Last week's post about visualization made me think of all the time I spent hiding -- or practicing hiding! -- in small spaces as a child. It wasn't always snow tunnels, you know. For one thing, they have a tendency to melt when the weather starts warming up. For another, it's good to have as wide a variety of self-concealment skills as possible if you're planning on living a life centered around paranoia, self-hatred, and regret.
Some of the most vivid memories I have of hiding aren't of hiding at all, but of playing at hiding. Like everyone else I knew growing up, I would drape scarves and blankets over tables, chairs, and assorted furniture in order to construct a private space for myself where I could play unobserved. I could read in there, hug a stuffed animal, play with my toys, or just be comforted by the muted quality of the light filtered through knitted scarves and thin blankets.
With other children, and sometimes adults, I built pillow forts and snow forts, indestructible precisely because they could so easily be rebuilt.
Although I don't remember it, I have many pictures of myself as a child where I've crammed myself into laundry baskets, boxes, and tubs from laundry detergent. I've played hide-and-seek and fit myself into hampers. And, of course, I know as well as everyone that if you cover yourself completely with your blankets, nothing bad can happen to you during the night because you are invisible.
This kind of hiding is more like playing at hiding than actually hiding. For one thing, most of the time you're only partially hidden. For another, sometimes people can actually see you. It's fun, and the whole objective is to have fun. It's enjoyable. You aren't hiding for any reason other than the pleasure it gives you.
As a child, I would sometimes spontaneously hide, and I'm not really sure why. Occasionally I would hide under my parents' bed, amid the boxes and dust, thinking that no one would ever think to look for me under there. Playing by myself outside, I would hide behind the shed, within the lilac bush, inside fur trees, high up in the maple, crouch down in window-wells, and below the driveway retention wall.
Inside the house, I would hear my father's footsteps coming down the carpeted hall and crouch down flat behind the end of my bed, or behind my brick-red stuffed chair, desperate for some reason that he not see me.
This kind of hiding wasn't really a game. I'm not sure what it was about, but I know I wasn't doing it for enjoyment. I didn't feel good, or happy, or relaxed while I was doing it. I just know I was gripped by this sudden intense fear and felt compelled to hide. Hiding made me feel...not so much safe as less bad. It helped take the edge off. In a way it wasn't really hiding either: as a child in a confined space like a house or a yard, it's likely that someone will find you sooner rather than later if they're really looking, and that they'll be pretty pissed off when they do. I think most hiding, in the end, is not like this.
This is the kind of hiding that's followed me into adulthood. I'm not sure why, exactly. I know that sometimes I feel driven to hide because I'm under a lot of stress, or experiencing other peoples' conflict around me. This has been worst when I am at my most depressed -- naturally, I've felt most compelled to hide when I've been hospitalized, thereby making my hiding habit super problematic for the psychiatric team trying to help me. It makes me the most annoying patient in the world.
Back in St. Jerome, I hid in the closet that was in my room, eventually leading the staff to start locking it. I hid under my bed. I hid in the shower. One night, I caused a code white that had the hospital searching for me for an hour after I'd run past the (glass) nursing station unobserved to hide behind a chair in the games room. I hid in the elevator after running past the nursing station in the middle of the night. The night I escaped into the basement but couldn't get through the connecting tunnel to flee from the main building (which would be less suspicious) because it turned out you needed a code, four orderlies eventually dragged me away from where I was hiding among lockers (and clinging to them).
At St. Mary's, I hid behind a door. I locked myself in showers and curled up under their benches. I hid in my own bathroom, and under the covers. I eventually settled on routinely cramming myself into the cubbyholes in the wall that once held fire extinguishers. Some doctors thought it was hilarious. Some people thought I would fall out and hurt myself. One doctor walking past commented that he could still see me. My own psychiatrist thought it was an ingenious solution because I had somehow combined my need to be small and concealed with the staff's need to know where I was and what I was doing. I liked it because I could fit myself in there without the staff coming to unlock the door and extract me.
Now that I live alone, when I'm very distressed I still find myself hiding, especially when I wake up during the night. I hide on the balcony, under the table, in the shower, and any small corner I can wedge myself into. I have no idea why I would hide when I'm completely alone, but I guess it just goes to show that wherever you go, there you are.
As a child, I also used to practice hiding. I would climb into my closet, get as deep and as far into it as possible, and pull the clothes and boxes around me so that it looked like nothing had been disturbed. I remember how it felt to be in the dark with the doors mostly shut, the light only a thin sliver muffled by the clothes hanging softly around my face. I would pull things out from under my bed, crawl into the space under the headboard, and pull the stuff back in again. In the total darkness, I felt safe. Nothing could get to me here; no one could ever find me. I practiced breathing in the dust without coughing or sneezing, being as still and as quiet as possible. I would come out of my hiding spots after carefully listening for several minutes to make sure no one was around to discover where my spots were by seeing me emerge, dust-covered and prepared.
I don't know very much about developmental psychology, but I'm going to go ahead and assume that all these forms of hiding are completely normal for a child. The fact that I still try and hide as an adult, however, is somewhat more problematic. Since I don't know why I'm doing it, I don't have any idea how to fix it, either. Suggestions?
On a completely unrelated note, I've printed out 25 pages of the crappy book I'm writing. If anyone really loves reading incredibly drafty-drafts that end in the middle of a sentence, you're welcome to borrow it!
Showing posts with label Saint Mary's Hospital. Show all posts
Showing posts with label Saint Mary's Hospital. Show all posts
Tuesday, August 19, 2014
Saturday, June 28, 2014
Sometimes Your Brain Thinks Thoughts
The brain is a truly complex and amazing organ. It does some pretty unbelievable things that we never have to think about, like regulating the pace of our breathing, our heartbeat, some reflexes, vasomotor activity, plus the obvious stuff like generating our emotions and thoughts. The brain, in conjunction with the nervous systems, reaches out to tell our organs what to do, and to make our bodies move around. Our brain allows us to see, to hear, and to feel. Our brain is so sophisticated that it does what no other parallel processing computing device has ever been able to replicate: it allows us to have consciousness.
Kinda makes it sad that the machines are wasting our potential by using us as batteries, right?
I joke, of course. This isn't the Matrix. Whatever you do, don't take the red pill.
Sometimes, our brains think thoughts. If you think about it, we're thinking thoughts all the time, possibly as an outcome of linguistic capability (it might also be the other way around but, really, who cares). It seems obvious that we think thoughts when we're trying to solve a problem, or planning, or listening, or having a conversation, or learning. We think little thoughts all the time as we ask ourselves questions like, I wonder if I'm hungry? What should I have for dinner? We think little thoughts as we keep up a running commentary on things going on around us. Our brain thinks little thoughts to remind us of things, sometimes by interrupting something else that we're doing to tell us something completely different, like if we're doing the dishes and our brain tells us that we have to go to the drugstore tomorrow and buy more cottonballs.
We think thoughts so often that most of the time we don't even notice them; they're part of the background noise of being human. We take them for granted. In retrospect, part of what I find most terrifying about severe acute depression is the moments where the pain gives way to a nothingness where there are no thoughts. People tell me later that it's like I've frozen staring off into space. Subjectively it feels like time has stopped and then picked back up again, except that it turns out there was a gap with nothing in it. I'm lucky that this tends to last only moments at a time. But the idea that it might be possible for my brain to stop thinking thoughts, even temporarily, is chilling.
But I digress.
Sometimes I have thoughts that I don't feel like I'm in control of. Sometimes these thoughts follow moods, but sometimes they just float into my mind like a passing breeze with no obvious genesis.
I wish I was dead.
I should jump in front of that metro.
I want to stick a carving knife into my wrist and pull it up to my elbow.
Do the thoughts bother me? Yes. Partly because anything I don't control bothers me, and I hate not being in control of my own mind. Partly because the thoughts are scary and bad, and I'm afraid that if they start to hound me I'll end up being powerless against them. Partly because it divides my attention away from other things, like data entry, or looking at pictures of cats, or obsessively replaying my rapes in my mind.
I talked a little bit about the hurting-myself thoughts with my first psychologist, whom I will henceforth refer to as Dr. Radio, because he had the best voice I've ever heard in my life. I could listen to him for hours, even if he were just reading copyright information, because the sound of his voice was so relaxing. Anyways.
When I started to get more depressed in the Fall, one of the things that happened is these thoughts about suicide and self-harm reappeared. I was terrified: I hadn't had these thoughts for years. I wasn't suicidal at all since 2006. I hadn't harmed myself at all since 2009, and not seriously since 2006. When these thoughts came back, I felt scared. I also felt like I'd failed. I felt like I was failing God, Who had given me the miracle of healing me from these ideas. I felt like I was failing myself. I fought against the thoughts for months, by the winter for most of the day, constantly. Both the feelings and the thoughts were painful and overwhelming. I was scared I'd have the thoughts forever, and I was scared because I both did and didn't want to do what they were telling me. I knew that at one point I wouldn't be able to stand the thoughts any more and would give in just to get a moment's peace.
When I was released from the hospital in March, I'd had weeks to think about it, and I knew something would have to change in the way I was dealing with the thoughts, especially since my mood was still pretty low. In a way I was also better off than before I went in, thought-wise, because trying to kill myself did work in the sense that it released a lot of the pressure. It was like taking a cork off a bottle of champagne: Ahhhhhh. Suddenly not so crammed-in and tight-feeling, crushed, unable to breathe. I think that's what they call catharsis.
Over the years, I'd taken steps to try and mitigate the potential impact of the thoughts. I don't keep Tylenol in the house because acetaminophen is shockingly hepatotoxic (that shit will destroy your liver). I don't have a gun, and wouldn't have a gun, because shooting yourself in the head is very bad. I keep stainless-steel blades specifically for self-harm because I can sterilize them with alcohol and, at the very least, avoid cutting myself with anything stupid like a rusty nail or a broken bottle I found in the street. At times, I've had my prescription medication locked up so it was inaccessible and gotten it dispensed weekly.
Obviously, these are attempts to control my environment rather than attempts to regulate the thoughts. Leaving St. Mary's, I knew it wouldn't be good enough because it manifestly hadn't been good enough.
The main thing I decided I would do is that I wouldn't chase the thoughts. It's natural, when you have a thought, to have the corresponding emotions. When a thought is powerful, either in the force of its suggestion or the tenor of its emotional implication, it's easy to get trapped in a cycle of thoughts. One thought follows another in an endless train, pulling along emotions that fuel the thoughts running on and on, a conflagration running like wildfire through the kindling of your mind.
You chase the thoughts, following them, fueling them and, ultimately, allowing them to burn uncontrolled. If you ever do stumble across a wildfire - which I sincerely hope you don't - the way to put it out is really to have it run into barren ground where there's nothing to burn. Chasing a difficult thought around is like throwing barns at a fire while you run away, hoping that it will eat the barns instead of you, all the while making it bigger and angrier and more uncontrollable.
Stop. Take a breath. Acknowledge that you're having a thought. I am having a thought. Okay.
Then let it go. You don't have to hold onto it. You don't have to dwell on it, or try to puzzle out what it means, or let it fill you up. It's just a thing that's happening, and it passes.
Talking about the thoughts with Dr. Radio, we discussed the ways that I felt badly about myself for having the thoughts. I felt like I was a sick person, a weak person, like I wasn't ever going to get better. I felt abnormal. These thoughts, these are illness. But he pointed out that, in reality, people with psychopathology and people without psychopathology both have random thoughts like, I wonder what would happen if I stabbed that person, or, I wonder what would happen if I jumped in front of that train. The research supports the fact that everyone is having these stray thoughts. The difference is what people with mental illness say to themselves about themselves because of the thoughts.
I have a thought about killing myself, and I tell myself that I am sick, that I am a bad person, that I am not capable of getting better, and that I am afraid I won't be able to resist the thoughts. So what I have to learn is not to judge or label myself because of the thoughts. Essentially, this involves noticing that a single thought is actually triggering an entire thought-sequence about yourself that really has nothing to do with the original thought and everything to do with your self-conception. So when my thought-train starts up, I take notice, stop, take a step back, and remind myself that the thought doesn't mean any of the things I'm saying to myself about myself, because the thought is just a thought. It takes a lot of time, and a lot of work, to interrupt thought patterns, but I'm sticking it out.
Recently, after rTMS, I've been feeling a lot better and doing the thought-work is easier, but I'm still having the thoughts sometimes, out of nowhere. It doesn't bother me as much as it used to. I do feel disappointed sometimes that they're not completely and miraculously gone, but then I remind myself that it takes a long time to undo thought patterns. Thoughts, like flowing water, carve grooves in the mind so that future thoughts more easily follow the same path. It's not easy to change the course of a river, and it's not easy to change thoughts, either. You definitely end up with two competing thoughts at once where you're telling yourself, gently, that you're wrong. So, at least while you're relearning, what you're having is not so much different thoughts as more thoughts, as you pile new thoughts on top of the old ones to divert them. I had to decide to be patient with myself.
Talking about my thoughts with my new psychologist, she mentioned that I didn't seem very distressed by the fact that I was having them, so I told her what Dr. Radio had told me and how I was trying to learn not to judge myself. She suggested that I take it one step further and, instead of saying to myself, 'I am having thoughts,' to say, 'My brain is having a thought.' This makes sense on multiple levels: it creates more distance between you and the thought by decoupling it from a sense of personal agency; it creates a gap between the thought and the emotional reaction by framing the experience in the most objective way possible; and it interrupts the thought-pattern by adding a new thought about the thought, namely that you are not the same as your thoughts. This last idea is actually pretty radical - the suggestion that you and your thoughts are not identical, or that you, as a person with personal worth and value, are not made out of your thoughts.
So, if you're looking to change the way your thoughts are running around in your head, I hope you find my tips helpful:
If all else fails, just turn yourself over and look for the little button that you can poke with a pen to force a system reset.
Kinda makes it sad that the machines are wasting our potential by using us as batteries, right?
I joke, of course. This isn't the Matrix. Whatever you do, don't take the red pill.
Sometimes, our brains think thoughts. If you think about it, we're thinking thoughts all the time, possibly as an outcome of linguistic capability (it might also be the other way around but, really, who cares). It seems obvious that we think thoughts when we're trying to solve a problem, or planning, or listening, or having a conversation, or learning. We think little thoughts all the time as we ask ourselves questions like, I wonder if I'm hungry? What should I have for dinner? We think little thoughts as we keep up a running commentary on things going on around us. Our brain thinks little thoughts to remind us of things, sometimes by interrupting something else that we're doing to tell us something completely different, like if we're doing the dishes and our brain tells us that we have to go to the drugstore tomorrow and buy more cottonballs.
We think thoughts so often that most of the time we don't even notice them; they're part of the background noise of being human. We take them for granted. In retrospect, part of what I find most terrifying about severe acute depression is the moments where the pain gives way to a nothingness where there are no thoughts. People tell me later that it's like I've frozen staring off into space. Subjectively it feels like time has stopped and then picked back up again, except that it turns out there was a gap with nothing in it. I'm lucky that this tends to last only moments at a time. But the idea that it might be possible for my brain to stop thinking thoughts, even temporarily, is chilling.
But I digress.
Sometimes I have thoughts that I don't feel like I'm in control of. Sometimes these thoughts follow moods, but sometimes they just float into my mind like a passing breeze with no obvious genesis.
I wish I was dead.
I should jump in front of that metro.
I want to stick a carving knife into my wrist and pull it up to my elbow.
Do the thoughts bother me? Yes. Partly because anything I don't control bothers me, and I hate not being in control of my own mind. Partly because the thoughts are scary and bad, and I'm afraid that if they start to hound me I'll end up being powerless against them. Partly because it divides my attention away from other things, like data entry, or looking at pictures of cats, or obsessively replaying my rapes in my mind.
I talked a little bit about the hurting-myself thoughts with my first psychologist, whom I will henceforth refer to as Dr. Radio, because he had the best voice I've ever heard in my life. I could listen to him for hours, even if he were just reading copyright information, because the sound of his voice was so relaxing. Anyways.
When I started to get more depressed in the Fall, one of the things that happened is these thoughts about suicide and self-harm reappeared. I was terrified: I hadn't had these thoughts for years. I wasn't suicidal at all since 2006. I hadn't harmed myself at all since 2009, and not seriously since 2006. When these thoughts came back, I felt scared. I also felt like I'd failed. I felt like I was failing God, Who had given me the miracle of healing me from these ideas. I felt like I was failing myself. I fought against the thoughts for months, by the winter for most of the day, constantly. Both the feelings and the thoughts were painful and overwhelming. I was scared I'd have the thoughts forever, and I was scared because I both did and didn't want to do what they were telling me. I knew that at one point I wouldn't be able to stand the thoughts any more and would give in just to get a moment's peace.
When I was released from the hospital in March, I'd had weeks to think about it, and I knew something would have to change in the way I was dealing with the thoughts, especially since my mood was still pretty low. In a way I was also better off than before I went in, thought-wise, because trying to kill myself did work in the sense that it released a lot of the pressure. It was like taking a cork off a bottle of champagne: Ahhhhhh. Suddenly not so crammed-in and tight-feeling, crushed, unable to breathe. I think that's what they call catharsis.
Over the years, I'd taken steps to try and mitigate the potential impact of the thoughts. I don't keep Tylenol in the house because acetaminophen is shockingly hepatotoxic (that shit will destroy your liver). I don't have a gun, and wouldn't have a gun, because shooting yourself in the head is very bad. I keep stainless-steel blades specifically for self-harm because I can sterilize them with alcohol and, at the very least, avoid cutting myself with anything stupid like a rusty nail or a broken bottle I found in the street. At times, I've had my prescription medication locked up so it was inaccessible and gotten it dispensed weekly.
Obviously, these are attempts to control my environment rather than attempts to regulate the thoughts. Leaving St. Mary's, I knew it wouldn't be good enough because it manifestly hadn't been good enough.
The main thing I decided I would do is that I wouldn't chase the thoughts. It's natural, when you have a thought, to have the corresponding emotions. When a thought is powerful, either in the force of its suggestion or the tenor of its emotional implication, it's easy to get trapped in a cycle of thoughts. One thought follows another in an endless train, pulling along emotions that fuel the thoughts running on and on, a conflagration running like wildfire through the kindling of your mind.
You chase the thoughts, following them, fueling them and, ultimately, allowing them to burn uncontrolled. If you ever do stumble across a wildfire - which I sincerely hope you don't - the way to put it out is really to have it run into barren ground where there's nothing to burn. Chasing a difficult thought around is like throwing barns at a fire while you run away, hoping that it will eat the barns instead of you, all the while making it bigger and angrier and more uncontrollable.
Stop. Take a breath. Acknowledge that you're having a thought. I am having a thought. Okay.
Then let it go. You don't have to hold onto it. You don't have to dwell on it, or try to puzzle out what it means, or let it fill you up. It's just a thing that's happening, and it passes.
Talking about the thoughts with Dr. Radio, we discussed the ways that I felt badly about myself for having the thoughts. I felt like I was a sick person, a weak person, like I wasn't ever going to get better. I felt abnormal. These thoughts, these are illness. But he pointed out that, in reality, people with psychopathology and people without psychopathology both have random thoughts like, I wonder what would happen if I stabbed that person, or, I wonder what would happen if I jumped in front of that train. The research supports the fact that everyone is having these stray thoughts. The difference is what people with mental illness say to themselves about themselves because of the thoughts.
I have a thought about killing myself, and I tell myself that I am sick, that I am a bad person, that I am not capable of getting better, and that I am afraid I won't be able to resist the thoughts. So what I have to learn is not to judge or label myself because of the thoughts. Essentially, this involves noticing that a single thought is actually triggering an entire thought-sequence about yourself that really has nothing to do with the original thought and everything to do with your self-conception. So when my thought-train starts up, I take notice, stop, take a step back, and remind myself that the thought doesn't mean any of the things I'm saying to myself about myself, because the thought is just a thought. It takes a lot of time, and a lot of work, to interrupt thought patterns, but I'm sticking it out.
Recently, after rTMS, I've been feeling a lot better and doing the thought-work is easier, but I'm still having the thoughts sometimes, out of nowhere. It doesn't bother me as much as it used to. I do feel disappointed sometimes that they're not completely and miraculously gone, but then I remind myself that it takes a long time to undo thought patterns. Thoughts, like flowing water, carve grooves in the mind so that future thoughts more easily follow the same path. It's not easy to change the course of a river, and it's not easy to change thoughts, either. You definitely end up with two competing thoughts at once where you're telling yourself, gently, that you're wrong. So, at least while you're relearning, what you're having is not so much different thoughts as more thoughts, as you pile new thoughts on top of the old ones to divert them. I had to decide to be patient with myself.
Talking about my thoughts with my new psychologist, she mentioned that I didn't seem very distressed by the fact that I was having them, so I told her what Dr. Radio had told me and how I was trying to learn not to judge myself. She suggested that I take it one step further and, instead of saying to myself, 'I am having thoughts,' to say, 'My brain is having a thought.' This makes sense on multiple levels: it creates more distance between you and the thought by decoupling it from a sense of personal agency; it creates a gap between the thought and the emotional reaction by framing the experience in the most objective way possible; and it interrupts the thought-pattern by adding a new thought about the thought, namely that you are not the same as your thoughts. This last idea is actually pretty radical - the suggestion that you and your thoughts are not identical, or that you, as a person with personal worth and value, are not made out of your thoughts.
So, if you're looking to change the way your thoughts are running around in your head, I hope you find my tips helpful:
Don't chase the thoughts.
Don't judge yourself for the thoughts.
Be patient with yourself as you learn a new way.
Remember that the thoughts are not you, and don't define you, and will never define you. The thoughts are something that is happening, and that you are living with, and that are giving you an opportunity to change.
If all else fails, just turn yourself over and look for the little button that you can poke with a pen to force a system reset.
Saturday, June 14, 2014
The Difficulty with a Difficult Recovery
Sometimes people get confused because I'm a chronic optimist despite living under the cloud of depression for so many years. Admittedly, this confusion is understandable since it only makes sense that an illness which robs you of a hopeful perspective of the future would make a person - well - less than hopeful about the future. Lack of rose-colored-glasses and all that. But I feel like looking on the brighter side has, for me, been the natural consequence of spending years searching and searching (and searching!) for the light even when it doesn't appear to be there.
If there's a problem, I think it'll be all right. My life is on fire? Oh, it's not that bad, I can make a new one. Oh, my academic career has been destroyed by my illness? That's okay, I'll find something else to do with my life. Oh, I lost my job? Well, that's not ideal, but I've been meaning to make a change anyway.
Having said that, if I smudge a freshly-painted manicure, nothing will ever be okay again because this is the end of the universe, so I think I'll just sit on the floor and sob hysterically for 20 minutes. I think what I'm mostly lacking isn't a sense of optimism so much as a little perspective.
Anyways, when I heard that having rTMS was a possibility, I was already thinking we are trying something new, and it will work. I was fully prepared for it to work spectacularly well. And it did: it gave me moments of clarity and feelings of well-being that were beyond even my expectations. I feel truly blessed that it worked so well for me. And when I had the opportunity to try adjusting my medication levels to try and alleviate some of my lingering exhaustion and bursts of inexplicable sadness, give me back a little pep-in-my-step, of course I jumped on it. It is a great plan, and this time we are going to go all the way and it will totally work, especially while I'm still in the consolidation period following rTMS.
Well, as it turns out, not so much. Of course, there's always a period of adjustment while medications are being changed, and that's only to be expected. But it might be that more of a good thing is sometimes just too much. I hate to admit defeat, in anything, but sometimes it just has to be done. I was wrong, universe: it is not a smooth line upward - though I do believe that upward will be the ultimate trajectory. Sometimes, it's just hard when the direction is more sideways than you were hoping for.
It's easy to tell people you're doing poorly - that you need their visits, their prayers, their support, and their offers of fresh fruit - when you are so sick that you're an inpatient in a psychiatric unit. It's another to tell people you're struggling when you're doing so much better. You, as well as everyone who has rallied around you, need the story with the happy ending. You need the recovery story. You need to tell it to yourself, and so you tell it to everyone around you. I am doing so much better. I am recovering. I am in recovery. Even, I am better. It's so, so easy to leave out the second half of those sentences: I am recovering, but I am still struggling. I am doing so much better, but the truth is that it's still really rough. I am in recovery, but the road is uneven and I am afraid of falling, and I have fallen.
The logical part of my mind reacts to setbacks as setbacks. I tell myself that this is part of the recovery process, that it will take time, that it will not always be smooth. The part of my brain that is still depressed tells me that this is just like before and I will never, ever be better. The truth is that when you live with an illness in which your brain tries to convince you that nothing will ever be okay, you're going to spend a lot of time arguing with yourself. It takes patience, and self-compassion, and determination to tell your brain that it is wrong. Your brain is saying two contradictory things at once, the one which you encourage and the one which you struggle against.
And it's hard. It's so, so difficult. And part of that difficulty lies in not knowing how to say that this is a story about recovery and also a story of learning to live with not being completely well all of the time, of learning that recovery is a process requiring you to learn and to grow and to stretch your fragile wings, and that you are not quite all the way out of the nest and ready to fly.
If there's a problem, I think it'll be all right. My life is on fire? Oh, it's not that bad, I can make a new one. Oh, my academic career has been destroyed by my illness? That's okay, I'll find something else to do with my life. Oh, I lost my job? Well, that's not ideal, but I've been meaning to make a change anyway.
Having said that, if I smudge a freshly-painted manicure, nothing will ever be okay again because this is the end of the universe, so I think I'll just sit on the floor and sob hysterically for 20 minutes. I think what I'm mostly lacking isn't a sense of optimism so much as a little perspective.
Anyways, when I heard that having rTMS was a possibility, I was already thinking we are trying something new, and it will work. I was fully prepared for it to work spectacularly well. And it did: it gave me moments of clarity and feelings of well-being that were beyond even my expectations. I feel truly blessed that it worked so well for me. And when I had the opportunity to try adjusting my medication levels to try and alleviate some of my lingering exhaustion and bursts of inexplicable sadness, give me back a little pep-in-my-step, of course I jumped on it. It is a great plan, and this time we are going to go all the way and it will totally work, especially while I'm still in the consolidation period following rTMS.
Well, as it turns out, not so much. Of course, there's always a period of adjustment while medications are being changed, and that's only to be expected. But it might be that more of a good thing is sometimes just too much. I hate to admit defeat, in anything, but sometimes it just has to be done. I was wrong, universe: it is not a smooth line upward - though I do believe that upward will be the ultimate trajectory. Sometimes, it's just hard when the direction is more sideways than you were hoping for.
It's easy to tell people you're doing poorly - that you need their visits, their prayers, their support, and their offers of fresh fruit - when you are so sick that you're an inpatient in a psychiatric unit. It's another to tell people you're struggling when you're doing so much better. You, as well as everyone who has rallied around you, need the story with the happy ending. You need the recovery story. You need to tell it to yourself, and so you tell it to everyone around you. I am doing so much better. I am recovering. I am in recovery. Even, I am better. It's so, so easy to leave out the second half of those sentences: I am recovering, but I am still struggling. I am doing so much better, but the truth is that it's still really rough. I am in recovery, but the road is uneven and I am afraid of falling, and I have fallen.
The logical part of my mind reacts to setbacks as setbacks. I tell myself that this is part of the recovery process, that it will take time, that it will not always be smooth. The part of my brain that is still depressed tells me that this is just like before and I will never, ever be better. The truth is that when you live with an illness in which your brain tries to convince you that nothing will ever be okay, you're going to spend a lot of time arguing with yourself. It takes patience, and self-compassion, and determination to tell your brain that it is wrong. Your brain is saying two contradictory things at once, the one which you encourage and the one which you struggle against.
And it's hard. It's so, so difficult. And part of that difficulty lies in not knowing how to say that this is a story about recovery and also a story of learning to live with not being completely well all of the time, of learning that recovery is a process requiring you to learn and to grow and to stretch your fragile wings, and that you are not quite all the way out of the nest and ready to fly.
Friday, June 6, 2014
Short-Term Disability (Or, the Insurance Policy I Didn't Even Know I Had)
I went into the hospital at the beginning of January to get some stitches, because I knew that I literally couldn't do my job with a gaping hole in my forearm. Oh sure, there were some other reasons. For starters, I'd actually been making incisions in my arm in an attempt to locate my artery, because I was convinced it would look really beautiful when I sliced it open...luckily, my lack of stamina as well as my apparent lack of basic anatomical knowledge meant that I eventually gave up and decided to go to church instead, where a friend helped me get to the emergency room.
For another, I knew I needed some sort of help that I just wasn't getting. I was both relieved and devastated when I was finally admitted to the psychiatric ward at St. Mary's. I was relieved because I knew that I was incapable of doing my job, and this would save me from destroying my fledgling career. I was relieved because I'd been having an incredibly public breakdown all over social media and being unplugged from the internet would keep me from posting any more cartoons about how I wished I was dead, and generally humiliating myself any further (P.S. it's really hard to look people in the face after you've had a complete meltdown in public view for a few weeks). I was relieved because I didn't have to spend any more energy trying - and failing - to pretend that I am perfectly fine, goddamit!
But I was also kind of a little crushed inside, in the part of me that cares, the soft squishy vulnerable part of me that I have to shield at all time because weakness is a liability that just isn't acceptable. Weakness means rape, and pain, and all sorts of failure. I just can't stand it. Every time a doctor talks to me about allowing myself to be vulnerable I want to punch them in the face and throw myself off the nearest building.
But I digress.
It was crushing to call my boss every day during the first week and tell her that I was still in the hospital and wouldn't be coming into the office. It was humiliating to be so...I don't know...a terrible employee. I knew that I was protected from being fired because it's against the law to fire someone for being in the hospital, but I still felt pretty shitty. You've got to be thinking you've made the wrong hiring decision when your employee goes AWOL less than a year into the job; it wasn't fair to either my manager or my team for me to so completely drop the ball. I felt like someone had thrown me the ball, it was busy season and they needed everyone to be on their A-game, and I was like 'Oh, this ball? I think I'll just throw it back in your face.'
I hadn't been hospitalized at all since 2006, and my last significant stay was in 2002-2003. I felt like I'd wasted all this time and all these years only to find myself back in the same shit-hole. I was so disappointed in myself, in my failures, in all the things I should have done to get better but somehow didn't manage to get around to doing.
Me and the hospital. I was like 'Please, please, help me. Please save me from myself,' and also, 'I don't deserve to be here, and I don't have what it takes to get better, so you might at well give me the boot and make room for someone who will.'
Anyway, in one of my many conversations with my manager, she mentioned that we'd been using up the two weeks of sick days I had in my bank, and then we'd be contacting HR to get started on a short-term disabilities claim. I was like, 'short-term what in the what now?'
I'd been thinking that I was really fortunate not to get fired, and that I'd saved up money for years so that if I was ever too sick to work I wouldn't end up homeless and completely bankrupt. But, instead, it turned out I had an entire short-term disabilities insurance policy that would pay 75% of my salary. It had come with my job, and I didn't even know it. I work in the insurance industry, and I knew the insurance they were giving me as part of my compensation package was outstanding, but I didn't even know short-term disability was a thing.
I felt so, so lucky. But, when week three of my hospitalization rolled around and it was time to fill out the complex paperwork, I also felt deeply conflicted. I was basically saying, to my employer and to myself, that I was a failure. I was incapable of working. I was worthless, a financial liability. I couldn't even do my job. I have always tried so hard, worked so hard, kept going no matter the personal cost, and here I was giving up. I mean, why couldn't I just make myself go in to the office? I'd been doing it before, hadn't I? I felt so overwhelmed and incapable. I'm not sure I've managed to work out all the things I was feeling.
When I finally did go back to work on a progressive return, and started to struggle with working four days a week, I wondered if I would ever be able to work a full week again, if I would be able to manage it. I was doing the best I could, but I was failing. And then, I went back on full disability benefits to receive rTMS treatment at the Douglas. I realized, 'I am disabled.' It wasn't something I thought I'd ever have to say about myself. I am disabled.
I still struggle with what saying that means. I was disabled. The part of me that's trying to learn self-compassion tells me that it's okay, that it's not my fault I was sick, that this is something that just happens. I was lucky to get through it. I was lucky that rTMS treatment worked well and I could get back to my old activity level without distress. I was lucky. I know that having been disabled doesn't say anything about my character, or my strength, or my worth as a human being. But I still feel somehow less than I did before. I still wonder what value my life has when I can't be a functioning, productive member of society. Sure, everyone needs a little help sometimes, but not everybody ends up disabled because they just can't handle their workload.
I am so, so lucky to be employed at a place that gave me such great insurance, because not everyone has that benefit. I am so, so lucky that my team and managers believed in me, and welcomed me back so seamlessly. I am so, so lucky that HR and my short-term disabilities case-worker were so compassionate and willing to work out a solution that would get me back in the workforce without making me sick again. But I also feel broken. And I'm not really sure when I'll feel whole again.
For another, I knew I needed some sort of help that I just wasn't getting. I was both relieved and devastated when I was finally admitted to the psychiatric ward at St. Mary's. I was relieved because I knew that I was incapable of doing my job, and this would save me from destroying my fledgling career. I was relieved because I'd been having an incredibly public breakdown all over social media and being unplugged from the internet would keep me from posting any more cartoons about how I wished I was dead, and generally humiliating myself any further (P.S. it's really hard to look people in the face after you've had a complete meltdown in public view for a few weeks). I was relieved because I didn't have to spend any more energy trying - and failing - to pretend that I am perfectly fine, goddamit!
But I was also kind of a little crushed inside, in the part of me that cares, the soft squishy vulnerable part of me that I have to shield at all time because weakness is a liability that just isn't acceptable. Weakness means rape, and pain, and all sorts of failure. I just can't stand it. Every time a doctor talks to me about allowing myself to be vulnerable I want to punch them in the face and throw myself off the nearest building.
But I digress.
It was crushing to call my boss every day during the first week and tell her that I was still in the hospital and wouldn't be coming into the office. It was humiliating to be so...I don't know...a terrible employee. I knew that I was protected from being fired because it's against the law to fire someone for being in the hospital, but I still felt pretty shitty. You've got to be thinking you've made the wrong hiring decision when your employee goes AWOL less than a year into the job; it wasn't fair to either my manager or my team for me to so completely drop the ball. I felt like someone had thrown me the ball, it was busy season and they needed everyone to be on their A-game, and I was like 'Oh, this ball? I think I'll just throw it back in your face.'
I hadn't been hospitalized at all since 2006, and my last significant stay was in 2002-2003. I felt like I'd wasted all this time and all these years only to find myself back in the same shit-hole. I was so disappointed in myself, in my failures, in all the things I should have done to get better but somehow didn't manage to get around to doing.
Me and the hospital. I was like 'Please, please, help me. Please save me from myself,' and also, 'I don't deserve to be here, and I don't have what it takes to get better, so you might at well give me the boot and make room for someone who will.'
Anyway, in one of my many conversations with my manager, she mentioned that we'd been using up the two weeks of sick days I had in my bank, and then we'd be contacting HR to get started on a short-term disabilities claim. I was like, 'short-term what in the what now?'
I'd been thinking that I was really fortunate not to get fired, and that I'd saved up money for years so that if I was ever too sick to work I wouldn't end up homeless and completely bankrupt. But, instead, it turned out I had an entire short-term disabilities insurance policy that would pay 75% of my salary. It had come with my job, and I didn't even know it. I work in the insurance industry, and I knew the insurance they were giving me as part of my compensation package was outstanding, but I didn't even know short-term disability was a thing.
I felt so, so lucky. But, when week three of my hospitalization rolled around and it was time to fill out the complex paperwork, I also felt deeply conflicted. I was basically saying, to my employer and to myself, that I was a failure. I was incapable of working. I was worthless, a financial liability. I couldn't even do my job. I have always tried so hard, worked so hard, kept going no matter the personal cost, and here I was giving up. I mean, why couldn't I just make myself go in to the office? I'd been doing it before, hadn't I? I felt so overwhelmed and incapable. I'm not sure I've managed to work out all the things I was feeling.
When I finally did go back to work on a progressive return, and started to struggle with working four days a week, I wondered if I would ever be able to work a full week again, if I would be able to manage it. I was doing the best I could, but I was failing. And then, I went back on full disability benefits to receive rTMS treatment at the Douglas. I realized, 'I am disabled.' It wasn't something I thought I'd ever have to say about myself. I am disabled.
I still struggle with what saying that means. I was disabled. The part of me that's trying to learn self-compassion tells me that it's okay, that it's not my fault I was sick, that this is something that just happens. I was lucky to get through it. I was lucky that rTMS treatment worked well and I could get back to my old activity level without distress. I was lucky. I know that having been disabled doesn't say anything about my character, or my strength, or my worth as a human being. But I still feel somehow less than I did before. I still wonder what value my life has when I can't be a functioning, productive member of society. Sure, everyone needs a little help sometimes, but not everybody ends up disabled because they just can't handle their workload.
I am so, so lucky to be employed at a place that gave me such great insurance, because not everyone has that benefit. I am so, so lucky that my team and managers believed in me, and welcomed me back so seamlessly. I am so, so lucky that HR and my short-term disabilities case-worker were so compassionate and willing to work out a solution that would get me back in the workforce without making me sick again. But I also feel broken. And I'm not really sure when I'll feel whole again.
Friday, May 16, 2014
Why Yes, I Bought Myself a Card
One of the things I occasionally do which some people might find a bit on the odd side of the spectrum is that I buy myself cards. Sometimes. Sometimes it's because I like the picture or sentiment but don't have an occasion that matches the card. Sometimes, like yesterday, it's because I feel like the card is giving me something I need: it throws a challenge in my face about something I need to own up to, focus on, or just plain acknowledge. The card speaks directly to my soul, like some kind of voodoo psychic. It's watching me.
The card I picked up yesterday has this message in it:
I've been pretty focused lately on trying to figure out some way to coordinate all my medical appointments with my upcoming return to work. To be honest, I feel like time is one of the things I don't have on my side. I was thinking I still had a week of 4 days left on my progressive return-to-work plan, but because of the way the director of my clinical trial filled out my medical certificate, my short-term-disability plan is requiring me to return to work full-time as soon as the treatment is completed. And, let's face it, it's not like a single day off would have made that big of a dent. It would have been more like a polite society lady nibbling a cucumber sandwich, and less like the way I tackle an ice-cream sundae. By which I mean a small, ladylike bite rather than an all-consuming bite of humongous gluttony. Beware my ice cream eating mouth of DOOM!!
It's just all so...overwhelming. I have at least two appointments with the psychiatrist at the Douglas once treatment is over so we can do an assessment; with the travel time, I know I won't be able to make up all the hours I miss work. I have to see my St. Mary's Psychiatrist at least once to adjust my medication levels, and probably a few more times for follow-up, which is time I won't be able to give back, either. This all strikes me as annoying, but ultimately manageable, as they are once-in-a-while things.
But I'm worried about the psychologist I've started seeing at St Mary's. That's probably going to be a once-a-week-thing, with me missing at least an hour and a half each time. For me, that means I'll be working an hour and a half overtime on another day, or spread out over a few days, to try and make up the hours I've missed. Every week. Until we've accomplished whatever our goals are supposed to be. I'm worried about it. I'm worried about always getting home late, and burning out a new and fragile remission. I'm worried because I know what disruptions to my schedule do to my mood, and my sleep, and my ability to do all of the other things that are part of my illness management. I don't know how I'm going to handle it all.
If I could work part-time, just until I get some solid ground under my feet, that would be ideal. Financially, I know I can do it. But, realistically, if I decided not to make up the missing time, that would mean a significant rate of absenteeism, and I'm not sure I could pull that off right now after already having taken so much sick leave. I wish I could have had treatment while I was an inpatient. I wish I could have left the hospital and returned to work having actually been better. When I think of all the time this illness has stolen from me this year, I find myself wondering what the point of it was, what it was all for. I worry that I will undo everything we've been working toward.
There was a woman in the hospital with me who was there by court order, and I remember her psychiatrist yelling at her that it was her time to get better, that it was her time to be well. I wonder what that would be like, really having that time, having someone in my corner who wasn't looking for a fix that would prop me up enough to keep going. I wonder if wellness would be worth that sacrifice, the cost and the effort involved. I don't know, I've never really done it, just taken the time to get better, work on all my shit. You'd think I would have done it when I took 8 months of sick leave from graduate school, but sadly my psychiatrist was not interested in exploring all the shit that was coming up and out of me, so I ended up stuck in the same place as before - except that I recovered less functionality. Win?
What I'm trying to say, I think, is that I bought the card for myself because in my fantasy puppies-and-rainbows world this is how things would be. But reality isn't like a skittles commercial, and ultimately I come away finding that what matters isn't so much me as it is my capacity to contribute, to be useful, to fill the roles that I am supposed to fill. I think I can do it: I've done it before. I'm just worried that I won't ever have the chance to really be well, which is - after all - what I was so desperately searching for in the first place.
The card I picked up yesterday has this message in it:
I know it must be hard
having to stop
everything for awhile
and just focus on getting better.
But whenever you
find yourself
worrying about
the million and one things
you think you should
be doing instead
just remember...
This time is for you.
Your time to rest.
Your time to heal.
And nothing's more important than that.
Because you're important.
I've been pretty focused lately on trying to figure out some way to coordinate all my medical appointments with my upcoming return to work. To be honest, I feel like time is one of the things I don't have on my side. I was thinking I still had a week of 4 days left on my progressive return-to-work plan, but because of the way the director of my clinical trial filled out my medical certificate, my short-term-disability plan is requiring me to return to work full-time as soon as the treatment is completed. And, let's face it, it's not like a single day off would have made that big of a dent. It would have been more like a polite society lady nibbling a cucumber sandwich, and less like the way I tackle an ice-cream sundae. By which I mean a small, ladylike bite rather than an all-consuming bite of humongous gluttony. Beware my ice cream eating mouth of DOOM!!
It's just all so...overwhelming. I have at least two appointments with the psychiatrist at the Douglas once treatment is over so we can do an assessment; with the travel time, I know I won't be able to make up all the hours I miss work. I have to see my St. Mary's Psychiatrist at least once to adjust my medication levels, and probably a few more times for follow-up, which is time I won't be able to give back, either. This all strikes me as annoying, but ultimately manageable, as they are once-in-a-while things.
But I'm worried about the psychologist I've started seeing at St Mary's. That's probably going to be a once-a-week-thing, with me missing at least an hour and a half each time. For me, that means I'll be working an hour and a half overtime on another day, or spread out over a few days, to try and make up the hours I've missed. Every week. Until we've accomplished whatever our goals are supposed to be. I'm worried about it. I'm worried about always getting home late, and burning out a new and fragile remission. I'm worried because I know what disruptions to my schedule do to my mood, and my sleep, and my ability to do all of the other things that are part of my illness management. I don't know how I'm going to handle it all.
If I could work part-time, just until I get some solid ground under my feet, that would be ideal. Financially, I know I can do it. But, realistically, if I decided not to make up the missing time, that would mean a significant rate of absenteeism, and I'm not sure I could pull that off right now after already having taken so much sick leave. I wish I could have had treatment while I was an inpatient. I wish I could have left the hospital and returned to work having actually been better. When I think of all the time this illness has stolen from me this year, I find myself wondering what the point of it was, what it was all for. I worry that I will undo everything we've been working toward.
There was a woman in the hospital with me who was there by court order, and I remember her psychiatrist yelling at her that it was her time to get better, that it was her time to be well. I wonder what that would be like, really having that time, having someone in my corner who wasn't looking for a fix that would prop me up enough to keep going. I wonder if wellness would be worth that sacrifice, the cost and the effort involved. I don't know, I've never really done it, just taken the time to get better, work on all my shit. You'd think I would have done it when I took 8 months of sick leave from graduate school, but sadly my psychiatrist was not interested in exploring all the shit that was coming up and out of me, so I ended up stuck in the same place as before - except that I recovered less functionality. Win?
What I'm trying to say, I think, is that I bought the card for myself because in my fantasy puppies-and-rainbows world this is how things would be. But reality isn't like a skittles commercial, and ultimately I come away finding that what matters isn't so much me as it is my capacity to contribute, to be useful, to fill the roles that I am supposed to fill. I think I can do it: I've done it before. I'm just worried that I won't ever have the chance to really be well, which is - after all - what I was so desperately searching for in the first place.
Subscribe to:
Posts (Atom)