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Let it Go

I love Disney movies. And Disney’s latest, Frozen, is one of my favorites, not only because the music is awesome, but also because it is a story about self-acceptance and love between two sisters.

Elsa is the heir to the throne in the kingdom of Arendale. She has spent her life locked in her room, afraid of her power to create ice and snow, because she accidentally injured her sister Anna when they were children. At her coronation, Elsa’s powers are revealed when she sets off an eternal winter. When she sings the theme song, she is exhilarated that she no longer has to hide her secret. She creates her own palace of ice and snow on an isolated mountain top.

Although Elsa is free from her secret, she still doesn’t want to let her sister into her life. And ironically, in her effort to protect her sister, she accidentally freezes Anna’s heart, which almost kills her. But even then, she still tries to push Anna away, for fear that her powers will do even more damage.

It is not until the end of the movie, when Anna sacrifices her life to save her sister, that Elsa understands that surrendering to love is the answer to controlling her power. She is then able to unfreeze the kingdom and open the doors to the palace.

Tonight my brother called me because he has been depressed and struggling to make it to work. For the first time I shared with him how I had gone through the same thing 5 years ago in an effort to convince him to get on meds and to reassure him that this is not a sign of weakness. He was surprised that I had suffered as he had and that he had not known about it. But it wasn’t his fault, because I didn’t tell any of my brothers about it.

Although I had been on and off meds for several years, this episode forced me to accept that they would have to be a permanent part of my life. As humbling as this was to acknowledge, it was also freeing. But even after I felt better, I still remained in my kingdom of isolation, afraid to let people know.

Writing this blog is the first time I have been completely honest about how dark my depression was. And perhaps sharing my story will save someone else. But in this moment, the most important thing to me is that it saves my brother’s life.

We all have the power to create barriers to keep our loved ones away from the darkness inside us. Yet the real answer is to let go and to bring that darkness into the light.

Meds

The first time I started anti-depressants I was 30. By this time I had been depressed for at least 15 years on and off and anxious non-stop for about 30 years.

Obviously, it would have made more sense to start them sooner, and people told me that, but I was anti-meds up until this time. I was in a research program that strongly favored psychological interventions. Meds were just a product of the money-making pharmaceutical industry and were over-prescribed. People were more likely to relapse when they stopped taking meds. Blah blah blah.

Most of my resistance was really because I was stubborn. No one could have talked me into taking them any sooner.

I finally decided to try them after my husband and I had moved again after a year. Before we finished unpacking, he was already obsessing about buying a house. I knew at some level that we weren’t going to make it, which triggered a depressive episode.

I started on Paxil and sure enough, I felt better immediately. So much better that I wondered why I had allowed myself to suffer for decades when I could have just put myself out of my misery by taking the freaking pill.

Still, after being on them for a year and a half, I stopped taking them–with my doctor’s approval. And I was OK for awhile. But then we bought a house and my husband wanted to find another one a year later. My marriage was moving closer to its sad conclusion.

This time I took Lexapro and stayed on it for much longer. When my life finally seemed stable, I tried going off them again. As soon as the meds were completely out of my system, I felt the depression slowly creeping back. I was a little more irritable. It was a little harder to tolerate stress. My thoughts were a little more negative. Occasionally I was emotionally explosive. And finally, I was barely able to get out of bed.

It turned out to be the most severe episode I had ever experienced. It seemed out of the blue at the time, but now I know that it was because my dad was also experiencing his most severe depressive episode. Even though I didn’t talk to him much, I felt it. That whole super-empath thing. Damn empathy. So annoying sometimes.

I can honestly say that this time the meds saved my life. The depression and anxiety were so debilitating that I spent most of my time lying on the couch, willing myself to keep living, counting the days until the drugs kicked in.  And when they did, I was immensely grateful for the pharmaceutical companies that came up with drugs that allowed me to be myself again.

All clients want to try therapy without drugs, and we always do.  And sometimes that’s enough.  But sometimes it’s not.  And the process of going on and staying on meds for as long as necessary–which might not be for life–is long and arduous.  But when they finally take them, they are thankful that they did and wonder why it took them so long.

But they still want to go off them.

I don’t criticize them for this, because my path to acceptance was longer than theirs.  I used to beat myself up over my stubbornness, but the reality is, you can’t be ready until you’re ready.

It takes a long time before we are willing to give up suffering.

 

Self-Disclosure

I started this blog as a way to put Brene Brown’s claim that vulnerability leads to connection to the test. I believed it in theory but now I have empirical evidence that it works. But self-disclosure is still scary.

It’s still a challenge to write about myself in a way that doesn’t out all of the people in my life who have not chosen to be vulnerable. So I try to talk about myself without blaming anyone else for my problems–in public, at least. Which is a good approach to life in general, I think.

It’s still hard to be open about my weaknesses, although people’s responses have been positive. I freak out a little when people remark on how honest a post was, because that means I said something that they probably wouldn’t have shared about themselves. But mostly I take it as a compliment.

There are still some posts that I have the urge to take down.  I haven’t done so yet, because then it will take me longer to get to 100 posts. Luckily I have enough posts that only the most dedicated readers will find them. And if they like my blog that much, they probably won’t judge me for them.

I still haven’t told clients about my blog. Partly because I’m not brave enough, but also because therapy needs to be about them. Usually they come to see me because they don’t have anyone else who will give them their undivided attention. If I were to say, Hey you know what? I wrote a blog on that very same problem. Here’s the address, that seems a little self-serving.

It’s hard to draw the line between unburdening yourself and burdening someone else. The best part about blogging is that I don’t have to feel guilty about unburdening myself because if you’re reading this, you have chosen to give me your undivided attention.

And for that, I am thankful.

No Good Reason

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Most people who come to therapy for depression berate themselves for not having an excuse for their feelings.  Even when they can identify the stressors that led to their depression, they claim that these aren’t good enough reasons to be depressed.

Sometimes people try to make them feel better with the “count your blessings” approach.  This usually makes them feel worse, because now they don’t deserve to be depressed since they have so much going for them.

In cognitive-behavior therapy (CBT), therapists challenge irrational beliefs as a way to help clients see that their depression isn’t logical.  Sometimes this works.  But sometimes they know their depression isn’t logical, and pointing this out makes them feel even more ashamed for not being able to control their feelings.

For clients with the “no good reason” problem, I have found that the most useful strategy is to debunk their myths about feelings.  Since you probably believe these myths, too, I thought I would go through my whole therapy spiel.

1.  Feelings don’t have to be rational.  That’s why philosophers make such a big deal about distinguishing reason from emotion.  Sometimes they coincide, and it feels better when they do.  It feels better when we can say I’m sad because I’m sick of winter versus I’m sad and I have no idea why.  But we don’t have to know the reason why for our feelings to be valid.

2.  There is no right or wrong way to feel.  We have a lot of implicit rules for what we should be feeling in a given situation.  Take my Ph.D. example in my post on self-worth.  I thought I would feel ecstatic after defending my dissertation.  Instead I got depressed.  Positive events don’t always lead to positive feelings.

3.  We can experience positive and negative feelings at once.  Researchers say that we can’t do this, but I think they’re wrong for reasons that are too complex to explain in this blog.  But I’ll give you an example to prove that I’m right.  People cry at weddings because they are both happy and sad at the same time.

4.  Your feelings aren’t your fault.  We like to believe that we have more control over our feelings than we actually do because…well, because it makes us feel more in control.  But this illusion comes at a cost.  Which is why I wrote the posts on blame and free will.  You didn’t choose to be depressed, and it’s not your fault that you can’t stop the depression.

5.  If you try to make yourself stop feeling, you’ll just make things worse.  Because this will involve some level of deception, like denying or suppressing or minimizing your feelings.  And at some point, this will blow up in your face when you least expect it.  Plus it will make you less empathic when other people tell you how they feel, which will lead to relationship problems.

Although I can write logically about these myths, I still fall prey to them, because feelings aren’t always logical.  Knowing isn’t enough to solve the problem; you still have to practice.  Which is why I practice mindfulness and self-acceptance.  And I encourage you to do the same.

So the next time you catch yourself saying that you have no good reason for your feelings, remind yourself that you don’t need one.


Fear of Sadness

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Most people find it difficult to tolerate negative feelings like sadness.  This task is even more difficult when you suffer from depression, because any time your sadness feels too intense or lasts too long, you worry that the depression is coming back.  And if you’ve ever been depressed, you know how terrifying the prospect is of going back to that dark place.

Your loved ones also become hypersensitive to your sadness, which just exacerbates your fears.  If you’re feeling down, they ask you if you’re taking your meds, or if maybe your meds need to be adjusted.  Don’t get me wrong–I’m all for meds.  I’ve tried to go off them several times, and each time I got depressed again.  But it’s unfortunate that once you’ve been depressed, every feeling has to be scrutinized for potential pathology.

There’s also this added sense of failure associated with relapse.  Like you should have been able to prevent it this time, since you’ve been there before.  And even though you recovered before, you fear that if it happens again, you won’t be so lucky the next time.

And even if you do recover, you fear that the wait will be agony.  I fear depression much more than anxiety because when I’m anxious I can take an Ativan and I feel better immediately.  But antidepressants don’t work that way, so there’s not much I can do to feel better right away when I’m depressed.

Whenever I am afraid I’m becoming depressed, I journal about my fears, my sense of failure, and my pain.  And when I look back at these entries, I realize how strong I am.  There are a lot of things that suck about depression, but I have no doubt that it has made me a stronger person, even while it tries to convince me that I’m weak.

But how do I know when I’m sad versus depressed?  To be honest, I don’t always know.  Sometimes I feel depressed for a day.  Sometimes I feel sad for what feels like an eternity.  The line is not as clear-cut as we’d like to think.  But regardless of whether it’s sadness or depression, the best I can do is to control what I can control.  This includes therapy, meds, stress management, and self-care.

And most importantly, for me, it means practicing self-acceptance–of my sadness, my depression, and everything else that makes me who I am, for better or worse.

How to Save a Life

A few years ago a client told me that I saved his life. Well, he didn’t tell me directly.  He told my colleague when he was drunk at a gala. But he told her to tell me. Although I’m not sure he remembers doing so. Still, I was humbled by this. I knew therapy was important to him, but I didn’t think his life was in danger. But then again, even when clients are in therapy, they don’t always tell you the full story.

Once I had to cancel a session with this client and he stopped coming in for about a month. Apparently he got depressed because he felt like I had abandoned him. A professor contacted him because he had also stopped going to class. When he came back to therapy, he told me that his professor saved his life. That was the first time I really understood how much therapy means to some clients, even when they say they’re not sure they want to be there.

Last week I went to a threat assessment training, and the first case that the presenter discussed was a student who had to go to the police department because she told her roommate she was suicidal. While she was there, she asked for a piece of paper and a pen. She drew what appeared to be a bunch of random doodles. But later when they looked at the drawing, they saw that she had embedded the word help three times.

This, too, reminded me that people may say they don’t want help but their actions tell you otherwise.

Before I started blogging, I thought blogs were just another example of our narcissistic culture in that journaling, which is supposed to be a private experience, was turned into something that you shared with the world and everyone was free to comment. But now I realize that blogs can be a way for people who have never had a voice to connect with people like themselves.

My favorite blog is by Nelly N. She writes passionately and honestly about her struggles with obsessive-compulsive disorder, among other things. She shares her most painful experiences so that other people who suffer in silence will realize that they are not alone. And it works.

A few days ago the student group that I advise had their annual eating disorder panel. It consists of students in recovery who are brave enough to share their story. On our campus, people with eating disorders are blamed and judged more harshly than any other disorder. Not surprisingly, no one wants to admit to having one publicly.

Every year, at least one student seeks treatment after attending the panel. And the next year, those students volunteer to speak on the panel so that they can help someone else who is alone with their eating disorder. Sometimes they use the opportunity to speak as motivation to get better.

We don’t have to be able to leap tall buildings to save someone’s life. Sometimes heroes are ordinary people who take action when someone needs help.

                    

Free Will

When I was in college, one of my fellow psychology majors asked me if learning about psychological theories made me question whether we had free will.  It did not.  Although his question did make me read through the theories again, just to make sure I understood them correctly.  But I was still convinced of my free will.

In my last post I used the example of an alcoholic father to illustrate how difficult it is to sort out blame and responsibility.  If alcoholism is genetic, and his parents were alcoholics, and all of his friends drink, what chance does he have of living a sober life?  How much of his behavior is in his control?

What if you have someone who is depressed with no family history of depression and no apparent cause, and she can’t get out of bed to make it to class.  Is her depression real?  Does she deserve to fail?  What about if she refused to go to therapy and start meds?

I mentioned in my last post that these problems require forgiveness.  We have to forgive ourselves for having the disorder.  We may have to ask for forgiveness from people whom we have harmed.  And we may have to forgive people who have added to our suffering.

When I’m depressed, I think everything is my fault.  In the midst of an episode, I am angry at myself for not being able to function.  I don’t think I have an excuse to be depressed.  In those moments, it’s hard to forgive myself for not being able to control everything.

I also mentioned that there is always some part of the problem that we can take responsibility for.  It may not be the alcoholic dad’s fault that he is prone to addiction, but he can join AA.  He can stay away from friends who pressure him to drink.  He can see a therapist.

I believe that knowing our limitations allows us to have more freedom.  In my work, clients often try to convince other people that their suffering is real.  I tell them that they have limited control over what other people think about their disorder.  However, they don’t have to blame themselves.  They can take control of what they can control.

Some people think that going to therapy is a sign of weakness.  In reality, therapy increases your degrees of freedom.  And I want to make sure I capitalize on all the freedom I can get.

 

Whose Fault is It?

I love playing games.  One of my favorites is the Blame Game.  Even though any couples therapist will tell you that you’re not supposed to do this, I’ll use every piece of evidence of every argument I can remember to prove that it’s not my fault.  I have no doubt this has contributed in part to the demise of some of my relationships.

However, even though I don’t like being at fault, I also blame myself for everything.  I’m one of those people who takes too much responsibility for problems.  Maybe that’s why I am also willing to do more than half of the work to try to “fix” the relationship.

The whole blame and responsibility thing is even harder to sort out when you throw in mental illness.  Lets say, for example, that you have an abusive alcoholic father.  Is it his fault if he hits you while he’s black out drunk?  Is it his fault that he has an addiction-prone brain and can’t just have one drink?  What if he had been sober for a year but relapsed because a buddy guilt-tripped him into going to a bar to celebrate his new job?  What parts of the alcoholism are his responsibility?

In my work, the Blame Game is the most problematic in a sexual assault.  It is often the case that both parties were drinking.  However, when friends are assigning blame, the perpetrator is seen as being less responsible because he was black out drunk.  The victim is seen as being more responsible for allowing herself to get that drunk.

And when the victim comes to therapy, she also believes it was her fault because she had been drinking.  The perpetrator usually doesn’t come to therapy.  In rare cases, the victim will bring the sexual assault to our judicial system to get the perpetrator to take responsibility for his behavior.  And the victim almost never wins.

The two most common disorders we see in the Counseling Center are depression and anxiety.  These are disorders where the person takes too much responsibility for their problems.  If they can’t will themselves to get out of bed and go to class, it’s their fault for being lazy.  When I suggest that a client try meds for her panic attacks, she often says no.  That’s a cop out. She should be able to do it on her own.

I don’t claim to know the answers for how much blame a person should assume.  I do know that the split in assigning blame is rarely 100% to 0%.  There is always some part of the problem that we can take responsibility for.  And when we take responsibility for our part, it usually makes things better.

Sometimes no one is to blame.  This one is really hard for people to accept.  How can you play the Blame Game if it’s no one’s fault?  But let’s say a typhoon hits the Philippines and causes mass destruction.  Whose fault is it?  There is power in blame because it gives us the illusion of control.

But there is also power in forgiveness.  We can forgive the other person for wrongdoing, even if they haven’t accepted any responsibility.  And we can forgive ourselves for our role in the problem.  And forgiveness is much more freeing than blame, regardless of whose fault it is.

 

Wants and Needs

The other day I had a session where I was talking to a client about wants and needs.  She said that she knows that she needs to allow herself to be taken care of, but she doesn’t want to do it.  I thought that was interesting.  How can you not want what you need?  But then after I thought about it some more, I realized that there are all kinds of things that people don’t want to need.  They are usually the things that bring people to therapy.

Most people don’t want to need other people.  That would make them dependent, and dependency is bad.  It’s a sign of weakness.  There is even a diagnosis called dependent personality disorder.  Excessive independence, however, is not considered a problem.  In our culture, you can never be too self-reliant.

While I have certainly seen clients who depend too much on others, more frequently I see people who are afraid to rely on anyone, like this client.  Which is strange, because in the animal kingdom, humans have the longest period of dependence on their parents.  And even as independent adults, we still need other people to have babies, to have jobs, and to survive.  Even hunters and gatherers relied on one another.  I don’t think anyone would consider them weak.

Despite this knowledge, I have to admit, I don’t like to rely on other people, either.  I don’t ask for help unless absolutely necessary.  And the flaw that I am most of ashamed of is my need to be in a relationship.  That’s why I’m so proud of myself right now for being alone.  But the truth is, while I’m not in a romantic relationship, I’m not really alone.

The other thing that people don’t want is to feel.  Usually they come to therapy with the hope that I can help them stop feeling.  This includes the feelings that accompany disorders like anxiety and depression, as well as normal feelings like sadness after a breakup or loneliness–because that makes you weak.

Like dependency, feelings are also necessary for survival.  Without feelings, we would have no signal to figure out what is causing us pain.  Without feelings, we aren’t able to empathize with other people.  Without feelings, we would be classified as reptiles in the animal kingdom.

I don’t want to be a reptile, but I do get frustrated with the intensity of my feelings.  Sometimes they reach the level of depression and anxiety.  And then I feel other people’s feelings, too.  That’s a lot of feeling for one person to tolerate.  And some people do find my feelings overwhelming.  I’m too needy. Too sensitive. Too much.

Or maybe they were too reptilian to be able to empathize with me.

I often have to tell clients up front that if what they want is to stop needing and feeling, I can’t help them.  Sometimes they transfer to other therapists, which I understand.  Who wants to be told that they have to accept being human?  But most people stay.  When I point out that only robots have the luxury of not needing or feeling, they acknowledge that they don’t want to be a robot.

But it’s surprisingly hard work, this being human stuff.  It requires a lot of self-compassion, self-acceptance.

Which is why I started this blog.

Judgment

There are certain personality types that are sensitive to being judged, and I have one of them.  It takes very little criticism for me to feel ashamed that I have done something wrong.  Sometimes I interpret neutral comments as criticism.  And in some cases, I’ve even interpreted positive feedback as criticism.

Once my first husband was talking about a picture of Alicia Keys and commented on how she had big hips.  I replied with, Are you calling me fat?  Which really annoyed him.  I kind of thought it was funny but true.  Even if I get what is intended to be a compliment about having an athletic build, I take this to mean that I look fat.  This is why it’s better to refrain from comments about women’s bodies in general.

Although I have never had an eating disorder, I can relate to being obsessed about my body.  I also have a similar personality to the types of people who develop anorexia.  I am prone to anxiety and depression.  I am perfectionistic.  I am highly motivated to avoid harming others, even if it means hurting myself.  And I am so sensitive to criticism that I never forget a mistake.

This is why I am drawn to Buddhism–especially the practices of mindfulness and compassion.  I find comfort in the idea of letting go of what I “should” be thinking, feeling, and doing.  That I can accept whatever is true of myself at this point in time, without judgment or criticism–even if it’s something that I hope to change.

I often point out to clients when they are using judgment words to describe their feelings.  For example, if you say I feel pathetic, the word pathetic is not a feeling.  There is no emoticon for pathetic.  Sometimes it’s actually hard to come up with a feeling word.  Usually when you can’t think of one, you’re probably feeling ashamed.

Even when we’re successful in describing our feelings, we often get judged for them.  For example, if I say I feel depressed, someone might say You shouldn’t feel that way.  You should be happy because you have so much going for you.  This is meant to make me feel better about myself, and perhaps it works for some people, but it never works for me.

Sometimes I have tried to point out to the person that they are judging me, but people who judge others are often sensitive to being judged.  So they usually get defensive and say they were just trying to be helpful–that I’m being too sensitive.  So then I judge myself for being too sensitive.

But I am all about controlling what I can control.  Today, I realized that I can’t control whether someone else chooses to practice nonjudgmental acceptance of my feelings.  I can only control what I say to myself.

I can also choose not to share my feelings with people who judge me.  I think I’m going to start doing that, too.