Thursday, December 18, 2008

What? Why? How?

I usually start my pdoc appts by providing a recap of any symptoms I have been having. It's just always the way I start. I always forget something important. I should write what happens down. This is how it went this morning (as I remember it):

Me: I've been depressed, well all over the map actually.

Dr. X: All over the map?

Me: Yeah, depressed most of the time, but my mood has gone up when things happen, like I reconciled with my best friend, which I am very happy about. I visited another friend, Drawing with her one day, and that was fun. My mood went up. But when I got home I felt ashamed of how poorly I draw. I felt sad that I was as bad as I was.

Dr. X: This is something concrete we could help you with, your phobia of feeling ashamed, or embarrassed.

Me: Yeah. (Translation in my head)...nothing in the world will help me learn to trust people are honest with me. Nothing will ever make me stop feeling I am bad at things I do, and that people are always making fun of me, or dismissing me. Even when nothing in their actions suggests this.

There are so many times I have thought Dr. X was "most certainly ridiculing" my skills/talents. However, if I really think hard I can't see him doing that to anyone else. Why would he think bad things about me? Why would others think bad things about me? Why do I think bad things about me?
  • I'm tired all the time and sleeping between 3:30 and 6, or one day from 2-6. I just get exhausted.
  • I feel like I'm in a daze. It's not my memory as much as it feels like I am losing my brain cells. (I forgot to tell him I poured myself a drink and forgot the vodka...didn't clue in until I had drank half of it...duh!) (I did this again tonight...maybe my subconscious is telling me something)..."leave out the vodka"...Ya think?

    I picked up a knife right after making my coffee and looked at it wondering why I had done that, or I tried to put the martini shaker sieve on top of the vodka bottle. I take something out of the cupboard and have no idea why, I put thinks in the microwave that are supposed to go in the fridge. I momentarily look at the syrup (for my pancakes) and I can't remember what it is for...the list goes on.

    (Aside): I also forgot to tell him I am back to only two drinks a day. I was doing worse than that the past few weeks so that's good.

    This week and last week I forgot to tell him I have been falling....alot.

    At my middle sister's I took my dog out in the middle of the night to pee. I took a misstep on her porch (forgot there was a step there), fell, twisted my ankle, had a huge bruise and road rash on my back and on the palm of my hand. I thought I broke my foot.

    Afterwards, it was freaky, (but kind of funny), because as I feel I fell on the dog's leash, releasing him from his collar and there I am in agony unable to get up and my puppy takes off into my sister's back yard with no identification on him. I finally manage to get up, but at this point I have lost my shoes and am in my sock feet and I am limping all over my sister's soaking wet back yard in the pitch black trying to catch the dog...which, thank god, I did.

    I also fell twice in our driveway the past 3 days. I am destined to be one of those old ladies who falls and breaks her hip in old age. I have always been a klutz.

    Anyways...As the session proceeds....

    Me: Will you tell me how you see me? Tell me how you would explain me to a colleague if you had to pass me on to someone else.

    (Aside): So now Dr. X sits silent and inside my head I am thinking..."he's trying to frame bad news in some acceptable way, or he's trying to edit what he wants to say, rather than tell me the truth...and usually I interrupt and say it's okay to say what ever he thinks,
    ...but this time I slowed myself down and tried to think this silence is just his way. He is thoughtful about things before he speaks. He's just thinking. But deep inside I think he's thinking about how avoid giving me the truth, but I am struggling to believe he is, and always has been honest with me.

    Dr. X: First I would spend much of the time explaining your ongoing symptoms
  • I would like to change the question, so rather than address a colleague, I am addressing you (this brings me a step closer to trusting he is going to be honest)

Me: Tell me what I am doing wrong. Am I doing something that is making nothing work? Am I resisting for some reason? Does my therapy need to done differently...can't think of the word

  • I think it would be helpful for you to have some kind of benevolent structure in your life.

(I think he is referring to daily goals, plans and activities, that are both constant and positive for me. Examples, might be teaching at the Art Clubhouse, seeing friends, gaining more of a social network, exercise etc.)

Inside I feel the pain of losing my job, but recognize the structure there was too full of fear and stressful events for me to continue, but I long for that sense of accomplishment I got from working at something challenging. Deep inside I know I cannot manage the kind of stress that comes with a corporate job...still I long for the ability to work full-time again. So I ask about working.

Dr. X: You are working!

Me: (inside my head)...I mean REAL work. What I do is not good enough, I don't work enough, I am a burden on the system...but I don't say it because I know it must really annoy him that I can't move on and accept I am a different person now when it comes to the types of jobs I will be able to manage.

Dr. X: (Later on in the appt)...Actually I would like to see you go somewhere for a while, to the tropics or something, to somewhere that had a really structured longer term program.

Me: Like a sanitarium? (I was thinking of this in a positive way, as a place of rest with lots of support and stress relieving routines in place)

Dr. X: "No, that sounds too pejorative, something more like a retreat, where you felt you fit in with the other people there, where you did things together.

Me: (Inside)...that sounds more like a nightmare. I HATE group activities. I am a more one-one person or one - two person. Groups scare me.

(Out loud) I meant "Sanitarium in a positive way, like a place where a person goes to heal. (Inside)...I have thought about and tried to find someplace like know like the places people with TB went at the turn of the century, or the places you read about where therapy is available and it is a beautiful, hospitable place to become well again)

There's more...but I will write about that later. I went into my session sad and feeling things will never change, but Dr. X soon began helping me feel cared for. While for the past few days and on the way to my pdoc appointment I just wanted to quit therapy and medicine and quit trying altogether. Sitting in the chair, across from Dr. X. for only a few moments changed my mind. He has a way of making me need to keep trying, even when I don't want to. I will.

Going away somewhere warm and sunny does sound like a good idea...hmmm.


Border Life said...

How wonderful to have Dr. X in you life.

Catatonic Kid said...

I used to take post-it notes with me to see my shrink. They helped keep me a bit more focused, especially on the big stuff which funnily enough tended to be the parts I'd forget.

When I get really down on myself and fearful of being judged and such by other people I practice walking outside and running a loop in my head that says "they just don't care that much". It sounds a bit off - I mean it's not a very PC thing to think, is it? A bit bitter but it works for me.

I take a step, take a breath and repeat, repeat, repeat until suddenly I'm just walking and whatever I was so focused on doesn't matter so much anymore. It doesn't always work. Don't get me wrong, I know there isn't a quick fix for this stuff but it has helped start to get unstuck at times.

I sort of started to take the focus off the intensity of my own head. And sometimes I'd look up and realise just how true it was because everyone around me was so clearly focused on their own stuff and not what I was worried about.

catatonickid said...

Oh, and I meant to add maybe you could look at the website for The Gesundheit Institute? I don't know if you ever saw the movie, Patch Adams, but the doctor who that was based on created it as a place of joy and healing for all - it's still being built. You can volunteer to help out and it'd depend how much structure you need but I thought you might like to see that there are indeed sanitarium type options out there that don't necessarily have the same stigma as the old fashioned clinics and such.

I recently went to a wonderful yoga retreat in the Berkshires called Kripalu which was very similar. Did me a world of good just to be in the company of others with 'good vibes' who were willing to share the simple things in life. Sorry for the really long comments, btw. I know I'm rambling a bit!

Border Life said...

Oh, and have your brought up your falls? Is this typical or atypical? I know one friend who hurts her ankle whenever her stress and anxiety build up, it's an indicator of her mood, but falling could be an indicator of many other medical conditions. It's probably worth it to address it...

Yah, post its, a memo book-- I have one of those checkbook sized weekly calendars that I write stuff in to keep track of and recount. to my pdoc and tdoc... of course I also have a DBT diary card which helps, too...

Aqua said...

Border Life...yes, I thank god (or whatever it was that made it possible) that Dr. X continues to care for me...even if I'm a slow learner

Catotonic Kid...Aww to go somewhere and volunteer to be a clown...what a wonderful idea. I agree with the "they just don't care that much", except when thinking clearly I'd say, like you, that people are to busy with their own struggles that often other's go unnoticed. Looking back at some of the ways I was at work, and my boss saying she never saw my illness impact my work woke me up to that...what a horrible thing our mind is sometimes.

Borderlife: I used to keep a detailed mood diary calendar with all this info, but I stopped it because I began to believe the constant reminders of my bad moodstates was not helpful.

I've always been a person who falls a lot. My balance is horrible. If I got pulled over by the police and had to walk a straight line I'd fall over and get sent to the drunk tank even if I had no drinks.

I am constantly bumping into people I walk with. It's like I always drift to one side. very strange.