We All Need Therapy

Wheat For Man

I was having a conversation with a client last week about the hole in the heart concept (God, self, family, friends) and she was expressing regret and confusion as to why she feels unable to have a relationship with God. I left the session feeling excited about our time next week and furthing the conversation.

This week when she came her emotion was different. She was angry. Very angry. She was still angry about her friend from the week previous that had vandalized her property while she was housesitting for her. Added to that was anger about a neighbor talking about how Boyd K. Packer spoke out against homosexuality at the most recent General Conference for the LDS Church. Then she reported that she was angry about our conversation about God last week.

Totally not what I expected. I erroneously began a conversation with her regarding Elder Packer's statements, but quickly recognized my error and shifted back to therapy. I am not here to have religious/political debates.  I am here to help.

I don't read the news. I don't watch the news. I am exposed to so many negative attitudes/perspectives through my job that I do not seek more. I want my home to be a safe place and bringing in the negativity of some news stories does not protect my home.  A few days after Elder Packer's talk, I received a petition from a "friend" on facebook regarding the opposition of the talk on behalf of the LGBT community. I ignored the petition and went on.

There was a period of time when I very much struggled with my responsibilities and how I should be appropriate in my beliefs regarding alternate lifestyles. The first boy I dated, after we had stopped dating and he moved across the country, told me he was gay. Then I made a really good friend, spent lots of time together, then found out that he was also gay. I moved for grad school and there was a kid in my ward at church that also came out soon after I moved away.

In each of these situations it was difficult for me to find the balance between caring about the person, but not appearing to approve of their choices. It is definitely a delicate balance.

In thinking about this and the many ways that I could have responded to the struggle to find the in-between...I feel like I ended up choosing the correct response for me. I believe there are several things that are presented to us, on a daily basis even, that either pull us away or bring us closer to our true self and to God. I believe that life is designed in such a way that we are repeatedly given opportunities to vote for or against good and evil.

Today alone I chose between:

Taking my medicine or not. Eating breakfast or not. Being happy to see a waking baby or get mad because I was still tired. Being frustrated with a full day or being grateful for secure employment. Being upset that the car was cold or being grateful to have a car at all. Choosing fast food for lunch or going home and making something. Working hard all day or stealing a little Solitaire time. Being judgmental or being helpful. Being lazy or being productive. Studying or watching TV.

Of course, this is the short list, but every one of those choices brought me one direction or the other. Sometimes those choices are between moral stands and sometimes they are about emotional, physical, or spiritual stands. I believe that there have been and there will continue to be more boldness in regard to the discussion of right and wrong. I believe that the more specific that these topics get, the more opportunities we have to choose to learn for ourselves and gain a testimony of it or reject it out of fear or offendedness. This type of thing will not stop and one day the wheat and the chaff will truly be separated.

Eggshells

Yesterday the doctor told me his diagnoses. One, I knew, PTSD. I knew about his trauma and I had diagnosed him a while ago with this. Then the doctor said "Borderline Personality Disorder". In my mind, that was the person that would do drastic things to keep a person in a relationship with them. Well, that doesn't fit. But I set my mind to look it up when I got to work this morning. For a person to be diagnosed with BPD they have to have at least FIVE of these symptoms (according to the DSM-IV):

1) frantic efforts to avoid real or imagined abandonment. Note: do not include suicidal or self-mutilating behavior covered in Criterion 5.

2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

3) identity disturbance: markedly and persistently unstable self-image or sense of self

4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: do not include suicidal or self-mutilating behavior covered in Criterion 5.

5) recurrent suicidal behavior, gestures, or threats of self-mutilating behavior.

6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

7) chronic feelings of emptiness

8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

9) transient, stress-related paranoid ideation of severe dissociative symptoms.

After reading it, I knew they had it right.

When we took Abnormal Psychology in grad school, we were told by our professor to be careful when studying the DSM because we might end up diagnosing ourselves. I look at this list and I think...hmmm, sometimes I might have five of those. Then I think how weird it would be if two people with BPD married each other. I guess they would never leave each other.

Of course, I don't have BPD (at least no one has diagnosed me yet), but it is something to think about and consider. It makes things make more sense for some reason. Now, just to find the right book...I'm thinking about this one:

Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personal

Paul T. Mason

Acceptance

I keep going through the stages, denial, anger, bargaining, depression, acceptance. It seems like they change every hour or so. I walked into work today and got a pity face from a co-worker. A coworker that I didn't tell anything to. It makes me feel angry. Angry that she assumes things, or angry that someone told her what is going on. What happened to confidentiality? Yes, she has to put in the paperwork, but who said that she has to read the admission paperwork. Ticks me off.

My throat hurts. I'm tired, although I slept wonderfully last night. My brain keeps replaying Tuesday morning in my head like a broken movie reel repeating. Seeing the blood all over the shower in the bathroom. The look he gave me before he told me what his plan was. The words he used to rationalize that my life would be better without him.

Then having to tell over and over again what happened. To explain the unexplainable to people who think that there has to be ONE thing to drive someone to this. Very few people take into consideration how many things THEY have to have on their plate before they just break. Imagine that...times a few hundred and that is the ONE thing. People ask and I do not have the time, energy, or knowledge to itemize the list of the "reasons" this happened.

I hate his dad's first question. "Is it because of finances?" We are NOT broke. We have never been BROKE. We pay our bills. We have a savings. We have a little leftover for fun stuff. That does not mean broke! Broke is not paying bills. Broke is getting your power/water/phone/etc. turned off. Broke is not knowing where your next meal will come from. NO DAD, IT IS NOT FINANCIAL PROBLEMS! Anger.

I was staying with some friends Tuesday night. I was watching some Food Network with the wife and the husband came and snuggled her. Depression. I had to stop myself from crying. This is a good thing. This will help. This will make things easier for everyone. This is the right thing.

It feels like, sometimes, he's just staying with friends like the past couple weekends. It just so happens that I'm working on the weekends. Denial.

I keep thinking of all the things I should/could have done differently, specifically a better spiritual example to him. I will try harder when he gets home...Bargaining.

My husband tried to kill himself. He is in a mental hospital. Acceptance.

CATCH!

I recall a time that doesn't seem like the distant past, but if I ponder on it I would have to admit it was five or six years ago. It was long before I knew that my future graduate school even existed, much less considered attending. I was (from my perspective) considerably older than the rest of the members of the singles group at my church. I would hang out with them and we were friends. It was good, but different. A lot of them were my little sister/brother's age and there wasn't much of a connection.

I remember one night in particular that we had dinner after an activity at a local late-night eatery. It was fun, joking, etc. Then someone had the brilliant idea to do trust falls from this concrete wall back behind the restaurant. A person would stand on the wall that happened to be level with the arms of everyone else. They would fall backwards from the wall and be caught...building trust, in theory. I think I was the only one who opted out of the activity. I did catch the others and it was a memorable experience, but there were few in the group that I had anything past an acquaintance relationship.

Fast forward a couple years. Graduate school. Experiential therapy. I find myself standing on a wood platform waiting to fall and be caught by 9 people that I had only known for a year. Minimal hesitation. What made the difference? I had certainly known these other kids from my group earlier much longer. I would definitely say that it had to do with my relationships with the people about to catch me. The uncounted number of hours spent with each of them in class, talking about class, watching live sessions of therapy, in supervision, driving to/from internship locations, talking in a circle and crying our eyes out, climbing over physical and figurative walls in our lives, walking tightropes and knowing the inner workings of their minds and lifes. To learn their deepest hurts, fears, hopes and dreams and for them to know mine...and they caught me. Many of them, I don't talk to very much anymore, sad day. I miss each one at one time or another. But, I can promise you one thing...every time I fall to any of them, I will be caught.

And that is a nice feeling.

GOAL!

Today, my supervisor asked me "what is your goal?" I don't think anyone has asked me that in a long time. At least not since I was in graduate school. It is one of those questions that is difficult to answer on the spot. Especially when it hasn't crossed your mind in a while. The trick is...when someone has a family, the goal is strongly tied to the family members. If someone has to move to a random town in a random state because of furthering the education of a spouse...that sometimes means their own plan has to be postponed. I suppose it is time to take an inventory and prioritize. :)

Food Glorious Food

It is one of my co-workers' birthdays on Saturday, but she is gone to a conference from Wednesday to Friday so Tuesday she got balloons, flowers and two dozen "two bite" cupcakes. I opened both packages and at the first one(s). I justified it because I hadn't eaten breakfast. This not eating breakfast thing has happened for a while. At least a few months. My doctor told me it was bad to eat anything that wasn't protein for breakfast because the carbs make you crash earlier and make you have cravings during the day. Eggs for breakfast. Cheap, easy, but not so easy. Because of this...we stopped buying cereal so we wouldn't be "lazy" and NOT eat eggs. Instead, we just don't eat (breakfast, that is).

Another barrier is that we have developed a new routine in the mornings. The princess wakes, mommy changes diaper while daddy fixes the bottle and we all snuggle in bed together while she eats and then play after she's done. This is great except that mommy stays in bed until her alarm to LEAVE FOR WORK goes off then gets dressed, takes her meds and walks out the door...breakfastless.

I have entire closet full of clothes that fit me four years ago (Wow! Has it been that long!?). I got on a schedule, I made a plan, I had support, I lost about 45 pounds and was very excited. This was all motivated by the fact that I promised myself I would NEVER have to buy size 20 ANYTHING. Well, that and the fact that I had extra money on my flex-card to pay a nutritionist after getting my braces paid off.

My first stupid mistake was to get rid of my old "big" clothes because I thought I would get lazy and be tempted to wear them and not pay attention to my weight gain. Yeah, it just cost me more money in the long run. Now, post-grad school, marriage and baby I'm bigger than I was when I first started seeing a nutritionist. As I'm typing this, I'm thinking of the name of the nutritionist I saw here once while pregnant to help me with my gestational diabetes stuff. I'm thinking...maybe I should call her.

Then I think...how much is it going to cost? When will I have time to see her? When will I have time to plan the meals? Where will the extra money come from to eat healthy? Admit it, being healthy is expensive. Maybe that's why the obesity rates in the US are rising, who knows?

I went to my first Anonymous meeting when I was nine years old. Some people may think that is insane, but it was life. I've been told much of my life that I am a member of a family of addicts. We are all addicted to something. My grandmother always said she was addicted to food, but I really never saw her as obese. My mother also admits to being an overeater. I just now (like five seconds ago) occurred to me that I am an overeater not because I am one independently, but that I've been told...repeatedly...that is what I am. I never questioned it. EVER.

I never said...hmmm, maybe I'm different. Maybe I'm the exception. Maybe I can overcome this like others haven't before in my family. After all...I did this about college. I'm different. I'm not going to be stuck. I'm going to have financial security. I'm going to graduate college AND then some. And it worked. I resisted the patterns in my family that seemed to hold others back and I made it. Why is food a different story?

I run a teen substance abuse group. I, personally, have never tried any substance aside from caffeine. I used to drink it, but quit when I was sixteen. No smoking, drinking alcohol, nothing. I had been told I was an addict and didn't want to risk it. It wasn't really like I could abstain from food to prevent an addiction, was it? When we open the group we each talk about how our week was, if we have had any uses or any invitations to use. Most of the kids report invitations to go to a party and drink or smoke weed. I report whether I emotionally ate something.

There is a difference. Some days I eat for the right reasons, energy, sustenance, etc. Sometimes I eat for the wrong ones: stress, anxiety, sadness, avoidance, etc. When I eat for the wrong ones...these kids hear about it.

I have had some pretty good excuses since having the baby. I had surgery that prevented any kind of physical exercise and an incision that didn't heal up until April. Sorry, no Pilates yet, I might rip my incision. Oh no, can't walk those two blocks to work, remember the incision? Really. Good. Excuses.

I've never been much about looks. I mean, I like to present myself well (maybe that's drilled in my head as part of being a girl raised in the south), but I've never cried because I'm overweight or because I don't like my features. Most of the changes I have made is because of frustration or exhaustion. I'm tired of sucking in to button the biggest pants I own. I still like "me". My husband still likes me. I've never gotten a comment from ANYONE about my weight other than my mother...and an aunt that hadn't seen me in a long time.

This is just one of those things that remain left undone because I am a bit ambivalent about it. Things getting in the way of moving forward on something. Much of my excuse tends to be time. I work 8-5 pretty much every day. Have family obligations until about 9. Study for my tests (ideally) from 9-11. Sleep, wake, etc. until it's been three months and I still haven't done anything different. Time to take a minute to do a little motivational interviewing on myself and then go from there.

Eat Here

I'm generally a content person. I try to find joy in what I DO have instead of whining about the things I don't. As a thearapist, there are things that I learn are good for families and kids. I try to do as many of them as possible, but there is one that seems doomed to wait for a larger space. It drives me a little nuts. Maybe it's the ettiquette shoved down my throat as a child/teen/young adult, but it's much appreciated and (personally) a good tradition. This is the art of family meals. I love, love, love that there are ads these days encouraging family meals. Even websites such as The Power of Family Meals  and Meals Matter are encouraging family meals.

I enjoy family meals. Well, I enjoy all meals, but still. There is just something great about getting together and having a common purpose (even if it is just to see who gets the last scoop of whatever is on the table). People eat competitively and are still sitting at a table sharing the experience. Currently, my apartment does not allow for a dining table. We have no two chairs that match. There is no space.

I know what a great thing it means to have family meals. Research will tell you that it will: discourage smoking, drug use and teen pregnancy; position your kids to do better in school, pass on their ethnic, familial, and religious heritage; help prevent eating disorders and obesity; build your kids' literacy, vocabulary, and conversational skills; teach your kids manners; promote a sense of resilience; and enjoy each other more as a family. I'm pretty sure my mom didn't know ALL of these things when she forced us to sit up straight, put one hand in our lap, take our elbows off the table, don't reach over people, etc. would help us in our social interactions, but I'm sure with eight kids there had to be some semblance of structure for her to maintain her own sanity. :)

I miss sitting at a table and eating. I'll have to start saving my money for a table, a few chairs and some kind of organization for my kitchen so we can fit all that in there.

Mean Girls 1692 Style

I saw Mean Girls. It seemed really unrealistic to me. Yes, I did go to public school, but I really had no part in any of the drama. I'm sure it was happening, but I was so clueless and naive that I didn't see it happening. Also, it's possible that the fact that I was not a contender kept me out of the drama of our circles. Right now, at work, I'm a third party participant. I have clients who have beefs with each other and they don't know that I know almost all the members of the drama. It's pretty messy and quite silly. Girls and the rumors they start. Seriously. The most interesting thing is that most of the girls "hate" the other girls just because the boy they like happens to like the other girl. It's rather ridiculous, in my opinion.

These fights have been on my mind for a while. Through a series of events I was reminded of the Salem Witch Trials. I think this is the old school version of mean girls. If you didn't like a girl. If you thought she was going to steal the blacksmith's son from you, accuse her of being a witch and then they'd kill her. Isn't that how Mean Girls works? It's pretty bad. Of course, the girls learn it from their mothers. It's a difficult pattern to break. I wonder, were the Salem Witch accusers all just making stuff up like most girls (and their mothers) do now? At least now, the consequences aren't so...permanent.

Of course, I say this knowing absolutely no history of the Salem Witch Trials. I know they happened, or at least the history books tell us that. Wikipedia will tell us that women who were not subservient to men were often accused and thought to have the devil in them. I suppose many women would be dead today if they kept up that craziness. In either case, I wonder, truly wonder, how many girls in 7-12th grades would accuse a girl if they knew the end consequence would be death. Sadly, I think there would be at least a few that would hesitate and this is a sad thing indeed.

Drawing A Line

I've tried to write this two or three times. The short of it is, I'm a pretty poor decision maker. Not that I make bad decisions, but that it takes me a long time to come to a decision about certain things. I will wax and wane about something and then wax again. It used to save me a lot of money because I'd say yes, then no, then yes, then no and end up running out of so much time that I didn't buy the thing.

Because of my intensive process, I tend to like to limit my decisions to one at a time. When I have multiple decisions to make at one time the emotions of one thing overflows into the other decision and I cannot tell which one is okay, which is not, and which is pushing me to the point of tears.

This being said, sometimes help is not help. I have very generous relatives. So generous that our previous count of a laptop and a desktop will double by the end of the week. I don't know about the rest of you, but two people and four computers, just doesn't make sense. But their generosity doesn't stop there. So, that adds to decisions. Which ends up adding to stress.

While there is stress in this decision making process, there is also work stress. I'm pretty sure most people have felt, at some point in their lives, work stress. If you haven't, please tell me what you do for a living and I will promptly change occupations.

There is a decision to be made in regard to a client. An agency we work with feels that my client would be better served by a "more experienced" therapist. I'll confess, I'm slightly offended. I'm even a little more offended because this is becoming a pattern. The decision is placed before me to resist and demand that I continue to attempt to treat an avoidant, manipulative family or I turn the reigns over to a fellow therapist. Does my pride interfere with this decision? Yes. Do I feel the other therapist is equally qualified? Yes. Is it therapeutic for them to switch therapists? I don't think so. Will the family lie to the other therapist in the way they lie to me and everyone else? Most likely. If the family lies to everyone, how would it be more therapeutic for the family to lie to someone else?

Maybe I just trust too much. But then how do you know what to trust and what not to trust? Shouldn't I at least get a chance to help the family with the newly exposed information?

At least I have a great supervisor who will go with me to the meeting and help me not get emotional and/or defensive. One plus for the boss.

Does my emotionality about the situation at work affect my decision making at home? Certainly. Still trying to draw that line a little stronger.

"You'll Never Take Me Alive!!"

Fridays are my busy days. For whatever reason, I usually have every hour set for an appointment. Today was not much different. I had a doctor's appointment at 8:15 and the rest of the day at every hour was set. The morning went rather easily and at lunch I jinxed myself by telling my husband that the afternoon would be pretty laid-back. 1:00 was a family that I'm doing co therapy with, so no pressure there. 2:00 was a kid that is pretty laid back, love those teens. 3:00 was a treatment plan review which is pretty routine and my 4:00 was another teen which is pretty new, but I like her.

1:00 ended up showing up at 1:40 and expecting my co-therapist and I to do family therapy in 20 minutes. Not thrilled. My 2:00 was pretty routine. 3:00 turned crazy before my 2:00 was even over.

I printed out my 2:00's grades and attendance because he had to turn them in to court every Friday. As I walk out of my office to get them off of the printer, the grandmother of my 3:00 is at the top of the stairs asking if I've seen 3. No, I haven't seen him, but then I hear and see shoes peeking out from under a couple chairs by the window. Yes, he's right there.

Usually when clients come in they have to fill out a questionnaire. Since grandma has bad knees, she asked if she could stay upstairs and forgo the questionnaire. Sure, she can do it after on her way out.

We get started. What is 3's primary goal? 3 is playing in his typical manner, which isn't always quiet. He had already dumped over a large plastic container of building blocks. He then goes and spins in circles hitting the corner with a rubber chicken. Grandmother threatens counting (doesn't everyone know by now that counting does not work!?) and he gets a glimmer in his eye that says that he knows he's going to get away with this. We get about 20 minutes into the treatment plan and 3 decides he's going to tie the slinky around his ankles. Bad idea. Next, he chooses to open the office door and hop around the upstairs. Since grandma has mobility problems, I offer to pursue him. Besides, I get the impression that he doesn't listen to her anyway.

By the time I get out of my office he has made it to the sliding glass door. I grab him and hold him to get the slinky untangled from his ankles. He runs.

I go back into my office, unwilling to pursue a seven-year-old around the building. Chase is not a game I play. I come back out to see him hanging over the balcony on the verge of falling over the edge. I decide I can't just let him crack his head open and I pick him up and bring him inside. He resists and begins saying "You'll never take me alive" repeatedly. I carry him by his armpits as he kicks and continues to report that I will not be taking him alive. Just watch me.

Grandmother decides she needs to "talk" to him so I leave to lock the sliding door. He runs out again, down the stairs, around the building, repeatedly. He comes back up the stairs and cannot get in the door because I locked it. He wants in. I open the door and give 3 the option to come in or not. He chooses to run. I tell him I'm not playing this game and lock the door again.

Grandma wants him to clean up the blocks. Knowing the kid as I do, I know this is not a realistic expectation, but I persist in trying to help her get him to comply. Multiple efforts to get him back in my office, upstairs, follow directions, etc. were unsuccessful. I told grandma I would clean up the blocks. She headed out the front door, I headed out the back and we met him and he quickly went into the car.

The last thing I hear is that he is going to have to deal with his mother when she gets home from work. I do not envy that kid. We did finish the treatment plan and we did not get the questionnaire on the way out.

The front desk then asks me what is going on with him as though they are completely unaware that this is a mental/behavioral health facility and every person that comes through the door has problems.

Next Friday, I'll just keep my mouth shut.