Therapy and Therapists

My inspiration for taking on this topic is something I heard that made me wish I could shout my knowledge from the rooftops; this person said, “I don’t want to go talk to a stranger about my life and problems, that’s what my friends are for!”. No, emphatically no, that is not what your friends are for, ever.

In an earlier post I described mental health therapy as the feeling of drowning in the deep end (of your mind) where a lifeguard can swim out to you, but they can not pull you to shore. All they can do is tell you how they might get to shore or how you can tread water until you figure out how to get yourself to shore. And, maybe you belong in the deep end, where you have to just live with the waves and learn to always tread water. The analogy could go forever, because it is the exact feeling: drowning, with help that can not help you. Therapists are lifeguards, essentially, in-training. They can swim out to you and help you not die, but you have to get yourself treading water or to the shore.

I was 14 when I saw my first therapist. It was 1992, there was only one place in town to even get mental health therapy, and that place was old and sterile. The green, scratchy fabric chairs and florescent lights buzzing did not help the situation. I went in, and the lady asked me why I thought I was there. The first of MANY to ask me that, and every time after that first time, I thought, here we go again. And, I love to talk. But, having to recount the very things that you don’t really understand yourself to a person who knows zero about you, your family, or your life-only what you tell them is super taxing and stressful. Pay attention here: if you are going to lie in therapy, do not go.

However, if you are ready to be bold and honest with a stranger to better your life, therapy and therapists are who you need. Our friends are our friends for a reason; they accept us and they are most likely to agree with you or feel similarly to you, because they know you. Your friends know your family. Your friends know your co-workers. Your friends are there as a support system, not a life-saver. The only life-savers out there are us. Only you can save you. And, you’re there to support and enjoy your friendships-not make them be work. Friendships are not work. Therapy is work. The work you do for yourself, with or without the help of a professional, is what saves you. You are who keeps yourself above water and treading or swimming to that shore. Despite the swelling and crashing waves, this is your job in life.

When I was 29, I saw my (probably) 15th therapist and she told me I had low self esteem within the first thirty minutes of meeting me. I was too depressed to laugh at her, because she was dead wrong, but I never saw her again. Just like every other relationship humans have, a therapy/client relationship must be built on trust and mutual understanding. So, if you struggle with those two things, finding the right therapist could take years. It is an investment. It is a commitment. It is hard. It is hit or miss, which is frustration amplified when you are already dealing with chemical imbalances in your brain. It is very easy for a doctor to prescribe you a pill, but a therapist is who helps you manage all that comes with trying to balance freaking brain chemicals! It is not diabetes; there are no strips or devices to detect how much of my anti-depressant to take each day.

Then, 2011 brought the most rude of diagnoses, and only after meeting once for MAYBE sixteen minutes. She said the words coldly and frankly, leaving me in a million confused pieces. “You have Borderline Personality Disorder.” Usually I could just add them to the list, the diagnosis list was already pretty lengthy, but this was different. Basically, BPD is a nice way of saying you are inherently batshit crazy with little chance of change. This is my opinion, not fact, about Borderline Personality Disorder. I did not have that, and if I did, I was going to figure out how to fix it, and started with never seeing that therapist again.

At 32, I had my last therapy appointment. I had been seeing this particular therapist (I think he was my 24th one) for over a year and our rapport was quite helpful. I was an old pro at being in therapy, which I am sure helped, but he also stood out for me because he never diagnosed me with anything. He would always say, “you are a very thought-provoked woman, and a seeker” and never once spoke of me HAVING a mental illness. It was a new feeling and I did not quite understand it for a while. On our last visit, I came into his office like always, with my purse and a bag carrying my books about mental health, anxiety and depression, dressed in whatever I had slept in the night before and ready to cry. He greeted me, we said our pleasantries and got into the session. A few minutes in, he stopped me and said, I have your diagnosis, Wendy. I was then diagnosed as “smart and careful, intuitive and empathetic, and introspective to a fault’. He said, “You could easily run a major bank or company if you wanted. Stop reading about what you have been told you have for twenty years. Stop. Or, go back to college and become a psychiatrist.”.

I went home, put all my books away, and kept treading my waters.

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Xanax

In 1996, my general practitioner of one year, prescribed me .25 milligrams of Alprazolam, generic for Xanax. I had no clue what a Benzodiazepine was or even why I needed it, really. My doctor said, take one a day along with the Prozac I had been taking. I did as I was told. I was eighteen, I was a nervous wreck, what’s it going to hurt?

Let me tell you what hurts: depression. I did not know about sadness and depression until I was 21 years old. I can not medically or scientifically prove this; but, I am 90% sure Xanax introduced depression to my mind and brain chemicals. All drugs are different for all people, this goes without saying, however in my experience and now speaking with a better pharmacological understanding of the drug; Xanax is extremely effective in managing panic and anxiety but with a slight come down after its half-life (length a drug stays in the body) which can be from 11 to even 40 hours. While in your body, only a few hours are devoted to blocking the dopamine that is causing anxiety, so the rest of that time in the body and brain it is slowing everything down. And slowing so gradually, that you do not immediately feel the ‘come down’ for lack of a better word.

At 22, I began drinking alcohol pretty frequently, as most college kids do, only I can no longer remember a lot of those years. I have the highlights, but zero details. The depression was cyclical then, and the anxiety was constant so the Xanax had to stay, I felt. And, my doctor continued to prescribe-explaining the proneness to black outs when mixed with alcohol. I was warned, but given no alternative or any discussion of addiction. Zero. Also through those years I was switched to multiple different SSRI/anti-depressant drugs (the Prozacs, the Paxils, the Zolofts, the Cymbaltas, the Celexas, the Lexapros, the Luvoxes) which meant basic emotional and physical hell for every pill I had to ween off and every pill I had to ween on, wash, rinse, repeat. For years! If you’ve ever been on the Tilt-A-Whirl or the Grav-A-Tron at a fair or theme park; just imagine that feeling right when the ride starts and right when it stops repeating over and over, with no reprieve, and, you’re not on a ride. You’re in your every day life, with the very stressors that have you on the medicine. It’s the cruelest Catch 22 ever put into play.

By my 30th birthday, I was no stranger to depression and still suffered with severe anxiety and less, but still present, panic attacks. Add a dash of PTSD, due to the Hurricane and I was on a lot of medications. My Xanax dosage was up to 1 milligram as needed, because of course, your body gets used to the drug and then you need more. And, the doctor gives them to you and sends you on your way. I’d had therapy on and off, its importance not as harped upon as the drugs and for a few years uncovered by insurance. But, I was getting all the help I could and I was still suffering. My marriage was suffering because I could not work due to deafening negative thoughts, only curbed by sleeping. The breaking point was going to the Intensive Outpatient Therapy my clinic and my insurance offered, and my psychiatrist pretty much insisted.

Intensive Outpatient is a three week group therapy, individual therapy, homework, 9am-4pm, job working on yourself. We had a nurse on-hand, and two psychiatrists oversaw our progress and prescribed and altered medications more directly. It seemed like a really important place for me to be. I benefited greatly from the therapy and the group (see entry COMPASSION for more) and the program really helped me figure out some healthy coping skills. I had gotten so bad, that when I was in that dark, sad place I had to feel something else. Until then, I never understood self-harm, but I dug my fingernails into my forearms until they bled–so I could feel different pain than I felt, even if just for minutes. It is embarrassing to admit, but I have to say it, to say that the alternative I learned in that program has saved me from the shameful act of inflicting pain of a different kind on yourself to gain some semblance of control. Ice cubes. Put an ice cube in your hand and squeeze. Sometimes I use both hands. It hurts and your mind is seared with a very different kind of pain, and, when you are ready to drop them, you are ok.

I made it about two months after the Intensive Outpatient ended. I had my ice cubes. The doctor had upped my Xanax to 2 milligrams twice a day, yes that’s 2 milligrams. Yet, I still felt the urge to run as far away as possible. I would hold my breath, defying my body’s innate defense to smothering oneself. I cried. I worried. I took all the medicine as directed and I still cried and worried, felt sick, exhausted, doomed, worthless. My husband came home to me sitting at the coffee table with all my medicine bottles on the table and a bottle of Fiji water. Just staring at it all. Needless to say, I was in the Intensive Inpatient Treatment the next morning, for more help.

By day six of my second round of group therapy, the doctor had me up to 3 milligrams of Xanax…wait for it…twice a day. They’d added another SSRI/anti-depressant, I have blocked out the name of it. It was horrendous. I felt completely done with everything that was happening to me. Pulled out of group therapy because of my obvious tremors, I went to the doctor, with just an insane amount of fear inside me. I could tell these professionals did not seem to know what to do next. Scared doesn’t even cover how I felt when he looked at me and said, ‘it’s time.’ Dazed, yet shaking like a leaf with panic and nerves, I ask, ‘for what?. I can not remember any movie I watched from the age of 29 to 31, thanks to doctor- prescribed Xanax, but I will never forget the words that came out of this doctor’s mouth.“You have to go to rehab, we have you on too much Xanax, and in order to take you off, we must monitor your vitals 24/7 and withdrawal can be very hard for some.”

 

Diagnoses

In my family, you go to the ‘lady doc’ when you hit eighteen or when you start having sex. Both happened for me at the same time, so I had to make the dreaded appointment. A doctor was going to be poking around my hoo-hah and getting some type of smear. Smear is just the worst of words. Ew. I did not want to be smeared.

This is well before cell phones, so no pleasant distractions in the waiting room besides eavesdropping on others and in the hoo-hah doc, it’s all whispering so you have to hone your ears and sit close to your target. I try to take my mind off the fact that a doctor is going to probe me, but to no avail, and the anxiety hits. Mack truck slamming into your clueless, stationary body making it a shaking, sweaty mess of anxiety.So, within minutes I had to poop. You know what is more fun than having a poop-inducing anxiety attack in a public place that you can not leave? Having a poop-inducing anxiety attack in a public place that you can not leave and doesn’t have a bathroom.

I got to the bathroom and anxiety pours out of me as I remember someone is about to be in that very area, up close. Inspecting it. Post poop! I wanted to die a thousand deaths. I wanted to run out of the bathroom and not stop until I reached my bedroom. I wanted to never be inspected! But, just as the jelly legs subside and I am physically able to move again, the nurse knocks on the door saying ‘we’re ready’. Yeah, y’all are not about to be spread eagle for inspection, of course you’re ready. I was no where near ready, but at that point I knew I never would be and knew I couldn’t stay in their restroom for the rest of my life, as much as I wanted.

Easiest part of the visit…being spread eagle and inspected. My doctor was fast and worked with ease and a sense of wisdom. Almost no discomfort. Hardest part of the visit…my first diagnosis. The first of many, many similar conversations happened while I was being probed. She was making small talk to take my mind off of the probing and of course small talk with me led to an hour of me explaining my thoughts and feelings, openly and honestly. And then, as she was labeling the smear tubes, she tells me, ‘you have Generalized Anxiety Disorder and seem to be borderline Agoraphobic.’. I did not know what agoraphobic was, but I knew what phobic meant and that I felt phobic about a lot of things. And, now I learned one more new thing, I learned that being naked and probed and smeared is easy compared to a diagnosis like that.

During the clothed part of the visit, she explained the anxiety disorder and told me that my fear of leaving home, my stomach aches at restaurants with lots of people and my general fear of the public was an actual chemical imbalance in my brain chemistry that would last forever, but could be altered with medication and make me feel more ‘normal’. Well, I thought I was normal. Until that moment, I assumed every human got a stomach ache before school and felt sick or uncomfortable a lot of the time. I had no idea people were walking around not obsessing about where there might be a bathroom, or how many people might end up in the store they’re in, checking for exits and always thinking of a way to excuse themselves quickly and successfully.

In the 21 years since, I have been diagnosed with the following additional mental illnesses: Post Traumatic Stress Disorder, Severe Depressive Disorder, Acute Anxiety with Panic, Major Depressive Disorder, Borderline Personality Disorder. But, what I feel like my diagnoses should’ve been was guinea pig. I have been put on and taken off more medications than I can count. Doctors have tried to balance my brain chemicals without ever looking at my actual brain for my entire adult life. Now, I say, diagnose away–I still have to live this life in this brain. Diagnoses change nothing.

 

Compassion

This one may get long, due to some back stories that need telling.

My family is very loving. I grew up with everything I could ever need or want. Spoiled, even. But, as a rule, my parents were just not touchy-feely. My Mom was a hugger, but not my Dad. His parents weren’t touchy-feely either. And, I’m sure on back it goes. Anyway, I grew up moderately touchy.

Through various friends and boyfriends, I became a lot more comfortable with a more touchy outlook. But, in 2002, when I began working at a high end salon and spa in my home-town, I was reconnected with an old acquaintance and friend. First, the salon/spa atmosphere lends itself to touching. Literal, hands-on work. And, in the South, we hug. So, I was catapulted into touchy-feely all the time. And, most importantly, my old friend, who is now my closest friend in the world-we will call her Tracey-is a massage therapist. One of my area’s very best and most trusted. And, she is, of course, touchy-feely; it is her job. But, Tracey touches you with more than her hand on your shoulder to comfort you as you walk back to her treatment room. Tracey touches you with her soul and surrounds you with a warmth that I once thought only a Mother could give. She possessed this trait/gift with ease and zero thought, so I know she was born with it. And, it definitely rubbed off on me. Pun intended!

I touched everyone. I hugged. I adopted the hand on the shoulder when walking clients to their stylists or the restroom. And, slowly, without even realizing it, I got the warmth, too. Or, I should say, the ability to transfer my caring energy to a person with warmth and touch.

So, this brings me to the story and the framed photo. During a very dark time in my life, living away from home in Alabama, I was enrolled in a mental health day treatment program. The Hurricane (we’re not ready for that entry-none of us) had been gone, but the storms in my mind were ever present and I missed home. I sought professional help, and got it.

I bonded hugely with this group and the three weeks we spent talking when we didn’t want to, crying, laughing, screaming, talking too much, learning, feeling, growing, struggling, and fighting. Every morning was hard and we all left emotionally exhausted at the end of the day. Do not let anyone tell you therapy is fun, they’re doing it wrong! Therapy is diving into yourself, the deep end, you’ve forgotten how to swim, and there is a lifeguard…but they can only swim out to you. Once out, they can only TELL you how to swim back, not save you. It is not fun.

One lady and I had the closest connection. She sat by me on the first day. By the fifth day she and I were talking about a lot of personal life stories and woes and histories. This woman was a photographer, and old enough to be my mother.  She actually had a daughter my age who ‘did not understand her’ and a husband who tried to understand which was a lot like my world. She listened to my Hurricane stories and my homesick, reclusive lifestyle. We bonded.

On, or about, the second week of group my friend was feeling a little tired. I got her some coffee, she felt better. An hour into group she gets my attention and says, I feel dizzy. And when I turned to talk with her, she was as white as a ghost. I explained quickly to the therapist and we got her to lie down while another group member went to get the on-staff nurse. My friend was becoming more scared by the minute, and I could tell. I did not want to overstep the therapist’s boundaries but I went and sat at my friends side and began lightly stroking her arm. I’d been out of the spa and salon business for a while, but my instinct was to soothe her the only way I knew how. At first, I could tell my friend was a little uncomfortable so I stopped and said, ‘was that helping to distract you?’ and she looked up at me with almost child-like eyes and nodded her head with swift approval. I put one hand on her shoulder, firmly, and went back to just a gentle stroke of her arm. The nurse asked me to continue as it seemed to help. He checked her vitals, all were fine. He got her some apple juice. The therapist had released the group for a break due to the situation, and eventually, my friend felt better.

The next day, I was glad to see my friend was feeling well enough to be there and she pulled me to the side and proceeded to tell me that she did not have the words yesterday to express her gratitude for my compassion during her sinking spell. We think her sugar must have been low. This woman, my friend, also expressed to me that she had never felt the warmth she felt from me ever in her life and that my level of compassion is remarkable and gave her a hope like she had not had in years. I had no idea the connection compassion had with hope. Not until that very moment. I was moved, to say the least. And group went on as usual.

The last day of day treatment came and we “graduated” and all said our goodbyes and exchanged encouragement and positive words for a better future for all of us. Nothing too out of the ordinary, until my friend said, ‘walk me to my car’. I obliged my friend because I was going to miss her and thought we would exchange phone numbers–even though the facility advised against it. We did not. She got a fairly large framed item out of her car with a card and said, just take this and we will always remember the compassion and hope we need.

The photograph was taken by my friend, in my home town that I longed so much for, over fifteen years ago. In her card to me, she said she hoped at least the big tree survived the Hurricane, and that she knew for sure that I was not only surviving it but my compassion showed I was thriving. The hope that picture gave me and still gives me, everyday, is a true testament to the bonds and compassion we share that give us hope.

I have not had any contact with my group therapy friend since that last day in 2008. One day I hope to be able to tell her; the tree survived the Hurricane just like I did.

 

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Gotta start somewhere…

and, I did start somewhere. I kept a journal from the age of probably 9, when I just recounted new shoes I’d worn or which BFF had been rude. I always wrote my feelings down. Then. A hurricane took them all and made them illegible. I think I have them somewhere, just for posterity. I have spent a lot of time hating that hurricane, and I am visibly moving into the acceptance of the life it threw me in to, against my will. Nature can really fuck shit up.

I am the anxiety-ridden child of two parents who are of the “it’s all in your head” generation. I’ve grown to feel apathy for them; but, it’s been a very long and tedious journey. One I don’t think ends.

I am the average height, overweight sibling to a tall, athletic, book-smart older brother who has worked just as hard as I have to accept me, and vice versa. We are very different and just alike. Our problems sort of mirror themselves, but the way we approach life and its problems is polar opposite. Respect has kept a bond between us, that we both appreciate and reciprocate.

I was married. It is sadly forgettable and overshadowed by the darkest time in my life. Well, let me say, one of the darkest. He was a good man, is a good man. But I am all in or all out–to a fault. He is but one casualty of my inability to balance.

I have no children, by choice. I was often told I would change my mind, even crave the need to nurture. I believed these people, but it never happened. I can barely nurture myself–and oddly, I knew that even as a young child as I was being nurtured. I didn’t learn to self-soothe until I was in my early thirties. It explains a lot of unnecessary angst. Doesn’t change it, just defines it.

I have been involved in LOTS of therapy over the past twenty years, this blog is going to serve as my own release. I fully believe that is how all writers become-writers. Release. I want to be a writer. But, like most writers, I am terribly insecure about what to write, who my audience would be, would they even care. So, here is the first step.

And, I feel like it will possibly turn into a Pulp Fiction-esque timeline because my life is better told out of order. The balance of a chronological biopic would be just another thing I avoid. Oh. I am a HUGE procrastinator. Like, wasting years of my life is a hobby of mine. Or, maybe it is a guilty pleasure?