Tuesday, July 12, 2005

No Replacement For Therapy

First..this blog is in no way intended to be therapy, or be a replacement to therapy. I have no degree in psychology, I am not a psychologist or a psychiatrist. I am just a person looking to increase my functioning and live a full and meaningful life while trying to manage the symptoms of seemingly treatment resistant and chronic Major Depressive Disorder. Some of the content may upset others as I am going to be explicit about my thoughts of suicide and my struggle with depression. Be forewarned if that is something you have a difficult time with.

If you think you need therapy believe what you are thinking and seek professional help. Those niggling voices in our heads are often right. Well...they are often wrong too...but that is a whole different topic.

I just got back from my therapy session with Dr. X. I love my psychiatrist (pdoc). He is an extraordinary person who has taught me so many things. I have a connection with him like I have never had with any therapist or Dr. I ever seen. When I walk in his office and breakdown in tears because of my depression, or express my rage and anger at not getting well, he calms me so much. He is so relaxed, accepting, caring and compassionate. He accepts all my behaviours no matter how sad, distorted, or bizarre. He is genuine, honest and authentic. I believe he is my greatest role model. I can also honestly say that without him I would not be here today.

I was just reading my diaries from this time last year and despite my current insistence in therapy that I am not getting better, I realize I have made small leaps forward in terms of wellness. Just last week I told Dr. X. I was feeling suicidal and had taken to driving at extraordinary high speeds, praying my car would crash. I was feeling suicidal and I was driving erratically...but I realize now those suicidal thoughts were much less extreme compared to the constant and obsessive thoughts I was having this time last year.

Last year at this time I had been writing pages and pages of detailed and often violent descriptions of how I was going to kill myself, when I was going to and why I was going to. Reading those descriptions now I wonder how I survived. If you have never had this type of suicidal ideation you may not understand, but the thoughts are unrelenting and they come over and over and over...Almost like they trying to push you to act.

My last year's journal entries detailed how I would drag myself into my sessions afraid to say anything for fear of being hospitalized. Dr. X seemed to have an uncanny knack for knowing I was having suicidal thoughts and he would ask outright if I was having suicidal thoughts.
I could not lie to him as I respected him too much so I told him the truth. He would ask me my plans and would then ask me "Was I going to kill myself"...everytime I paused, thought about it, and realized they were just thoughts. Awful ones...but still only thoughts. Dr. X never hospitalized me like I feared he would.

My ability to openly share my suicidal thoughts when I am having them is definitely made easier by how strong my therapeutic alliance is with my pdoc. I first began to trust him more and more, when I started to recognize that he never judged me, never tried to challenge the validity of the thoughts...(they are MY thoughts after all), and he always asked me if I wanted to be hospitalized when the thoughts seemed to become overwhelming to me. I felt like a partner in these decisions. I began to really believe he would only hospitalize me if he thought I was a danger to myself.

I think another thing he did that allowed me to feel safe opening up, and facilitated my trusting him more, was make himself available to me. He gave me his pager number in case of an emergency. He explicitly told me to call if I thought I might try to commit suicide. Even though I knew I would never call him it was important to me to know I could if I needed to.

What I am trying to convey in my post is that ongoing trust and a strong sense that I am a partner working with my psychiatrist towards my wellness is a huge factor in my starting to get well. It took me a long time to learn to trust. That is something I struggle with. He won me over by continually showing he was ALWAYS caring and worthy of my trust.

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