autopilot. And meanwhile I felt alienated from what I said and did, a kind of depersonalization. I felt so much hate, but could not listen to it, because I felt I would not survive it. I was torn apart! My personality split in two. And every time I tried to express my anger, it was always in an awkward way, and I felt like I was being disapproved of again, which made me cry a lot (“that crying will probably last a while”, Eelco once said), causing that bit of strength to disappear from my mind forever. And that controlling (or manipulating) was done in a very clever way: Eelco kept telling me that I wanted nothing more than intimate contact, and I was reminded of the moment I spoke to him during the second evaluation, when he said that my aggressive fantasies destroyed intimate contact. Then I had to cry a lot, because I had such a need for intimate contact, and that caused me to be disapproved of again. Eelco interpreted my sadness as if I was mourning about the things that weren’t present in my family, but in my head a completely different story was playing out: I was crying because I felt belittled again! But I didn’t have the strength to express this.
Once I thought back to something Anke had once said. Someone in the clinic had been very angry. And Anke understood that very well and put it into perspective. She said (more or less): “Sometimes damaged people test whether they are still allowed to express their feelings in contact with the therapists!” When Eelco once asked me why I had been angry during that turbulent time, I said: “It was like a test!” Eelco had absolutely no understanding of this, and he came back with the usual line that I wanted intimate contact so badly.
At a certain point I was so distraught and destructive that once again my fellow therapy patients turned against me, which caused me to cry a lot again. At a certain point I had been completely silenced. I had no defense left and everyone was all over me, loyal to the therapist as they all were. (They would have called it adapted behavior in the clinic …). From that moment on, I felt totally alone. Dead. Broken. Estranged. I walked to the bus station on autopilot, without it seeming like it was me who was walking. I could feel that this was going completely wrong. I was on the bus, and I no longer recognized the places I was passing through. I knew where I was intellectually, but the feeling of recognition was completely gone. Total derealization. I also had no emotional memories of the past whatsoever, everything was gone. The first thing I did when I got home was to hug my mother and seek her support. And she supported me like she always did so well! But I was going out of my mind. I thought I was going to die. I thought: I have to go back to the clinic! This can’t be happening! I suddenly thought of Dick, a fellow therapy patient in the clinic who had been psychotic and ended up in the clinic. His therapy was abruptly stopped while I was still fully engaged in it. He supposedly had a defense mechanism that prevented them from getting his aggression up. And because of that, he would have to live a very structured life for the rest of his life to prevent deterioration. I remember well that he said he would have to go on living like a vegetable for the rest of his life. This was terrible. And I was convinced that this also applied to me! That increased the fear even more! And it was unbearable!
The next day I had to go back to therapy, but I was panicking about returning. My mother drove me to the therapy location, and we went in together. I wanted to ask the receptionist if Eelco could come down, but I immediately burst into tears. Eelco came, and we had a conversation. I told him that I was so terribly anxious and felt so alone. He said: “It’s good that you are addressing this.” Such an irritating therapist’s catchphrase, to which I said he could go to hell! He would fill in the details of my story every now and then with: “The aggression is ‘in there’!” – by which he meant that the aggression was in my system and that I was now allowing it to completely overwhelm me – and: “You are cut off from contact inside.” He asked if I wanted a time-out and I agreed. I would stay at home for a few days. I spent these few days at home mainly taking doses of Oxazepam, sleeping a lot, but also keeping busy, because that was the last therapy tool I had been given by the therapists, and I did my best to comply. It did not make me feel any better.
I felt awful: extremely gloomy, anxious, angry and desperate, but I refused to believe that the therapists would let me go in this state. I kept telling myself that if I continued the therapy, things would get better on their own. I was unstoppable! So I called again after a few days to arrange when I could start again. Eelco told me he wanted to discuss it in a personal meeting and that I could bring my parents. At the meeting, he said he did not think it was a good idea for me to continue with therapy. He said that they had put a lot of pressure on me in therapy, and that I had a vulnerability, so it was better to stop and say goodbye. I thought: who caused that vulnerability? You did!! Who exposed that vulnerability: you!! You bastard! But I was all adjusted again. I felt like I had been cast aside, as if I had failed in therapy. As if two years of intensive therapy had been pointless. I told him that I now felt worse than before I started all the therapies, to which Eelco assured me that I was no worse off. After all, I was no longer compulsive, but to be honest, I just didn’t dare to do that anymore because he had said it was immature. And what else did I dare to do? Nothing, really. I had become a patient for life.
In one of my last conversations with Lieve Deruyter, the psychiatrist, she told me that I was never really allowed to express my anger at home, but that I was allowed to be angry, even though I now had the distinct feeling that I wasn’t. And she assured me that the process I had been through over the past year was not irreversible. And then I totally looked down on her, because I thought of Dick, the vegetable, and knew that Lieve was not right.
Since I was diagnosed in the regular hospital (2003), my antidepressants had been increased considerably. After the clinical therapy in the psychiatric hospital, when I felt so good, I had even partially reduced them, but in the last periods of the part-time therapy, when I was having such a hard time, they were increased again, even doubled, “just as a helping hand! So not as a deterioration,” Lieve and Eelco assured me. But when this almost maximum dose did not sufficiently help with the anxiety, I was also given an antipsychotic for the first time in my life, which was increased to a fairly high dose, ”just as a helping hand! Not as a step backwards!” But the expected progress that would ensure that I would no longer need my medication failed to materialize and has not yet materialized. I was too badly damaged.
The worst part was that I couldn’t figure out what had actually happened and what part the therapists had played in it. When it was time to say goodbye, they acted as unfailingly as ever, as if nothing had happened. That was awful. They just carried on with their little manners and techniques, and they let me go in this state without looking critically at themselves and admitting their own mistakes, although Eelco did say that it was their responsibility, but I didn’t know what exactly that entailed. I had to figure out for myself what went wrong, where the mistakes were made, how it all works psychologically, and so on. That is really hard! They had placed so much trust in their therapy, and it had all been for nothing. At one point in the part-time therapy, when I could no longer fantasize aggressively, they assured me that I could be there as I really was, but I did not go home with that feeling. I felt the conditional love that I had experienced in my family in the past, and which now, with this event, came crashing in again. Because I was not what they thought I was: I was as I was when I left the clinic, that was the real Jesse, back then I was still standing on my own two feet. Back then I had the extra space in my head that I had always needed so badly to keep my great fear (of real and actual danger!) manageable. This was unbearable. And I was furious, but I kept it all inside. By putting a lot of pressure on me, not validating me and challenging my boundaries, the therapists hoped that I would express my terrible anger and defend my boundaries, so that I would gain more self-confidence and then be able to let go of my anger and push my boundaries! And at first glance, they thought that was what was happening to me. But that was not what was going on in my head, as I have already made clear. The therapy had a completely different effect than what was intended. If their assessments had been correct, and I had not suffered serious trauma with my parents, then after this therapy I would have been diagnosis-free. Unfortunately, things turned out differently for me, and I was completely confronted with a serious trauma that you can only escape or fight against if you want to survive. And it was precisely these ‘escape and fight mechanisms’ (black-and-white thinking, aggressive fantasies, disengagement) that were taken away from me. And when they saw the effect this had, they also admitted that fleeing was justified. But by then I could no longer flee: the damage had already been done. Now I know that Anke and Desmond, the therapists from the clinic, should not have redirected me to this part-time treatment. There was too much at stake. Apparently they were willing to take the risk, and I may have unconsciously misled them. After all, they brought up this subject several times: the time after therapy when I had knocked on Desmond’s door several times because I wanted to talk to him about it in person. And the time that Anke asked me what exactly I was afraid of when I held in my anger. It is the job of a therapist to confront his or her patients with the trauma they have suffered and to make the patient understand it. That was done well with the trauma to my sister, but not with the trauma to my father. Out of great fear and shame, I also unconsciously avoided talking about it. I denied that part of myself. Sometimes I feel very guilty about that, but believe me: it is unbearable to look at the damage all of this has caused with feelings of guilt, so I try not to listen to it here…
