I Think You're Describing Love

When You Ditch an Anarchic Childhood and Seize a Future of Joy

“The problem is you.” Growing up in Minnesota in squalid conditions, Emi Nietfeld heard this message again and again. Never mind the unlivable home, the hoarder mom, the absence of stable adults, foster care: by age 14, she had 13 psychiatric diagnoses and was told needed to accept that she was ill—revise her goals, lower her ambitions. But she didn’t. As she describes in her gorgeous memoir Acceptance, she crawled out of the nightmare of her youth, got herself into the college, a CS degree, and a job at Google, and started a beautiful family of her own. Emi is now an author and journalist, and writes the newsletter Post-Mortem.

How do we transcend the limitations of our pasts? And how do we come to see our lives clearly? Emi and I talk about what kids in foster care really need, the dream of a pharma panacea, and the risks of being loved. [This is an expanded version of our conversation from last year. A content warning: this interview contains discussion of self-harm and suicidality.]

illustration by Maria Mendoza

When we grow up in a particular reality, that becomes our “normal.” When did you realize something was really wrong about your situation?

That’s a great question. I had this sense that if somebody just came and looked around our apartment, they would immediately know something was wrong. I didn't have words for it, in part because the word “hoarding” was not a part of the vocabulary. It really took that TV show "Hoarders" to bring that idea into the mainstream. I think my sense of what was wrong was really only the tip of iceberg. In the working class Midwest, there really was this sense of your parents are the rulers of the family, and you should not try to transcend them or get away from them or disobey them.

How do you now understand your mom's pathological behavior?

My mom and her sisters all had a lot of issues. Her parents were abusive and neglectful, and then it left them with some really deep scars. There's this whole group of people who are all hoarders. Success meant just moving on and pretending it didn't happen.

And so my mom brought me to all these therapists and told them, "My daughter has ADD. My daughter is really unwell." She could not see her own issues, and she really did think that she was trying to help me. Unfortunately, she was convincing. I requested all the medical records, so I can see exactly what these doctors and therapists wrote. A lot of them could see that she had major issues. One of the notes said, "The patient's mom is giving her leftover Adderall. And so I wrote her a prescription if she agreed to stop giving her the leftovers." I was put on Adderall because my mom was giving me her 20-year-old speed pills.

It reminds me of the idea of “the identified patient." In a dysfunctional family, it’s often a child who expresses unusual behaviors or emotions. That child is seen as the source of problems instead of an expression of the family's dysfunction.

That resonates so much. My mom really considers herself the parent of a former special needs child who just could not receive the help that she needed. This is her reality that she lives in.

These people were doing the best that they could, given that they did not want to call Child Protective Services. They knew my mom would just go to somebody else if she didn't like the treatment I received.

It's such a stark divide between your reality and hers. Is there any way to bridge those two?

I'm an engineer by training. I investigated every possible bridge. I have concluded that there is no bridge in the logical world.

Part of coming to that realization for me was to read thousands of pages of records. For people who have been gaslit, fact-finding can be so important. We're told, "Trust your feelings." But how are you supposed to do that if you have always been told that your feelings are wrong?

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I literally wrote down what happened, and then I would give it to people. I was hoping that they would explain my life to me. And they did.

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It can also help to have other people reflect our experiences back to us.

When I started writing my book, I literally wrote down what happened, and then I would give it to people. I was hoping that they would explain my life to me. And they did. Through seeing people's reactions, I realized, "Oh, that's fucked up."

It's essential to put your experience in context. But people with certain stories have a hard time telling them because those experiences strip you of context.

What do you mean by that?

I'm thinking about being a teenager in a very punitive mental health system—I spent nine months living in a locked facility when I was 14. And in this place, I was made to feel like I was there because I had been bad. Every night we're having confessions: "Here's what I did wrong. Here's how I ended up here. Here’s how I'm going to be a better person to earn my freedom." You're made to feel like you are completely responsible for what's going on.

That the problem comes from you.

Exactly. And meanwhile, nobody is saying, "Here's why your mom has a mental illness and is not getting treated" or "Here's why you're going to go to foster care." You feel alone. You don't have any broader understanding of this whole industry for kids with these problems where they make a ton of money.

A lot of adults tried to help, in their own limited ways—whether it was your foster parents or social workers. What would have actually helped you when you were suffering so much?

What a great question. I wish somebody had asked me, "What do you think the problem is? What would be helpful to you?" Children are treated as if they're not really human—that they don't know what's wrong or what they need.

I was a person who wouldn't always have all the answers. My request shouldn't just immediately be granted. But people were always asking my mom or my caregivers, “What do you think is the problem? What do you think she needs?” Teenagers know so much more about themselves and about the world than we give them credit for. Clearly teens do not have a fully developed prefrontal cortex, but I think they have an especially acute sense of injustice and also an awareness of themselves.

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If someone had asked, "What do you want? And how could we help move you towards that?" my teen years would've been very different.

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If someone had asked, "What do you want? What do you see for your future? And how could we help move you towards that?" my teen years would've been very different.

What would have happened? What would you have said?

I would have said, "I want to get out of here. I want to not live with my mom.” I wanted to go away to school as soon as possible. I ended up in boarding school, which was great. Maybe we could have expedited that process.

I was not willing to do a single thing that adults just told me to do, but I was willing to do absolutely anything to achieve my goals. My way out was through college. In hindsight, if people had leveraged that, I might've not felt so depressed. I might've been able to stop hurting myself.

From your vantage now, how do you understand your self-harming behavior?

I was desperate for any way to feel better. It did get me through the day. In the long run, it was not helpful because you quickly develop a tolerance. You do it just to feel normal.

I would never encourage somebody to go out and cut themselves. But I also think that sometimes we unfairly make this dichotomy between healthy and unhealthy coping skills. A lot of people use exercise in a way that is harmful to them and will cause permanent injury. They're doing it because they desperately need a way out.

It makes me think about how some people describe suicidal thinking as a way to cope with an unbearable reality. Having those thoughts can feel like a relief, an escape valve. I know people who have used those words.

That tracks. I wonder what would have happened if adults in my life had taken a harm-reduction approach. If somebody had said, "If you're going to do this, here's how to avoid infection," it might have been a deterrent. I would have thought, "I do not want to be having this conversation with my doctor.” It's no longer this secret thing that only I can do.

I was also really moved by your description of thinking about how part of your reason for not committing suicide is that it would hurt your favorite teacher, Ms. J.

You trusted her. But you never told her what was really happening in your life. You wrote something like, “If I couldn't share this with her, then I'd never be able to let anyone really know me.” What were you afraid of?

I was really afraid of being too much. As a teenager, I needed things from adults that they could not give me. I was looking to teachers to do things my parents should have been doing for me. So I was always worried. To this day, I worry so much about taking up too much of somebody's time.

I felt such a strong conflict with Ms. J and also a lot of other teachers—I really wanted them to worry about me. And also, I didn’t want them to worry about me too much. I wanted things to be normal between us, but also I wanted them to know what's going on.

You wanted her to worry about you. You wanted her to know what was going on, but you also wanted things to be normal between you.

Emi, I think you're describing love.

Wow. Yeah.

That's what love is, right? Knowing the truth about someone, and still having everything be okay. To me, that’s the experience of love— being seen and being known and still being accepted, even with the full truth.

I did love my teachers. And I wanted them to love me back.

Was part of you worried that if someone really knew you, that would change how they felt about you?

Yeah, absolutely.

There's a great line in this book by

Miranda July

. She says, "In my paranoid world, children and animals see the real me, and it is evil." <Laughs.>

Oh, man, so relatable!

I feel like that's such a universal human struggle. We want so much to be seen. We want so much to be known, and we're so afraid that if someone really knows, then they won't love us anymore.

Exactly. I think it's so much easier as an adult— I have emotional regulation. It's so much easier to be able to be like, I can honor other people's boundaries. I can sense what they need or ask them what they need. It was so hard just being a ball of feelings with an on switch or an off switch, and there's no in-between.

Some people would label that a mental illness, like there's the borderline personality traits right there! But to me, that's just part of natural human development.

It's also being a teenager.

Yeah, exactly.

Mental illness? Or teenager? You decide.

Being a teenager could definitely be defined as a mental illness. <Laughs.>

I’m so curious about your take on psychiatry. What were some of the diagnoses that you were given?

At one point, I had 13 psychiatric diagnoses. I was a 14-year-old with 13 diagnoses, one per year of life.

If anorexia is a discrete condition, I probably had it. PTSD—I definitely meet the criteria for that one. But I was also diagnosed with borderline personality, a classic diagnosis of people who are being abused. It's like, "Why are you being so emotionally unstable?" "Well, maybe because I live in hell."

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I thought if I do have bipolar disorder or some diagnosis that could explain it all, then at least maybe there's hope for me through psychopharmacology.

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I was also diagnosed with psychosis. My mom took me to an exorcist and then to the psychiatrist. I told him what happened, and he did not believe that my mom had actually brought me to a lady's house who saw the devil in my soul.

Did you believe the labels?

For a while, I really put a lot of stock in the diagnoses. I mean, some of them pissed me off. I did not enjoy being labeled as having a budding personality disorder. It felt insulting. At the beginning, my mom brought to to this therapist and said, "My daughter has ADD." I was like, "This is crazy."

Your mother said she knew you had ADD because you were "hyper-focused" while reading books. That is literally the goal of every author—to have a hyper-focused reader!

Yes. So I was prescribed Concerta, and I just felt like I was seeing into this abyss of depression and misery. In hindsight, it makes sense that I would take this medication and have one of the worst experiences of my life. And as an adult, I can't even drink decaf coffee. That is how strongly I react to stimulants.

I had had problems in my life before, but this was like, holy shit. I did not know that it was possible to feel like this bad.

They were like, “She's having a panic attack!” So they gave me Xanax. Then when they were like, “Well, because you reacted with panic to stimulants, you must be depressed!” I was like, “Yeah, maybe I am depressed.” I could not imagine getting out of my situation or feeling better. So I really was hoping that there would be some pill that was a panacea that was going to make me feel all better. And I thought, maybe if I do have some diagnosis that could explain it all, then at least maybe there's hope for me through psychopharmacology.

You were so young that you didn't know yourself enough to know, "Actually, I feel worse on this drug."

At times, I did feel, "This is not making me feel better." I attempted suicide when I was 13—that was when I was withdrawing from Lexapro. Doctors were like, "There's no such thing as 'antidepressant withdrawal.' You're suicidal. It must be because of you. Now you need an antipsychotic to make the antidepressant work."

Clearly, some of these meds work for some people. But they were not working for me, and nobody would listen. One of the big downsides of being labeled mentally ill is that as soon as you're labeled, people stop trusting you.

If you protest—

You have lack of insight.

What’s your perspective on what we call “mental illness”?

One of my most useful college classes was the History of Psychiatry. Before that, I believed that I had been irrevocably mentally ill, and by some miracle, I left my home, stopped taking medication, and became okay. The class opened my eyes to how, with a few exceptions, cultural these definitions are.

Labels can be useful— it was useful to me to seek out treatment for PTSD. But sometimes when we identify with the problem, it makes it harder to solve.

For instance, I had an eating disorder and was hospitalized. It was pretty severe, but I also refused to accept the label. People said, "You are never going to get better if you don't accept it." But actually, it was easier for me to stop doing those behaviors because it wasn't part of my identity.

That is fascinating, Emi.

We have an Alcoholics Anonymous model in the US. You have to say, "I'm Emi, I'm an anorexic." But as soon as you do that, it's part of your identity, and you can't just start eating—you have to confront your entire identity.

There's a beautiful line in Rachel Aviv's book Strangers to Ourselves, inspired by the anthropologist T.R. Luhrmann: "There are stories that save us and stories that trap us and sometimes it's hard to know the difference."

I'm someone who's also been assigned various labels. I'm so interested in the idea that not accepting the label can be helpful—to think, "This is an experience that I'm passing through."

I started taking antidepressants as an adult voluntarily during the pandemic, and it was really helpful to me in some ways. And I also had side effects that made me eventually want to go off. And whenever I've posted on social media about going off antidepressants, I have received so much vitriol. Where is it coming from? It's insulting to other people, if you go off.

Why did you want to share your story?

I thought if I didn't I would actually go crazy.

I was shoved into a lot of narratives: being this sick kid, and then this overcomer who got into Harvard. None described my actual experience, and I was really fighting—how to retain my sense of self when I'm playing this part. I saw writing as my opportunity to tell the truth. And give my younger self back this complexity that had been stripped.

I love the idea of giving complexity back to your younger self, like a gift.

People always ask me, is writing therapeutic? And my answer is always, if it is, it's really bad therapy. You're going to be doing it for a while before you see any benefit! The first step in my process is to show it to somebody, like, “Here are my uncensored thoughts, and please just tell me that I'm still a good person, that you still care about me.” I think that is the most powerful gift that we can give other people is that acceptance.

I was at this dinner the other night, and I was asking people about grief, because I'm a fantastic party guest. Someone shared David Kessler’s idea that grief needs to be witnessed. Maybe that’s also why we write memoir.

Yes. And I find so much solace in memoirs, especially brutally honest ones. I wanted to do that for other people and for myself.

We have these really strong ideas about worthiness in America. When my life turned around and I won awards and got into a prestigious school, I felt like every other person in this situation was this perfect child. I had shoplifted. I had lied. I had hurt myself. It's important when you're a young person to realize that the newspaper human interest story is different than the reality. Nobody is that perfect child.

Do you feel you changed as a result of writing this book?

I changed so much. I started writing it six months after I graduated college. I started out writing this tale of triumph—this book will justify why I got into Harvard and why I deserve it. And then I went to this place of, "Actually, I'm bad. I'm bad. I cheated. This is all a lie." And then I came out in this third totally different place that was much more outward-looking. And so I really credit writing Acceptance for bringing me into adulthood. It was the catalyst to get into therapy that actually worked, to start caring about my physical health. It's incredible how a book can change us, and I'm so grateful. I don't think I was going to make those changes on my own.

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