Turning to go in, Zak felt a glow, warm inside. Peculiar. In bed that night, while one of the old fellas snored and the other muttered at him to put a sock in it, Zak figured out what the feeling meant. Safe. In here, turning in for the night, waking up in the morning, there was no fear. Except for the dreams. He was safe.
Fiona
The therapy wasn’t quite what she’d expected. No digging into her childhood or searching questions about her relationships or how she expressed her emotions. Instead Hazel Fuller began by taking an account of the circumstances surrounding her first panic attack.
As soon as Fiona began to speak, her mind flying back to that hot summer day, the boy on the ground, she found herself growing tense, her muscles retracting, her breath out of synch, words tangling.
‘I’m sorry,’ she said, ‘it’s still so-’ She stopped, wrestling tears. ‘I’m frightened it’s starting again.’ She was stupid, a child in the dark. How had she grown so weak?
‘A natural fear,’ Hazel reassured her. ‘Relax your hands.’
Fiona looked down at her fists, clenched, the knuckles white. Consciously she opened them, palms up.
‘And your feet.’
Fiona laughed, spread her toes, turned her ankles.
‘Breathe out.’
Fiona obeyed.
‘Wait,’ Hazel cautioned. ‘Drop your shoulders.’ She nodded. ‘Now, a steady breath in and draw it down into your diaphragm. And hold, and release.’
Once the breathing had calmed Fiona, Hazel explained that all their sessions would be looking at practical techniques that Fiona could use.
‘What do you know about CBT?’ Hazel asked.
‘I’ve read a bit online,’ Fiona told her.
‘Then you’ve probably seen that there are two elements to CBT – changing how you think and changing how you behave. We enable you to accept that however unpleasant the symptoms are they will pass, that you will not die or have a heart attack, that nothing is physically wrong. And we look at the physiology of what is happening – understanding that helps put it in perspective. As far as behaviour goes, we examine patterns that aren’t helping your condition and teach you ways of controlling your anxiety and rehearsing responses to hopefully minimize the number of attacks.’
Fiona nodded. Grateful.
‘You’re on antidepressants?’
‘Yes.’
‘Those combined with CBT offer the greatest chance of improvement according to the latest studies.’
‘Good.’
‘You’re a midwife,’ Hazel observed.
‘Yes.’
‘Think about your work, times when something unpredictable happens, when the mother or baby is at risk and you need to act quickly. Can you give me an example?’