Yet ask me to reconstruct exactly how I felt during a particular low period and the words can still disappear. I know there were ups and downs, I know some of the things that happened and I know considerably more about the patterns, but knowing that Tuesday Jeff was down there does not necessarily allow Friday Jeff, or sixty-six-year-old Jeff, to describe precisely what it was like to be him.
There is something faintly ridiculous about making an appointment with a doctor because you have finally accepted that something is seriously wrong inside your head, sitting in the waiting room rehearsing at least some version of why you are there, walking into the consulting room and then answering the first question with, “Fine.” I suspect I have done some variation of it hundreds of times in my life, although usually without depression waiting further down the conversational track.
“How have you been?” is not really a medical question most of the time. It is an icebreaker, no different from the countless opening exchanges I had with clients who sat on the other side of my desk and told me that business was “good” before spending the next hour explaining why it wasn’t. Professional advisers learn very quickly that the answer to the first question is rarely the reason the person made the appointment, and I understood that perfectly well from my side of the desk. Apparently, understanding it didn’t prevent me from doing exactly the same thing when the chairs were reversed.
The doctor whose surgery Robyn and I visited during that period was actually a client of mine. I can’t remember his name now, which seems strange considering the significance I subsequently attached to those consultations, but I had no difficulty relating to him professionally. When he was the client and I was the accountant, we occupied familiar territory where I knew the language, understood my responsibilities and had reasonable confidence that I could find my way from a problem to an answer.
Then somewhere along the way that relationship morphed into doctor and patient. The bloke who had previously been entitled to expect me to understand his problems was suddenly expected to understand mine, with the additional difficulty that I wasn’t entirely sure what mine were. It was a reversal of roles that probably should have made me more sympathetic to every client who had ever sat opposite me knowing something was wrong with their business but unable to explain precisely what it was.
Robyn came with me. We have always regarded ourselves as a partnership, and although her presence initially contained an element of emotional support, it quickly became considerably more useful than simply having somebody sitting beside me. She was another mind in the room, another memory and, potentially, somebody better able to articulate what was happening than the person to whom it was actually happening.
We sat together in the waiting room like everybody else. We knew the receptionist because she was the mother of one of my BNI colleagues, so there was the potential for the usual social conversation, but a busy medical practice has its own momentum and the work takes precedence. Multiple doctors were working from the building, patients were waiting their turn and, somewhere amongst all that ordinary activity, Robyn and I were preparing to discuss something that had become increasingly unordinary in our house.
I had initiated the visit. This wasn’t Robyn dragging an unwilling husband to a doctor while I insisted there was nothing wrong with me, nor was I attending so that I could later claim I had tried something and therefore everybody should get off my back. I knew there was a problem and I wanted something done about it, even if what I thought the problem was would prove to be somewhat different from what the doctor eventually found.
The problem, as I understood it, involved moods and anger. There were explosions that could occur at almost any time, and while I was never physically violent, describing them simply as raised voices doesn’t adequately capture what they brought into the house. Jeff wasn’t dangerous, but he was dangerous, and I realise the contradiction in that sentence is probably closer to the truth than any attempt to tidy it up.
Nobody needed protection from me physically, and there was never a threat that an argument would turn into physical violence. There is, however, another form of uncertainty created when somebody can suddenly explode and the volume and intensity bear little relationship to whatever has just happened. The stress I had spent years insisting didn’t exist was apparently coming home to roost, and it hadn’t bothered to ask whether I believed in it first.
That was one of the reasons Robyn needed to be in the room. I could describe what I thought was happening inside me, while she had been living with what was coming out of me, and those were not necessarily the same account of events. There were occasions when I prompted her to add her two cents’ worth, but she very quickly understood why she was there and contributed when something needed to be added, remembered or perhaps expressed more clearly than I had managed.
In accounting terms, I suppose I had brought the internal management accounts while Robyn had brought some of the external audit evidence. Neither was necessarily wrong, but the doctor had considerably more chance of understanding what was happening if he had access to both. More importantly, Robyn could remember the things I might have forgotten by the time we were sitting there trying to reconstruct them.
The difficulty was that I arrived with one set of things I wanted to explain while the doctor had another set of things he wanted to know. I didn’t literally arrive carrying a list because everything was verbal, but there was certainly a list in my head. I knew what I wanted to deal with, and I thought I had a reasonable understanding of the problem that had brought me there.
The doctor didn’t know what I wanted to deal with until I told him. More importantly, I didn’t yet know what he needed to know until he started asking, and somewhere between my explanation of the problem and his investigation of it we had to arrive at something resembling the truth. That sounds relatively straightforward until the subject being discussed is how you feel and the person being asked has never been particularly good at putting that into words.
I had spent most of my professional life using words. I could sit opposite a client and explain a complicated taxation issue in language that made sense to somebody who had no interest whatsoever in becoming an accountant. I could talk about businesses, structures, money, strategy, mistakes, opportunities and consequences, and if somebody didn’t understand the first explanation I could generally find another way of explaining it.
Ask me what had been happening inside my head for the preceding six months and suddenly the vocabulary wasn’t nearly as cooperative. It wasn’t that the words didn’t exist, or even that I didn’t know them. I had a perfectly adequate vocabulary and had spent most of my adult life using it professionally, but knowing thousands of words is quite different from knowing which particular ones accurately describe what is happening inside your own head.
Was I sad, unhappy, depressed, frustrated, angry, anxious, disappointed, overwhelmed, exhausted or simply pissed off? I knew what every one of those words meant, but knowing their dictionary definitions didn’t tell me which one belonged to what I had been experiencing, whether several applied simultaneously or whether none quite captured it. Even something apparently straightforward like saying I was “down” raised another question, because how far down was down, how long had I been there, and what did it actually feel like compared with the last time?
There had never been any training in this. I had been trained in accounting, taxation and business, and decades of dealing with clients had trained me further in asking questions, identifying problems and translating complicated concepts into language other people could understand. Nobody had ever sat me down and taught me how to distinguish between an emotion, a mood, a reaction and something deeper, or how to take whatever was happening internally and convert it into information that might actually be useful to a doctor.
That became even more difficult because I was trying to describe the experience while also trying to understand it. The doctor could ask a perfectly reasonable question and I could understand every word in the sentence, yet still have difficulty deciding which words belonged in the answer. I wasn’t searching for vocabulary so much as trying to work out which pieces of an enormous vocabulary applied to this particular situation, in what combination and with what degree of intensity.
There was an irony in that because words had rarely failed me professionally. If a client didn’t understand an explanation, I could approach it from another direction, find an analogy, simplify the language or ask another question until we reached common ground. Sitting in the doctor’s surgery, however, the subject I was attempting to explain was me, and suddenly I didn’t have the advantage of standing outside the problem looking in.
Perhaps that was why having Robyn sitting beside me mattered more than I initially understood. She wasn’t supplying words I had never heard; sometimes she was helping attach familiar words to behaviours and events that I had not connected properly myself. Between what I thought was happening, what she had observed happening and what the doctor was trying to establish, we were effectively building a vocabulary for something I had spent years experiencing without ever learning how to describe.
Being articulate therefore wasn’t the same thing as being emotionally articulate. I possessed the words, probably far more of them than I needed, but I had never learned which ones belonged to this particular conversation. For perhaps the first time in my professional life, the problem wasn’t finding a better way to explain something I understood; it was finding the words while simultaneously discovering what it was I was trying to explain.
There was another complication that I didn’t properly appreciate then and still struggle with today. Once a bad period has passed, I am remarkably poor at reconstructing precisely what it felt like while I was in it. I can remember that there have been ups and downs and I can often remember what happened around them, but remembering the emotional intensity is different from re-entering it sufficiently to describe it.
Tuesday Jeff might have been somewhere near the bottom of the pit, yet by Friday the mood might have lifted sufficiently for me to be functioning reasonably normally again. Friday Jeff could report that Tuesday had been bad, if he even remembered the episode at all, but he might struggle to give anybody an accurate guided tour of the place. That remains true today, which makes writing this book an interesting exercise in trying to describe experiences that I know occurred but cannot always emotionally reproduce on demand.
That creates a peculiar problem for a medical consultation. The doctor is necessarily dealing with the Jeff who has arrived at that particular time on that particular day, showered, dressed, functioning and capable of holding an intelligent conversation. He may be asking that Jeff to describe another version of himself who is no longer available for questioning, and the witness he has been left with doesn’t always have particularly good notes.
Robyn helped bridge that gap. She didn’t need to accuse me of hiding anything because I wasn’t deliberately hiding anything, and I tried to be as truthful as I possibly could. There would have been absolutely no point initiating the process myself and then deliberately withholding the information needed to make it useful. I simply could not articulate the feelings or lack of them as the case may be.
Whether I absent-mindedly withheld things because I couldn’t remember them or couldn’t find the words is another question entirely. There is an enormous difference between refusing to tell somebody how you feel and genuinely not knowing how to tell them. I suspect much of my difficulty sat in that second category.
The consultation therefore became a process of working our way past the icebreaker. I had turned up with a purpose, the doctor had questions designed to identify what that purpose might actually represent, and Robyn could occasionally fill the space between the two. Slowly, the battlefield began to describe itself, although it was describing something rather different from the battle plan I had brought with me.
Up until then I could still maintain a reasonably comfortable version of what was happening. I had problems with anger, my moods were moving around more than they should, the nonexistent stress was apparently demanding recognition, and Robyn and I had sensibly decided that something needed to be done about it. None of that was particularly pleasant, but it was understandable enough for Logical Jeff to get his arms around. Identify the problem, talk to somebody qualified, find a treatment and get on with fixing it.
Then came the bloody test.
The questionnaire threw a substantial spanner into any works I might otherwise have been able to keep comfortably turning. I could explain anger because I had seen the evidence, and Robyn had certainly seen it. I could accept mood swings because I knew they existed, and I could even reluctantly concede that this thing I had spent years insisting wasn’t stress might have been making a contribution. Those were problems I could put into familiar boxes and, once they were in boxes, I could start thinking about what needed to be done with them.
Depression was not the box I had brought with me. Worse still, the questionnaire wasn’t gently suggesting that we might like to consider adding it to the list; the score was pointing towards a level of concern sufficiently serious for the doctor to raise hospitalisation. I had walked in believing I was living somewhere near the edge and looking for assistance before I got any closer, only to have a series of apparently innocuous questions effectively suggest that, according to this particular measure, I had already fallen off it.
That was a considerable affront to the bloke who thought he had arrived with a reasonably good grasp of his own problem. I was accustomed to being the person who listened to somebody else’s description, asked the questions they hadn’t thought to ask and eventually helped identify what was really going on. This time I had arrived with my own diagnosis neatly enough assembled in my head, only for the bloody test to scatter the pieces across the consulting-room floor.
I thought I knew what I was talking about, but the questionnaire suggested fairly emphatically that I didn’t. More unsettlingly, it raised the possibility that the problem wasn’t simply that I had chosen the wrong words to describe what was happening; I might have misunderstood the scale and nature of what I was trying to describe in the first place. That was an uncomfortable position for somebody accustomed to being the bloke in the room who was supposed to understand the problem, although discomfort was hardly the most significant thing that bloody test was about to produce.
The questionnaire took us somewhere I hadn’t expected to go because I had arrived thinking primarily about anger and moods, not carrying a carefully developed theory that I was suffering from depression. When the result was sufficiently concerning for hospitalisation to be raised, my understanding of where I stood shifted rather abruptly. I had thought I was living somewhere near the edge; according to the score, I had apparently fallen off it.
We have travelled further into that particular consultation elsewhere, and the score itself matters less here than the communication problem it exposed. I had walked in knowing there was something wrong, believing I had a reasonable description of it and expecting that description to form the basis of whatever happened next. The doctor’s questions effectively said that there might be considerably more going on than the things I had chosen to put on my imaginary agenda.
For somebody who made a living diagnosing problems in businesses, that was an interesting reversal. Clients frequently arrived in my office knowing precisely what they wanted me to fix, only for the conversation to reveal that the problem they had identified was merely a symptom of something else. Apparently doctors had discovered the same trick long before I had.
Perhaps I should have recognised the process because I used it myself. A client might arrive wanting to know how to reduce a tax bill, while I wanted to know why the profit had fallen, why the overdraft had increased, why the margins had changed and what they were actually trying to achieve. Their opening question wasn’t irrelevant, but neither was I necessarily going to accept their diagnosis merely because they had reached it first.
Now I was the client, or more accurately the patient, which somehow sounded considerably worse. I had expected people to trust me enough to let me move beyond the question they had walked in asking, so there was a certain justice in discovering that I was now required to extend the same courtesy to somebody else.
My experience with somebody resembling a psychologist had actually begun much earlier, although I didn’t exactly volunteer for that one. During the deterioration of my first marriage, my first wife arranged what I understood to be some form of marital mediation for both of us. We arrived together, but she disappeared from the process fairly quickly and I found myself continuing for a number of sessions with the doctor on my own.
The marriage was clearly on the rocks by then and those sessions didn’t ultimately save it. Looking back, I sometimes wonder whether that period was another preliminary visitor from the territory I would later call depression, but I don’t know that and I am not going to retrospectively diagnose myself simply because several pieces now look as though they might belong in the same box. It is tempting when writing backwards through a life to make everything fit the explanation eventually discovered, but life wasn’t considerate enough to provide labels at the time.
What it did mean was that sitting in a room talking about myself wasn’t entirely unprecedented when Robyn and I later began the medical battle. What was different was that this time I had initiated it, Robyn and I were approaching it together and we had a reasonably clear objective. We wanted something to change, even if we had not yet worked out precisely what successful change would look like.
There was humour occasionally because there is nearly always humour somewhere when I am involved, but this wasn’t a performance and humour wasn’t particularly useful as an escape route. I might lighten the impact of a question or make an observation that produced a smile, but we hadn’t gone there to entertain each other. We wanted to drain some of the anger from our household, and somewhere behind that very practical objective sat the rather more ambitious idea that I might become happier.
I think I genuinely believed the doctor might “fix” me, and there is a romantic simplicity to that thought when I look back at it now. Something wasn’t working properly, doctors fixed things that weren’t working properly, therefore I would present the malfunctioning Jeff Banks for repair and eventually collect the properly functioning model. I wasn’t expecting miracles in the religious sense, but I certainly hadn’t abandoned the possibility of one in the medical sense.
We kept turning up because we wanted to win the battle. Medication followed medication and adjustment followed adjustment over the next year or two, and I approached the process with a degree of trust because that was what I expected from my own clients. If somebody came to me for professional advice, gave me the relevant information and then ignored everything I said because they preferred their own expertise, there wasn’t much point employing me in the first place.
What was good for the goose was good for the gander. I didn’t understand the pharmacology, the possible interactions or all the dangers and benefits associated with the medications being tried, but I had deliberately sought professional help and eventually had to allow the professional to do his job. Trusting him didn’t mean surrendering my judgement; it meant accepting that I had sought expertise precisely because mine didn’t extend far enough.
The problem was that his definition of improvement and the one lurking in the back of my mind may not have been identical. Neither of us necessarily expressed the distinction in those terms at the time, but looking backwards I can see that we may have been measuring success on different scales.
Medicine, at least as I experienced it during that period, seemed primarily capable of attempting to reduce things. Reduce the troughs, reduce the volatility, reduce the anger and perhaps narrow the distance between the emotional extremes. There was considerable value in that, particularly when one of the things we desperately wanted was to stop anger arriving uninvited in our household.
I wanted reduction too, but I also wanted something travelling in the opposite direction. I didn’t merely want less of the Jeff I didn’t like; I wanted more of the Jeff I did. Somewhere in the back of my mind was the hope that treatment might not simply make me less depressed but actually make me happy.
If one medication produced some improvement, perhaps another might produce more, and if a particular approach reduced the problem without producing the result I had imagined, perhaps there was still something else waiting further down the tunnel. There is something resembling the addict’s propensity to believe that something better might be available in that thinking, although addiction is not what I am describing and I don’t want to pretend that it was.
What attracted me was the seductive possibility that better might be waiting one more step away. The next adjustment might not merely control the unwanted part but somehow unlock the wanted part as well, and when you have already accepted the premise that something inside you needs fixing, it isn’t a very large leap to start wondering whether it might also be improved.
That wasn’t necessarily what the doctor had promised me. In hindsight, I am not even sure it was something I had properly articulated to myself, let alone to him. I had gone there asking for help with anger and moods, been introduced to depression and somewhere along the way quietly expanded the assignment into creating a happier Jeff.
Perhaps that was another limitation of the Fifteen-Minute Jeff. I was asking the doctor to help produce an outcome I couldn’t adequately define, based upon feelings I couldn’t adequately describe, while relying upon memories of emotional states that became increasingly difficult to reconstruct once they had passed. For a bloke who liked evidence, systems and reasonably clear objectives, it was an extraordinarily imprecise project.
Even the idea of becoming “happy” becomes slippery once I examine it too closely. Did I mean waking every morning delighted to be alive, enjoying everything more, becoming more patient, laughing more easily, eliminating anger or simply spending less time down the bottom? I don’t remember defining it because I doubt that I ever did, but beneath all those possibilities sat the much simpler desire that I just wanted to be different.
That desire explains why we kept turning up even after the initial diagnosis had thrown me. We were still wandering down the tunnel, still trying medications and still hoping that somewhere ahead there might be an answer that looked more like the destination I had imagined. The fact that I couldn’t precisely describe the destination didn’t make me want it any less.
Decades later, I have considerably more language around depression than I had sitting in that doctor’s surgery. I have written about the Black Dog, triggers, anger, functionality, medication, the radio in my head and the peculiar ability of depression to occupy the same body as a bloke who can answer a telephone normally and solve somebody else’s taxation problem. I can analyse the bastard now with considerably greater sophistication than I could then.
Yet ask me to reconstruct exactly how I felt during a particular low period and the words can still disappear. I know there were ups and downs, I know some of the things that happened and I know considerably more about the patterns, but knowing that Tuesday Jeff was down there does not necessarily allow Friday Jeff, or sixty-six-year-old Jeff, to describe precisely what it was like to be him.
Perhaps that is why I am less inclined now to criticise the man who answered “Fine” when the doctor asked how he had been. He wasn’t necessarily wearing a mask, avoiding the truth or refusing to engage with the problem, because he had deliberately walked through that door and brought Robyn with him precisely because he wanted the truth discovered. “Fine” was simply where the conversation started, and all three of us knew we had to travel considerably further before we reached the reason we were there.
What I wanted at the other end of that journey was another matter. At the time I probably would have said I wanted the doctor to fix me, remove the depression, control the anger and make me happier, as though those objectives were different descriptions of the same destination. Experience eventually taught me that reducing what I didn’t want wasn’t necessarily the same thing as increasing what I did, although it took me considerably longer to recognise that distinction.
Effectively, I think we wanted a new me, but even that isn’t quite right when I look at it now. Perhaps I wanted the me I wanted to be, and the difficulty was that I had walked into a doctor’s surgery hoping he could help me find somebody I had never actually been able to describe.
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