Thank You Dr. X.

Thank God I have a psychiatrist who cares about me. I was so stressed out all Tuesday day and night about the OT thing. I cancelled my volunteering at the Art Clubhouse on Wed. as I just couldn't face the staff. On Wednesday morning I finally got the courage to call my pdoc to see if I could meet with him before Friday so I could manage to get to the Friday class I co-teach at the studio.

He was so nice. When I phoned I felt really uncomfortable...because I have this intense sense of responsibility in terms of keeping the boundaries of our therapeutic relationship really strict. I see him on Tuesdays...and everything is supposed to wait until then (according to me).

When I called he readily booked me in first thing this morning. I said, I am sorry for calling, but I really don't want this incident to stop me from going to the Art Clubhouse. You know what he said? He said, I am glad you felt comfortable enough to call me. He is so compassionate.

This a.m., once I explained what had happened, he said there is absolutely no reason for me to apologize for crying, or for feeling down at this place. He said it was not my problem. The OT is mistaken about the therapeutic value of my behaviour.

He explained that if you take a child who is extremely socially shy or phobic, afraid to go to school, to be with classmates, and you show them another child (a model) who is AS shy/phobic, but is managing to do the shy/phobic tasks (go to school, talk to playmates etc.), the first child will learn from the experience that maybe they can do it too.

It does not work if the model child is only a little shy and manages the task. The model has to be AS shy/phobic for the first child to see that maybe they to can go to school, or be with classmates.

He said my crying, and then managing to get myself together again and starting doing my artwork, or teaching classes, or volunteering is modelling that behaviour for others. It is helping others see that even if I am really depressed and feeling hopeless I can do things. Maybe, just maybe, one of them will see me doing that and believe they can too.

Dr. X. I wish you could read my blog. You made me feel so much better today. I still feel scared about tomorrow, but I feel much more confident about who I am and how it is okay to be me, despite what others say. Thanks for that.

Fatally Flawed

I was reading the Dinah's latest post on the "Shrink Rap" blog. The blog is titled "Are you my Patient"...and I very well could be. She writes about patients who come to see her yet never seem to follow her advice, or manage to make any meaningful changes in their lives. Although I follow my pdoc's medication advice for the most part... (I have said no to some things only to end up trying them out of desperation later on). I try to change, but amotivation, apathy, severe depression...where I can't seem to get out of bed for my life, all seem to get in my way.

My pdoc likens change, under these difficult circumstances, to a symphony. The music appears repetitive. It seems like the the music is not changing, but it is. With each movement the music builds and changes, rises and falls, sometimes ever so slightly, until finally it is something, not altogether different, but definitely changed, and developed into an even more beautiful piece of music.

Do you ever feel like you will never be able to change? Never get better? or that you have always been this way only it is getting worse?

I feel like no matter how much I try I will never get my normal life back. Even in my normal life I was so afraid of everything. I would get a great promotion and all I could think of was how I was going to fail, even though I worked extremely hard and was fairly intelligent, was proactive and had lots of drive and ability to do well.

I feel fatally flawed. Like all I will ever be able to do is serve coffee somewhere (for those of you who enjoy this work I am not that that is a bad thing...it just is not what I want to do), but have so much work experience and have worked so hard my whole life to get well paying and intellectually challenging positions. Now I feel like I can't do anything.

Yesterday I looked up what I needed to become an Occupational Therapist...something I'd be interested in, and I saw all I needed was 3 more credits from university to get into the OT program. Then I read the next line and it said 50% of my entrance requirement was a panel interview"...and I knew I couldn't do it.

I knew I couldn't manage the stress. I knew I couldn't explain why i haven't worked for 4 years, I knew I didn't have the confidence to sit in front of a panel of interviewers. Then I knew even if I did pass the interview I couldn't manage the stress of school...the exams and essays and even the classes with all the other people.

So I feel like there is no hope for me. I will never be anything. I don't know how to move forward, to change, to gain more self-esteem. I don't want to live the life I have, and I will never be able to achieve the life I want. I wish I would just die.

Exploding Pumpkin Head

Warning: Gruesome images...may trigger

I've been hiding under the covers for two hours...trying to hide from the voices inside my head; those brutal, self-critical, damning voices that won't go away and are continuously pushing through my head, intensifying both my anxiety and irritability and occasionally making me cry.

A sampling of the voices..."Do the BDI"(Beck Depression Inventory)...because I have no idea what I'm feeling right now. I told Dr. X I wasn't feeling depressed anymore, but I think rather my depressive symptoms have changed and the sadness is less, but the rest are worse. Am I depressed? Dysphorically manic? Anxious? Irritable?

So I do the BDI and I score 44, well, I think...it's better than when I was at the Outpatient Hospital Program...but my voices say, "both times the scores seemed way too high to be right". "Look up what the scores mean", they say. So I go online and it says, "...anything above 40 is unlikely and is indicative of either an exaggeration of symptoms, Borderline Personality Disorder, or Histrionic Personality Disorder". My voices tell me I have heard this type of criticism of my scoring on these types of tests before...remember the psychologist who tested me for vocational aptitude. I feel judged. I also feel like the veracity and intensity of my symptoms and the despair they cause me have been dismissed

I sit shocked...feeling like I was trying to answer the questions as honestly as possible and I know I was more depressed when I was in the hospital program. I try to be okay with this outcome and think, " Well, the questions are really open to interpretation (and I always over think the questions) and they are highly subjective. The questions and interpreters of my responses don't see/hear what goes on in my head"...but a huge part of me doubts myself and thinks, "maybe I'm not depressed, maybe this is just the way I am...and there's no hope for me in terms of being able to change".

Then the voices start asking, "Why won't Dr. X just tell me I have a personality disorder"? The question that I do or don't always seems to come up in my head. I do have a poor sense of self, I think of suicide all the time, a couple of my relationships are all over the map, I feel lost, empty, depersonalised and dissociated from my world and the people in it.

Many times I have asked Dr. X. if I have borderline personality disorder (BPD). He always answers, "I have never even considered it, you have some of the symptoms, but if you look at the general population almost everyone will have some of the symptoms". This, and the fact that when I am well I lose all, or almost all, the symptoms of BPD should console me. When well I rarely have interpersonal difficulties. In fact, I have been praised for my diplomacy and relationship or team building skills (at work) throughout all my jobs. When well I am alive, a bit wild, and have what is called a "hyperthymic temperament".

But I am not well...I start to feel really stressed out. I can't breathe. I'm having so much anxiety I feel like I'm losing it. Then the voices tell me I should kill myself. I start to visualize myself shooting myself in the head, over and over and over. I feel intensely angry at myself. I visualize myself taking a thin piece of wire between two sticks. I wrap the wire around my neck and I pull as fast and hard as I can until my head pops off. Then I pick up my head and I smash it into the cement over and over and over, until it breaks apart like a pumpkin exploding on a sidewalk.

Then I think...This is an impossible scenario, though comforting in some macabre way. So I think about how I could leave the party tonight, go swimming in English Bay and keep swimming until I drown.