Tag Archives: awareness

tattoos and hasty conclusions

Posted on July 21, 2011 | 17 comments

I think I mentioned briefly in a past post that I had just got a tattoo–and if I didn’t, well I just got a tattoo. Not going into too much detail, I’m a fan of  dialectics–thesis, antithesis, synthesis–so I got a tattoo of a dragon, some waves, a peaceful river, mountains and a sun–all done in Japanese style–each representing a phase of the dialectic process, on my right arm.

Anyway, during my first tattoo session, which by the way was my first tattoo session for my first tattoo, I felt nervous/anxious/excited/etc./etc. I took an Ativan to help calm my nerves, which did very little if anything.

I had to take off my shirt, and even before the tattooing began, I was, to put it mildly, sweating horrendously (I brought a rag to wipe up the sweat from my underarms), not much worse though than any other social interaction. I was also wincing and wasn’t talking much to the artist who badly wanted to talk. Thankfully my girlfriend did most of the talking. Being a twenty year tattoo vet and slightly insensitive, about halfway through the session, he looked at me and asked, “Why is this so much harder for you that for everyone else?”

Shocked and caught off guard, I said, “It really hurts.” I left it at that.

I didn’t think much of this until a few days later when it hit me–I was pissed. Him saying that seemed akin to a therapist asking, “Why can’t you be like my other patients?” On the surface what he said was not only insensitive but extremely hurtful as well. It’s my job to sit as still as possible while getting a tattoo. The experience itself is mine, though. If I don’t want to talk that should be fine. If I want to wince that should be fine too. Shouldn’t that be somewhat expected, especially from someone who has been tattooing for that long? As soon as I started thinking about it, I realized just how angry I was. I also knew right away that that anger had been building and was ready to burst. I didn’t really know what to do with it so I just put the anger aside for a few days.

And that’s exactly what I did. Inspired by Layara, I came back to the issue when I had some time alone to think a day or two later and came to the conclusion that perhaps I had been jumping to hasty conclusions on what exactly he meant. He could have just been having a bad day and did in fact take it out on me. Maybe he really was just trying to ask if I was doing okay and it came out wrong. Whatever the reason, it’s not my fault. I did nothing wrong. It’s so easy for me to blame myself in situations like that.

Further, I tend to jump to huge conclusions based on the most minute types of behavior. For example–

  • If someone gives me a tired look while I’m talking to him or her then it’s my fault. They find me boring. They would rather be doing something else.
  • If someone doesn’t say hi to me and smile then I’m probably just not worthy of it in the first place and he or she really doesn’t like me.
  • Etc.

My point is that I have programmed myself to jump to very negative conclusions based on outward behavior, which has not served me. My hope is that one day I can catch myself making those hasty conclusions and and provide arguments or other scenarios to counter my irrational thinking. For now though, I’m doing my best to go back and look at situations and try to re-frame them, in order to attempt to objectify the situation more.

I go back to get my tattoo finished on Sunday. I’m excited, and the experience will be mine. If he’s not okay with that, I have the confidence now to let him know.

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Posted in beliefs, cbt, negative thinking, past, social anxiety

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an example of avoidance

Posted on June 3, 2011 | 9 comments

Yesterday my boss asked me to go downtown today to pick up some tax documents at the state’s local field office. I didn’t think they could provide the documents, but I didn’t have the nerve or desire to argue with him so I reluctantly agreed.

I’ve had to go to this field office a few times before. Each time, I’ve had to endure a rather difficult social situation because the receptionist is very attractive and socially adept. In other words, she’s beautiful and perfect, and I’m not. These thoughts happen in a split second and ensure that I will fail. Now, CBT has taught me to catch these thoughts before they happen, to counter them with positive, rational thoughts. But this never seems to happen quick enough. I sum up that she’s perfect and place her on a pedestal before my rational mind has a chance to kick in–and I’m left playing catch up.

Anyhow, earlier I started having anticipatory anxiety about the situation: Not only would I have to face this perfect being but I also don’t feel comfortable asking for the documents since I don’t think they could provide them. And so, I started coming up with ways to get out of going–

  1. I could lie to my boss by telling him that I went and that they either didn’t have the documents or couldn’t give them to me.
  2. I could call in sick.
  3. I could call the tax office to see if they could even provide the documents.

The third choice seemed the most logical, but I’m terrified of making phone calls, especially when I have time to think about what I’m going to say beforehand, so I wanted to do the first choice. Eventually though, I talked myself into calling, which was horrible in itself, but I found that I was right: They couldn’t give me the documents after all.

I’m now beating myself up, telling myself that it wasn’t that bad and I shouldn’t have been fretting about the situation at all. I’m also disappointed in myself for avoiding another social situation.

Why can’t I look at the good parts? I mean, I made the phone call even though I was terrified and obtained an answer without lying. Those are positives, I guess.

If I’m not perfect then I’m nothing at all.

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Posted in cbt, negative thinking, perfectionism, social anxiety

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three things (and four stages)

Posted on May 29, 2011 | 8 comments

First, sometimes I cannot trust myself. Losing your capacity to reason isn’t quite as bad as thinking you can still reason when it’s clearly illogical (in retrospect, of course). I need to do my best to question my logic. Logic can be its own monster. That is, fallacies and distortions can build on one another, creating what appears to be logic–but it’s far from it. Staying connected with others and communicating more with them will help me stay on top of my own distorted thinking.

That said, I think there are instances where death makes logical sense–and suffering from mental illness(es) can be one of them. However, I owe it to others and more importantly myself to exhaust all options before even considering death. I need to grind away at each day no matter how difficult life becomes.

Second, killing myself will affect so many more people than I realized. I tried my best to push people away. But I now know that no matter how much distance I put between myself and others, they can still see me–and will be greatly affected by my loss in ways I cannot even begin to imagine. I thought I could simply die unnoticed. I was wrong.

Finally, I need structure now more than ever. In The Four Stages of Spiritual Development, the author, Scott Peck, posits that there are four stages of spiritual growth (from Wikipedia)–

  1. Stage I is chaotic, disordered, and reckless. Very young children are in Stage I. They tend to defy and disobey, and are unwilling to accept a will greater than their own. They are extremely egoistic and lack empathy for others. Many criminals are people who have never grown out of Stage I.
  2. Stage II is the stage at which a person has blind faith in authority figures and sees the world as divided simply into good and evil, right and wrong, us and them. Once children learn to obey their parents and other authority figures, often out of fear or shame, they reach Stage II. Many so-called religious people are essentially Stage II people, in the sense that they have blind faith in God, and do not question His existence. With blind faith comes humility and a willingness to obey and serve. The majority of good, law-abiding citizens never move out of Stage II.
  3. Stage III is the stage of scientific skepticism and questioning. A Stage III person does not accept things on faith but only accepts them if convinced logically. Many people working in scientific and technological research are in Stage III. They often reject the existence of spiritual or supernatural forces since these are difficult to measure or prove scientifically. Those who do retain their spiritual beliefs move away from the simple, official doctrines of fundamentalism.
  4. Stage IV is the stage where an individual starts enjoying the mystery and beauty of nature and existence. While retaining skepticism, he starts perceiving grand patterns in nature and develops a deeper understanding of good and evil, forgiveness and mercy, compassion and love. His religiousness and spirituality differ significantly from that of a Stage II person, in the sense that he does not accept things through blind faith or out of fear, but does so because of genuine belief, and he does not judge people harshly or seek to inflict punishment on them for their transgressions. This is the stage of loving others as yourself, losing your attachment to your ego, and forgiving your enemies. Stage IV people are labeled as Mystics.

I for one believe that no one person is totally in only one stage at a time–we fluctuate across many stages throughout our  lifetimes, often residing in more than one stage at a given time and between stages as well. At this point, I find myself mostly in stage one. I still carry with me pieces from the other stages, but, for the most part, I unraveled, tried to kill myself, and now am left vulnerable, disordered, and reckless.

Now, I don’t believe that organized religion is the only means of finding structure in Stage II. I’ve decided to focus more on my job, as well as to start studying for an Enrolled Agent exam so I can move up in my company and get a raise. I’d also like to spend more time writing and connecting with others through my blog. Reading, exercising, and cooking are also on the agenda.

Sorting through the pieces of what’s left from my suicide attempt is all I can do at this point, and I need to take it slow, one day at a time.

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Posted in beliefs, interventions, social anxiety, spirituality

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always wishing i was somewhere else

Posted on March 1, 2011 | 26 comments

I’ve spent most of my life dreaming of either being somewhere else or being someone other than who I am. For example, for the longest time I wanted to be a writer. I spent over five years working on a novel. I put that dream on hold last year and started writing flash fiction. I got a few stories published, but I gave up after that. My perfectionism makes writing really, really hard. Plus, I can’t handle rejection. I guess it’s not even really like I thought I could be a writer; it’s more like I used the thought of possibly being a writer to propel me forward, through my depressions.

Lately, I’ve used running to push me through. In the past, I’ve put my hope in life transitions, like going to college or moving to New York, to get me through the day. I remember when I made the decision to move to New York and bought my one-way ticket how good I felt. No matter what was going on in the present, just the thought of that ticket made everything better.

You see, I thought the transitions would change me. I thought moving to New York or running seventeen miles or writing a book would change who I am–that is, I would no longer be depressed or anxious. This thinking not only took me out of the present moment, it pushed a lot of negative feelings aside. Instead of dealing with my problems, I focused on the future–something that doesn’t even exist–and suppressed my feelings and emotions.

I think this deep, all-encompassing depression I’m feeling now is all those feelings and emotions catching up to me. I’m running out of options. I’ve tried a lot of things. I can’t run anymore. I have to be present–and the present is complete shit when there’s no hope.

Maybe awareness will save me?

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Posted in beliefs, depression, perfectionism, theory

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phone therapy

Posted on December 23, 2010 | 20 comments

Three posts in as many days! I don’t know what’s come over me. 🙂

***

So, since my therapist is out of town this week we arranged to have our regular session over the phone yesterday. I was dreading the session most of the day, even more than usual actually because I don’t like talking on phones. I don’t like checking voice mail. I don’t like seeing/hearing others talk on their phones. I don’t like hearing them ring (or vibrate, in my case). I cringe when I hear other people’s phones ring. I’d get rid of mine, but that probably wouldn’t be smart for someone with social anxiety.

It must have something to do with the fact that there are no distractions over the phone. It’s me and the other caller–that’s it. There is no one else to take the spotlight off me. There are no external distractions either, like television or eating or music or a movie, etc. But there are no distractions like that in therapy anyway, so I don’t know what I was so afraid of.

Anyhow, about thirty minutes before the session started, tension, nervousness, and anxiety hit. I just wanted to get it started (or over with). My stomach hurt, and I began sweating a little under my arms. I felt like I was getting ready to go to a large social gathering or something. I think it must have been the combination of the phone and pre-therapy jitters.

I’m probably freaking out about nothing, I told myself. So I’m going to stop  indulging in my negative thoughts. Once I became aware of what was happening and told myself to stop, I felt better.

***

The session started like all our other sessions. We talked a little about how this–therapy over the phone–is new territory for us and what not. I wish we would have explored my phone-phobia a little more. I brought it up, but we quickly turned to other things.

I told him about how I was feeling anxious about Christmas, about how I’d be seeing my relatives. I told him how anxious I felt as soon as I found that out. We spoke about this for a while (mostly about how I’m afraid of interacting with my cousins’ children) before he said–

“You can push back if you want but what I think it all comes back to is self-acceptance. It’s okay to be introverted and reserved. It’s okay to be soft-spoken. But these things are not okay for you.”

He went on and on, and yet I was still stuck on his words push back. It had a negative connotation to it. To me, the words said–

Now you can push back, but if you do, you will be wrong because I am the therapist and I am right.

After he got done talking about self-acceptance, we were both silent.

“Where are you?” he asked, finally breaking the silence.

I told him the truth. I told him how I didn’t hear much of what he said because I was still stuck on him saying push back. I told him how I’m uber sensitive to his wording sometimes and how I’m afraid to stop him because I’m afraid he’ll say I’m just avoiding things (like he’s done in the past). We had a good discussion about that, and I feel a little better about it, actually. I think he understands better that when I do stop him, sometimes it’s not that I’m avoiding–it’s just that I want to say something and that should be okay. I don’t think there has to be a hidden/deeper meaning in everything.

One thing interesting that he did mention is that therapy is the one place where I can–and should–feel comfortable pushing back. A lot of times in life, I want to do that, but I just don’t have the self-esteem.

We then went on and talked more about the letter (part 1, part 2) I sent to my parents and how I can use that to start more discussions. I’m scared to talk more about it, yet I do want a closer relationship with my parents. I know my relationship with them hasn’t changed because of one letter. I have to keep moving forward, and I feel a lot of pressure to do that.

Finally, at the end of the session, I started getting flooded with anxiety, as I always do, and I checked out by browsing Facebook. When we finally said goodbye, I found myself looking at pictures of someone from high school who used to pick on me. Whenever I get on Facebook I’m unconsciously brought to the people who did me harm. I should probably bring that up in a future session, among other things. I’ll add it to the list.

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Posted in about me, introverted, social anxiety, therapy

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Autobiography in Five Short Chapters

Posted on December 19, 2010 | 14 comments

Chapter 1

I walk down the street.
There is a deep hole in the sidewalk.
I fall in.
I am lost … I am helpless.
It isn’t my fault.
It takes forever to find a way out.

Chapter 2

I walk down the street.
There is a deep hole in the sidewalk.
I pretend that I don’t see it.
I fall in again.
I can’t believe I am in this same place.
But, it isn’t my fault.
It still takes a long time to get out.

Chapter 3

I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in … it’s a habit … but, my eyes are open.
I know where I am.
It is my fault.
I get out immediately.

Chapter 4

I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it.

Chapter 5

I walk down another street.

***

I love that poem. It’s from There’s a Hole in My Sidewalk by Portia Nelson. I feel like each chapter represents a stage of my recovery.

Chapter 1 encompasses my middle school and high school years, when social anxiety began to develop. I started avoiding social interaction by ending friendships and isolating myself; developing powerful, yet irrational beliefs and attitudes; and reinforcing those same beliefs and attitudes with my thoughts and actions–all while being unaware.

The years (early college) which make up Chapter 2 are even harder than the previous years, as I’m in denial. I know that I am an introvert and highly sensitive, yet I know there’s much more to it than that. That is, I know there’s some deeper issues. I avoided them by locking myself in sexual relationships, avoiding friendships, and abusing alcohol. I was absolutely miserable, yet I put up a happy, normal facade. I hid my problems well, and that’s the only way I knew how to cope–because I didn’t know what was wrong or where to seek help.

Chapter 3 represents my latter college years and the year I spent in New York after graduation. By that point I knew I suffered from Social Anxiety Disorder. I knew I kept people at a distance because I was afraid of what they may see inside. And I knew I needed to seek professional help, but I didn’t. Again, I coped by drinking and denying; however, those tactics began to lose their power because I knew there was a deeper issue.

Today, I’m somewhere after chapter three but before five. (I don’t want to say I am in Chapter 4 because sometimes I feel like I’m beyond it and sometimes I feel like I’m not even there yet). I am seeking professional help. I am aware of my thought processes and where they can take me. I know not everybody is a fan of CBT–or its wording and metaphors–but it has greatly helped me. I know, for instance, that certain thoughts will lead me down familiar roads, and I know at the end of those roads, there is nothing good there. I know that if I continue to take those roads, I will continue to feel a certain way. I haven’t totally changed my habits, but I am getting closer. I think Chapter 5 is in sight.

Now, for those who are at an earlier stage, there is no shame, because how you are feeling is not your fault. You are not explicitly choosing to feel anxious or depressed. We’re all at different stages, and we’re all in this together. What’s more, recovery is not linear. You don’t go from bad to good to better to best. Sometimes I’m in Chapter 4; other times I move back to Chapter 2–but, in the end, I am moving forward. More and more of my time is spent in the latter Chapters.

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Posted in cbt, introverted, negative thinking, past, social anxiety, social anxiety disorder, spirituality, theory, therapy

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in a safe place

Posted on December 6, 2010 | 21 comments

For longer posts, dealing more with theory, I usually start writing them three or four days, sometimes weeks, before I post them. I have an idea in mind, and I like to watch it grow, like a piece of art. As of late, though, my moods have been fluctuating so much that I often times abandon my original idea altogether or change it so much that it barely resembles its original form–which is the case for this post (the latter issue, that is).

***

Put simply, I had to give two class presentations this past week. One on Thursday, and the other on Sunday. I haven’t had to do any sort of public speaking in over a year, so I clearly was very nervous/anxious going into it. I decided to try to get some of my thoughts out to help not only understand the anxiety (and where it’s coming from), but alleviate it as well. What you’ll soon find out is that the presentations went well. Sure, I was nervous, but I did fine, probably better than most people, in fact.

Anyway, here are some highlights–

Anticipatory anxiety hit me on Wednesday: I feel like shit. My stomach is tense and wound up in a knot. I’m having trouble swallowing. I’m sweating. I feel like I should take an Ativan or something, but I sort of feel like I’m becoming dependent on them. But none of my relaxation strategies are working. I’m sick (with a cold), so I can’t go running. I don’t know what to do.

Honestly, I’m mostly worried about the questions after the presentation. What if I won’t be able to answer them because I’m flooded with anxiety? What if I sound nervous? What if I fail?

I eventually calmed down, but anticipatory anxiety returned before my presentation (no surprise there): My presentation is in less than 3 hours. I’m in denial (sort of). I just ate, took an Ativan (1mg) and a Propranolol (10mg), and went over my presentation again. My stomach is tense. I’m sweating pretty bad, especially under my arms, and I feel an impending doom. I know the negative thoughts are hidden under this doom, but I’m scared to see what’s under there. I wish I had therapy tonight–and I wish even more that I hadn’t skipped therapy on Tuesday (because I was/am sick).

Again, the presentation went fine: It’s over. It didn’t go bad at all. I got hung up on one question, but overall, it went really well. I feel stupid for making a big deal out of nothing. About five minutes before the presentation started, I chatted with the professor and the other students. I then stood up, shook my body all over, and then went to the mirror and smiled (to make sure I still could). This helped to calm me down. I can now strip off my sweat-stained undershirt and move on.

Anticipatory anxiety started again on Sunday, about seven hours before my next presentation. I’m starting to feel a bit nervous. I feel that impending doom again. It’s scary because I don’t know what lies beneath. It’s unknown. Thoughts, on the other hand, are tangible, while this feeling is not. I can hold thoughts. I can touch them. They are real. But I’m too scared to find those thoughts.

Then two hours before the presentation depression hit: I’m depressed, and I DON’T GIVE A SHIT ABOUT THE PRESENTATION. I don’t know where these feelings came from or why I’m having them. Maybe they’re connecting with this doom feeling?

The depression wore off for the presentation, leaving me with anxiety, but it came back immediately after: Well, the anxiety  pushed the depression into the background. I took an Ativan (1mg) before the presentation. Again, the presentation went well, and, again, the anticipatory anxiety was much worse than the actual presentation. I feel good about the week, but depression is hitting me again. I’m scared.

***

By the end of the night I was really low. I binged on food, drank a big beer, and had a cigarette (the first one since the wedding)–nothing helped. I woke up feeling even lower. What’s going on? I asked myself. I had a fairly good week. I mean, I not only got through the presentations, I did really well. I should be feeling good. I should be feeling great. As always, though, there’s much more going on than what meets the eye.

Actually, depressions usually hit me after successful social situations because that part of me that wants to be messed up–that part that likes having social anxiety, that part that I know, that part of me I think is me–flexes his muscle and brings me down. He, my anxiety, wants to maintain control. Does that makes sense? However, I still think there’s more there.

I’ve been triggered by quite a few things this week, namely this post and this post and this post and the movie Black Swan.

For the sake of length, I’ll try to not go into too much detail.

As some of you know, I’ve been dealing with this question as of late–Without social anxiety, who am I? The answer is a resounding I DON’T KNOW!, which is exactly why I’m so scared to find out, which is exactly why I sometimes like my anxiety–and even fuel it. My illness is warm and fuzzy; it’s familiar; in some ways, it’s all I know about myself.

There’s also my perfectionism, my need to always be perfect. I can’t make mistakes. I can’t have any flaws. I have to anticipate every move. I have to always be on the guard. And yet, perfectionism, is about mistakes, because a perfect human is flawed. Thus, by not allowing myself to make mistakes, I prevent myself from not only being perfect, but knowing what it means to be truly human. There is a part of me that does want to let go, but I’m still wrestling with the question of what exactly that means–and how to go about doing it when all I know is rigidity and repetition and compulsion.

But maybe I got a glimpse of what it was like to not be hindered so much by anxiety or my perfectionism this week? I engaged with people and was able to give two presentations without feeling too much anxiety. I also let go (somewhat) during them. I allowed myself to fail a bit on the question and answer section afterward. I could of been more thorough. I could have answered them better. But, frankly, I didn’t give a shit. I also have a huge, 15-page paper–30% of my grade–due on Thursday that I haven’t even started–and, again, I don’t give a shit.

I’m wondering, am I feeling depressed because I’ve seen a glimpse of myself in a new light–without so much anxiety and perfection–and not liked what I saw? Or is my ego (my anxiety) just flexing it’s muscle, wanting to maintain control?

***

Finally, without my anxiety, I’ll have to deal with deeper issues–

I really hate this system I’m living in. As reminded here, we’re just living a joke (capitalism) and our lives are the punch lines.

Here, I’m left with the difficult question of how do I fill this void inside of me? I’m continually looking to the future for happiness. That is, my next goal, my next achievement, my next cure, etc. What happens when there is nothing left to cure? What happens when I actually have to start living, and what if I really don’t believe there is any point to living besides not dying?

Finally, here I’m reminded that these feelings I’m having are temporary. In fact, I’m feeling much better now–but even that is temporary.

How did I know that someday–at college, in Europe, somewhere, anywhere–the bell jar, with its stifling distortions, wouldn’t descend again?  ~Sylvia Plath, The Bell Jar

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Posted in alcohol, beliefs, binges, cyclothymia, depression, food, medication, negative thinking, perfectionism, self-harm, social anxiety, social anxiety disorder, spirituality, theory, therapy, uncategorized

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is social anxiety real?

Posted on November 29, 2010 | 17 comments

Please note: I wrote this post for the first ever Blog Carnival of Mental Health. The topic is diagnosis.

***

So, as many of you know, WordPress allows me to see what people search for to find this blog. As of late, I’ve had some alarming searches, namely–“is social anxiety real” and “is cyclothymia real.”

I guess it’s good that people are questioning their inner experiences, but I’d like to know to what end? Labels are dangerous. It’s very dangerous to define yourself by a set of labels (or diagnoses) because you limit yourself. For example, if you say, “I have social anxiety, so I should be acting a certain way,” you can literally limit yourself to those courses of action. I also believe that the pharmaceutical companies profit greatly on these labels. If they can make us believe we have something wrong with us (i.e., a particular diagnosis), when in fact there’s not, then they can profit at our expense.

I think it’s easy to forget that there is a big difference between experiencing some anxiety during social experiences and having Social Anxiety Disorder (more on this here).

However, diagnoses can also be good, namely because they allow you to get the treatment you need. If you don’t understand your inner experiences, it’s hard to get treatment. When I finally sought out professional help, I felt greatly empowered. I took back some control from my anxiety, but I also had to take responsibility for my well-being. In other words, I had to do the work inside of therapy and out, to learn strategies on how to manage my social anxiety.

In a sense, the people who conducted those searchers are right–labels aren’t real. They’re only the tip of the iceberg. When we label things (without looking deeper), we ignore the essence. We ignore what’s really going on. I think it’s good to question your labels and diagnoses, as long as you are still addressing your inner experiences–because those are real, without a doubt.

If you deny the way you feel, you only strengthen the negative emotions, in my opinion. You must learn to accept.

***

As for me, I’ve been suffering with social anxiety since high school. It took me a long time to figure out though what was going on. I just thought I wasn’t trying hard enough and needed a stronger will to get through social situations. I’ve since found out that only makes the anxiety worse. Anyway, I was officially diagnosed with Social Anxiety Disorder in the Fall of 2008, and I was just diagnosed with Cyclothymia this past August. In both instances, I felt relieved, because I could finally explain what was going on inside of me–and start getting the treatment I needed.

EDIT: All the posts on the Blog Carnival can be found here

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Posted in about me, cyclothymia, labels, past, social anxiety, social anxiety disorder, theory

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perfectionism or punishment?

Posted on November 24, 2010 | 23 comments

Why are pdocs always late? I’m always having to wait at least fifteen minutes after our scheduled appointment time. It’s not fair. Because of I was late like that, I would probably get a lecture on the importance of being on time. It throws my day and all my structure off. On days I have to see him, I can never plan for anything after. Anyway this time I decided to say something–

“Right on time, as usual,” I said, quite passively. His non-response indicated that he didn’t appreciate my sarcasm.

I had high hopes for the session. I wanted to drop the other medications I’m on–Lamictal and Klonopin–and start taking Nardil, as a friend of mine with social anxiety has found Nardil quite helpful. The problem was/is that my pdoc hasn’t prescribed Nardil in over twenty years as he had a patient almost die while on it. You see, there are some dangerous food interactions, particularly alcohol, cheese, aging fruits and vegetables, some meats, soy, and so on. It’s quite alarming. You could eat the wrong kind of cheese and end up in a hypertensive state and have a heart attack.

But if the ends justify the means, I think I can live with the reduced diet–and the risks. My pdoc, however, wants to exhaust all other options first. So, he increased my dose of Klonopin and added Xanax into the cocktail (both of which, I might add, I’m having trouble filling due to insurance restrictions–so frustrating). Anyway, I came out of my appointment disappointed.

Oh, and I also got lectured.

My perfectionism came up. I told him I’m frustrated because I don’t have many friends, and outside of my relationship, I pretty much only hang out with my girlfriend’s family. And since she has a large family, I pretty much bounce from one large group social gathering to the next. I don’t believe that type of exposure works. I need gradual exposure. I need to see small successes and build from there. I won’t get any better if I continue going to huge social gatherings. But I don’t feel like I can opt out of them, either. Otherwise, I would just sit around the apartment, isolated.

“It’s okay to avoid things,” he said. “In fact you need to take back control from your anxiety and start saying ‘NO!’ every now and then.”

“But then I’ll be completely isolated,” I said.

“You’re going to school, you’re starting an internship, you have a girlfriend–you don’t sound isolated to me.”

“I’m going to school online,” I countered, “which isn’t helping my anxiety. I’m scared to death of the internship. I’m too dependent on my girlfriend.” We sat in silence for some time. “I can’t help but think this way. I know my perfectionism is fueling my anxiety but I can’t control it.”

“Mike, it’s not perfectionism. It’s punishment. You’re punishing yourself for not being perfect, and by doing so, you’re giving control to your pain. You still have control, though, but you don’t feel like you have it anymore, because these beliefs of yours are so ingrained. I don’t think you’re challenging your beliefs enough.”

I’ve been in therapy for over a year–is that not enough? But he’s right. I do not feel like I have control. I feel like I am my anxiety. I am my beliefs. I am who I say and think I am. How does change occur, though? It’s easy to intellectualize this process, but that can only take me so far. Change is deeper, in areas that I don’t like to touch. In areas I don’t know how to touch. When I do touch them, I shut down, I get flooded, and I push away.

He also brought up the issue of learned helplessness. I’ve failed so many times in the past, I do not believe I can succeed. I’ve taught myself how to fail. I’ve let my anticipatory anxiety get the best of me. I think I’ll fail, therefore I will fail. But maybe–just maybe–being conscious of this will help me change? I hope so.

***

Later on in therapy that night, my therapist asked, “What does it mean to be perfect? What does perfectionism mean to you.”

“It means I avoid being judged negatively,” I said.

There’s more but I don’t feel like typing it out. It was a tough session, to say the least. He pushed right up against my beliefs, and I pushed right back, shutting down in the process. I feel like we’ve been at a standstill for some time now. Why does change have to happen so slowly?

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Posted in beliefs, medication, perfectionism, self-harm, social anxiety, theory, therapy

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high to low and back again

Posted on November 22, 2010 | 22 comments

I started writing this post yesterday afternoon, and it was originally called, stable .. for now, but nothing I wrote felt right, and by the evening I had abandoned it altogether. Some highlights–

I’ve been fairly stable since the wedding. That is, not depressed. I’m caught up with schoolwork again, and I’m starting to enjoy activities again, like reading, writing, running, and cooking. (I even went to a yoga class on Friday!) I’m looking forward to seeing my student on Wednesday and tutoring in general (I volunteer at an adult literacy center), as well as Thanksgiving. (I’m not delighted about being around fourteen people, but I do want to see if my mood holds up and how, or if, that will affect the outcome of the social situation. Plus, I want to test out some of my new cognitive techniques. So, it’s not so much about the social situation itself; it’s more about seeing whether I can get through it without being flooded with anxiety [an experiment, really]. And I’m actually feeling more confident that I will be able to do just that, and if I don’t–NO BIG DEAL!)

I’ve been doing lots of CBT lately. I still don’t know whether it’s working or not–whether it’s affecting deeper change–but I do know that it’s changing the way I think. I’m more positive and upbeat. I haven’t been engaging in my normal destructive behaviors of finding faults in the past and using those to ruin the present, etc. It’s a strange feeling, really. I’m not comfortable with feeling good–or, more precisely: not feeling bad. I guess I’ve just been feeling neutral lately. I look to the future and I don’t get the hopelessness that I got a week ago; it’s more like a staleness.

Finally, I’m also excited about trying a new drug. I’m not comfortable with taking Klonopin daily, so I’m going to talk to the pdoc on Tuesday about trying an MAOI–Nardil. A friend of mine who also has social anxiety is on it and I have noticed a huge difference in her behavior. Yes, MAOIs have some pretty bad side effects and you have to be on a strict diet to avoid hypertension, but maybe the ends will justify the means (for once)? I just have to talk my pdoc into it, because he had a patient die while on Nardil because s/he ate the wrong kind of cheese (aged) and didn’t seek medical attention.

Anyway, somewhere between writing and watching a football game and reading and taking a bath, my mood changed. By the end of the night, I was pretty low. Actually, I could feel my mood turning pretty much throughout the evening. My energy level dropped, and I couldn’t do the things I wanted to do. I’ve been pretty hyper (or hypomanic) this past week. I’ve bounced from activity to activity to activity. I haven’t given myself much leisure time or given myself time to think about things, which is good and bad. Sure, I didn’t think about the bad things, but I also didn’t get to process and own my negative feelings. I pretty much suppressed everything throughout the week, and maybe some of the those feelings were coming up while I was writing.

It’s a strange feeling knowing that your mood is going to turn. I started to panic a little, actually. I wanted to do everything I could to stop it from happening. I stopped writing altogether, and I tried to just sink into the feelings a little with the hopes of crying. I always feel better after I cry. I think it allows some of the feelings to release. It’s healthy. But it’s very hard for me, especially now that I’m on medication. I need to find more triggers. Last week I found a good song that brought me into tears almost immediately but I played it like ten times over the week, so when I listened to it last night, nothing happened. I need to find more triggers. What works for you?

I’m also very stressed about school and the holidays in general. I have three papers and two presentations to do in less than a month. The papers are no big deal. Sure, they’ll be a lot of work, but I’m more worried about the presentations. For those who don’t know, I’m in an online graduate program studying Library and Information Science. I’m becoming a librarian. Anyway, the presentations are done over a conference call, and even though they aren’t in person, I’m still a little upset about them. CBT is helping, though–I may have had lots of anxiety in the past, but I’m doing better. And it may not go exactly how I want it too, but I will get through it–and it will be okay. Again, I don’t know how much of that’s suppressing my feelings and how much of that is subtly dealing with the feelings but not letting them take control. I don’t know.

The holidays are another big thing. Thanksgiving is coming up. As I said before, I’m going over to my girlfriend’s brothers, where fourteen people from her family will be there. I am still hopeful that I’ll be able to get through it without getting flooded–with the help of Ativan and Propranolol, of course. I’m counting on there being a little anxiety there, just not the debilitating kind like I had at the wedding. I want to be able to converse with people and smile and not have to worry about sweating through three sets of shirts and looking like a complete idiot all the time.

I’ll address Christmas at a later date.

So, with my mood rapidly changing, and without being able to release some of the pent-up emotions through crying, I went to bed feeling like I’d wake up feeling even worse. But here I am. I feel a little down, a little stressed and depressed, but a little happy and hopeful too. Maybe I avoided a depression? I don’t know, only time will tell. But for now I am going to continue with what I’m doing: schoolwork, running, keeping myself busy.

Oh and I probably won’t be updating much until the end of the semester (12/9). I hope you are all doing well, by the way.

Finally, I’m curious how you deal with things when you know your mood is getting ready to turn. Do you just accept it, knowing you can’t change it, and try to do your best to weather the storm? Or are you more proactive about it–are there ways for you to avoid the depression altogether, or at least lesson the severity of it?

Thanks for reading, and I look forward to hearing from you. 🙂

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Posted in cbt, cyclothymia, depression, medication, site news, social anxiety, theory

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