Tammy

A few years ago, I started calling the most critical voice in my head Tammy. The name didn’t really come from anywhere in particular, just spawned from the recesses of my mind one day when I felt particularly beat up inside. I began to use Tammy as shorthand in conversation and it seemed to make sense when I explained it to folks, as well as giving that tiny bit of distance between the “real me” and the Statler and Waldorf in the balcony of my mind. Beyond my bitter complaints about her ceaseless commentary, I didn’t give much thought to why some part of my psyche seemed so mad and vile all the time - I just thought I was cursed with a really mean brain.

To my genuine surprise, Tammy got all kinds of defined when I decided to undergo a series of ketamine-assisted therapy (KAT) sessions this summer. As I have belabored on here, I have been dealing with depression for nearly two decades. I’ve tried a lot of different approaches to resolving symptoms - lifestyle changes, medication, talk therapy - but I haven’t been able to do much beyond muzzling it. When I read that ketamine (an anesthetic used in humans since the 1960’s) was FDA approved for treatment-resistant depression, I looked up “ketamine clinic near me” and Google directed me to a brand-new practice offering “psychedelic-assisted therapy” nearby. I immediately filled out the website form requesting a spot on their waitlist.

In talking to everyone that I’ve shared my experience with KAT, they seem shocked that I had zero hesitation is lab-mousing a newly approved treatment with a completely un-road-tested provider. The thing is, I’m not really much of an advice-taker. I tend to go with my gut and hope for the best. It’s not anyone’s favorite attribute of mine but it’s pretty baked in at this point. It took a few months to get in to see the counselor (KAT is quite popular), and another couple of weeks to get my medication delivered, but before I knew it, I was lying on a couch with a sickeningly sweet lozenge under my tongue listening to nature sounds with eyes ensconced in a satin mask ready to taste some colors, or whatever kind of crazy happens when you take psychedelics.

I opted for an integrative therapy approach to KAT, which means that I took the medicine in the presence of a trained psychedelic-assisted therapy counselor. We met for two sessions before the ketamine got involved to discuss my goals for treatment and set some boundaries, like, could she put her hand on my shoulder if I was weeping? The answer to that was a firm no. I’m not comforted by comforting. I’m comforted by avoidance and nervous laughter. I will say that if I ever were to want to be comforted by someone’s hand on my shoulder, it might be hers. She emitted positivity like an LED bulb - consistently, effortlessly and without overheating.

For the actual dosing sessions, we sat and talked for a few minutes ahead of time and then she read me a guided meditation, mostly to remind me to be curious about what I was experiencing and to get grounded enough that even if I thought I was careening into space on the back of a large purple cat, I was, in fact, sitting under a fleece blanket in a therapist’s office. Then in went the sugar pill with the ketamine dab and I got to work swishing my thick warm spit around for twenty minutes. By the end of it, with all my mucus membranes thoroughly awash in horse tranquilizer, I was off to the races.

The first session was cool as shit. I moved through feeling like I was walking on the beach with my feet in the sand to feeling like I was a warm ooze flowing through cracks in a mountain. I felt like I could actually see the music I was listening come alive and I sought to become one with the pan flute. I had this overwhelming sense that I was “ok” and, I gotta tell you, the feeling of a baseline “ok” after decades of a baseline “piece of wet crap” was a profound improvement. I had this thought that I was special, but also not special. Like I was special to my family and the people close to me, but not so special that I need to feel guilty about the fact that my contribution to the overall world is completely insignificant. I found myself saying out loud - as if the ketamine version of myself was speaking to the lucid version of myself - “you’re not the worst, I’ve seen worse and you are definitely not the worst.” Which is really pretty comforting. And accurate. There are definitely worse. I was under for an hour or so and then it just … ended. I sat up and chatted with the counselor a bit and then I caught a ride home.

After Journey #1, I was pretty geared up for my second session. Who knew that treating depression could be so fun and interesting? I did the same twenty-minute saliva aerobics and took off for Trip Town. The theme of session #2 was “Joy”. My insides were dancing to the beat of music; I was riding a surfboard on clouds in the sky. I kept having ideas for paintings I wanted to create even though I don’t paint. I felt immense love towards everyone in my life. The baseline “ok”, which had been tentatively flickering in intensity since my first session, burst into a strong glow. I laughed a lot. Again, an hour or so passed, and it was over. I walked out tired, a little nauseous, but feeling outstanding.

My third session was scheduled for a week later. I don’t remember what events transpired in that week, but they sucked. I almost canceled my appointment. I was really worried that taking the medicine when I was so out of sorts would lead to me having a “bad trip” and I was scared to go into a dark place, even though I now had some experience under my belt. I went anyway, mostly because appointments were hard to come by and if I missed this one, I didn’t know when I would be able to reschedule. On went the headphones and the eye mask, in went the medicine. Twenty minutes passed, and … nothing.

I sat up and told my counselor that it wasn’t going to happen today. As you might expect, she didn’t immediately shrug her shoulders and send me out the door. Can’t imagine she wanted a substantially sedated, though somehow still agitated, middle-aged mom in pajama pants wandering around the halls of her office building. No - she was curious. She asked me why I felt like it wasn’t going to happen. I told her that it was Tammy. That Tammy is what I call the voice inside my head that primarily functions as Debbie Downer and Tammy said I didn’t get to detach from life for an hour to go prancing through fields with laughter in my heart. There was too much real shit going on for that today.

“What does Tammy look like?” she asked.

This was a new line of thought. My ketamine-saturated mind took this in. Floated around trying to pin down an answer.

“Tammy is a man.”

Tammy is a dude! Tammy’s appearance hit me with perfect clarity out of freaking nowhere. Tammy looks like the Comic Store Guy from The Simpson’s but with darker hair. And he wears jeans instead of shorts. He’s balding with a goatee, wears shirts that are too small and show his gut and gives the overall vibe that he lives in a basement. Surliness drips off of him like pizza grease.

She then asked me what Tammy sounds like. Tammy’s voice was a caustic mashup of my dad and oldest brother at their most cynical and convicted. Then she asked when I could first remember hearing from Tammy. This answer surprised me even more than the whole animated-character-living-in-my-head response.

“When I was seven.”

Seven. Seven was when I partitioned off some piece of myself to sit on the sidelines and berate me. From there we navigated murkier waters. We talked about what was going on in my life at that time. My mom had gone back to work and my brothers and I were left home alone in the afternoons from the time school got out until one of my parents came back hours later. (Ah, the 90’s.) We talked about how much I dreaded those afternoons. I mean the author of Lord of the Flies did claim to base his character’s behavior on observations of real children and it isn’t farfetched for me to assume his research included the antics of three siblings under the age of 11 alone for hours on a daily basis. We lingered for a minute on the impressively creative, often cruel, ways we treated each other on those long afternoons before leapfrogging to why Tammy might show up amongst those young, chaotic feelings. What purpose did he serve in my life in that time?

One thing Tammy has always done really effectively is to badger me into being as small as possible. To be meaner inside than anyone could possibly be outside. I’d have to say he’s quite accomplished in this regard - no one has actually ever said anything more awful in the real world than Tammy has said in private conversation. Perhaps, I thought, Tammy’s purpose was to toughen me up in an effort to protect me from external pain. If I moved through life without drawing too much attention, without being too squeaky and annoying, then I could possibly avoid drawing the attention of potential enemies. When I thought about Tammy that way - as a part of me that showed up with a very heavy-handed and painfully unorthodox approach to help a younger version of me - I actually felt a spark of kinship towards him.

I can confidently say that I would have never gotten that far into an analysis of the dark-humored backstory of an insulting internal voice if it weren’t for a powerful anesthetic used in tranquilizer darts to take down errant bears. It’s just too weird of a conversation for a sober mind. We talked a lot more about Tammy and how to work with him instead of against him and we talked about other potential parts of my psyche yet-to-be-named. We talked all the way through the medicine session, in fact. I was exhausted, physically and emotionally. I left with the unbelievable realization that I had made more progress in understanding my inner critic in an hour than nearly two decades of talk therapy. Cheers to modern medicine y’all.

I set the intention for my fourth, and final, session to be a celebration. To celebrate my newfound ok-ness. To feel gratitude towards all the parts of me: the fun ones and the smart ones and the kind ones and the hard-to-love ones too. To delight in my specialness and to absolve myself of expectation that my specialness will ever extend beyond my very small circle of influence. My journey ended with some lovely thoughts about my mother and her mother and how my maternal line shaped how I view my role as a mother and what a gift I’ve received from the universe to come from a line of women who are gentle and kind. I said a tearful and gratitude-laden farewell to my counselor, who at this point I had grown a deep affection for, and wandered out to the climb in my ride home.

It’s been about two months since my final session and my depression symptoms have dramatically decreased. Don’t get me wrong, I don’t walk around all the time with a smile on my face and a skip in my step, but I do have an internal sense of peace that I haven’t experienced before. I feel like I’m on my own team.

And Tammy’s on my team too. He’s certainly not who I would’ve picked to have been beside me as a protector all these years, but he’s not the worst.