With a Bad Attitude, I will Hurl Myself Toward Healing

I decided to have bariatric surgery. There are a lot of reasons and maybe one day I’ll feel like listing them. To put it simply, it feels like the answer to a number of heartbreaking questions I have when I feel my own body existing in a world that is too small and too big all at once. 

To qualify for insurance covering the surgery, I had a psych evaluation. The recommended psychiatrist is a man who does these evaluations often. The perk is he knows exactly what insurance needs to hear to approve the surgery. The downside? It felt sterile, clinical, distant to speak to him. I was one of many patients he was seeing for these quick two visits- $120 to meet him, $20 to follow up and have him read my results from a computerized personality test. 

I knew what to expect of the test. The beginning pages have warnings against trying to be dishonest: “this test measures attempts to cover the truth.” I knew when being asked about the past six months that my results would reflect that I still struggle with depression and anxiety. I still have PTSD. None of this is news. 

When he began to read my results, I resigned myself to nodding politely. In 20 minutes, he determined that I scored 77 out of 100 as a potential patient for surgery, 100 being “the best potential patient with no mental health issues.” 

He explained that I had a tendency toward emotional eating. I could see the synopsis reflecting in his glasses as he read from his computer screen: “though it is not your first inclination, when faced with a stressful situation, you have the tendency to eat.” I nodded. He explained how, culturally, we are often taught to seek food when faced with difficult emotions. He took a sarcastic tone, “had a hard day? Come on, child, have an ice cream cone. Have an extra piece of pie. All the way to adulthood, bad day at work? Treat yourself to a big dessert.” I nodded again, saying nothing, smiling politely. “It also says you have a tendency to use food as a comfort” 

Isn’t that the same thing? 

He read the synopsis reflected in his glasses. 

He breathed deeply and explained how these behaviors could be problematic for me if I had the surgery… 

Yes. They could be. But the synopsis themselves said it was a tendency but not my first inclination. I wanted to argue that I knew this tendency and fought against it often, and that the surgery would allow for extra incentive to build on current coping mechanisms that don’t include food. 

But I didn’t say anything. He moved on to the second portion of the evaluation where “100 is bad.” I scored close to 50 on depression and anxiety related issues, showing these issues don’t control my life but that they do impact it. I scored 40 for potential panic disorder. I scored 30 for trauma related issues. 

He asked about my therapy journey. I explained I’ve had a therapist on and off for about 8 years. My most recent therapist was in South Carolina and I hadn’t established with anyone since moving to Georgia. I explained that I did feel like I had a good understanding of my PTSD and in answering the questionnaire, I was honest about panic attacks and depressive episodes relating to my health, specifically the ruptured ovarian cyst, and trauma dates that caused me extra anxiety. 

He nodded, and his face didn’t change. He said I needed to establish with someone local before he approved me for surgery, or he could submit his findings as they are now. It felt like I was a child, I could choose my own consequence. Father knew best. But he wouldn’t make me do anything. I had to choose. But I don’t actually have a choice.

I was already planning to find someone local. I was taking my time but it was in the plan.

I looked at the clock. It had been 20 minutes. In 20 minutes, this man had measured me and found me wanting. 

He said I scored well in many areas but he didn’t want to take time to explain those.

He said I would benefit from the surgery, that it would improve my health and my self esteem. 

But I had another hoop before he approved. He wouldn’t approve based on me agreeing right this moment to seek a psychologist. I had to make an appointment and get back to him so he knew I’d follow through. 

Shouldn’t he know from my extensive questionnaire that I would follow through on my word? I didn’t like being told, unprompted, that he wouldn’t give his approval on my verbal agreement to establish care for my mental health. I had to prove it. Then he’d know I was serious, and he’d approve my surgery. 

I expected my test results. He said there was no deception detected (a 0 out of 100 during the “100 is good” portion, to be exact.) I’m familiar enough with evaluations. I’ve had plenty before in other therapy settings. I studied them in college. I had a whole class dedicated to types of evaluations. I wanted to be honest. Things have been hard but I’m surviving and doing well, all things considered. But I didn’t like that I didn’t feel safe to be vulnerable with this man and his reflective glasses, reading my tendencies to me as if I didn’t already know them. No discussion. No requests for feedback. His eyes glazed slightly when I felt the need to expound on my responses. He wasn’t interested in my interpretation of the findings of this test. It was very simple: I could choose to either put even more money toward a new therapist and have this surgery, or I could keep my fingers crossed and eventually get denied by my insurance because I have tendencies toward depression, anxiety, and panic— even though he agrees the surgery would be a benefit to my life in many ways. 

I didn’t go to him for advise on how to handle my PTSD. I went to him because I needed to be cleared for a surgery. Would I be okay if I had this surgery? His answer? Yes. The surgery would benefit me. The surgery would improve many areas I currently struggle in. But even though he sees that, my only option is to arrange my schedule to ensure I have regular meetings with a different therapist. “You don’t even have to mention the surgery to them” he said, “I just need to see you’re getting help for your other issues.” 

That’s not what he was there for. 

And I think that’s what really bothered me. He knows the surgery is a good choice for me. He tested me, measured, found the areas that I struggle would be improved by the surgery, but added a condition that I don’t agree is his to add… and made my surgery eligibility dependent on that. 

Granted, I know if he approves me without conditions and something happens to cause my mental health to decline after the surgery, he could be held accountable for approving me. 

I think that’s what bothered me most- it didn’t feel like he was saying “I think you really need continued care.” It felt like he was saying “unless you have care, I’m not giving my approval.” It was about his actions, not about my choices or my journey. 

I got off the 20 minute call feeling so small. It’s like the past years of scraping and struggling for my mental health didn’t matter. It wasn’t enough. I’m still broken. 

I have an appointment on Thursday with a local counselor to establish care. I’ll let him know tomorrow. And he will approve me, I guess. 

I just feel low. Defensive. Vulnerable and marked. 

Three years ago, almost to the day, I saw my ex-husband for the last time. He held me down. I’d been crying. He promised to end my life. 

Two years, eleven months, and two weeks ago I sat in a lawyers office. I left to go to a therapy appointment where I was diagnosed with PTSD and given instructions to a woman’s shelter where I could make a report and get more resources. 

Two years, eleventh months, one week ago I went to the women’s shelter and made a report. No one ever followed up with me. 

Two years, eleven months ago, I submitted the signed paperwork to annul my first marriage. 

Two years, ten months ago, I reconnected with a friend who is laying beside me now, breathing peacefully in his sleep. 

Three years ago, I said goodbye to the complacency I felt when a man promised I’d breathe my last. I promised myself I’d stay soft, determined to love and be loved, determined to continue my life and make it one worth living. 

And in these three years, I’ve fought my body every step of the way. Living in abuse does horrible things. I’ve been in the hospital 5 different times. I’ve been diagnosed with health issues I’ve never struggled with before. I’ve gained weight I can’t seem to lose. I could not have tried any harder to be healthy and full of the lovely things that make life worth living. I’ve fought for my life and most of the time, I have won. I’ve chosen well for myself. I’ve been wise and kind and good. 

And I just hate that in 20 minutes, a stranger can tell me it’s not enough for what feels like the answer to questions I can’t answer for myself. Willpower isn’t enough. I need help. I need some help to continue healing my body and my mind. And I want credit for choosing what is good for me in these last three years. I didn’t turn to drugs or sex to numb my pain. I didn’t go back to the man who had a hold on me that I still can’t put into words. I found a man who loves me with calmness and peace and I built a life with him. I found things that made me feel alive and poured myself into them. I built my life into one worth having. I pursued professionals to help me figure out my mental and physical struggles that seemed so determined to stay. 

This surgery is the last step of removing my past from my body. And I wanted credit. I wanted to be seen for everything I’ve done to be extraordinary in these last three years. 

But I wasn’t. That isn’t the conversation I had. I was told what to do because what I’m doing isn’t enough for a stranger to be comfortable giving an arbitrary approval stamp on a surgery he agrees would benefit all these painful areas in my life. 

I have another hoop. 

I know it isn’t personal. He’s protecting his business and I do understand that. But I wish it was personal. I wish I felt seen and understood and encouraged to do what I already planned to do for myself— seek continued professional support for difficult things that linger. It’s easier for me to do one thing at a time. I wanted the surgery done and then I could focus again on mental health. I like one thing at a time. I want to heal my way. It’s been working so far. But I don’t get a choice here. 

It feels like the email I got from my attorney three years ago. “The judge won’t annul your marriage because you lived together for almost a year. We’re moving forward with divorce.” 

No conversation. No further discussion on why annulment mattered so much to me. Fraud was a reason for annulment. I had texts to prove he’d lied about so many things. Important things. He’d tricked me. I had proof. But it was Covid times and I was lucky to get a response at all. There would be no discussion. I would not get an annulment. I’d have to carry a divorce with me through life. All the big talk from my attorney about her one other annulment case didn’t seem to matter anymore. I wouldn’t get mine. I would be divorced. Legally, always his wife at one point. Legally, always attached in some way. No one asked how I felt. No one asked if I wanted to fight it. I had to just move forward and do things their way if I wanted to be safe- and safety meant removing myself from him- no matter what. So I would divorce. And it would be over. 

This is much easier to swallow than that was. But I think that lawyers and psychiatrists should make it a point that when they say “we’re on the same team” it actually means we’re both on my team. Not that I’m on theirs. They’ll hear me out and make me feel respected and understood… 

In two months, none of this will matter. The order that things happened won’t matter. I’ll get wholistic care and it’ll all be fine. I would’ve dragged my feet some on getting my own therapist here if I wasn’t being forced to. But I guess I just want the option to drag my feet. I want the option to not always be hurling myself at every opportunity to grow. 

But. I will hurl myself. And it’ll be fine. And I’ll have surgery. And it’ll be fine. I am divorced. And that is fine. And maybe it isn’t perfect or justified but it’s enough to get me where I need to be so I can keep making this life something beautiful. And that just has to be enough.