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Monthly Archives: April 2014

2014 Blog for Mental Health Project

“I pledge my commitment to the Blog for Mental Health 2014 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.”  
A Canvas of the Minds

Sometimes we make the most important decisions in our lives without consciously knowing why we made them at the time.I knew that I wanted to become a psychologist since I was in high school. At the time I wasn’t fully aware of being depressed in the clinical sense. Being anxious was so much a part of my personality that I didn’t think I had an anxiety disorder. And I definitely wasn’t aware of any mental illness in my family. I had no idea at the time that depression, bipolar disorder, and anxiety would impact every aspect of my life–in both positive and negative ways.

It’s probably not surprising that I have been negatively affected by mental illness. But as I write this post, I realize that there have been positive things about it, too. I have learned the most important lessons in life through suffering and loss.

Even as a therapist, when I heard clients make comments about how they had a bad week, it didn’t fully register how horrible that week was for them. In part because clients don’t elaborate unless you ask them to. Unless they are certain that you really want to know. And because they are embarrassed about it. Ashamed, even. But after going through my worst depression 5 years ago, I have much more compassion when clients make these offhanded comments.

I admit, during that period there were times when suicide would cross my mind. But there were two things that kept me from seriously entertaining it. One is that my dad would be devastated, and I feared he would never recover if I went through with it.

The other reason is that if I took my own life, it would undermine everything I ever said to my clients about how pain passes. That one day when they look back they will realize how strong they were at the time. That they will learn lessons from their suffering that it takes some people a lifetime to learn. How can you believe anything your therapist said if she committed suicide? That would be the ultimate betrayal.

So I spent months willing myself to get better. I went back to therapy, started meds again, meditated and prayed, and forced myself to play tennis and spend time with friends. And I did get better. And everything I said about realizing my strength, becoming more compassionate, and acquiring wisdom were all true. I would have never chosen depression, but we usually don’t choose the experiences that teach us the most about life.

People often ask me how I can listen to client’s problems all day long. In all honesty, I can’t imagine what else I would do for a living. It feels more like psychology chose me. And when I hear a client’s story, I always have hope that together we can change the plot for the better. After all, I always root for the underdog. I am the eternal optimist. And I never back down from a challenge.

There was a time when I would never have told this story about my struggles with depression and anxiety to my students or clients. Or even friends and family. But now I want to share it with the world, because every act of courage benefits someone else. My blog is proof of that.

Patience Isn’t Always a Virtue

I looked it up. While it is included in some lists, in Catholicism the 7 virtues are faith, hope, charity (the theological virtues), prudence, justice, fortitude, and temperance (the cardinal virtues). Since I at least grew up Catholic, I’m going to use this list, because I’m not patient at all, and I don’t want to be unvirtuous.

My greatest strength is probably fortitude. I never give up in a match, even if I’m down 0-6, 0-5. I continue to play tennis, even though it makes me throw up. I will do everything I can to make a relationship work, even if it’s a lost cause.

Last week I had a client who started antidepressants and experienced a sudden onset of suicidal ideation, which sometimes happens in young adults. As she was describing what it felt like, I realized that I had experienced the same thing when I got back on meds, even though I was not a young adult. But I was on a higher dose than I was before. In retrospect, it turns out it was too high; I had a lot of side effects that I had attributed to the depression.

I didn’t think much of it at the time because I always have some suicidal ideation when I’m depressed, but it was definitely different. It was what psychologists call ego dystonic. As my client put it, my brain told me in the most illogical way that suicide was the next logical step to whatever I was thinking. If I didn’t have the energy to walk over to the fridge and get a milkshake, my brain would say Well why don’t you just jump off the balcony, then? It freaked me out. I would yell back. No! I don’t want to do that! I want to live!

So I fought the thoughts off until the meds kicked in. At the time I thought I was weak, but when I recognized myself in my client’s story, I realized how strong I am.

Patience, on the other hand, is a different story. Patience also requires strength, but in a quieter, more peaceful way. And as you know if you’ve been reading my blog, I am loud and obsessive. You can’t will yourself to be patient the way you can will yourself to save break points. In fact, although this blog is about practicing other quiet, peaceful things like self-acceptance, compassion, gratitude, and forgiveness, I have never included patience in that list until today. Probably because it seems impossible to achieve–even for a warrior like me.

As I mentioned in the post on obsessiveness, I can only focus when I meditate about 5% of the time. But it still works. I am definitely less anxious, better able to tolerate my emotions, and more compassionate. Maybe patience is the same way. Maybe if you at least have the intention of being patient, even if you suck at it, it will still work. That’s what they say in Buddhism–in a less judgmental way, of course.

Might as well give it a shot. Whether or not it’s a virtue, it’s still a good quality to have.

Memory

I love the movie “Eternal Sunshine of the Spotless Mind.” I love the idea that even if you take the memories away, the love between two people remains. And I like the message that we must experience pain in order to experience joy. But lately I’ve been wishing I could erase the painful memories from the past 10 years.

Let me first say that I am thankful for my memory, lest I be struck down with dementia for being ungrateful. It helps in my job because clients expect you to remember everything they’ve told you from the first session on. And when you see 30+ clients a week, that’s a lot of stuff to remember.

The most painful memories help me to have more compassion for other people’s suffering. When I was depressed, I could not conceive of any possible value that could come from my pain. But now that my brother is depressed, I am better able to help him because I know what he’s going through. You’re not afraid to sit with other people’s pain once you know firsthand how lonely it is.

My memory also helps me capture the intensity of my feelings when I write about my experiences, which hopefully makes my blog better. I am guessing that most writers have good memories and intense feelings. But sometimes it can be a tough combination. That’s probably why writers are so neurotic.

Lately there have been some memories that I wish I could forget. Or at least remember without feeling like it’s happening all over again. It’s almost like having PTSD, reliving these hurtful experiences every time they pop up.

Yesterday I remembered how my first husband told me while we were separating that I have a heart of gold. He said it was the happiest day of his life on our wedding day and the saddest day of his life when we signed the divorce papers. How can you feel that way about someone and still choose to leave them? What good does it do to have a heart of gold if it doesn’t help you make a relationship work? In a way I am thankful that he was loving through the entire process, but sometimes I wish I didn’t remember how I felt at all.

The letting go process in my second marriage has been just as painful. It hurts just as much now as it did 4 years ago. It still makes me cry. Every step we take away from each other renews my sadness. When will this grief subside? That whole one year estimation is a bunch of crap. I wish I could just forget the past 4 years–all the pain and all the stupid things I did to try to ease the pain that just made things worse.

The only memories I would miss from the past 4 years are the first trip when my mixed doubles team went to districts, getting Federer’s autograph at the Cincy tournament, and UVA’s basketball season this year. Which makes me seem like some superficial sports fanatic, but it’s true. In my defense, part of what made these experiences memorable is that I shared them with my friends and family. I’m sure there were other positive memories worth holding on to during that period of time, but I can’t think of any at the moment. Right now, all I remember is the pain.

The only good thing about this second divorce is that it helps me understand how you can love someone and still let them go, even when it breaks your heart. I’m not angry at my first husband any more for leaving. I understand why he did it. It doesn’t alleviate the pain of either loss to realize this, but I have a better appreciation for how complex love and marriage are. That’s something.

Today I’m not able to do the things I try to focus on in my blog–practice self-forgiveness, self-acceptance, and self-compassion. But maybe tomorrow I’ll feel differently.

Saving Lives, Part 2

You know that song “It’s Not Easy,” by Five for Fighting? It’s one of my favorites–and not just because it’s a great Karaoke song. I don’t claim to be a superhero, but I can relate to how hard it is to be the one who is expected to help other people.

Today I saw a client who exemplifies why I became a therapist. His life is filled with traumatic stories involving drugs, alcohol, mental illness, and abandonment, yet he is amazingly well-adjusted–on the outside, at least. He’s never had a chance to tell his story. In fact, he’s been coming to the counseling center for almost 2 years, but there’s very little in his chart about his family history.

Not all my motives are altruistic, however. It’s gratifying to give someone what you wish you had received. It feels good to be important to someone. And in all honesty, when you work with clients like him, you are changed just as much in the process. I know it’s cliche to say that I get more out of it than they do, but it’s true.

Not coincidentally, he bears an eerie similarity to my first husband. It’s unfortunate that the compassion that helps me to be an effective therapist has not served me well in my romantic relationships.

I understand why. With my client, I can be there for him, but he doesn’t have to be there for me. Nor should he be. In a romantic relationship, it needs to be closer to 50/50. But when you are in a relationship with someone who has been traumatized, their needs always seem to trump yours.

Some people see the red flags right away and steer clear of these kinds of relationships. But to me, they look like those orange flags that the ground crew at airports wave to direct you to the gate. They are more like a signal to move in closer than a warning sign of imminent danger.

I haven’t yet figured out what to do with my empathy in red flag relationships. How do I ignore someone’s cries for help when every part of me tells me to go to them, comfort them, and help them feel better? Their pain is my pain, and I don’t want to be in pain.

One of the advantages of being alone is that there is finally room for me to register my own feelings. It turns out that I’m not as needy as I thought I was. But I wish I had someone who can do for me what I do for other people. Today, I wish I had someone to come home to so that I could tell him about my day. Blogging about it helps, but it’s not the same.

I am still hopeful that I can find a relationship where someone can be there for me.  But for now, I’ll try to limit my rescue efforts to my clients, my family, my friends, and myself.

Embarrassing Moments

If you were ever to meet my tennis friends, I guarantee they would tell you about several embarrassing anecdotes involving me being loud and occasionally dangerous. But since you probably won’t meet them, I’ll out myself and tell you what they are.

The first thing they would tell you is that we have to keep going to new restaurants because I get us kicked out for being too loud. It all started when we were going to a Christmas concert and had dinner at a Chinese restaurant beforehand. We were getting ready to leave and I made a comment about why you shouldn’t have sex on the first date a little too loudly, and the owners were not pleased. Luckily, we were already on our way out, so I wasn’t officially kicked out, per se.

Later that evening, we went to Starbucks after the concert, and I swear I thought they closed at 11, but they said they close at 9 and asked us to leave. I’ve often been in restaurants where the staff give you dirty looks while they sweep and put the chairs on the tables, but I’ve never been told that we have to leave. Of course, my friends said that it was because I was being too loud again. Two establishments in one day. This sealed my reputation as someone who you don’t want to take to your favorite restaurant.

The next anecdote involved this Mexican restaurant we often go to after tennis. You know how sometimes the waiters and waitresses will sing Happy Birthday to you and give you a free dessert when it’s your birthday? Well at this place they like to startle you by popping a paper bag and smear whipped cream on your face instead. My friends were on a kick of saying it was someone’s birthday so they could watch this happen.

I had a couple of friends tip me off that I was their next victim, so when I heard the pop, I knew what was coming.  When the waiters came toward me, I stood up so they couldn’t corner me. They tried to grab my arms so I couldn’t move, but I freed one hand and flipped the plate in the air. It flew across the room, about 10 feet away, and the plate shattered, whipped cream flying everywhere. Dead silence. The waiters were so shocked they just turned around and walked away.

Again, technically I did not get thrown out, but my friends used this incident against me, just the same.

The last anecdote involved a New Year’s party shortly after the Mexican restaurant fiasco. My friends were relating this incident to all of the people who did not have the pleasure of witnessing this spectacle first hand. I was trying to defend myself, explaining how the waiters were holding me down, and I demonstrated how I flipped the plate out of the waiter’s hand. Well wouldn’t you know I was wearing this heavy watch, and that sucker flew off my wrist and hit one of my friends square in the forehead. Hard. From about 12 feet away. It happened so fast he didn’t know what hit him until the watch fell in his lap.

My friends had a field day with that one. They joked that the he had 8:30 permanently tattooed on his forehead. He bandaged his head with a fake bump made out of a meatball to show how badly he was injured. Another friend filed a fake lawsuit against me on behalf of the injured party. And even though this happened over 6 years ago, they were talking about it last night while we were at the Mexican restaurant.

There was a time when I would have been mortified by anecdotes like these. I felt like everything about me was wrong, so I scrutinized every interaction after the fact to make sure I hadn’t offended anyone. But now I have friends who know that I’m loud and that if you try to hold me down I might assault you with a deadly watch. But they love me, anyway.

Still, if you ever meet me, you might want to choose your restaurant wisely.

Obsessiveness

I don’t know if you’ve noticed, but I’m kind of obsessive. I can’t blame people for being annoyed with me. Sometimes I annoy myself.

I’m an excessive planner.  For example, because of my GERD and exercise-induced asthma, I’m constantly obsessing about what and when to eat. Last night I made rice at 1 a.m. while I worked on this post because it will save time and decrease the likelihood that I will throw up on the court tonight.

Sometimes obsessing is a memory device. Like I’ll repeat a sentence that I want to say over and over until I see the person. Writing it down helps, but I can’t always do that–like when I’m driving. Lots of obsessing while I’m driving.

You know how I said that blogging is my new boyfriend? Well, I’m kind of a stalker girlfriend.  I will check my blog stats repeatedly–hundreds of times on the first day I publish a post. Thank goodness it can’t break up with me.

Sometimes I obsess like it’s a hobby. I might obsess about my next blog topic.  Or what my strategy will be in my tennis match. Or when I can schedule my next haircut and if I want to try something different, like get bangs.

Obsessing is the most painful when it is fueled by the inner critic or drill sergeant or perfectionism. Then it’s this relentless voice pointing out all my flaws (Your arms look fat in that picture!). Or when I’m not being productive (Get out of bed and do something!). Or how stupid I am for making a mistake (You shouldn’t have dated that loser!).

There are things that help. I take antidepressants, which also help with anxiety. And when the obsessing gets out of control, I take Ativan. I used to obsess for days rather than take the Ativan, but my psychiatrist reframed taking it as a way to have control over my anxiety. And I’m all about having control.

I also practice mindfulness meditation.  You’re not supposed to judge how well you meditate, so I will just say that I obsess about random things for 95% of the time while I’m doing it. But it seems to work, nevertheless.

I tell myself the same things I tell my clients. I remind myself that I don’t know what will happen and I can’t prepare for every possible scenario. To take one worry at a time. That no matter what happens, I will be able to cope with it. And that I have an excellent memory and won’t forget.

Most importantly, I try to accept that this is a part of who I am. Some people may not have to deal with obsessive thoughts, but everyone has to deal with something. This is my thing.

Since blogging has helped me accept other aspects of my personality, I thought I would try blogging about my obsessions. Sometimes it helps just to say them out loud. And it’s an added bonus when readers say they can relate.

I still obsessed all the way home about what to eat before and after tennis tonight and how to end this post, though. Oh well. I guess practice makes perfect.

Words

I’ve always been a good student. So last night I had to stay up until I finished my homework; I had to finish reading The Book Thief for book club today. I can see why it’s a best seller. It is beautifully written. It’s one of those books that makes me marvel at the power of words–spoken and unspoken.

In the book, Liesel has a love/hate relationship with words. Words were one of Hitler’s most powerful weapons, and she lost many people whom she loved because of them. But words also comforted her, connected her to other people, and ultimately told her story.

I rely a great deal on words in every aspect of my life–except tennis. But even there, you have to at least call out the score. Without words, I wouldn’t be able to sing Karaoke. I guess you can just make a bunch of nonsensical sounds, but that wouldn’t be as fun. The words don’t have to make sense–and I am often surprised to find out what the lyrics are at times–but you have to sing something.

I’m not really artistic. I can’t express myself through drawing or sculpting or dancing like my other family members. But I can write. And I like public speaking. So without words, I wouldn’t have a job. And I wouldn’t be able to blog.

When I write a blog post, I try to keep it as short as possible, so I have to leave a lot of words out. I am always relieved–and surprised–that people understand exactly what I was trying to say in the spaces between the sentences.

Sometimes I have an idea for a post but I’m not quite sure what I want to say. So I just write, because I know the idea is in there somewhere. I usually come up with something I didn’t expect to find. An ending that I hadn’t conceived of at the beginning. Artists often say they don’t create something from nothing; they’re just expressing an idea that’s already there. Sometimes that’s what blogging is like, too.

I spend most of my time listening to and choosing words carefully.  People think the hardest part of therapy is hearing people’s problems, but it’s not.  The hardest part is understanding what clients are trying to tell you and conveying that message back to them.  Again, the idea is in there somewhere, but they don’t quite know how to get it out.  In fact, therapists often say that the nonverbal communication is more important than the words themselves.

I guess that’s why what is left unspoken is meaningful, too. There were many times that Liesel wanted to say things but couldn’t bring herself to do it. I love you. I’m sorry. Don’t go. Sometimes we choose not to say hateful things. Sometimes we punish people with silence.

That’s the paradoxical thing about words. You need them, but you also need the space between them. And good writers like Markus Zusak know how to find the balance between the two.

I was trying to write a message about reading my blog in this doodle, but it ended up looking like someone typing on a computer. But that works, too.