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One year ago this week, I ended 23 years of therapy with R. It was time; I was ready.

I want to share my experience of this past year, tell you what I’ve noticed and learned, and offer some thoughts on how I’ve changed and how I haven’t.

First—I miss R.

Outside of my family, she was the most consistent presence in my life for 23 years. She was a maternal figure, someone I relied on and trusted. She taught me almost everything I know about recovering from a lifetime of being unwell. I hear her voice in my head when times are rough.

And, dear readers, right now times are rough.

Things at Stern Enterprises (as my friend Liz calls my endeavors) aren't going well. In every category except for pets, the mood at Chez Stern is bleak.

I share this not so you’ll worry, but to be transparent about my own mental health struggles.

This newsletter is my effort to help de-stigmatize such anguish, to make the invisible visible, and to openly unearth the unseen unconscious forces that can steer a person off course.

I tell you this because I know that a lot of people are going through a desperately tough time.

If you are struggling right now, please take heart that I am with you. You are not alone, even if you have never felt or been more alone in your entire life. 

Moments like this test my ability to weather life’s squalls on my own, without a therapist. My 23 years in psychodynamic therapy taught me a tremendous amount.

My therapist gave me names to identify my all-encompassing wordless despair, and everything she taught me, I write about here, so you too can have the tools and language to identify your invisible pain.

R’s expertise, manner, guidance, and methods saved my life. There is no getting around that. Without her, and without my sister Kara, who has stood by me through all serious bouts of clinical depression and panic attacks, I am certain I would not be alive today writing these words.

When I began therapy in my late 20s, I was clinically depressed, tormented by relentless suicidal ideation, and despite being on antidepressants, still imprisoned by my lifelong panic disorder.

Having a panic disorder impacts every day of your life; it’s an exquisitely fraught existence when even breathing feels dangerous. You are trapped in a chronic invisible battle, with little relief, and the life that is happening around you is secondary.

Living alone inside chronic terror that no one can see or help you with is, well, traumatic.

It’s not living.

It’s easy to understand how being exposed to the physical terror of combat would cause veterans to suffer from PTSD.

it’s harder when the terror is invisible.

We are adept at identifying external causes for trauma, we can point to specific events or situations—terrorism, a home invasion, domestic violence—but we spend less time understanding how living alone inside the horror of a mental health condition can also give rise to trauma.

Imagine being trapped alone inside a body that feels unsafe at all times; that mistakes routine things (like leaving your house to go visit a friend) unpleasant feelings (like worry) for life-threatening danger, yet instead of helping you, everyone around you keeps dragging you toward the things you fear will kill you.

Now imagine living inside that existence as a small child. 

That it went undiagnosed and untreated until I was 25 is just bad luck, but like any physical injury that goes ignored for too long, the harder it becomes to treat.

By the time I arrived at my therapist, I was in my late 20s, and had lived all my years without ever being treated for anxiety, much less a panic disorder, which by then had sprouted into a variety of other anxiety disorders and clinical depression.

Medication alone barely scratched the surface; I needed real help.

In the late 90s, talk therapy was the main form of therapy. The public didn’t know about EMDR, Somatic Experiencing, or the range of options we have now.

By the time I started therapy, I had not experienced life without an inner terrorist. Therapy, alongside antidepressants, helped me understand my panic and anxiety. It offered me tools and techniques for communicating with others and talking myself down and through.

Through the years, my therapist took my disorganized thoughts, synthesized them, and reflected back. She made me feel known and like I counted. She taught me how to self-reflect, how to take myself seriously and stand up for myself.

She helped me understand that the way I process things is first as an experience in my body (which we all do, but my body-mind is very sensitive and excessively loud) and that things feel much easier once I turn the embodied experience into language, which she taught me how to do (and is part of what I try and do in this newsletter).

This past year, I have come undone, really undone, twice.

I am currently in the second undoing.

As I’ve been trained to do, I study the inner workings of my distress and despair, taking stock of the patterns and textures, the contours of my internal anguish.

As I’ve studied myself this past year, I’ve noticed how I’ve changed, and how I haven’t.

Talk therapy helped me deal with the symptoms of my panic and anxiety and my clinical depression. It helped me grow up, draw boundaries, know when to end a relationship, stop putting other people before myself, say no, communicate, and rely on myself.

It’s an effective treatment for the thinking mind. It’s a wonderful tool for processing thoughts and stuck beliefs.

But here’s the thing—having a lifelong panic disorder means suffering somatically (in the body), and if the body itself doesn’t get therapy, also, only one part of your condition is being treated.

The thing that has remained the same, all this time, are the negative beliefs about myself that my panicked body absorbed as truth.

When you suffer from a mental health condition as a child, you suffer from childhood trauma, which moves with you into adulthood, if it’s not properly treated.

And it’s my belief that the proper treatment for embodied childhood trauma, is talk therapy (for the mind) in conjunction with intensive somatic work (for the body).

A year out of therapy, I understand now, that for people like me, the mind and the body both, must be in two different types of therapy.

I believe talk therapy is necessary and that everyone should have a therapeutic experience at least once in their lives.

But I also believe that for those, like me, with deeply embedded somatic conditions, there must be adjunctive, long-term therapies, like Somatic Experiencing and EMDR.

Of course, this is wildly expensive.

I could only afford a handful of EMDR sessions. It was insanely helpful, but I didn’t do it long enough for it to make a real dent.

Therapy changed me for the better. It made me smarter, self-aware, and emotionally intelligent. It taught me how to advocate for myself, recognize patterns, name and communicate my feelings, stop joking about things that are sad, and face the sadness.

It taught me that I am more capable and smarter than I was raised to believe, and that my values—wanting to live a life of genuine connection and authenticity with people who don’t take me for granted, treat me well, and value and respect my time—will often leave me lonely.

Because there is a double-edged sword to getting better.

Once your condition is under control, the world you’ve been hoping to access and live in becomes available to you. But finding others ready for genuine connection is incredibly hard.

When we expect things from other people, we are often disappointed.

Expectation gets you nowhere good, which is why the Stoics warned against it.

Talk therapy saved my life, and had I been able to afford it, trauma therapy would have reached the somatic place a voice cannot.

So, if you suffer from trauma, especially childhood trauma, and can afford to, consider integrating trauma-informed work with talk therapy.

And if not, keep reading this newsletter.

Until next week I will remain…

Cover image by Edwina White