Category Archives: therapy

a familiar voice

My therapy session on Tuesday went a little better than usual. Usually when things get hard–that is, when we start going deeper–I shut down. On Tuesday I stayed with my t as much as I could. I feel good about myself (for once) for actually having stuck it out even though it was incredibly difficult. I’m giving myself credit where credit is due; it’s a strange feeling, to say the least.

Well, now that I am analyzing, and writing about, it, there were times I felt very frustrated and maybe did quit a bit.

We’ve been talking a lot about the cycles I go through. Anticipatory anxiety, social event, depression–and how each one is setup by my own negative beliefs about myself. My t is interested in my beliefs, because that’s where change will occur. I’m not sure I believe that. It’s hard for my beliefs to change if they’re constantly being reinforced by my actions. But in a therapeutic session we can only work on what’s inside me, not the outside world and what goes on around me. So, we talk constantly about my beliefs, which is frustrating.

There is a genuine part of me that does want change, that does want my deep, rigid beliefs to be exposed for what they are–lies. I want to be able to engage socially without that voice in the back of my head saying, You are no good. People notice you are anxious, and, consequently, they don’t like you. You will never be anything other than what you are right now. Logically, I know I have an innate worth, and I know sometimes I do appear anxious (but it’s not as bad as I make it out to be), and even if people do notice I am a bit anxious, they probably aren’t judging me or coming to conclusions that I am a bad person. But logic doesn’t always help. It’s what’s deeper that matters. And sometimes I do want those beliefs to change–or at least be challenged.

Which is what happens in therapy. Which is why I shut down sometimes. Why would I want those beliefs to change? They are me. Without them, I won’t know who I am. So, most of the time, I don’t want those beliefs to change. I just want to be able to live my life, while still thinking I am a piece of shit, which has been difficult thus far, obviously.

What’s more, sometimes it feels great to fail because it reinforces those negative, irrational beliefs about myself.

“It feels so good sometimes,” I told my t, “coming in here and telling you what a shitty weekend I had, because now I have something to point to. Now I have something to show you, and say, ‘See. I am messed up. There is something wrong with me.’ It’s fuel for the fire.”

“That voice is what I’m interested in,” he said. “That’s the voice that doesn’t want change, the voice that says you’re not good enough and never will be, the voice that says you should die. It’s a familiar voice. It’s something we need to shine light on. But when we look at it something happens in this room, something changes. You get flooded and leave.”

Anyway, during the session, I tried to open up about the voice, explaining when it comes out in social situations and how it’s, seemingly, out of my control during periods of anticipatory anxiety. I stayed with it as long as I could, but, inevitably, I shut down, relinquishing control. But I did stay with it longer than I have in the past, which is a step in the right direction. I just feel frustrated that I wasn’t able to open up more. I couldn’t find the words.

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perspective

Although my head is still in a fog, I think I’ve gained some perspective not only about the wedding, but the last year of my life, as well. Despite what most people are saying around me, I feel I’ve taken quite a few steps back over the past year. I wouldn’t say I’m moving backward, but I wouldn’t say I’m moving forward either. It’s more like I’ve been stagnating; some things have definitely gotten worse, while other things are better.

The basis of this post, by the way, comes from two major events that have happened this past week or so. One being the wedding, and the other my one-year anniversary with working with my therapist.

I can’t ignore the fact that I am not the person I was one year ago. I’ve changed in many ways, good and bad. I’m really an entirely different person. I went to a wedding a year ago, and it really wasn’t that bad. I felt some anxiety, but I got through it. The wedding on Saturday, however, was a much different experience. I was completely flooded during it and could barely communicate, let alone smile.

So, what’s different about me? Let’s take a look–

Anticipatory anxiety. My anticipatory anxiety is much worse now than one year ago. The dreading and worrying is much more intense, and it starts to happen earlier and earlier. It’s even been so bad that I’ve had to avoid certain social situations altogether. I never avoided situations a year ago; I’d be scared to go, but I’d still go.

Depression. Like my anticipatory anxiety, my periods of depression are much more intense and they last longer. I’m usually knocked on my ass two days a week, unable to do anything, and I have a breakdown about once a month.

Mood swings. The lows are much lower today, and the highs higher. I’m constantly swinging from low to high, as well; in a typical day, I usually have at least one or two swings.

Binging. I didn’t consciously binge a year ago. That is, I wasn’t purposely binging to elevate my mood. Today, I know how to control my moods through binging; and, consequently, I’m binging a lot more.

Isolation. 14 months ago I quit my job; moved in with my girlfriend, away from my roommates and friends; and started an online graduate program. I quickly became isolated and stopped hanging out with friends. My best friend moved to NY last January. I pretty much have to rely on my girlfriend for support and someone to hang out with.

Joy. I do not get pleasure out of the activities that used to relax me. I don’t enjoy reading, writing, meditating, yoga as I did a year ago. I don’t really enjoy much anymore, actually.

Medication. I’m on some serious medication now. Lamictal, Klonopin, Ativan, Propranolol. What’s next? Just seeing all the pill containers reinforces my beliefs that I am fucked up and broken.

Therapy. Yes, I am in therapy now–isn’t that a good thing? I don’t know. I’ve had to admit that I have issues and that I need to work through them. Instead of internalizing everything, I’m having to face my beliefs, feelings, and fears. I’m not convinced this is a good thing. I’m moving too fast; it’s all too much to handle.

Beliefs. I’m also finding out that my beliefs are extremely rigid. I sincerely believe that I am a bad person; no one likes me; I’m inferior to those around me; I can’t cut it in this world; I’m a fool, a failure, a loser; and I will never get better. These beliefs are obviously reinforced by my actions and social experiences. Each time I engage, my beliefs are reinforced. It doesn’t help either that I bounce from one huge, overwhelming group social situation to the next; there’s nothing in between because I’m so isolated.

Awareness. It all comes down to awareness. I am much more aware of things going on inside my body. I can recognize when a depression is coming (but it’s frustrating because I can’t stop it). I know about my beliefs and feelings (but, again, I feel powerless to change them). The major difference is that I understand why I feel the way I do, but I haven’t been able to change it, and so, I feel even more powerless, hopeless, and listless. I’m scared.

What’s more, last night my g/f said she’d like us to go to couples counseling. It feels like the beginning of the end. I can’t deal with anymore therapy at the moment. I can’t deal with unlocking more deep-seeded beliefs and feelings because I can’t deal with the ones I’ve already unlocked.

I don’t know what to do anymore. Maybe things aren’t as bad as I think they are, but I cannot dismiss the fact that I am more unhappy than ever.

Each day grows harder. The longer my beliefs stay the way they are, the harder it will be for them to change. Plus, my inadequacies are further reinforced each day as I go about my life watching all the other “normal” people function like I should be functioning. Every time I see someone smile, I tell myself I’ll never be happy, which only fuels my beliefs.

I’m stuck. I’m trapped. I’m really, really scared.

    making contact

    I sent my parents a letter about three weeks ago, detailing some of my issues and frustrations, and I finally talked to them (separately) about it last night. They were difficult conversations, to say the least–but good. My dad gave me practical advice and validated my issues, while my mom got very emotional and questioned my issues. I welcomed both. It felt good to actually be talking about me–the real me. I felt transparent. I felt naked. I felt vulnerable. I haven’t felt like that around my parents in a long time; again, it was good.

    Afterward, I cried a bit, but I didn’t feel very emotional. I don’t understand why, beecause the conversations were so emotionally-charged. I thought I’d want/need to binge, but I didn’t. I ate a salad and went to bed. I’m proud of myself for actually having an “adult” conversation with my parents. They now know what I’ve been going through, and my hope is that I can now lean on them for support.

    My dad’s highlights–

    “I used to be very shy and had trouble communicating with people too, but my job demanded it. I found that I could use running as a form of mediation to help me relax and deal with my issues.”

    “Keep your head up; you’ll get through this.”

    My mom’s highlight’s–

    “I don’t know what to say to you. I’m scared to say anything because it won’t be the right thing to say.”

    “I thought we had a close relationship”

    “You dwell too much on the past; you just have to let things go and live in the present.”

    “I don’t know why you just can’t live your life like everyone else.”

    “I’m sorry for getting angry. I’m hurt and frustrated and don’t know what to say. I feel like I failed you.”

    inhale, exhale, slow down

    As you know, the last few days have been tough. I started feeling better yesterday afternoon though, but the depression hit again on my way to therapy. I didn’t want to rehash everything that’s been happening; I didn’t want to think about anything any longer. I just wanted relief and understanding, and, surprisingly, I got it last night in therapy–sort of.

    ***

    Most sessions start with me manically describing every detail of my week; it’s like a giant exhale. I don’t feel much at that point, because it’s all very shallow. There is a little anxiety, I guess, because I’m processing everything so fast. I want to get everything out there in the open and let my therapist decide what to look at. Inevitably, at one point or another, he stops me, asks me to take a deep breath, and slow down. I smile. There’s no more anxiety, but now I don’t feel anything at all–which is sometimes worst.

    Sometimes I say a few more things, sometimes I don’t, and then he decides what to focus on, and more often than not, it’s the things I don’t want to touch; it’s the subject I speed through even quicker, hoping he won’t hear it. I like this about him; he knows what I don’t want to touch, and he makes me touch it. Anyway, we talk for a bit about the subject, still superficially. I’m a little anxious; I can feel the tension creeping up from my stomach, like a tank slowing filling with water. And then it happens–

    “What’s beneath?” he asks, knowing I’m going to shut down. “What are the underlying beliefs–that’s what I want to know about.”

    I manage a few more sentences before shutting down. The remainder of the session is like pulling teeth. He brushes right up against my beliefs, and I push back. I get angry, frustrated, and very defensive. I feel attacked. I feel threatened. I feel like he’s not on my side. It usually gets to the point where I don’t say anything for the last five or ten minutes. We sit in silence. Sometimes he talks about how difficult therapy can be; sometimes he even congratulates me on coming in and doing the work, which is the last thing I want to hear in that moment. Thankfully, there’s a beautiful picture of the ocean right behind his chair. If I look long enough, I leave the room altogether.

    I become the ocean.

    ***

    Last night I did something different, though. I started out by talking about the thing I didn’t want to talk about: my suicidal thoughts.

    “I don’t know what to do when I have them,” I said. “It’s hard. Most days I just have them while walking down the street–looking up at every building, wondering if it’s high enough for me to die if I jumped off it. But over the weekend, the thoughts intensified. There was intention. I may have had a plan, I’m not really sure. When they get that intense, I’m not going to call you. I’m not going to call anyone. When I’m that low, I only want to binge because that’s the only way I know how to regain control.”

    I paused, letting this seep in. His facial expression changed; he was visibly upset. Sensing I had more to say, he nodded.

    “But I’m scared because binging is becoming less and less effective. I can’t rely on it anymore. I’m scared that I won’t be able to quickly pull myself out of my next deep depression.”

    I talked about the wedding, and the holidays, and my upcoming class presentations. I’m scared of them, yes, but they are not the cause of my suicidal thoughts. It’s easy to blame them, but the real culprit is beneath.

    “Tell me about the beliefs?” he asked, as always.

    “I’m a monster inside,” I said. “An ugly monster. I’ve made so many bad decisions in my life. I deserve everything I’m going through. It’s all my fault. People do not like me because I’m not like any of them–and I made the choice not to be like them. I will fail. I am a failure.”

    “There’s more there,” he said. “It’s in the room. We just nicked it.”

    At that point, I was flooded. I felt a bit nauseous. All I wanted to do was leave, but I didn’t. I never leave. I guess I like the pain, or I just don’t want to disappoint. I thought he was going to push back against my beliefs again, but he didn’t, something different happened–

    “You know,” he said, “if it becomes too much you can ask me to pull back. It’s okay.”

    He gave me exactly what I needed in that moment: space. I looked at the clock: five minutes left. Five minutes of silence and me staring at the ocean. I am that ocean, I told myself over and over and over again.

    therapy and medication

    My therapist doesn’t get it. Or maybe it’s I who isn’t getting it? I told him on Tuesday that I struggle through so many simple things most people take for granted, like saying hello, or making small-talk after saying hello, saying goodbye, shaking hands, smiling, playing with children ..

    His response: “You went to an interview. Did you shake hands? Did you make small-talk? Did you smile? Did you say goodbye?”

    I nodded several times.

    “So, you showed up and engaged socially,” he said. “You were there–that’s the most important thing–and it sounds like it went well.”

    I usually show up to things. I usually make small-talk. I usually smile. I usually shake hands, hello and goodbye. That’s not the problem. The problem is that I don’t feel comfortable doing any of those things. The problem is that I feel like an idiot while doing them. I think people are watching me closely, scrutinizing every move, and making negative judgments. After I leave, I think people are thinking, Wow. Mike really doesn’t know how to engage with people.

    The problem is that I’m 27 years old, and yet I feel like I have the social skills-set of someone half my age.

    But then again, I got the internship, so maybe I am okay. Maybe I’m not as bad as I think. Maybe everything will be okay. I don’t feel like it, though, and right now, my thoughts are in control of me.

    ***

    In other news, I went back to the psychiatrist on Tuesday, as well. Now that my mood swings are a little more stable, the anxiety can be addressed once again. I don’t want to go on another SSRI, so my psych suggested Klonopin. .25 mg, twice a day. I don’t like being on a cocktail of drugs, and I don’t like being on benzos, especially everyday .. but then again, I don’t like anxiety.

    So I’m going to give it a try.

    Also, he made me feel very little by saying that my problems are minimal compared to others. He even said that it’s like I’m walking around and I get a tiny pebble (the anxiety) in my shoe, stuck between my toes, and I’m too lazy to get it out. So, not only are my problems tiny, but I’m not doing enough to alleviate the problems. Yes, I’m skeptical towards drugs, and, no, I don’t like taking them, but I think I am doing a lot to help ease the anxiety.

    interview success

    So, as many of you know, I had a group interview yesterday. The interview was originally scheduled for last week, but I canceled last minute because I was overwhelmed with anxiety. Fortunately, I found a good, partially true excuse and was able to reschedule for yesterday.

    I already had one interview with them a few weeks back with the library director. It went well. It was very relaxed. We talked about my future and what areas I’d like to work in–nothing too formal. At the end of the interview, she mentioned that she wanted me to come back in to meet with her and the rest of the librarians. I said fine. On the way out, I asked her how many librarians worked there and she said ten, and she also said that out of those ten there are a few who aren’t receptive to interns.

    That information hit me hard–not only am I going to be interviewed by ten people; not all of them want me there to begin with. And since I take everything personal, I took this personal.

    This set off my hypothetical mind; I began thinking of different scenarios of what this interview would be like. Mostly I just pictured ten librarians sitting across from me, asking difficult question after difficult question. Me, barely able to breath, stumbling, blushing, sweating.

    My original interview was on a Thursday, and we scheduled the next one for the following Monday. I was a mess that weekend. Actually, I think I probably wrote a post about it. Anyway, the anxiety intensified to a point where I couldn’t function. I couldn’t sleep Sunday night and had to reschedule for yesterday.

    From that point until today, though, I’ve been doing great. So what’s different about this past week from the week before?

    Well, for starters, my thoughts haven’t controlled me. The negative thoughts were still there–they just didn’t dominate my consciousness. Part of this is attributed to CBT, the other part mindfulness. By becoming aware of my thoughts, before they took control, I could use cognitive techniques to ensure that they wouldn’t take control.

    Next, I began to use meditation to help me relax. Two hours before the interview, I was laying in the bath, listening to a meditation. Once I got out I felt at peace. This feeling carried me into the interview.

    Finally, I hashed out the situation with my hypnotherapist on Friday, meaning: we tried to look at my hypothetical scenarios in a different light.

    “What’s your worst fear?” she asked me.

    “To get up at the end and have to go down a line of ten librarians, shaking each of their hands,” I said. “They’ll see how much I’m sweating.”

    “Do you really think it will be like that?” she asked.

    As soon as she said that it was clear: there’s no way it would be like that. I may have to wave goodbye, but shaking hands with ten people sounds absurd, and it certainly wouldn’t all be in one line. I always feel so much better after playing out scenarios in my head. Seeing just how absurd my thinking can be, reminds me that my logic can be irrational at times.

    The interview, itself, went well. I met only with the library director and one other librarian–no biggie, especially since I was expecting ten people. I did have to engage in a formal interview, but it went well. The director called one of my references earlier today. I think I got. Hurray!

    therapy, 10-5-10

    Therapy’s supposed to be safe. It’s supposed to be a place where I can share and my therapist can share, and I can grow and my therapist can grow, together. It’s an intimate bond between two people. In fact, there’s probably nothing more intimate than two people sharing the same space, just being who they are.

    “Therapy isn’t safe,” I told my therapist, J. “I can’t run or hide, and I can’t use distractions either. I can never get the attention off me. I have to be here, and I have to be present. I have to be me.”

    “You can’t protect yourself from the intimacy in here,” J said.

    He paused, and I looked away. When my eyes returned, I saw him looking at me–I mean really looking at me. I don’t think anybody has ever taken me in like that before. My eyes darted away again.

    “You can’t protect yourself from yourself,” he said, breaking the silence.

    He’s right: Therapy, like meditation, has only one demand–that I be myself. Simply me. Whoever that may be in the moment.

    And that’s why it’s not safe.

    I spend so much of my energy outside of therapy just trying to fit in and remain anonymous. By doing so I don’t live in the present moment, and I think people probably recognize this. When I’m feeling comfortable and can be present, people respond to me. They enjoy being around me. People like that; they want me to be there with them, not somewhere else. And if I am somewhere else, people can sense that too. Their response changes, they see me differently, which reinforces the anxiety.

    I’m very fortunate that I have a place where I can be present. I may not be present all the time in therapy–I can go places in my head, make lists, think about what I’m going to do outside of therapy etc.–but I really believe that I spend a little more time in the present moment each session, and that this present awareness is beginning to spread to other parts of my life.