Shouting “STOP!” in retrospect (content warning: rape)

a cure for what ails you, abuse, personal experiences, ptsd, relationships, therapy

Hey readers!

I had a great, if intense, EMDR session this afternoon. I’ve mentioned X a few times before, especially in my last post, and he was the subject of today’s sessions.

I’ve mentioned before, in very vague terms, that I have a long history of sexual abuse. Those of you who have listened to the RISK! episode have heard me say it directly: I never talk about it. I’ve been to literally a dozen other therapists in the last eleven years, but due to insurance issues or money in general or whatever, I was never able to see a single counselor for more than a few sessions.

As a result, I am extremely uncomfortable discussing any of the rape-and-what-have-you in anything less than broad terms. I can vividly describe everything else–the physical and emotional abuse, what it did to me psychologically, how the effects have rippled through time and still mess with me to this day. But if you sit me down and ask me to tell you exactly what happened, to describe it? Then I clam up and can’t even say the word “sex” without looking at the floor.

I had to do that today. I had to lay out the details of a memory that I very recently had a flashback about. I had to describe how we were positioned, to talk about that rolltop desk and how I used to lean into it and stay absolutely silent because I knew if I made a sound or asked him to stop, he’d be angry. And when you’re in abuse-victim-survival-mode, avoiding that anger is pretty much all you think about. I just had to get through that moment and then things might be better. (This is called “conditional assumption” or “deferred happiness” and is extremely common in abusive relationships.)

I want to pause to make an important distinction here, since we are talking about rape and consent–by “had to,” I mean that my therapist (who we’ll call S from now on) invited me to talk about my flashback in very general terms: “Can you tell me what the flashback was about?” She never probed for details, and her sensitivity was much appreciated.

We began by identifying my negative false belief: He is raping me and hurting me but I’m not saying anything because “I don’t matter. I have to do this.”

She asked me, as is typical by now, to rate how disturbing I found that belief while I was thinking about the scene I’d described. Then, she asked what I’d like to replace that belief was (and how believable it was to me as I was sitting in her office, pre-EMDR). This is what I replaced that thought with: “I do matter, and I don’t have to do this.”

I’ve probably mentioned this before, but I prefer to use the hand buzzers for EMDR–I’m migraine-prone so the lights don’t work well, and because I have that thing where sudden and/or loud sounds in my left ear trigger an uptick in the dissociation. So, I relaxed (as much as I could) into the couch, a buzzer in each hand, and willingly stepped back into that moment.

It was like entering a time capsule. I was disturbed and amazed at how easily I could reenter the memory. I saw myself, leaned against that desk, slipping my fingers, one at a time, into the grooves in the wood as a distraction. My abuser–my rapist–was not there, only a strange, smooth grey nothingness behind me. It was like my mind wasn’t even going to let me go there, to see his face. I’m actually grateful for that. I imagine my mind saying, “Okay, so you have to relive this a little so you can rewrite it and feel better, but you do not need to see his face. I’ve got your back.”

I was standing in the corner of my bedroom, just at the foot of my bed, and looking across at that girl by the desk, that girl who was me-and-not-me. I saw our dresser. I saw the window–the light outside was, as in most of my memories of X, a strange grey-blue that could have been dawn, dusk, or midnight. In my memories, it is often all three.

S. stopped the buzzers and had me draw a deep breath, as is our custom by now. She asked what I saw, how I felt. Then we started the second round.

This time, the details were clearer–the way the yellow light cast shadows at the corner of the desk, the frayed edges of the area rug behind the dresser. I began to feel angry. I wanted to scream at him to get off her, to let this girl–this child–go. To stop filling her head with bullshit and lies.

I was 18. I’m 29 now. Looking back, I was a baby. I was coming out of this intense childhood full of abuse and anxiety and no one had taught me what a relationship was supposed to look like. The only relationships I saw were dysfunctional ones; later in life, I sought out and clung to what was familiar to me. Unfortunately, what was familiar was also rape-y and weird, which are two words that could pretty accurately sum up my life from ages 17 to 19.

I told S. about my anger. We chatted for a few minutes to decompress, then jumped back in.

This time, I was furious. I was screaming at him, telling him that I am a human being, not something to masturbate into and that I do matter. That I don’t need to perform for anyone. That I am not a dog that does tricks and licks its owner’s boot even after being kicked. 

That my body is mine, and that my ownership means something.

By the end of the session, I found the false belief, the “I don’t matter and I have to do this,” disturbing for a different reason. I find it disturbing that I ever felt that way. And above all, I find it disturbing that another human being was not only capable of doing that to me, but that he enjoyed it.

We’re going to pick up again next Monday. In the meantime, S. told me to keep yelling at him in my head. I left her office with a smile.

You know how in Dogma, Alanis Morissette plays God and absolutely destroys Bartleby with her voice? That’s how the scene with X is going to play out in my head from now on. I’m also picturing the final stanza of “Lady Lazarus” by Sylvia Plath:

Out of the ash
I rise with my red hair
And I eat men like air.

I am wishing you a wonderful week filled with ferocity, dear readers! Y’all come back, now, y’hear?

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Reclaiming my body, or: ¡Viva la Revolución!

a cure for what ails you, abuse, anxiety, dissociation, memories, personal experiences, ptsd, relationships, therapy, three hopeful thoughts

Sometimes, EMDR can take a while.

This week, my therapist and I tried to pin down a common theme in some of my more disturbing memories of X. We essentially started freestyling at each other, throwing out possibilities and ultimately ending up…pretty stumped. She thinks it all goes back to what she calls “the rabbit hole”–dysfunctional patterns with my mother and my other relatives that began when I was a child and are coloring how I interact with the world even now, twenty-odd years later. We also had a really great conversation about body autonomy and ownership, and how I’ve been seeing myself as a commodity for so long and “going along to get along” for pretty much my entire life.

My existence has been defined by one thing: the need to protect myself at all times, to defuse all the bombs, to take all the right steps so I don’t fall into a crack or a lava pit or inadvertently provoke someone else’s rage. I make myself as pleasant and agreeable as possible because I grew up learning that rocking the boat meant someone screaming in your face.

I am a nice person, yes. The whole thing isn’t fake or some survival mechanism from long ago. I don’t see a reason to be unkind to people, when giving a stranger a compliment takes less time and brightens someone’s day. But I am gentle with others because I am so often afraid. As a child, survival meant being quiet, being kind; never confronting, never correcting.

My therapist and I have also spent the last few weeks working with my deep-seated body image issues. It’s a topic I don’t often talk (or write) about because there’s a mountain of shame that comes with it. However, I try to be transparent in my posts and other communication with you, readers, so let me bring you up to date.

My family-of-origin is weird in a bunch of ways. Even if you’re relatively new to the blog, you’re probably aware of this. But one of the most pervasive and insidious messages I received as a child was that my stomach was ugly and needed to constantly be “held in.” You know, like how you sometimes suck in a bit to zip up a new pair of jeans? Like that, except all the time.

Long story short, we were at Disney World when I was nine or ten and was wearing this cute little biker-shorts-and-crop-top deal, neon green and black. I thought I looked so cool with my white bucket hat, despite the fact that it was 95 degrees and I was wearing, well, a bucket hat. We were posing for a picture in front of some palm trees and one of the relatives who’d brought me on the trip poked my stomach and said, “Suck that in.”

Again: I was, like, nine or ten when this happened.

And I had been holding in my “gut” every day for the next twenty years. I was terrified to let anyone see me not “holding it in.” Even as a 90-lb freshman in high school, I still held it in. I was terrified of sleepovers–with friends in school, and with lovers later in life–because I knew I would not have complete control of my body and what it looked like while I slept.

It took two long, very difficult EMDR sessions, a ton of self-care, and lots of encouragement and positive feedback from my fella, but I am slowly letting go of the compulsion to suck in my stomach at all times. As I write this, I’m slouched over like an overstuffed possum* (thanks to our wedding food tasting this weekend!) and I do not care. I know no one here is going to judge me. I am comfortable that I am not some hideous trog if I’m not pretending like I don’t have organs in my abdominal cavity.

The way I view my body changes from day to day, of course, but the last week has felt effortless.

But this is only the first step. My body has never been truly my own. Over the course of my life, I have allowed others to pick at me like gulls on a whale carcass: this one takes my body but nothing else–they use my flesh and forget that I am human. That one only likes me when I’m not sad. This person takes for granted that I will always forgive them. And it goes on and on, the give-and-take-but-mostly-take that made up all but the last three or four years of my life.

Think about that for a moment. Twenty-five years of feeling vaguely “other” in my body, like I was driving a leased car. Mine, but not really mine.

And I have allowed–even willingly participated in–this parceling-out of me, of my body, of my mind, of my experiences. I have done this because submission means safety. If I don’t really care either way, I’ve long said, what does it hurt? Why not let someone else make the decision? Why even bother giving an opinion, if it will make this person happy?

It’s funny that I am just now realizing how dysfunctional this mindset is. Having those thoughts on occasion is natural. Having those thoughts form the basis for every interaction you have with another human being is probably not the healthiest way to go about this whole “life” thing.

Those patterns are why it’s so scary to have finally found a partner who wants all of it at once–even the parts of myself I find the ugliest and most shameful. I am learning that it’s okay to express my opinions, even if I’m not 100% sure the other person shares them. Wedding planning has, on the whole, been full of great opportunities for me to test out the whole “assertiveness” thing without the stakes being too high. For the first time in my life, I feel safe disagreeing with my partner because I know it will not immediately lead to a breakup or abuse.

So, my assignment moving forward is to nurture myself, to keep being me, to keep doing the things I enjoy without worrying so damn much about how it’s going to look or who’s going to judge me. I’ve been doing this, to some extent, for a while (my guy and a certain friend can attest to me publicly howling and barking like a dog through a bronze metal sculpture last summer). I vowed last year to make absurdity common in my life and to ask “Why not?” more often than “Why?” when thinking about doing something. I want to be freer. I want to feel that my body is my own. And most importantly, I want to keep being stable and happy.

Now that you know a bit more of my tragic backstory, readers, how many links have you been able to make between your early childhood experiences and the person you are today?

* This guy right here:

possum-150200

We came home from the tasting and just kinda slouched on the couch like this while the cats prowled hungrily, begging for leftovers.

 

On Vulnerability

a cure for what ails you, abuse, anxiety, memories, ptsd, therapy, three hopeful thoughts

There are so many words in the English language relating to innocence and vulnerability, and most of them can bring me way down if I’m not careful. They provoke some ancient anxiety that I’ve come to realize, with the help of my excellent therapist, are linked to what she calls my “wounded younger self.” (I was incredibly skeptical of inner child work at first, but it is incredibly effective and incredibly healing.)

“Little” is an adjective that, when paired with certain words that also remind me of innocence, usually messes me up emotionally. That’s the word that got under my skin tonight.

I’ve been feeling kind of “off” the last few days. I recently blocked my mother completely on my phone–including the second number I thought she’d deleted until she used it to contact me after I blocked the first number–and was treated to some really unsettling dreams on Monday and Tuesday night.

Monday’s main feature involved me skipping my grandmother’s birthday party because my mother was going to be there and I knew she’d be drunk. Tuesday’s late-night horror show involved a healthy helping of guilt because I was hiding from her (in a Target, of all places) while she wailed and lamented that she “couldn’t believe [I] didn’t want to talk to her.”

Naturally, this put me in a pretty weird headspace today. Wednesdays are my big clinical days and I do group as well as individual client work. As such, I generally store my feelings away to deal with later and do a pretty good job of not thinking about them at all during the day because I’m 100% focused on my clients. (Side note: I adore them, and I’m bummed that I’m leaving my practicum site in a few weeks!)

On the drive home from class this evening, though, those neglected feelings reared their ugly collective heads and roared.

The anxiety and guilt were so powerful that I considered just going to bed early and sleeping it off.

Instead, I took a shower.

I focused hard on those thoughts and attempted to get a good, cathartic cry in. Nothing happened.

I turned the focus to that wounded younger self I mentioned and took the opportunity to literally hug myself while I waited for the conditioner to work its magic on my decidedly unruly hair. I decided to speak aloud because I’m home alone most days during the week and hey, I knew the cat wouldn’t judge me. (Audibly, anyway.)

I told my younger self that it’s okay. I told her I love her and that I’m sorry she felt like no one could keep her safe. I told her that I’m going to do it. This changed into me speaking to whatever hypothetical future child I’ll end up having. I promised that child to take the best care of it I can and to make sure it never feels afraid or lonely.

And I cried. Instead of stifling it or trying to be tough, I gave myself over to it completely–ugly, wracking sobs. After a while, those sobs turned into relieved laughter that I’m sure sounded like I’d finally gone completely ’round the bend.

I think there’s something to be said for having a good cry.


On Monday, I spoke to my clients in group about the concept of “ghosts”–they had all shared some intense and profound stories about their deepest wounds, their secret shames, their most painful memories. I told them that while they can haunt you, they can’t physically hurt you. You can start to let go of them.

I led them in one of my new favorite exercises, which is “HA!” breathing. Basically, you take a deep breath and push that breath out while making a “HA!” sound. I opened the group with the exercise and invited them to imagine themselves yelling at someone or letting frustration out. I demonstrated (because I am not afraid to look silly anymore), and they loved it. After the big, intense sharing session, I led them in the exercise again, this time instructing them to imagine the “HA!” on the exhale as them blowing out part of their ghosts.

I’m glad it was a hit, and I encourage you all to try it, readers. Howling into the void or, as I called it, “therapeutic yelling,” is incredibly cathartic.

 

Archaeology

a cure for what ails you, abuse, anxiety, dissociation, memories, ptsd, therapy

This afternoon, my therapist and I had planned to do some EMDR related to X, but we started talking about my birthday (which was last Tuesday, which means I survived another trip ’round the sun, which is excellent!) and the somewhat messed-up present my biological mother sent me.

I won’t go into details on the gift because details are irrelevant. The important part is, we started talking about The Night My Mother Tried to Kill My Grandmother™.

I’ve written (and spoken) about it pretty extensively before–or at least made reference to it–but the gist of it is, there was a huge argument that culminated in my (very drunk) mother assaulting my grandmother.

(There is a brief, yet potentially disturbing description of assault below, in white; please mouse over only if you are comfortable with and prepared to read it.)

My mother knocked my grandmother’s walker away.

Side note: My grandmother had broken her hip a few years before and was still having trouble getting around. Plus, she was around 73 years old by this point. My mother stood on my grandmother’s feet and punched her repeatedly in the face.

All of this was relayed to me, years later, by one of my aunts.

When it happened, I was seven years old.


At this point, you may be wondering why in god’s name I would want to go dredging that up. After all, memories are repressed for a reason, right?

Basically, we mapped out the first few years of my life and discovered that my grandmother was my strongest attachment figure, which is kind of a no-brainer. The woman was the one constant in my life. When I was four and she broke her hip shoveling snow and had to spend months in a rehabilitation facility, I was gutted. Sure, my great-aunt was around, and I loved her dearly, but she wasn’t my Grandma. She wasn’t my mom.

Side-side note: Anyone can be a mother, but not anyone can be a mom. Also, anyone can be your mom–it doesn’t matter whether they gave birth to you.

We’re finding that a lot of my anxiety–most notably my fear that something bad will happen to my fella or someone else I care about–stems from my overwhelming terror that on that night, my grandmother was going to die.

She didn’t, thankfully. But from that point on, I was a different child. True, unfettered happiness no long existed. It was tempered by a constant watchfulness, the fear that she would be taken from me again.

I couldn’t sleep in my own bedroom for a year or so after that night. My grandmother, in her infinite wisdom, noted that there were two twin beds in her bedroom–she’d previously had them pushed together and was using the space in between as a quick place to stash her books, a flashlight, tissues, and so on. However, she cleared all of that out and I started sleeping down there, which helped.

A little.

There were many nights when I would wake from a dead sleep in a panic and watch her closely to make sure she was still breathing. More than once, I ran upstairs and woke my sleeping aunt in tears, afraid that my grandmother had died.


My therapist and I also think that this whole attachment thing is the reason I experience love (and most other positive emotions) cerebrally rather than in a true emotional sense. I can’t process those feelings anymore. It’s not that I don’t want to, or that I don’t try. I just can’t access that part of myself and it’s been decades since I last could. I am, in essence, a little bit dead inside.

Our hope is that by filling this gap, by finding the missing pieces that are hidden under the fridge, behind the bookshelf, between the cushions of the couch, I will be able to begin healing and connect my head with my heart. That has always been one of my primary treatment goals. I want to be fully present. I want to feel things instead of having a general awareness that I’m having feelings (and sometimes having brief flickers of actual feelings).

I want that block gone, and I’ll pay just about any price. I’ve lived too long with my head down, shouldering through every obstacle, focused only on getting to the next checkpoint. I’m tired of surviving. I want to live. If my quality of life has to momentarily suffer for that to happen, I can live with that.

For the greater good, right?

Right?

Life as a haunted house

a cure for what ails you, abuse, anxiety, dissociation, memories, personal experiences, ptsd, relationships, therapy, three hopeful thoughts

I’ve been having the nightmare again.

In it, I could be seventeen or twenty-nine. In it, I am standing in my childhood bedroom, looking out the window at the front lawn. There’s a weird unstuck-in-time feeling; it could be morning or late at night, but the sky is a flat indistinct expanse over the rooftops and trees. The lighting is confusing, too–is it dusk? Dawn? Just a cloudy afternoon?

His old, beat-up white Buick rolls up to the curb and my stomach twists in on itself, the knots fluttering like anxious birds.

What did I do this time?

He could be in a good mood, or a bad mood, or both, or neither. He could be smiling while walking up to my front door but then want to talk to me, right up close (as Stephen King wrote in my favorite novel of his, Rose Madder).

Or maybe it’s fine. Maybe he’s just going to pick me up and we’ll go hang out with friends or sit in his car down by the river, just talking for hours.

But I know damn well it’s not fine.


I am all ages, all the time. My therapist says that I need to nurture my wounded inner child, which I thought sounded stupid and New Age-y until I actually started trying it out. It’s effective–when I get anxious or depressed, I look at my younger self and pull her close.

You didn’t do anything this time, or any time. It’s going to be okay.

I wish believing was as easy as speaking.


On Thursday, the anxious snakes took up residence in my belly as I cleaned the apartment. My fiance had had a rough day on Wednesday and I knew he was feeling crappy, and also that it had nothing to do with me. He wasn’t rude or snappy with me, but he wasn’t really in the mood to spend much time talking during our nightly phone call. I knew this wasn’t my fault.

But the ghosts, the echoes, they spun a different story. As I swept and cleaned the kitchen floor (which, with two cats, is a neverending chore), the words kept flowing into my mind.

I have to do this right or he’ll be upset.

My fella? He never gets upset with me, ever. I think we’ve had maybe one argument in the entire three years we’ve been together. He is sweet and gentle and kind. We coo over the cats together, make a game out of going grocery shopping, laugh at hideously dark things that we know aren’t supposed to be funny.

But the trauma said,

Do it right, or else. Or else he’ll be mad. Or else no one will love you.

I paused many times during my cleaning spree to speak aloud to myself, to that wounded, younger part.

He is not like X. You were a baby. It was not your fault.

Sometimes, it works, but I’m pretty sure it’s just me handing a squalling child a piece of candy to shut it up. I don’t actually deal with the feelings. I invalidate and suppress and push, push, push until they go away.

My therapist and I have done three EMDR sessions now, and it seems to be a magic bullet for me. The first two sessions dealt with my childhood and centered around two specific disturbing memories and the phrase, “My mother’s anger is not my fault.”

Today, we dealt with X and the nightmare, which has been occurring with alarming frequency. I recently took an elective on domestic violence, and I know that’s what’s stirred all of this up again.


The ghosts are not happy when you call them out. They want to stay hidden and rattle the windowpanes, throw a few dishes when you’re not watching too closely.

And they expect to get away with it.


Today, we embarked on a grand journey of the hell I lived from ages 17 to 19. We worked on the phrase, “I didn’t do anything wrong.” I’m mostly believing it now, but only as it pertains to that one image. I know we have more work, so much more work, to do before I’m healed.

But the most upsetting part isn’t the actual image or the memory. The worst part is how young I was, how vulnerable. X saw that. He latched onto it. He told me his tales of woe and wept insincerity, and I bought it. He took my kindness, my urge to nurture and pacify, as weakness.

I don’t often cry in therapy, but when I do, it’s because that girl back then was so young. She was a baby, even at 17, and I feel overwhelmingly protective of her, this past-me. I’m not sure if it’s because I’m more self-aware now or if it’s some sort of misplaced maternal instinct, but when we’re focusing on a memory in EMDR, I see myself standing beside her. By round three of EMDR*, I have my arms around her and I am holding her close. I am telling her that it’s okay, that she didn’t do anything wrong, that she is good and lovable and so much more than what the trauma says.

And as the session progresses, the frightened, anxious self–the part that believes she did something wrong–becomes defiant. It was amusing the first time it happened in our first session, when the five-year-old self in the memory we used actually kind of yelled back at my mother.

This time, the wounded self snapped, “If he’s pissy, it’s because he’s an asshole. I didn’t do anything wrong.”

This defiance, my therapist says, is a good sign. I think it is, too. Also, it makes me chuckle–I’ve always been pretty stubborn, and time and time again, I’ve seen that if I’m pushed and threatened enough, I will gain the strength and courage to fight back.

As much as I hate that I’m going to be in therapy for a while (my insurance is awesome, but the co-pays add up), as much as I hate that other people dealt enough damage to put me there, I recognize that I am fighting back. That is so much. That is everything.

I am fighting the ghosts. One day, I will drive the last of them from my house and I will finally feel the peace most people take for granted. Right now, I’m actually feeling pretty peaceful–I went into therapy feeling very tense, and as I drove home, every muscle in my body felt loose and relaxed in a way I don’t often get to experience while I’m awake.

I’m going to leave you with this thought, readers. People may have done damage to you, but you are not damaged. You can fight. And I’ll fight right alongside you.

We’ve got this.


* We typically do three or four rounds with the same memory and the same phrases. Your mileage may vary, but my sessions go like this:

  • On a scale of 1-10, how distressing is the phrase (for example, “What did I do this time?”) to you now?
  • On a scale of 0-7, how believable is the phrase you’d like to replace it with? (For example, “His anger is not my fault.”)

I use the hand buzzers because I’m migraine-prone so the blinking light isn’t great (and I find that closing my eyes helps me visualize the memory we’re using). Headphones with alternating sounds between the left and right side can also be used, but since unexpected or loud sounds in my left ear makes the dissociation spike for some reason, we ruled that out.

Bilateral brain stimulation is awesome! The brain is so amazing, how it can bend into impossible shapes, at impossible angles, and not break.

Love your brain, your beautiful “broken” brain, readers.

 

Those Old-World Blues

a cure for what ails you, anxiety, major depression, memories, personal experiences, ptsd, therapy

I won’t lie, readers; I’ve been down quite a bit lately. Most of it stems from deep-seated guilt that’s been playing the long con on me for most of my 28 years–it likes to pop its ugly head up and hit me so hard that sometimes it feels like I can’t breathe.

I’ve been carrying around a back-breaking load of guilt since I was a child. Some of it was inflicted by others, some of it by myself. There were so many little things–messages, perhaps–that sneaked in and grabbed me when I was at my most vulnerable.

When my mother went to prison, one of my maternal aunts abandoned her life in Chicago–what I perceived to be a vibrant life of friends and work and independent living–to return to her hometown to help my grandmother raise me. She never tried to make me feel guilty, but the damage had been done long before her arrival. I felt that there was something “wrong” inside me, that I didn’t deserve to be treated well, that I had done something to deserve the early childhood abuse and neglect that made me into a cautious, anxious, hypervigilant kid.

It all began to snowball from there. Anytime someone would do something nice for me–even something as simple as buying me an ice cream cone–I would immediately feel terribly sad for reasons that my child’s mind couldn’t comprehend. (Fun fact: To this day, the music from an ice cream truck makes me want to cry. Brains are weird.)

As many of you know, I’m studying clinical mental health counseling at Hopkins. I never expected to get in, but I was ecstatic! (I still am, though thankfully, the disbelief has faded a bit.)

My fiance has generously offered to support me financially through this time, as it’ll be probably another year until I can land a paying gig in my field. He’s told me time and time again that he doesn’t mind doing this because he’s financially secure enough to do so and because he loves me (and I suspect it also helps that I’m incredibly low-maintenance–see above paragraphs on guilt). I trust him and try to take him at his word.

But more and more frequently, the old guilt starts to creep in, which leads to devastating lows. Lately, I’ve found myself wanting to cry but not quite knowing why. I think it’s because I’ve suppressed so many emotions. I deal with everything by not dealing with it, which I recognize as alarmingly unhealthy behavior. Once I’m added to his insurance plan, my first order of business is to find a really good trauma therapist (that isn’t based out of one of the sites I’m looking at for practicum/internship).

Today, my fella told me that he thinks I have things “more together” than I think. And he’s probably right–I feel very good most days, although there are little nagging low points on even the best days. I can usually brush them aside using a couple of methods I’ve learned, which I’ll describe below.

Tonight is a rough night. He’s at dance practice, which is awesome–I’m glad we each have interests of our own, and it gives me time to practice the piano without being embarrassed about how rusty I’ve become. It also means I have time alone to cry everything out without worrying about making him worry.

Earlier, I went out on our balcony and looked up at the sky. It wasn’t quite dark but the moon was out in full force. It reminded me of my Great-Aunt Mare and how she’d come to the house twice a day when I was young–once in the morning for coffee with Grandma (her sister) and once in the evening to watch Wheel of Fortune with us. (Side note: I was awesome at Wheel of Fortune.)

I decided that a good cry would be the best medicine, since I’ve been feeling kind of weird all day, emotionally speaking. Shortly after her death, I made a small album on Facebook of the best photos of me and my great-aunt–Halloween at a pumpkin patch, hugging me close for a photo at my eighth birthday party, holding me when I was a baby. I looked at them and I let myself cry. I let myself howl my sadness into the void. And then I sat up and said, “That’s enough; let’s go write a blog post about it.”

I find that if I don’t come up with ways to distract myself, the sadness will become endless waves of grief and shame and all of the emotions I’ve been hiding away all these years. Once it’s out of the box, it’s so hard, so exhausting, to put it all back in.

I apologize for the downer post, readers. I haven’t had a personal post in quite a while but I feel as though being open and honest about my emotions, good or bad, can make others feel less alone. There have been so many times when I’ve been endlessly Googling about a specific worry or fear and bam, there’s a blog post about it. Though it may not help right away or offer solutions, it does make me feel less alone.

I hope you’re all staying safe and doing at least okay tonight. We all need to support each other, at our best moments as well as (and especially) our worst. We’re a community. We survived horrific things, and we continue to survive. Never forget that.


A Few Coping Techniques

  • I saw this one on Reddit last week and loved it. In a nutshell, the poster’s therapist advised them to think of someone they really dislike and imagine that all of the negative thoughts and worries are being spoken aloud by [whatever person]. The person this poster chose to use is Trump.
    • The way it works: Whenever worries or negative self-talk pop up, you go, “Shut up, Trump! [or whatever person you’ve chosen].” It actually does work, and it’s great for shutting down those thoughts at the drop of a hat. Of course, it’s always good to revisit those thoughts at a calmer, more appropriate time, but it’s nice to have a method to use when you’re in a situation where you can’t fully emote.

 

  • Another method I love (and promote to others quite frequently) is Ellis’ A-B-C-D-E method of challenging distressing thoughts. It comes from Rational Emotive Behavior Therapy (or REBT). Here’s the breakdown.
    • Step A: Identify the activating event–this is the event that triggers anxiety, depression, etc.
    • Step B: Look at the emotion you’re feeling and combine it with the activating event. Then, try to identify the beliefs that go along with that event and examine how they cause anxiety/etc.
      • For example, someone buying me something makes me feel guilty. This feeling of guilt and sadness comes from early childhood experiences. The end result is that I feel as though I don’t deserve kindness.
    • Step C: Look at the consequences of your irrational beliefs and realize that they can become a self-fulfilling prophecy. Because my response to kindness has been guilt and sadness for so long, I expect to feel that way every time someone is kind to me.
    • Step D: This is where you start to challenge those irrational beliefs and replace them with other, more positive ones. In my case, I need to work on building up my self-worth (long term) and thinking about the symbolism behind gifts and acts of kindness–“This person loves me and cares for me, and this act of kindness is coming from that place of love, not from a sense of obligation.”
    • Step E: This is basically the end goal and is usually called “cognitive restructuring.” At this point, you put all of the steps together and take special care to notice how the process has affected you and whether or not it has helped you to combat all the pieces that bring on the negative emotions (in Steps A and B).
      • You’re essentially re-conditioning your brain to replace negative associations with positive ones. It’s definitely a long road, but I’ve found it to be extremely helpful. However, it’s less useful to me when I’m in a crisis moment.
  • The last one is very calming to me, because a lifetime of CPTSD has led me to an incessant and sometimes self-destructive need for control. I worry endlessly about bad things happening to loved ones (because abandonment issues are fun!), so this little mantra really helps me chill out and remember that I can’t control every variable in my life.
    • Essentially, the saying goes, “If you can change something, do not worry, because you will find a way to change it. If you cannot change something, also do not worry, because there’s nothing you can do about the situation.”
      • This takes some getting used to if you’re like me and overanalyze and catastrophize everything, but once you’re there, it can be a very powerful tool for derailing anxiety before it hits its boiling point.

News Day Tuesday: Ohio State Mental Health Triage

a cure for what ails you, anxiety, News Day Tuesday, therapy

Good afternoon, readers! Today, we’re tackling the concept of mental health triage for university students. Ohio State University has reported a 43% jump in the last five years in the number of students seeking mental health care. Needless to say, that’s huge.

The question of how much academic demands contribute to anxiety levels among the student body is a complicated one. Parenting styles have definitely changed over the last decade or so–I’m 27 and when I was young, “helicopter parenting” really wasn’t a thing. My peers and I were allowed to walk alone to and from school and play outside unsupervised, often late into the after-dark hours. My family placed relatively few restrictions on how I spent my free time; reading and viewing choices were left up to my own discretion, with the assumption that I would make good choices for myself. As a result, I didn’t have much trouble adapting to the freedom that comes with college life, though I did live at home for the first two years of my undergraduate program.

As a non-parent, I can’t speak personally to what parenting styles are in vogue these days. However, it seems that (for very valid reasons) parents have become much more cautious and protective. This naturally leads to students feeling anxiety over the unprecedented freedom that comes with college and living away from home for the first time. Tuition and student loans are also enormously stressful–I know I’m not the only one who had a bit of a freak-out upon receiving that first scary bill after the post-graduation grace period ended. The overall “climate” of university life, combined with the myriad of complicated developmental changes adolescents and young adults have to navigate, creates a perfect storm for the emergence of mental health issues.

This brings us back to the subject at hand: mental health triage. It’s an intriguing concept and one that’s particularly timely; with so many patients in need being turned away from psychiatric wards due to lack of beds, it’s clear that we need to figure out a way to prioritize who needs what kind of help, and how urgently they need it.

Ohio State’s triage consists of determining whether students require more intensive one-on-one therapy or more general group-based therapy and seminars. The university offers a workshop called “Beating Anxiety,” which is something that I’d love to see implemented at more schools, particularly as part of the standard first-year curriculum. During my first year of undergrad, I saw many of my peers struggle with taking full responsibility for every aspect of their lives. It can be overwhelming to navigate roommates and coursework as well as meeting daily needs for the first time. Add to that a work-study job or two to supplement financial aid, and it’s not hard to see why so many students are stressed.

Another aspect of Ohio State’s program that I love is the “Recess” event:

On a grassy lawn, there are tents where students can make balloon animals, blow bubbles and play with therapy dogs and a large colorful parachute. The event is designed to help students relieve stress and to introduce students to counseling center services and staff in a fun way.

– Students Flood College Mental Health Centers, The Wall Street Journal

You can read more about the impressive range of resources offered to students at Ohio State here.

Readers who have a college background, what kinds of programs do you think are most valuable? What was/is available to you?


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News Day Tuesday: Bipolar Awareness Day!

a cure for what ails you, explanations, major depression, medication, mood diary, News Day Tuesday, ptsd, rapid-cycle bipolar disorder, stigma, therapy

Happy Tuesday, readers! Today (October 4th) is Bipolar Awareness Day, so I wanted to share an article with you that outlines the basic symptoms (for the uninitiated, as I know there are some new readers here) as well as what’s on the horizon in terms of treatment.

First of all, let’s hear about what bipolar disorder actually is. I’m referencing bt.com for the purposes of this tidbit, as the article I found gives a really great Reader’s Digest condensed version of the illness.

National charity Bipolar UK characterise the condition as “a severe mental health illness characterised by significant mood swings, including manic highs and depressive lows”, and note that, “the majority of individuals with bipolar experience alternating episodes of mania and depression”.

According to this article, it takes 10.5 years on average (in the UK) for people with bipolar disorder to be properly diagnosed. The National Depressive and Manic Depressive Association (NDMD) paints a similarly grim picture: it can take ten years or more for a diagnosis to be reached, and 69% of cases are misdiagnosed.

What are the symptoms?

There are two sides to bipolar: mania and depression.

During a bout of depression, it is possible to feel: grumpy, without hope, guilty, self-doubting, suicidal, pessimistic, worthless, lacking curiosity and concentration.

And with mania: elation, full of energy, ideas and plans, easily distracted, feeling invincible, risky behaviour including spending huge amounts of money.

Both can feature: lack of appetite, insomnia and delusions.

-bt.com

My experience began very early. I remember fits of agitation and depression as early as eight years old, which at the time was chalked up to the incredibly rough hand I was dealt–a broken home, a mother who struggled with bipolar disorder herself as well as alcoholism, extreme bullying, and persistent nightmares (which were later diagnosed as a feature of PTSD). NAMI states that rapid-cycling bipolar disorder, the most severe form of the illness, seems to be more common in individuals who begin exhibiting symptoms early in life.

From NAMI.org:

Early Warning Signs of Bipolar Disorder In Children and Teens

Children may experience severe temper tantrums when told “no.” Tantrums can last for hours while the child continues to become more violent. They may also show odd displays of happy or silly moods and behaviors. A new diagnosis, Disruptive Mood Dysregulation Disorder (DMDD), was added to the DSM-5 in 2014.

– See more at: http://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder/Overview#sthash.l0XKtkSy.dpuf

When I was eighteen, I decided to see a therapist and psychiatrist for the intense mood swings that had plagued me for most of my life. I was initially told that my deep depressions were the result of PTSD. I was prescribed fluoxetine (brand name Prozac), which only made the agitation worse. And I was still depressed.

At 22, I relocated to Wisconsin and began the search for something, anything, that would finally help me feel “normal.” The misdiagnoses continued: major depressive disorder, for which I was prescribed Abilify and trazodone. I felt amazing on Abilify for about two weeks, and then I crashed. Trazodone made me a zombie. (Note: It is not atypical for antipsychotics to be prescribed to treat both MDD and bipolar disorder.)

Bipolar disorder is most often misdiagnosed in its early stages, which is frequently during the teenage years. When it is diagnosed as something else, symptoms of bipolar disorder can get worse. This usually occurs because the wrong treatment is provided. Other factors of a misdiagnosis are inconsistency in the timeline of episodes and behavior.

-healthline.com

When I was 24 and in my first “adult job” with health insurance, I found a wonderful psychiatrist who, over the course of several sessions, examined my family history and asked very specific questions to find the root of my illness. At first, I didn’t even think to mention my “up” periods, because even with the agitation and sleeplessness, I actually felt good–and no one goes to the doctor when they’re feeling well. But upon deeper probing, he came to a conclusion: first bipolar II, then, after further investigation and a few weeks of mood tracking in a journal, rapid-cycling bipolar I.

That first year was rough. I cycled so frequently that the days were exhausting. One day, I bounced between depression and mixed episodes several times in a single 24-hour period. Slowly but surely, the medications my doctor had prescribed (venlafaxine/Effexor, lamotrigine, and lithium) began to take effect. I began to stabilize. There were no more florid creative periods, but I was also able to sleep for more than an hour a night for the first time in weeks. My misery began to ebb, and though it didn’t disappear completely (a dysfunctional marriage contributed, among other things), I began to feel like a person again instead of a defective thing that needed to be turned off and fixed.

Aside from pharmaceuticals, NAMI’s website mentions cognitive-behavioral therapy, psychotherapy that focuses on self-care and stress management, and, in rare cases, electro-convulsive therapy (ECT). Learning to recognize the triggers for each type of episode is key; one suggestion offered by the numerous therapists I’ve seen over the years is mood tracking/journaling.

However, I had to stop at one point because, in the heyday of my illness, I began to obsess over the cycles, sometimes tracking up to ten or eleven times a day. Instead of the journaling soothing my mind, I began to worry that I was untreatable. I found my mood journal during a recent move and it was difficult reading, to say the least. But it was also a reminder of how far I’ve come and how much my quality of life has improved since receiving a proper diagnosis.

These days, I’m doing much better. My medications have been adjusted slightly to accommodate the deep depressive episodes I’m prone to during the fall and winter months, but I am proud of myself for being able to recognize that the winter storm was a-comin’. Three years ago, I would not have been able to see the symptoms for what they are: a warning sign and a signal that I need to not only keep up with my medications, but to practice good self-care. In the past, I saw fall and winter as something awful that I had to endure. Now, I realize that I can still enjoy life even when the days begin to get longer and darker. The seasons are no longer a metaphor for the overall “climate” in my head.

How long did it take for you to receive a proper diagnosis, readers? Are you taking care of yourselves as winter approaches? I hope you’re all doing well and staying healthy and safe. And spread the word–this illness is massively misunderstood, even by mental health professionals, so it’s our job to reach out and counter-strike against the misinformation and discrimination.


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News Day Tuesday: Local Mental Health Resources

a cure for what ails you, abuse, anxiety, medication, News Day Tuesday, ptsd, therapy, three hopeful thoughts

Good afternoon, readers! This time, let’s talk local resources for mental health care.

I saw a wonderful counselor through the Johns Hopkins Student Assistance Program (which I’m eligible for because my significant other is currently a student). I’ll share more of the personal details in a post later this week, but the counselor I met with gave me some information about local resources I had no idea existed, and I’d like to pass those on to you. I feel they’ll be particularly useful to anyone in the Baltimore area, but I’m sure there are similar programs throughout the country.

First is Sheppard Pratt. Being new to the area, I was unfamiliar with this hospital, but they have a program specifically designed to help people dealing with all sorts of trauma.

The Trauma Disorders program at Sheppard Pratt specializes in dissociative disorders and CPTSD, which is exciting because I had no idea these types of programs existed anywhere. They certainly weren’t a thing in the Midwest, where I’m from. It’s an inpatient program, which isn’t a good fit for me for a number of reasons, but I plan to reach out to see if they know of any good outpatient therapists who are well-versed in these issues.

It’s comforting to know that there are facilities that offer support specifically tailored to complex post-traumatic stress disorder, which can present challenges to many therapists. I found one therapist during my time in Madison who seemed to know quite a bit about PTSD, including my dissociative symptoms, but she went on maternity leave shortly after I began seeing her. My subsequent searches for therapists was largely unsuccessful, which is not a negative reflection on any particular counselor–as I said, it can be a tricky affliction to effectively treat. I’ve been told that because of the depth of my dissociative symptoms, I’m not a great candidate for EMDR, which eliminates one of the most widely-used techniques for treating PTSD.

The second resource I learned about last Friday is the Baltimore County Crisis Response, which offers not only crisis intervention (as the name suggests), but also a 24-hour hotline and–this is the most exciting part–one-time psychologist and psychiatrist consults, which are particularly useful for people who are in a transitional period and looking for providers in the area but need refills of medication or therapy. That’s right, readers; there’s actually a place you can go for those all-important refills you can’t get anywhere else, which means no more rationing of medication to make it through.

The counselor at JHSAP was also kind enough to email me a long list of references for therapists in the area. Admittedly, I’ve been procrastinating a bit and haven’t gotten around to checking them out, but it’s on the list for this week.

Are you aware of resources and programs in your area, readers? Are they easy to locate, or do they require a bit of digging?


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News Day Tuesday: Digital mental health care

a cure for what ails you, News Day Tuesday, stigma, therapy

This week, I’d like to touch briefly on digital mental health care, which has become increasingly popular. I recently applied to work as a volunteer with Crisis Text Line, which is an awesome resource that allows people in crisis to communicate with trained volunteers via text message.

I’m still waiting for one more letter of recommendation, but if I’m approved, I’ll get to counsel others via text–how cool is that? It’s a four-hour-a-week commitment that lasts for one year, and I’d definitely encourage anyone with an interest or background in mental health to consider applying.

From Crisis Text Line’s website:

  1. We fight for the texter. Our first priority is helping people move from a hot moment to a cool calm, guiding you to create a plan to stay safe and healthy. YOU = our priority.
  2. We believe data science and technology make us faster and more accurate. See our Founder’s TED talk for more scoop on how we’re using this stuff. While we love data science and technology, we don’t think robots make great Crisis Counselors. Instead, we use this stuff to make us faster and more accurate–but every text is viewed by a human.
  3. We believe in open collaboration. We share our learnings in newsletters, at conferences and on social media. And, we’ve opened our data to help fuel other people’s work.

This article from Scientific American examines digital mental health care and its pros and cons. I’m a huge fan of anything that allows people to get the help they need, and many people simply don’t have the means to physically attend therapy due to income, transportation, disability/illness, or other factors.

The article also raises very valid concerns about “impression management,” or the tendency clients have to only share information that is likely to make the therapist think positively of them. On the one hand, many people find it easier to express themselves through writing; because there are barriers between the writer and the reader, people may share more freely than they would in person.

On the other, it’s hard to overstate the importance of face-to-face interaction, particularly in a therapeutic environment. Being able to see the client allows the therapist to assess the client’s nonverbal cues, such as body language and facial expressions. This, in turn, can help the therapist direct the session in ways that make the experience as comfortable and productive as possible.

What do you think, readers? Would you be more likely to “talk” to a counselor via text, or do you prefer old school face-to-face therapy? Personally, I’m all for attacking issues from every possible angle, though I haven’t tried digital counseling myself (yet). If anyone has personal experience with digital mental health care and would like to share their story, please do! I’d love to hear from you.


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