Friday, November 26, 2010

Gratitude and Thankfulness

Hello Friends:

I wasn't going to add to the many lists of thanks out there, I really wasn't. But after reading all the well-thought-out and moving expressions of thanks on your blogs ... well ... I felt an urge to express some of my own gratitude to the universe.

So I went looking for a neat picture to express my feelings, and found something absolutely perfect. I love the image and so made it bigger than I usually do to show off the amazing detail. Here is what the artist has as text associated with the picture.

"The stained glass ceiling inside the Thanksgiving Chapel spirals upward to 58 feet in a crescendo of color, harmony, and form. It is called the Glory Window and designed by Gabriel Loire of Chartres, France, one of the greatest stained glass master of the 20th century.  Gabriel Loire describes this progression: ' express all life, with its difficulties, its forces, its joys, its torments, its frightening aspects. And then bit by bit, all that falls away and your arrive finally at a burst, an explosion of gold; you arrive at the summit.'"

The part that resonates with me is the idea of connecting the difficulties with life with the glories of life. I don't happen to buy into the imagery of climbing stairs to reach a summit of perfection - I do not see that as a helpful metaphor. I prefer to imagine our lives and our understanding as a flower blooming or a cocoon opening, each revealing the beauty that was there all the time. Still, this is so gorgeous, and somehow was a perfect expression of gratitude for me this year.

And here is some of what I am thankful for ...

1.  Being alive. This is a stretch for me, since there are still times I wish I hadn't been born so I wouldn't know about pain. But I no longer want to check out now that I am here. I feel more brave. Or maybe just more stubborn, although that's much harder to imagine. In any case, I am glad that I have the options that life brings, the greatest being the chance to know what it is like to deeply love another person.

2.  My spouse. The person who makes my continued healing possible, and gives me great reasons every day to want to keep at it. Constant help, love, and support. And lots of tea.

3.  My family. Especially a sister with whom I am very close. Since I've had to part ways with some members of my immediately family, I cherish even more the connections with those I can maintain, and which are mutually edifying and beneficial.

4.  My projects. I am glad to be well enough to really get involved in several creative endeavors that I have always enjoyed. Writing, making jewelry, doing crafts of all kinds, blogging, and so much more. These are the day-to-day things that give me the chance to be me.

5.  The necessities of life and more. A safe home, plenty of good food, clean water, nice clothes, and fresh air.

6.  My support network, mental and physical. Psychologist, psychiatrist, general doctor, physical therapists, acupuncturist, obgyn, spouse, family, friends, stuffed animals, and everyone who reads my blog, too! And a good network would not be possible without good health insurance - which I wouldn't have if my spouse did not have a good job. Really a blessing in tough economic times.

7.  My friends. From close confidants, to beer buddies, and onto folks I chat with only occasionally, it is great to have all kinds of friends. Every moment they spend on me is a miracle, life is so short. Each of those minutes is a gift.

I could go on and on. Which is very, very nice to consider.

Your Hostess With Neuroses

Image credit/info: Heaven and Soul Connection by alicia-lee-07 on Flikr via Creative Commons

Monday, November 15, 2010

Public Transportation and What Coping Means

Hello Friends:

I've been thinking about the differences between dysfunctional-enabling behavior and supporting-coping behavior. These thoughts have been coming to me as I've been taking public transportation more than usual this week.  And public transport gives me the willies (in other words it's chock full of OCD fodder.) So there have been plenty of moments where I could consider if what I was doing was helping me in a positive way, or just allowing me to avoid dealing with the tough realities of a gritty world.

Look at that nice piece of art. All the nice people being nice. A nice, uncrowded car. Nice and calm. Yeah, right. I've never seen a metro car like that unless it was the middle of the night. But this is idealized americana folk art, here. Check out how clean that floor is. No one is coughing or spitting.  And I'll bet there aren't any rats in the station, either. Oh, what a fantasy.

Anyway, I can't touch the bars or rails in a subway car unless I am wearing gloves. I wonder, do the gloves allow me to go about my day in relative peace, or do they enable my mental illness by allowing me to avoid the natural exposure of touching things other people touch? Or both? How about people sneezing on a subway car? I stop breathing for as long as possible. I don't look at anything dirty, since when I'm worked up, looking at something dirty can actually make me think that I am dirty. Let's not talk about what is on the floor. I do not look there or I'd have to throw my shoes out when I got home.  (I take them off right at the door as it is.) So forget about setting a heavy bag down on that tacky surface of dread, I'd rather pull my back out.

Then as soon as I get off of the train, I pull out one of those handi-wipes and scrub my hands. Which have been in gloves, remember? I also wipe off the handles of anything I'm carrying. And then I try really hard to say 'enough' and go about my day. But any day I've been on the subway or metro or T or whatever you call it, isn't going to be one of the days I feel at my best.

This all reminds me of my first therapist telling me that I didn't have to do things that gave me panic attacks. I was having severe attacks after eating canned food. He said I should stop eating it. I was appalled, since I thought that was 'giving in'. I was afraid that if I stopped I'd never start again. I was afraid I'd end up cutting out anything that bothered me, and end up stuck in bed all day in fear of leaving.

It took him a long, long time to get it through my head that I was re-traumatizing myself every time I opened a can. I had to stop. I'm sure you know this stuff yourself - but I had to stop doing the thing that was causing me to panic, give it a rest for a while, and then approach it slowly and methodically. That's the idea of increasing exposures that we've all heard about with regards to phobias and such.  And some OCDs.  Of course, if you have some CPTSD issues on top of it all, it isn't quite so straightforward, but you get the idea.

I don't know if he would have given the same advice to everyone, or if it was just me. But I ended up stopping a lot of activities that caused me high anxiety. I stopped eating anything that made me nervous. I stopped touching things that scared me. I stopped going places that triggered panic attacks. At the same time I started doing really intense CBT, added a lot of walking to my day, continued talk therapy, and against my therapist's advice I refused meds. Looking back, that might not have been the best plan, since I am on them now and am very glad about that. Whatever.

As I felt better, I started trying new things or adding them back into my life. He had been right. I didn't take his words as carte blanche to just drop everything and stop fighting. I kept struggling to do things. Kept challenging myself. I just got smarter about what I could handle on a given day and what I couldn't. For many years I could tell how well I was doing if I had the nerve to eat shrimp or any meat that wasn't cooked to the state of a hockey puck. And now I can touch door handles in almost any place but a hospital or doctor's office. I don't like it, but I can do it.

Life is easier, but still, OCD is disabling. I'm not likely to be able to take a job in a city where riding public transportation is required. The idea of doing that twice a day, and being forced to do it on days when my resources are low, is horrifying. I wish it wasn't. I don't like having my options curtailed by OCD, but I've come to more of an understanding of what I can handle and what I can't. So maybe it just isn't in the cards right now. Maybe in the future, as all my mental illnesses get more and more under control, as my meds stabilize, as I do more exercise, eat better, do my meditation and get good sleep, maybe public transportation will become as simple as eating frozen food. Which I had given up for two years, and now can do without a problem.

BTW, you probably know I still don't open cans. I haven't missed that at all.

Your Hostess With Neuroses

Image credit/info: Subway, Smithsonian American Art Museum

Tuesday, November 2, 2010

Apparently, Fear is Excitement Deprived of Oxygen

Hello Friends:

I'll explain the title of this post in a minute, but I need to wander off (potentially way off) topic and then back again. The subject of this post actually starts much earlier in the month.

I've been feeling better. I've noticed it mostly in my social anxiety. I've been able to go to group functions with less trepidation, have more fun at them, feel less mortified, and ruminate about them much less afterward. Sometime in the first week of October, I seem to have turned a small corner, and this ability to deal with social situations much more easily is the result. And of course, since it is now easier to talk to people, life has improved all around. Stores are not as intimidating. Going places by myself is an actual possibility. My email is getting read and answered in the same week for a change.

The ultimate marker? I joined Facebook. Still not sure that I'll stick with it, but if I don't, it probably won't be out of fear or anxiety. It will be because my excuse was right all along and Facebook is actually kind of useless. And I'll be able to say that from an informed position, rather than irresponsibly making it up because I am too scared to try it out. But I don't actually know yet since it has only been a few days, and I'm still figuring out this 'wall' thingy.

So of course the question buzzing in my head is "Why do I feel better?" And I answered myself pretty fast on that one. I think all the work is paying off a little. A small gain in one area is leveraged, and makes it easier for a small gain in another area, and on and on. It starts so slow you don't see it - gains take a long time in the beginning. Each is painful and hard won, and it takes time to adjust to the change and be ready for the next. But then there are more and more gains, and they start feeding off of each other. Here are a few of these 'gains' in more concrete terms.

I am more med compliant.  I have always known staying on the meds is important for me, but I allowed myself to forget them here and there. My OCDs make it so hard to take any kind of pills, that I cut myself some slack on difficult days. Then for some reason I started to pay attention to 'here and there' and realized I was "forgetting" two or three times a week. So my pdoc thought I was on 40 mg per day, but in essence I was really on about 28 to 30 mg per day, averaged over a week. I cracked down on myself, and am now missing one a week, max.

Messages from my body make more sense. The physical-mental-integrated therapies I've been doing have slowly made it easier to understand what my body is saying. For example, it wasn't that long ago that I first really learned what hunger pains felt like, and what their purpose was. I mean it, I didn't understand hunger pains, and did not perceive them as anything other than generalized discomfort that had no purpose and no solution. Why listen to your body when you were told "You are not in pain, you are just uncomfortable" or "You don't know what it really means to hurt" or "You are just making that up" all the time? Reconnecting with my body has been a painful but interesting and empowering experience. It is easier to be mindful about my eating, and not just eat because I'm having a sugar crash or because I'm feeling down. It is more obvious when I actually need to use my inhaler, instead of just ignoring that "not enough air" sensation that never made any sense. Etc.

More reactions have become choices. My first reaction to anything negative is an over-reaction of some kind. Then it usually becomes something dark and prickly living under my skin, like a thorn, that stabs you anew any time you give it the slightest brush. Yet recently things have felt a little different. After my first day of over-reaction, I can take one more step back than I used to. For some things, it is enough to say, "I don't want to care about this anymore. It is over. It is not important. I'm not going to keep thinking about this all the time. I'm not going to stay bent out of shape."And then, amazingly, I am not bent anymore. Never has it seemed like I could choose not to feel that way. Ironically, I think this came from giving myself permission to feel any way at all, to just say "My feelings are my feelings" and let them be. I still have my normal reaction/over-reaction, of course. It is simply that sometimes I can then say, "Enough of that," stop ruminating, and move on. Wow.

All this even lead me to try a combination physical therapy/acupuncture treatment today. Being OCD scared of contamination means needles are really nasty beasties. But I was feeling tough, and I knew it my gut it would help. I'd had a few, very controlled, exposures to acupuncture before, but never like this, with needles sticking out of me and someone bending my limbs and rotating my joints at the same time. It was weird. Scary. The needle-lady said something like, "Naturally with your background you'd find this scary. But remember that fear can be converted to excitement with proper oxygen. So when you feel fear, breathe, and let it become the fuel to do important things."

I laughed out loud. If if were that easy to convert fear, say by hyperventilating, I'd have figured that out a long, long time ago. But my new mindset means that I don't dismiss anything out of hand. I let it percolate a little, then take what seems useful and dump the rest. Scientifically and blood-chemistry wise, I do not thing fear is excitement deprived of oxygen.

But, the line stuck with me. I thought about how I've been breathing a little new air into my life. How there is less fear, and more excitement for the future. Even hope. So there you have it. I'd be interested to hear what it is that you think are your recent gains, and if they seem to help you make more ground in other areas that seemed, at first, unrelated.

Your Hostess With Neuroses

Image credit/info: Hot air balloon by ronnie44052 on flickr, via Creative Commons, CC2.0

Wednesday, October 20, 2010

Poetry, Halloween, and Healing

Hello Friends:

It seems like a really strange combination; poetry, Halloween, and healing.  But the triple-point of these topics has been on my mind as October rolls forward. (And I thought it a perfect topic to finally get in on The Blog Carnival Against Child Abuse, supported by very friendly blogger Marj aka Thriver on Survivors Can Thrive!  The carnival is being hosted by Tracie of From Tracie.)

I have been a reader and writer of poetry since I was fourteen. Given the, shall we say, 'unsettled' nature of my childhood, I felt I had plenty to write about. So naturally, like many other young people, writing became an avenue to express my inner turmoil, to help me view it more objectively, and eventually, to try to heal.

So why is Halloween in this picture? Two reasons. I have a sort of gothic alter ego who has always loved moonlight, monsters, the sound of dry leaves, and tales of things that go bump in the night. So the first reason Halloween is part of all this is - when I write poetry that comes from a dark place, it has this sort of gothic feel to it. Sometimes it is subtle, and other times not so much. But edgy goth, or even horror-like imagery is how I often express the mess inside. Here is an example; a poem I had published in The Newsletter Inago in 1999. It seemed apt for the 'harvest' time of year.

Missing Seedcorn
Sorrow reaps the harvest
of frustration's seed
as the mirror of each
pool or lake holds something
a little further from the dream.
It was ... what?
Besides, who can remember
the words out of the warm dark,
whispers from night's fertile seed
of cornucopia secrets, now
starving in your barren brain.
Malnourished, stagnant pond;
an early frost has come.
Newsletter Inago, Vol. 19, No. 6, June 1999

Being able to express this sort of inner pain, the sense of a seed losing its potential in neglect, is a healing act. For me, writing poems like this is an act of faith, and one that empowers me to confront my inner darkness. It's a chance to tap into a part of the brain that lies just below the conscious, and to bring forth images that need to be addressed. And might not be addressed any other way.

Okay, so the second reason Halloween makes me think of poetry - it has to do with my recent spate of poem writing in April. April is National Poetry Writing Month, and I chose to write a poem a day to 'celebrate' (or torture myself, depending on your view of that sort of commitment :)  I knew I was going to use art to inspire my poetry, but it quickly became apparent that it wasn't going to be just any art. The art that was inspiring me was quirky, dark, semi-humorous horror art, like the sort created by Tim Burton. This art also has a focus on the fears of children, which played into my own memories, and ended up inspiring about twenty poems about the darker aspects of childhood.

Normally, I don't like to put unpublished poetry in blog posts, since most publishers consider that published or at least it means that "first electronic rights" are already taken. But this post seems like a good cause, so here's a draft of a poem that came from my April poem run.

Pins and Needles
The muslin doll has
X's for eyes and a smile
drawn with black marker.
There is a large hatpin
with a red ball end planted
squarely in the middle of
her forehead.  There is
another in her stomach,
two in the chest, several
in the back and legs, and
just one stabbed through
the right hand.  The doll
doesn't mind except it
makes it hard to walk;
arms straight out, legs
bowed.  She trips a lot,
and when she falls she
always hears screaming.
Copyright Blue Morpho's real person, no touchy

I like the ambiguity, here. Who is screaming? Who is it that is using this apparently even-tempered doll for their voodoo dirty work? It makes me sad - literally in the poem the doll falls, driving the pins deeper, and causing pain to the target of the voodoo - yet just the image of someone screaming at a child when it falls, instead of feeling sympathy, really tweaks me. I like the idea that the doll is a metaphor both for the neglected child, and the act of the child seeking revenge. She causes pain to those who have hurt her, but note that in the process, she hurts herself.

It is in this that I find some healing. This reaffirms my growing commitment to not become the thing I hate. To not become the same bitter, depressed, self-absorbed, self-hating, mangled thing that caused my neglect, abuse, and subsequent mental illnesses in the first place. I may want to find ways to enact my revenge fantasies, but I have to realize that getting too caught up with that is not healthy. When I use those pins, it's me I'm hurting.

So what are your feelings on this? Does this dark aspect of poetry appeal to you? Do you find any catharsis in the creepy Halloween season? Read any Poe recently?

Your Hostess With Neuroses

Image credit/info: Happy Pumpkin by Dave Hogg on Flickr via Creative Commons, CC 2.0

Saturday, October 16, 2010

Continuing Improvements in Sanity

Hello Friends:

When you don't know what to blog about, time to head on over to The Sanity Score and see what your latest numbers are. As I've mentioned before (see post in April, Apparently I'm Getting More Sane) I occasionally take the sanity test at PsychCentral just for jollies. Okay, not just for jollies. I take it because even though it isn't a terribly scientific instrument, it does provide something of a benchmark for changes over time. And because I love online quizzes.

And because now that I've taken the quiz three times over the last year, I now have enough data to make a graph. God I love data.

So I took the test the first time in December of last year, then about 4 months later, and then another seven months after that. The data is pretty interesting to me. It would suggest I feel better overall since December '09. And I do feel better - maybe not quite as much as this shows here, but still, it is consistent. (Remember, low numbers are good. And again, not all the subscores are on my graph, just the ones that I thought were most interesting.)

So my Depression score didn't move much, not a surprise, since it dropped a lot in April. But my Anxiety score plummeted from 48 (reflecting a major problem) to 27 (reflecting a moderate to minor problem). I don't think this is really shows how I feel. I feel less anxious, but not quite this much. So I predict the next time I take the test it won't move, or maybe will even be higher. Still, it is an improvement.

I left the Dissociation score in to bring up another point about the test. Just like the Phobia questions, the Dissociation questions don't seem to be written very well. I definitely suffer dissociation whenever I have a flashback triggered, and it is bizarre and uncomfortable. But that symptom does not seem to be captured here very well. I'll note my PTSD score hasn't moved, and still indicates one of my major issues. So perhaps some of the dissociation is represented there. Hard to say.

So my average overall score is now 55.  Fifty-five is definitely a sane person (a person with issues, but still a sane person).  As I said before, this is starting to look like I have the "resilience, skills, and resources to cope and manage." Odd. But I do almost feel like that. Almost. I do feel more capable, more in control, and less overwhelmed. I hate myself a little less, as reflected by the Self Esteem score, yet self esteem is still one of my major problems. And it is one of the areas which there as been the least amount of change. I will hazard to say that many of the other areas for sub-scores relate to symptoms, and that Self Esteem is more of a core issue. If I can see some improvement there, I might actually believe this isn't just an interim period between major depressions, but instead a real change in my worldview.

As I said in my previous post, "I continue to bemoan the fact that I did not take the test when I was at my worst." Naturally, I hope I never feel that way again. But if I do, I will try to see the bright side of it - that'll be some really good data.

Your Hostess With Neuroses

Image credit/info:  Wishing by pinksherbert on Flikr via Creative Commons, CC2.0

Thursday, September 30, 2010

Book Review: The Mindful Way Through Depression by Mark Williams et al.

Hello Friends:

This book gets four out of five 'wings' from your Adventure Hostess.

As you know from my previous posts, I've been trying to include meditation and mindfulness regularly in my life. I got the idea from reading about BPD (Borderline Personality Disorder) and DBT (Dialectical Behavior Therapy). I don't happen to have BPD - I exhibit only a few of the characteristics, but I do exhibit some of them. And I was raised by a person with BPD. So I figured I would plumb the workings of DBT and see if there were pieces I could successfully apply to myself. The mindfulness component struck me immediately as portable to therapy for almost any mental illness (or really to anybody for any reason at all).

I promised to review this book over a year ago, I think.  So here, finally, is the always-glorious, never-trivial, certain-to-be-mind-bogglingly-useful review.  

The Mindful Way Through Depression by Mark Williams et al. was published in 2007, and spans 273 pages. It presents the reasoning behind, and the basic course for, MBCT (Mindfulness Based Cognitive Therapy). MBCT was developed by Zindel Segal, Mark Williams and John Teasdale, working from Jon Kabat-Zinn's already existing MBSR program (Mindfulness Based Stress Reduction). 

Mindful Way, as I am going to call it in this review, appears to be the popular level incarnation of a previous book, Mindfulness Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, that was published in 2001. This earlier book was directed more towards psychologists and such, including discussion of the research supporting use of MBCT in the arena of depression.

Some of What's in the Book

This book falls into four sections, and includes a final list of resources and an accompanying CD.  The sections are "Mind, Body, and Emotion", "Moment by Moment", "Transforming Unhappiness", and "Reclaiming Your Life". The CD has guided narration for six practices, including "The Body Scan" at 29 minutes, and "Mindful Standing Yoga" at about 11 minutes.  Overall, the CD is more than 77 minutes long.

The first section describes the authors' ideas behind the connection between mind, body, and emotion - how our moods and feelings are influenced by thoughts - and how becoming more aware and mindful can make a difference. The second section details the meditation focus points, such as the body and breath, and how to become more mindful of them. The third section is anchored by the passages that point out how our own thoughts are creations of the mind, are neither 'true' nor 'untrue', and that they do not define who we are. The final section brings together all the points from the book and tries integrate them into a coherent plan. This includes a breakdown of the full eight week program, with exercises, worksheets, and meditations on the CD.

The time commitment for the full program is substantial, as much as an hour a day some weeks, to do the required meditations, worksheets, and whatnot. Much of this is the Body Scan meditation, taking almost a half hour.

What I Liked

The authors recognize that we can't begin to think in new ways without new tools. Using what you have always used, you'll get what you have always gotten. Their eight week plan is designed to provide the necessary tools, by way of a step-by-step immersion into the world of meditation and mindfulness. This is a huge improvement over other CBT approaches, since mindfulness really does alter your perception of the world, and your place in it. And the authors offer their program as a way to manifest this opportunity.

For a systematic approach, I feel like all the pieces are in place. Specifically, the included CD makes it trivial to follow along with the specifics of what they want you to do. While you might wonder if the therapy is "working" you won't have to wonder what it is you are supposed to be doing today to be on track.

The personal anecdotes from people who have done the program are very useful, and show a good range of possible reactions to each stage.

Some of what they present helped me to make sense of certain things for the first time. While I disagree with some of their cause-effect reasoning, at least in two cases I was struck with a new idea that helped me a great deal. The first was one I have written about before, the idea that avoiding something is exactly what makes it impossible to avoid (Suppressing Does Not Work Part I and Part II). This is the whole "spend a minute and don't think about a white bear" thing that makes it clear you will spend that minute thinking about nothing but white bears. Mindful Way helps the reader to understand that engaging painful thoughts with a gentle curiosity is actually better at getting rid of them than trying to avoid them completely.

The second thing that grabbed me was the discussion of a list of automatic thoughts of those who are depressed (Kendall and Hollon, 1980). Although the list is a classic in the literature for depression, I simply had never considered the implications. They present this list of thirty automatic thoughts, like "What's wrong with me?", "I hate myself", "It's just not worth it", and "I can't finish anything." The program participants are asked how many of the thoughts they believe right now, and how many they believed in the middle of their last deep depression. The book goes on to say, "When they all answer 'Yes - all of them' ... something remarkable happens. A moment of realization that, 'This is depression, not me.'" I had the same realization when I read it. My negative thoughts are actually the symptom of an illness, and all depressed people have them. This list a chance to stare directly at that truth, and it was liberating.

What I Didn't Like

I am so, so glad I read Brach's book Radical Acceptance before I read Mindful Way (here's my review of Radical Acceptance). If I had read Mindful Way first, I think I would have looked at it as just another self-help book, with another five or eight or ten week course of stuff, another worksheet to fill out, and another eight steps to follow to cosmic enlightenment or optimum turbo libido or whatever (okay that last is just me being snarky). Either way, I'm sick of those kinds of books.

Fortunately, I had read Radical Acceptance, which artfully presents meditation, mindfulness, and compassion in a way that feels whole, connected, and meaningful. Radical Acceptance successfully walks the line between the mysterious/spiritual side of mindfulness, and the practical/daily side. In comparison, Mindful Way feels sterile. It presents only the clinical aspects of meditation, broken down into the authors' idea of a workable course/schedule. It cuts out much of the more compelling, mysterious, and motivating context to be found in Buddhism, and thereby saps the practice of an integral source of vibrancy.

I do not agree with some of the authors' ideas about the relationship between mood-thoughts-feelings-body. They very nearly fall into the whole trap of "you are depressed because you keep thinking depressed thoughts, so depression is your fault." They try to avoid this by blaming rumination and such on the "critical thinking part of the brain volunteering for a job it can't do",  and by admitting that thinking new things is really hard.  Yet it is still thinking = depression.  Too close to "it's all in your head" for my taste. I shouldn't be surprised, given the CBT roots of this kind of therapy, and even some of the worksheets that go with it.

They could have missed this near-accusation entirely had they included the important aspects of brain chemistry in the book. They say they recognize the existence of thinking ruts, patterns, and habits.  But they miss the opportunity to say how this manifests in brain chemistry, and how that in turn links directly to overall body chemistry. Thinking is, after all, nothing more than biochemistry. It is hard to think in new ways because our old thought patterns are actually "burned" in biochemically by past trauma, trauma responses, and years of repetition. Early childhood trauma can even inhibit development of certain aspects of the brain. These things are not mentioned.

Yes, we can change the path our thoughts follow from more negative ones to more positive ones by working for extended periods with the variables that alter brain chemistry.  Over time, this allows new preferred thought pathways to be electrochemically "burned" into our brains.  Successfully making those changes requires a complex combination of many possible approaches, including: good nutrition, stable sleep, social connections, support networks, talk therapy, meds, exercise, meditation, body knowledge, somatic therapies, massage, and on and on.  While I personally believe that mediation is a hugely powerful tool, this book presents it too disconnected from all other possible sources of an integrated plan for mental wellness.  The old CBT message of "just think your way out if it" remains, and I am very wary of that message.

Summary and Final Comments

Overall, this is a very good book. I would not recommend it as the first book to read about meditation or mindfulness. Read Radical Acceptance first if you are new to all of this, then Mindful Way. I just think Radical Acceptance is more robust, more compassionate, and more meaningful. Meditation and mindfulness are great, but not everyone is going to approach their practice in the same way. What Mindful Way offers is one possible plan for integrating mindfulness practice into your life. It is systematic, and tailored to those who have suffered at least one major depressive episode. If you respond well to structure, then the one presented here could be very helpful. If you do get the book, make sure the CD is included, since it is critical to the program. Mindful Way underscores the idea that mindfulness is a life-long practice, not an end goal, and offers some new options for developing the tools for dealing with the mental struggles of daily life. Anyone might benefit from reading the book and doing the program, but there is some evidence that for those with depression, it really might prevent another deep episode, or at least help limit its length and severity.

Your Hostess With Neuroses

Tuesday, September 28, 2010

Returning, Again, and Still Confused

Hello Friends:

There is no question that the hardest thing about blogging (for me, anyway) is trying to get back into the swing after a long hiatus. Usually the reason I stop posting is because I'm overwhelmed with depression. Then when I start to get my feet back under me, I don't post because I'm overwhelmed with anxiety. Same stuff, different flavor. Either way, it all just seems so hard.

I've mentioned this before when I've come back after a "break". Somehow I can't shake the feelings that not posting every week means I've messed things up in some irredeemable fashion. This is extra-strange since of all the people who might be sympathetic to the struggles of dealing with depression and anxiety, it would be the sort of folks who would read this blog. And yet the feelings remain. I've "broken" the blog, somehow, and it can never be "fixed" and now it is all messy and imperfect and gray-area and I really hate that.

I know that it is very, very good therapy for me to force myself to come back, pick up the pieces, deal with the muddy reality of life, and move forward. And I am always very happy when I finally do, and vow that "this time I'll keep going no matter what!" When you are motivated and in the swing, it all seems so easy. Then the next depression hits. I had set all sorts of goals for this year: wanting to average so many posts a week, post about certain topics, maybe do a regular feature post, and on and on. I think it is important and useful to have goals. And yet simply having them seems to accomplish nothing more than putting more pressure on myself. Then it becomes too much, I freak out, and along with everything else in my life, it falls apart.

Okay, enough of the belly aching and all that. I've been trying hard to use what I've learned in meditation and radical acceptance to be realistic about life, and compassionate with myself about exactly these sorts of struggles. So I might as well do it, in spite of a bit of disgust for myself for it being necessary at all. Right.

So, fine, I've been gone for months. But hey there, Blue Morpho, that's okay. It's time to try again (and again) to push forward.  Time to "just be" with that mixed-up, logistics-part-of-the-brain-is-broken, feeling.  And I know once I force myself through the mucky stage of trying to catch up with the blogs I read, make some comments there, and make sure I respond to comments here, I'll be having fun.  Feeling connected.  Enjoying being a part of a community that's just as confused as I am.  Right?

Thanks for sticking with me!

Your Hostess With Neuroses

Image credit/info: LOL Cats

Monday, June 14, 2010

Flying, Phobias, and Fears - Oh, My

Hello Friends:

Thanks for sticking with me through this little blogging dry spell. I'm going through another rough spot, here, with anxiety and depression making computer use a challenge. But as always, this blog, and the knowledge that there are people out there actually reading (wow, and thanks again) brings me back in spite of it. Good therapy.

And I'm in the middle of an anxious scenario that was perfectly ripe for posting. I'm at the airport, awaiting the arrival of a family member who is now 3.5 hours late. Airplanes make our lives easier (snort).

I really, really do not like flying. In fact, it scares the f#@k!ng$h!% out of me. It has for more than twenty years. And airports, by way of association, now feel like hospitals. These are creepy places where painful things happen. In spite of this, I fly a lot. An average of seven round trips a year, down from nine or ten five years ago. I do this by using Ativan to get my anxiety to a level I can manage. It is almost the only time I use the Ativan, since I want it to remain potent. When I fly, the stuff has to work. It has to. So I try not to use it for any other purpose. That way I don't run the risk of developing a tolerance.

I have been working on this flying phobia for a long, long time. I've tried all the usual methods to deal with it - like gradually increasing exposures, booze, meditation, and all the rest. Booze does not work at all, by the way. You can be drunk and still terrified, so I gave up on that. Now, I have had some success over the years in with the before-trip anxiety, and the after-trip triage.  I've been able to reduce my overall fear so that I start getting worked up only about a day before a trip. Used to be I was hanging from the ceiling by my nails for a full week. And I can calm myself at an airport with deep breathing and meditation. But when I am actually on an airplane that is in the air, only the Ativan can beat the anxiety to the point that I don't spend every waking second thinking "I'm going to die right now. Wait. Still alive. I'm going to die right now."  Over and over. I mean it. I am not exaggerating. Every single second.

I find this fear really irritating for a whole host of reasons. First and foremost, I am a scientist who does a lot of statistics. I know perfectly well how it is planes take off, fly, stay in the air, and land. And I know how much safer it is, mile for mile, than driving. Does not matter. When I am in a plane my education becomes useless and I wonder how it is the whole thing doesn't drop like a brick out of the sky. I certainly feel like dropping a brick.

And I love travel.  Well - I love being new places, I just don't like getting there. And my job (when I'm actually well enough to work) requires plenty of travel. So this fear is a real pain.

So to the point, sort of.  Here I am, sitting in the airport observation deck, typing away, having thought ahead and brought my computer. I've never really just sat in one of these places and watched the planes do what it is they do. The place is freaky. I am watching planes take off and land, over and over. Hour after hour. It is businesslike and appears as precise as clockwork. Which it patently isn't since I wouldn't be sitting around for an extra 3.5 hours watching it, if it were. The planes take off, which has my mind spinning with the cognitive dissonance of thinking both "that's impossible" and "that's perfectly explainable" at the same time. Then they land. And I'm holding my breath for each one. The lack of air is no doubt contributing to that head-spinning feeling.

I thought that would be the sum of my 3.5 hour experience here. But, interestingly, even though I've spent hours and hours in airports waiting for flights and stuck on layovers, just sitting here watching is sort of ... interesting. Different. Still scary and creepy. Yet after all this time I am actually starting to look up at the planes less and less. It is just what is happening in the background while I finish a post. Then I look up, see a plane land, and inhale suddenly. I've forgotten for a moment to worry about them, and yet they went ahead and landed without me.

Very interesting. What is flying like for you? Does watching it calm you down?

Your Hostess With Neuroses

Image "Blue Sky" from flikr via Creative Commons by Ack Ook, CC Share Alike 2.0

Sunday, May 23, 2010

Self Parenting Part II of III - A Closer Look

Hello Friends:

Okay, I am posting Part II. Now. I've procrastinated so long that I wrote a post on procrastination.

My Part I of Self Parenting took a look at the model for a good parent, since I wanted to avoid making any assumptions, there. In Part II, right here, I'm going to look specifically at suggestions from books and sites about the model for parenting one's own inner child. Some of these ideas look similar to the list in the last post, and others don't. Then in Part III I will (hopefully) tie these and a few other ideas together in a possible practical approach to self-parenting.

And no, I don't understand why my theme for pictures on this is cats. Stress Cat is a little jealous, actually.

I realize I didn't post a clear goal for the process of learning how to self-parent in part one of this series.  On Recovery View I found some text I liked. "In this process the client is reminded that they are not the same as their thoughts and memories.  That to be an adult is to understand and to embrace that there are thoughts and memories that take us back to an earlier time, but remembering is simply that, remembering. Remembering is a momentary process, one that requires compassion for the child that they were. Remembering does not have to be the same as reliving, if we can learn to intervene with our adult at this point. This is the premise of Self-Parenting."

Here are some tips, then, that specifically address adult behaviors towards your own inner self. Note that there really isn't a process discussed here.  There are so many approaches.  Some self-parenting programs are exactly like AA, with twelve specific steps.  Some approaches emphasize mindfulness, while others use art therapy to reach into your inner self.  There is not a "best" way, but many of the approaches have a few of these tips or points in common.

1. Think about what sort of parents you wish you had and be that parent to yourself. "If you wish you had parents that took you to Disneyland and took photos of you having fun and bought you Mickey Mouse ears, seriously consider planning a trip to Disneyland for yourself with a couple of good friends who would take pictures of you, and wear Mickey Mouse ears with you as well." (drmarlo)

2. Learn Who You Are. "Commit to learn who you really are and what your values are – on a deep level. For example, ask yourself: In my favorite type of conversation, what do I talk about and with whom? What activities bring me joy? What’s most important for me in a love relationship? What does s/he say and do, and how does s/he behave? What are my most important priorities as a parent? What makes me happy? What are my passions and talents?" (theresident 

3. Rescue Yourself
. "When you are in a bad situation, don’t ignore yourself. Pay attention to the fact that you’re unhappy and do something about it. Rescue yourself from bad situations like you wish your parents would have rescued you when you were a child." (drmarlo)

4. Comfort Yourself. "If you wish you had parents who would hold and hug and comfort you when you are sad, you need to allow yourself to experience being held and hugged and comforted when you are sad now. If your romantic partner cannot or will not do this for you, be a good parent to yourself and re-evaluate your choice of romantic partners. Not involved in a romantic relationship? Check out your friends. If you don’t have a friend who could hug you and hold you if you needed to cry, figure out why you don’t have any good friends and make a point to meet some higher quality people than the folks you’ve surrounded yourself with."(drmarlo)

5. Affirm Yourself.  "Recognize your abilities and recite them to yourself with pride." (relationshipmatters) Encourage your spouse/SO/family to highlight your achievements, abilities, and positive behaviors.  

6. Choose Strong Supporters.  "Marry a supportive and admiring spouse." (relationshipmatters) Choose friends who value and support you and your efforts. Surround yourself with people who provide genuine love and friendship. Stay away from work/career situations that are repetitions of earlier family abusive/stressful patterns.

7. Refocus On Now.  At some point we have to abandon debilitating feelings of pity for ourselves about how we were neglected and abused. Otherwise, we can allow ourselves to remain trapped in the time when the inner child was "in charge" of all our reactions and decision-making. We need to place our adult self in charge, taking responsibility for making the positive changes necessary to move forward.  (livestrong)

8. Identify Needs and Fill Them.  Needs can be a simple (or as complex) as food, air, and sleep. Once you have "learned who you really are" it will be easier to understand your unique needs. When you know them, start filling them. (reparenting)

9. Set and Maintain Boundaries.  Know what it feels like when your personal boundaries are being violated, then react to maintain your integrity and self-trust. "I usually feel my chest tighten, my breathing stop and my face flush. That's anger. Then the voice(s) in my head begin their chatter. 'How dare he talk to me like that?' Sometimes I simply feel numb, paralyzed and my brain goes blank. I identify this state as shock. I usually retreat in silence in these situations. So my job has been to quickly notice when these body/mind reactions occur. Hopefully the boundary trespasser is still in front of me. If so, I can take a deep breath and then I say, 'I believe differently' or 'That's not true for me' or "I don't accept that.' Then I excuse myself and walk away. Sometimes I have to do this a couple of times before the boundary breaker backs off. This is self care in action." (reparenting)

Righto. Enough for now. Let me know what you think, and I'll post Part III soon. Right. Really I will.

Your Hostess With Neuroses

Image credit/info: / CC BY-SA 2.0

Friday, May 14, 2010

Procrastination - A Bad Word for a Real Problem

Hello Friends: 

I noticed today that I have 31 followers - thank you so much for joining me in my adventures in Anxiety Land! I learn a great deal from your insightful blogs, and the comments you make on my posts. It is great to have the validation and to know there are people like me, dealing with the same crazy and trying, whenever possible, to enjoy the ride.

Right, back to the post. Sort of. I know I owe you Part II of Self Parenting, but I'm still doing my research on that. I need it to be just so - I can't make a half-a$$ed post, after all. Which got me thinking about why. Why can't I make a half-a$$ed post? Why can't I accept that some posts will be better than others? Who is the one creating these expectations, anyway? Why am I stressing over this?

And the next thing I know, I haven't posted in days. I'm procrastinating again.

The word procrastination has such a negative connotation. We know we are procrastinating when we are avoiding doing something that needs doing. Something that we know, eventually, must get done. But we put it off, again and again, until it becomes a crisis. Why?

And therein, I believe, lies the rub. I think most people think 'why' is because the procrastinator is lazy. That this person simply does not like to work, or only wants to do what they want, and d@mn the other stuff and the consequences. This behavior is seen as destructive, anti-social, and selfish. But procrastination is not the same as lazy. Lazy is only one possible reason why people procrastinate. For those of us with mental illness, procrastination can be about self-hatred, fear of failure, a need for drama, perfectionism, agoraphobia, and so much more.

So here are my own suggestions for trying to cope with procrastination. I cope poorly, but here is how I do it, whenever possible.

1) Stop equating procrastination with lazy, and realize it is a true mental health issue that needs to be addressed.  Figure out why, personally, I am avoiding doing something specific.  Each thing might have its own reason.  Admit it is a problem and try to strategize instead of continue the cycle.

2) Stop beating myself up for what I do not accomplish. Positive reinforcement works on adults to change behavior, punishment does not.

3) Pat myself on the back anytime I do anything at all, no matter how "minor." (See 1, above). I deserve to get praise for what it is I do manage to do. Did I brush my teeth? On a bad depression day, this can be a major 'win.'

4) Get similar reinforcement from my support network. Example - hubby. We are beyond mind games or passive aggressive nonsense. He can't read my mind, and I know that. So I've told him to make sure he is not critical of mistakes or things left undone. I already know they are undone and don't need it pointed out. What I do need is praise for what I accomplish. If I don't get it, I ask for it. Really. "Tell me how great I did calling and getting my own meds refilled." When he gets a request like that, he's happy. He knows exactly what to do and say, he does not have to guess.

5) Realize that there are some things I can only do if I am well/motivated, and some things I have to do even if I am not well/motivated. For me, checking email is in the first category. There are days I cannot check email, no matter how much I might 'want' to do it. I'm terrified, deathly afraid, of emails telling me how I messed something up. Getting on the treadmill, however, is in the second category. I hate, hate, hate it. Some days it seems 'pointless' because of my depression. Other days it seems suffocating because of my anxiety. But on good days, I still hate it. Nothing will make me want to get on the treadmill. So it is something I have to force myself to do, even when I don't want to, because I will never want to. It is fraught with issues around my weight, self image, and hypochondriasis, but still, it is qualitatively different from my issues with email. I cannot force myself to open emails if I am 'unwell.' I can, in fact, force myself to get on the treadmill even on my worst days. It's hard and I hate it, but I can do it.

6) Realize that 4 and 5 above are different for everyone. Other people might think badly of me that I can't make myself check email. They might think I'm 'just not trying hard enough' or am 'lazy.' I have to realize that they are ignorant. Only I know truly what I can and can't do.

7) Do things "okay" intentionally. Some of my procrastination is related to a need to do everything perfectly. If I can't do it perfectly, why bother? This is self-defeating since perfect is impossible. So sometimes I do things only okay on purpose. I stop when it isn't perfect and go do something else. This sort of feels like ripping your heart out, and makes you go nuts. But in some cases it works really well. Housework, for example. I used to spend all day cleaning one room, and then had no energy for anything else for a week. Now I do a little here and there. The place isn't perfect (or even close) but it is now livable in every room, not just the one room I managed to clean.

8) Notice the reactions of other people when I do something less than perfect, intentionally or otherwise. In almost every case, people don't realize I didn't give it my all (or have my all to give). They are usually just happy to have participation or help of any kind. Sometimes that's not the case, but actually keeping count has made it clear that I drive the negative numbers way out of proportion.

9) Only worry about today. My task is not to take my meds 365 times this year. When I look at it that way it feels overwhelming. My task is to take my meds today. Only today. If I don't take them, there is no "make up" or something like that. It means I may have consequences and need to face them. BUT it also means when I get up, what I did yesterday is off the books. And I only have to take my meds once, today, for a full win.

10) The classic - break everything down into tiny parts. I often feel overwhelmed with something when it is too big to handle. I try to break everything down into tiny pieces, and just do the tiny pieces one at a time.

Anyway, those are the things I do to cope. It means that sometimes I actually CAN check email, because I continually pave the way to create safe mental space for that. Treadmill - ugh. How do you deal with procrastination? What gets you motivated and moving? Or how do you deal when you still just can't do 'it' whatever that is?

Your Hostess With Neuroses

Image credit/info: 

Monday, May 10, 2010

Self Parenting Part I of III - Learning From Good Parents

Hello Friends:

Part of my healing investigations include learning about how to self-parent. For those of us who did not have a nurturing childhood, learning how to self-parent your own inner child can be a key to developing needed skills for life. Or at least that's what they tell me.

I've done a lot of poking around for resources and ideas, and figured I'd put them up in a series of posts here on the blog. Note, that some of the places I link to here are not big favorites with me - they might be religious sites or have an agenda to sell something. But I want to give credit where it is due, and not just claim ideas that are not mine. But don't assume that I'm endorsing any of these places. There be weirdness out on the intarwebs.

The first thing I thought to investigate was ideas of a 'good parent.' I didn't want to rely on my own dubious internal models for such a thing, so I went digging around and created the following (long) list of what a good parent is/does. It is combined from Buzzle
, Cutekid, eHow, and Myyoungchild. It is hardly comprehensive, but it gives a good idea of what a 'good parent' might be.

Tops on most every list is Unconditional Love. I think I'm going to have that be a topic for another entire post, but will put it here along with the rest for now. The first category is what a 'good parent' would do. In parenthesis is my 'translation' for a good self-parent.

1. Love your children unconditionally (Love your inner child unconditionally.) For children, this means saying it to them, hugging them, kissing them, telling them how much they mean to you and how unique and wonderful they are. Words have to be backed up by actions to be believed however, and everything else on this list is how to back it up. The same is true for dealing with our inner children. We have to tell ourselves we have our own unconditional love, be there with 'hugs' for ourselves, and tell ourselves we are unique, wonderful, and valued. We may just start to believe it when those 'words' are backed up by the actions.

2. Make your children a high priority (Make your inner child a high priority.)  We have to make caring for our inner children a priority. It can be easy to ignore them or turn away, so we have to make a commitment to keep them in a high priority position.

3. Understand how your children grow (Understand the development and needs of your inner child.)  We need to understand how our inner child came to be, what it needs, and how it will change over time. That way we know what to provide for ourselves, and what are realistic expectations.

4. Provide Encouragement/Never Criticize (No translation needed.) Every child needs to feel like their parents are their best cheerleaders and biggest fans. Inner children also need encouragement, not criticism. Learn as you can from mistakes, and then move on to the next item that you can use to encourage your inner child.

5. Spend time with your children (Spend Time on your Inner Child.) Your inner child needs you to spend some time with it, learning and playing, as well as comforting and nurturing. At times, set aside the constant need to judge, weigh, and analyze, and let your inner child have some simple fun. Spending time builds trust and love.

6. Listen to your children (Listen to what your inner child says and thinks.) Your inner child probably has a lot to say, strong opinions, and some very clear ideas about things. Your inner child might also have questions. Listen to what that person is saying, and respond with straightforward and genuine answers or the care that is needed.

7. Accept and acknowledge your child's feelings and desires (No translation, again.) It is okay to feel sad, scared, angry, jealous, or confused. Acknowledge the feelings of your inner child, don't dismiss them or judge them. Ask the inner child to find out why it is reacting the way it is.

8. Give safety to your children (Create safety for your inner child.) Everyone needs to feel a different level of safety, and this changes with time. Find out what your inner child needs to feel safe. It might be something surprising, like a stuffed animal, a separate room, or a pet. Or less surprising, like a better lock on the front door or an investment in better tires for the car. Find out what your inner child needs, and then explain to the inner child how you are meeting (or will meet) that need.

9. Model Good Behavior (Show, Don't Just Tell.) Children watch, listen, and learn. They do not do what they are told, they do what they have had modeled for them. If you want your inner child to believe you, to trust you, you can't say "I'll take care of you" and then eat pizza every night. Your inner child sees you are not sincere about care. This goes the same for proper expressions of emotions, standing up for yourself, and meeting daily needs for food, sleep, health, etc. Nurture yourself in adult ways, and when you go to nurture your inner child, the inner child will believe your good intentions.

10. Set reasonable expectations and express them clearly (Know what to expect from your inner child.) You can't expect your inner child to respond like an adult, to be perfect, or not to have needs. You have to be realistic based on what you learn about the development of the inner child, and by listening to yourself. Be ready to counter unacceptable behavior when your inner child pushes you to act out, "I know you are angry and sad, but you can't self harm by punching walls or not eating for three days. Is there something else you can do for relief? A distraction, a bath, a nap?"

11. Keep a regular schedule for your children (Keep a schedule for your inner child.) Schedules help to develop discipline and responsibility, as well as create an environment with less confusion and more straightforward expectations. As an adult, you can easily bend your schedule, eat poorly, stay up all night, and do as you please. But your inner child might not be up to all that. Each day does not have to be totally planned out, but try to do some things consistently (other than work schedule).

12. Create togetherness through routines. (Engage the inner child in meaningful rituals and routines, alone and with others.) Daily, weekly, or even yearly family rituals create a bond between family members. It may be as simple as reading a book together every night or taking a yearly trip to the beach. Let your inner child get involved with family rituals now the way you did as a kid, even if (especially if) you are alone. Put up holiday decorations, go on a yearly vacation to a spot you love and watch a holiday parade. If you are separated from family, you can also engage in rituals with friends; like movie nights on Thursdays or a game every Sunday.

13. Create a consistent set of rules (Be consistent with your inner child.) Like a specific schedule and regular routines and rituals, consistent rules are necessary for structure. Don't change things on yourself after you have set a boundary or a limit. This is a part of understanding and meeting expectations for yourself and your inner child. The same goes for 'discipline.' After you have set the limits, rules and expectations, try to enforce them every time. Again, this builds trust and shows your inner child that you can build and respect boundaries.

14. Reward your children (Reward your inner child.) Give your inner child good things any time they 'do right' or for no reason at all. Rewards are the only real way to change adult behavior, and your child is stuck inside your adult body.

15. Don't spank your children (Don't hurt your inner child.) Spanking achieves nothing but fear. If you feel frustrated or angry take a break. This goes the same for that inner child. You might be very frustrated with yourself at times, and think some kind of punishment is in order. Punishment does not change the behavior of adults (or inner children). Learn from mistakes, disappointments, and failures, and then move on. Do not punish, harm, or self-sabotage.

16. Strengthen your team (Keep everyone on the same page.) Go ahead and share your plans for self-parenting with your spouse, therapist, or whoever. Let them know what you are doing, and how they can assist. They should also know about ways you are trying to develop more structure or routine for your inner child, so they don't end up making things more difficult.

17. Teach your children what you value (Not sure how to translate this ... but it was cool so I didn't delete it.) "It is crucial to show and teach your children the values that you hold dear. Discuss with your children the importance of being honest, of being fair, of being respectful, of caring for others, and of being patient and understanding. Model these values for them, as children are astute in watching how adults behave and imitating that behavior. Whatever your spiritual beliefs may be, teach them to your children in a way they can understand. By doing these things, you are laying an important foundation that will guide your children throughout their lives."

18. Parents need recharge time (Don't spend every moment obsessing about the inner child.) Parents need to take some time for themselves, or they risk being no good for their children or themselves. Avoid sleep deprivation, isolation and self-neglect. You are more than your inner child. You are a complex adult. Nurture all of yourself, not just the inner child part. Make caring for your inner child a habit or reflex, and your time being you, the adult, in a newly comfortable and nurtured way.

Now if that doesn't seem like a tall order ...

Your Hostess With Neuroses

Image credit/info: "Teardrop and Her Kittens" from / CC BY 2.0

Wednesday, May 5, 2010

Sane? Depressed and Overwhelmed, Instead.

Hello Friends:

I am choking on the irony of having posted "Apparently I am getting more sane ..." and then having the week I just had. No, nothing 'bad' happened. No illnesses or accidents or any of that. It is, as usual, the depression that comes out of nowhere. People see me, notice I am down, and say "What's wrong?" I want to say "Where have you been for the last two years (or ten or thirty)? Do you see the list of diagnoses at the top of this page? That's what's wrong. Do I need more?"

People are surprised. "But you were doing better." I want to pummel them over the head. "So that means I never have another bad day, or week, or month, then? Progress is always straight up, eh?"

Grumpy, down, overwhelmed, sad, and cranky. What a great combo. Oh yeah, I have a migraine, too, with that wonderful nausea that goes with it. I'm blaming this one on the Celexa. But I'm blogging, and I'm going to count this as my "functional" success of the day. Whoo.

I can, however, see a trigger for my current state of bleh. I went from anxious, to overwhelmed, to unable to cope, to depressed. It is a pattern I am familiar with, but before this last year I don't think I would have seen it quite this clearly.

What I think set me off was a series of health related stuff. Again, nothing bad, just stuff that is starting to need attention. I've been overweight for decades, and was able to get away with it because I was young.  I'm not young anymore, and my last physical shows me on the border of having some cardiac issues; my good cholesterol is going down, my lipids are no good, my triglycerides are on the line. Doc is saying that if the niacin does not work, I'll probably have to start a statin drug. This is ridiculous. I'm too young and the wrong gender to be on Lipitor. Yes, that's a stupid way to think, but here I am thinking it.

But taking all those supplements she has prescribed is hard. My OCDs are mostly contamination based. Pills are a daily struggle. I have seven total to deal with, given the mind meds and the supplements. It's too many. I showed her all the bottles and said I couldn't promise to be med compliant with all this stuff, and she had to eliminate some of them. She didn't. So I have the same lineup of bottles to deal with every morning, and that means some mornings I turn away from them in defeat.

So I have to lose weight. Which means exercise for real. I can do it, but it takes an inhaler to do it without practically passing out, since I have exercise induced asthma. And I'm afraid of the inhaler. I've been using it, but it makes me feel terrible. I need a different prescription. That means calling and getting one. And then finally picking it up and using it. Inhaling weird stuff. And then I'm still supposed to have mental resources left to get on the treadmill?

And then there are the flexibility and strength exercises. I have those from my somatic therapist. She at least agreed when I said she could give me three and no more. So there they are, another thing to do every day, added to a list that I can't handle as it is.

Include food. Food, which is one of my real trigger issues regarding OCD. Shopping, cooking, and then cleaning up. I can do one of those, not three. But losing weight and eating right means planning meals, shopping, keeping the pantry stocked, using leftovers, etc. etc. I can't even bear to think about it. My mind is not dealing with planning, and I don't have the energy to stand in front of the stove and cook.

Okay I could continue with the depressive ranting. But the picture is pretty clear. I am trying, really trying, to get better. It is never good enough. Never fast enough. There is always more more more to do more to try. Pressure. And then when I get some random physical chronic illness it'll be my fault.

There's my whiny post. I'll try to get something less self-indulgent next time.

Your Hostess With Neuroses

Image credit/info: 

Thursday, April 29, 2010

Apparently I'm Getting More Sane ...

Hello Friends:

As I mentioned in a previous post, I enjoy taking many of those time-wasting quizzes that one runs into on the internet.  In December, I took the The Sanity Score, and recorded my results.  I thought it might be interesting to see if the scores changed in any statistically meaningful way over time.  I have been feeling a little bit better recently (less depressed, although more anxious) and thought I'd see how or if this was reflected in my test results.

The quiz is hardly a precision instrument, since it claims to rate over a dozen issues in the space of about 80 questions or so.  So I took it twice, both times, and averaged the results.  This meant I had data to play with (dear God I love data).  I made up a spreadsheet, of course. And here's what I found. (BTW, numbers are rounded up behind the scenes, which is why 46 - 46 = -1)

Really the only important thing to note is the last column (D) which is the delta, or change since last time.  In this quiz, lower numbers are better, so negative change is good.  The overall sanity score is on a scale from 1 to 288.  Yeah, weird.  The other numbers range from 1 to 100, with anything 50 or above considered a critical issue that definitely needs addressing.  I'm not sure, but I think anything above 35 is considered a minor issue that probably needs addressing.

The largest drop was in Depression from a 'major issue' of 49 to 30.  I wasn't surprised to see the drop, but I was surprised it was so dramatic.  I still feel somewhat depressed, and my functionality isn't great.  But I suppose that's what 30 means, then.  I can't imagine what 100 must feel like - probably 'coma.'

The 17 point drop in phobias probably isn't real.  I say this because the test has some confusing questions about phobias, and they overlap with some of the anxiety questions.  I don't think my phobias were actually at 59 to begin with.  Even 42 seems high for how I deal with spiders, for example.  Plane flights, though, that's probably pretty accurate.

So that means the other serious drops were seen in PTSD and OCD, down thirteen points in each.  This seems right to me.  I do feel less like I am ritualizing about things like doorknobs, and my overall fear of places that can trigger flashbacks is lower, too.  It seems to be more difficult to trigger them.  These are still major issues, but I think the scores here gibe with my own experience.

The only gain was 5 points in the GAD category.  This definitely seems accurate, given that when my depression goes down, my anxiety always goes up.  When I'm depressed, I don't worry as much because I just don't care.  Now that I'm pulling out of the depression, I'm starting to worry more.  Still, GAD continues to hover around 50, and is not going through the roof.  This is good.

Overall, almost everything dropped or stayed constant.  This is reflected in the Overall score, which dropped a serious 18 points from 88 to 70.  Seventy would make me almost sane - a person with issues to deal with, but who has the resilience, skills, and resources to cope and manage.  Sounds scary.  Am I that person?  I don't feel that tough. But maybe I will ...

I continue to bemoan the fact that I did not take the test when I was at my worst.  Of course, when you are at your worst, you can't use your computer, let alone find a website and stay focused for 15 solid minutes to take a quiz.

If you check out the test, I'd be interested in hearing what you thought of it, and if you want to share any of your own numbers.

Your Hostess With Neuroses

Image credit/info: / CC BY 2.0

Friday, April 23, 2010

A Successful Visit to the Doc for that Pesky Exam

Hello Friends:

I had my annual physical exam yesterday, and it actually went pretty well. This is in contrast to my physical last year, which ended up being something of a disaster. That situation was what motivated me to try harder to express my needs and get advocates for health care. I have too many CPTSD flashback triggers in doctor's offices and hospital settings. The environments are too threatening. And as you know I recently geared myself up to visit the obgyn for the first time in years. I used a lot of my tips and ideas (from post I and post II) to make that visit go better, and it worked pretty well.

So I went into my yearly physical a bit more prepared. I took my Ativan the night before to ensure a good night's sleep. And since it isn't fully out of the system in twelve hours, I had some left to help buffer the visit itself. I had my husband come with me, so that he could listen to the advice I was given, and make sure I didn't forget to mention anything important. He also gets to sign all the forms so I don't have to touch any contaminated pens and clipboards. Ewww. I wore comfortable, loose fitting clothes and a tank top. This turned out to be a big bonus since they didn't have to remove it to do the standard EKG test. (Having to take off clothes makes me feel shaky and vulnerable.)

Let's see ... I brought a food bar to scarf after the blood test, and asked right up front for juice. Last time I spent the visit in a state we call, "gone a$$hole from hunger induced madness of the brain." This time I got my blood sugar right back up. I also had made sure to drink lots and lots of water the night before and day of, so the tests were easier. Nothing like performance anxiety when you are trying to pee in a cup.

I told the nice nurse I wanted her to take my blood. She says the same thing every time, "There are others better at it than me.  It might hurt more if I do it." She still does not quite understand that it isn't about pain, it is about personal trust. The pain of the stick is not what bothers me, it is the feeling of helplessness, the loss of control, the sense of violation (along with the fear of contamination.) All of these things are much less of a problem if I know that the person I am working with sees me as a real person, respects my limits and boundaries, and will take me seriously when I say "There is one vein. One. Only one that will work. It is right here." And she does, and did. We hit it on the first try, and the rest was cake.

But most importantly, my doctor is finally catching on to what it means to have a patient with PTSD and very bad anxiety. I asked specifically for continuity with the staff. This is a trick in that practice since people are always coming and going. But she is going to try. She made of point of having me introduced to the new nurse I'll be working with (when the old nice nurse retires, boo hoo) and introduced me to the manager of the front office. I've also been told to ask specifically for the manager any time I have an issue. This "permission" will make it easier for me to feel like I have a right to stand up for myself. Even if they forget, and they often do, I'll remember.

And even if I get the run-around for something in the future, just having gone through this will make me feel better. I felt respected. I felt like people cared about my individual needs. They still don't really understand. For example, my doctor still has me on five different supplements (I do need them, I do have all the deficiencies they are supposed to fill.) But when I told her I couldn't take them consistently, there were just too many, she couldn't understand that. No matter how many times I tell her that every single pill is a struggle, vitamin or not, she doesn't get it. So I will probably remain semi-compliant with my meds. I will always try, but there is only so much of me.

However, they are trying. And I am trying. It all feels much better. Still very scary, but it has become something that can be managed, something that can be coped with.  I didn't dissociate once during the whole visit, even during the blood test. I was present in the moment, and had only a few episodes of hyper-aware anxiety. And then I got a french-toast breakfast. Oh yeah.

Your Hostess With Neuroses

Image credit/info: Photoxpress

Monday, April 19, 2010

Grief and Mourning Part III of III - Starting to Move Forward

Hello Friends:

In my first post, I talked about how I had done some grieving of my losses in the past, but still felt there was more to do. And I didn't want to do it. In the second post, I put up a few reasons why we might resist grief and mourning, and what I thought my own hang-ups might be. So here's the third post, where I'm going to talk about the process of grief, and how I'm starting my plan to mourn and move on. Right. I'm sure it'll be just that easy ...

Anyway, we are all familiar with the canonical five stages of grief, which some people say are more like seven, or twelve, or whatever. The wisdom on stages of grief these days is that there do appear to be "places" one finds oneself, like denial, or anger. We seem to move through these places in one way or another as we grieve, but it is never the same. Some people visit one or two stages, and then are done. Others visit the stages in a random order, back and forth, then around again, up and down, with no apparent pattern. Eventually, they also are done. So there is no real predicting.

For myself, I find the idea of stages of grief a little frustrating, since I want to do things "right," and there is no right. Still, I found a site here that talks about these stages in a way that was actually helpful to me. This page lists seven stages; shock, denial, anger, guilt, sorrow and depression, acceptance, and then engaging with life. I found it most useful for the inclusion of "shock." Interestingly, because of the CPTSD, I sometimes find myself still there, still in shock, feeling as if something terrible has just happened. Creepy. I can imagine how that can be keeping me from moving forward with my grief, although I'm not exactly certain how to move it from "now" to the past.

One of the more useful things I found was an excerpt from a book about how to help someone else with grief. You realize quickly that these are the things you need to be doing for yourself. Rewording, some of the advice might look like this; grieve at your own pace, seek company, seek emotionally safe environments, don't judge what you say or feel, be patient with yourself, try to find some humor in life, honor losses with memorials/rituals, and seek others going through something similar. I find myself finding humor right here, since all this sounds like the whole reason I started blogging in the first place.

I'll admit that sites with any overtly religious content make me wary. But there is a site on 'devozine' that I thought very interesting. This is actually targeted to teens dealing with trauma (9/11) but I read some very useful stuff on their site describing trauma and grief. I thought the description of trauma, below, was insightful.

"What is a trauma? Loss occurs any time we feel restricted or diminished. Trauma is a loss that is outside our world view, an experience that brings up feelings of terror, horror and being out of control. An experience will be traumatic for us if it involves injury or death in ways that do not seem to be a natural part of living. Also, events that have a deep personal meaning for us or experiencing a number of losses may move us into feeling overwhelmed."

This site made a suggestion about the nature of grieving, what it does, and how to use it to honor our losses, and then move on. I've taken just some of the sentences here to shorten the piece. "The way we heal our experience of loss is called the grieving process. The feelings and issues of grief help us to understand what the loss means to us and what we need to be healed. Because we don't just grieve for the fact of a loss, but for the meanings and implications of that loss, spiritual issues always arise in grief. Find a symbol. A symbol is an object, word, place vision etc. that stands for a meaning other than its obvious or usual one. Choose a symbol to help your grieving. It could be a color, a piece of clothing, an object you carry in your pocket or anything that will provide comfort."

I really resonate with this idea. I've decided to go ahead and do it. I'm going to choose a symbol that gives me 'permission' to grieve, but that does not require it. I'm going to try to use this symbol to make sure my subconscious knows I'm allowed to grieve, to mourn, but it can do it on it's own time table and in its own way. So this symbol will now be my compromise. I can be sad if I want to, or not, as necessary. Meanwhile I can move on with other aspects of healing.

The symbol I've chosen is the "weeping seraph," above. I'm not entirely sure what it is about crying angels that appeal to me. There is something both sad and soothing about them. One of the things about losing someone that always bothered me was people saying things like, "you shouldn't be sad, they are with God/Jesus/Buddha/in the place with infinite beer/with the angels/etc." I had this idea that heaven was dancing and happy that so-and-so had died. I did not like that image at all. Seeing weeping angels actually makes me feel better. I think the angels do mourn, they don't go straight to the dancing. There is the sad part first. The despairing part. The part of utter despondency, when even the knowledge of future happiness cannot take away the pain. This seems right. Not that I want them to be stuck there, or to be stuck there, myself. But it seems proper to honor the loss. And this image makes me feel more like a loss is being appropriately honored.

I might even buy a small version of this statue to keep around as a reminder. The message is that grief is good and okay, whenever necessary. But it is also okay to keep moving forward.

That at least is the plan for the moment. How do you grieve your losses? How do you honor them? How do you move on?

Your Hostess With Neuroses

Image credit/info: / CC BY 2.0

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