All up in her business

Illustration: Charlene Potts

I am what you might call an excellent candidate for therapy. Outwardly, I seem like a pretty normal, well-balanced person; but, to use a cliché, appearances are deceiving. I’ve been pulling out my hair—a compulsive condition called trichotillomania—since I was 12 (and I’ve given myself bald spots a few times because of it). I have an eating disorder, ED-NOS (“not otherwise specified”), which means that I fit some but not all of the criteria for a specific diagnosis (anorexia, in my case). I count calories and obsess over food, but I’ve maintained a healthy weight for the past three years—and I kind of hate myself for it. As whacked-out as it sounds, I miss the days when I could starve myself (cottage cheese and rice cakes were staples of my diet), walk ten miles in one day and feel like everything was okay.

I also have a volatile temper: I’m prone to throwing and kicking things when I’m pissed off, and have broken a phone, a window, an iPod and my toe (well, the toe was just fractured). On top of those long-standing problems, 2007 was a fairly stressful year—I started a new job and one of my best friends died. Yeah, I could use some help.

I’ve tried therapy several times—a counselor at school, a few nutritionists, and one therapist who would sit in silence and stare at me. Obviously, none of it has helped much, and I’ve been too busy to even try again. But Rose Ortiz, a licensed clinical social worker based in Hell’s Kitchen, was willing to come to our office.

The first session

Going to a therapy session in an upstairs conference room at work is weird. My anxiety is not helped by the fact that I’m terrified that a coworker is going to overhear me detailing the ins and outs of my family issues. Thankfully, Rose is awesome: She has a nose piercing, her ring tone is AC/DC, and she curses. I like her already.

Then we get into the therapy, and I start to feel…strange. And not just because I’m talking about personal stuff in an impersonal environment: It feels good to get some of these things off my chest—like opening up about what I now realize was some pretty shitty treatment by an ex-boyfriend, or how my eating disorder brings me perverse pleasure. She asks a lot of questions about my family and my childhood—she believes that issues are often rooted in adolescence, and then “create a narrative” for your life—and has me outline the evolution of my eating disorder. After knowing me for about an hour, she’s able to offer some spot-on insights about my varying problems, and I feel at ease—something that has never happened before. I’m willing to see where this will go.

The second session

It takes only about ten minutes of talking in my second session with Rose for my hands to start moving toward my scalp. We’re talking about my hair-pulling, and my body responds accordingly. I do resist, if only to avoid giving her fodder—but it’s too late, she’s already noticed. The hair-pulling is just one of many tics that I have accumulated over the years: I bite my nails, I’m an incorrigible fidgeter, and sometimes I’ll rub my wrists or my clavicle involuntarily. It’s going to take some digging to get at the root of why I do all this.

Rose wants to figure out why I indulge in self-destructive behaviors—both the hair-pulling and the eating disorder qualify as self-harm, even if they don’t feel that way to me. To get the full picture will obviously take longer than the allotted three sessions, but she covers a lot of ground in the time we have. By the end of 45 minutes, she’s made a few observations: (1) I clearly have anxiety issues, and the tics are manifestations of that; (2) I also have a perfectionist streak, and not living up to my own high expectations leads to anxiety, which turns into food problems/hair problems/just plain problems. That’s news to me—I know that perfectionism is a trait often found in people with eating disorders, but I’m a chronic procrastinator. Though I am harshly self-critical—so I guess I do take perfection more seriously than I thought.

The third session

I was a very angry child who threw temper tantrums—a lot. My parents have a picture taped to their fridge of me mid–hissy fit, with my face scrunched up and my legs and arms flailing about. (It’s the one my mom always showed to my new boyfriends.) Knowing this, it should be no surprise that I have anger issues as an adult—but, as Rose points out, my problem is that I don’t have perspective when I get pissed off. Her advice is to slow down my reaction time and try to realize how I’m feeling when the anger hits. I’m less confident in my ability to do that.

This marks my last session with Rose, and I’m a little down about it. I’m actually beginning to feel comfortable with her (a first for me and therapists) and, for once, I opened up and told the truth about my issues (did I mention I’ve lied to therapists in the past?). I think this is a good thing: If I take nothing else from this experiment, then at least I figured out that I am finally ready for therapy. Well, as long as I don’t have to continue doing it in the conference room at work.

To schedule an appointment with Rose Ortiz, LCSW, call 917-554-8588.