To Save a Tooth

“How can someone so young and healthy have such a serious problem with their teeth?”

The endodontist (root canal specialist) actually asked this during our meeting today – after I’d described a previous dentist’s theory that over a decade of grinding my teeth had caused a cavity to form inside one of my molars. It had decayed from the inside out, to the point where I almost needed a root canal when the cavity was finally detected about a year ago. I thought the dentist had fully treated it, but he only inserted a temporary filling. Some miscommunication must have occurred because I didn’t realize any follow-up was necessary.

Now my gum is badly swollen from an infection – that came back worse after I’d finished the antibiotics I was prescribed four weeks ago. It’s actually less painful now, but still very uncomfortable and so sensitive to the touch I can’t brush my teeth the way I’m used to. I feel like I have a bean wedged between my gum and cheek, and my jaw is sore on that side. I really miss being able to chew on both sides of my mouth and I’m concerned about how a gum infection might affect my overall health.

The endodontist couldn’t have performed the root canal with the infection there anyway, but he pointed out a bigger problem. I’m in danger of losing the molar next to the one that was supposed to receive the root canal because it’s the one that is infected. Ironically, the endangered molar is the one I thought needed treatment; my only complaint about Root Canal Molar is that it feels weird when I touch it with my tongue because it’s the very back tooth and I think half of it is missing. No pain; food gets stuck back there sometimes but I get it out with floss, everything’s fine. Apparently it might actually need a root canal or I could lose it, but again, there’s a much bigger problem.

My poor Endangered Molar has been assaulted by an alien civilization for at least the past two months! In addition to the gum infection, there is evidence of significant decay in the roots, possibly bone? I am in serious trouble. I really need to receive treatment for this … well, apparently, about a year ago.

The endodontist is not qualified to deal with gum infections, and is not authorized to give referrals to see a periodontist (gum doctor) or oral surgeon. So, I had to go back to my primary dentist in order to take further action. I was so furious, I was ready to start destroying things. When we got home I saw that Dog had gotten into my kitchen garbage! I was so angry, I told Mom to take him upstairs so I wouldn’t kill or seriously injure him. It was terrifying and so frustrating because I didn’t have a safe, socially acceptable way to express my rage!!!

I called my primary dentist and learned she could see me if I arrived within the hour. Within about 5 minutes Mom was driving me there; we arrived just in time. She asked questions and took X-rays and said I had two options: I could go to the periodontist to try and save the tooth, or I could go to an oral surgeon to get it pulled.

To be completely honest, if money weren’t an issue I’d say pull the fucking tooth, clean out the infection, and give me an implant. But implants aren’t covered by insurance and can cost up to $3,000. That’s more than my wedding dress! I could get the tooth pulled and not get an implant; this might be what I end up needing to do, anyway. I don’t think a bridge would be an option due to the location of the tooth; the dentist didn’t mention it as one.

But everyone – by which I mean the dentist and my mom – seems hung up on “but you’re so young!” and “it’s really better to keep your own teeth.” There’s a chance a periodontist might be able to help me, so it’s best to take that chance and get the tooth pulled only if it doesn’t work. I expressed some uncertainty, so the dentist made the decision for me: we’ll try the periodontist first. This way the dentist doesn’t have to feel guilty (I don’t think I’d feel any guilt, sorry Endangered Tooth – regret maybe if I then experience problems, but not guilt) and I might get to keep my tooth until I’m old enough for extraction and replacement to be okay. I’d need to wait for the antibiotics I’m now on (again) to kick in and (hopefully) clear the infection before I could go to an oral surgeon, anyway.

Here’s the really fun part. I could get an emergency referral to see an oral surgeon, but my insurance doesn’t see gum infections as requiring emergency treatment. They wouldn’t approve the emergency periodontist referral over the phone; there’s a chance they might not approve it at all! I have to wait 2 to 3 weeks before I’ll even know if I can see the periodontist, never mind then having to make an appointment! The infection will probably come back and/or get worse in that time, and who knows? Maybe more of my teeth will be in danger.

The receptionist said I have to wait for the referral to come in the mail, but if I had X Better Insurance she could write a referral and hand it to me.

Pissed doesn’t even begin to cover it.

You might be wondering, what do dental issues have to do with mental health? Well, let’s see.

1) “How can someone so young and healthy have such serious problems with their teeth?” Well, sir, perhaps my health issues are not readily apparent because they aren’t medical, in the sense most people are used to. I have mental health issues, which impact physical health as well. In my case, they clearly affect my dental health! For example, I GRIND MY TEETH!!! due to chronic tension from repressed anger and overwhelming anxiety.

2) I’m not working because my mental health issues are severe enough that I can’t even follow through with a job interview. I don’t trust my mood to be stable enough for me to show up for work consistently, and my anxiety levels to be low enough to function once I get there – assuming I can manage to be on time. Wakana would say I’m being too hard on myself and I should focus on the times I have been punctual and consistent. But I don’t have to do it every day; when I have had to do it every day I’ve struggled. I need help getting to the point where I can try it again.

Anyways, not working means no income means I can’t afford better insurance or to just pull the fucking tooth already and give me a titanium implant.

3) It’s really hard to do things like stand up for yourself to make sure you get the best possible care, drag yourself to the dentist and wait Spock knows how long hoping you’ll get seen as an emergency patient even though you don’t have an appointment, and deal with the stress of going to the fucking mall to see an overbooked dentist with staff that is probably overworked and underpaid and sick of being the person patients get angry at when their insurance is being sadistic. It’s even harder when you have mental health issues (especially being more attuned to other people’s needs and emotional states than your own). I would rather pull my own tooth without so much as taking ibuprofen first, than deal with the headache that is going to the dentist!

Hmm…

4) When you have a mental illness(es), you start to rely more on other people’s judgment; sometimes you trust it more than your own. “Maybe I thought he was being a jerk because I was wearing depression goggles.” “Maybe the chest pain I’m experiencing is from anxiety.” “Maybe I’m having these symptoms because I read that they’re potential side effects of the medication I’m taking.”

I know I can’t always trust my thoughts and feelings because they tell me things like “nobody loves me” and “I can’t do anything useful” and much, much worse. I rely on people reminding me that those things aren’t true and encouraging me to think about situations from other, more creative, and generally more positive perspectives.

So if you’re in a situation like I was last week, when the hygienist who did my cleaning said the pain I was experiencing from my infection was “normal,” it can seem a bit “crazy” and “excessive” to insist on seeing the dentist anyway. They were busy, I was feeling overwhelmed, I didn’t want to be on antibiotics again anyway, and I’d just been told that my problem was no big deal. So I left. If I’d stood my ground (or had someone advocate for me like my mom did today) my gum might not be swollen. I don’t know if my teeth would be in any better shape, but at least I could brush them!

5) Extremely frustrating situations like this can trigger all sorts of painful, unhealthy, and outright dangerous thoughts. It’s even worse when the people who are supposed to help me when I have a serious health concern like this either don’t seem to care or care but can’t do anything because of bureaucratic red tape. I’m fortunate that I’m in a place where my primary concern is protecting my health, and that my mom was able to support me in expressing my anger – probably because she was angry and worried too.

I’m furious to think that I can’t get the help I need because of a rule my insurance company made up, that someone who has never even met me has to review my information, make a decision with more concern about the company’s bottom line than my health, and use fucking snail mail to communicate with me. It can be all to easy to internalize that ruthless capitalistic complete and utter lack of compassion, to absorb the message that I am worth less than someone who can afford to pay for a better insurance plan (or worse, unworthy of medical interventions, period). So for now I’m clinging to my anger like a life preserver; the hard part is doing that while keeping it directed away from myself.

Burn, Baby, Burn(s depression checklist)

I’ve been tracking my symptoms on the Burns Depression Checklist for another month; so far so good. (view July-August & August-September) Scores have remained in the teens on half the days, a phenomenon that was previously unheard of. My average score for the month was a 22, which is 10 points lower than last month!

A graph showing Ziya's scores on the Burns Depression Checklist from September 16, 2014 to October 16, 2014.

Ziya’s scores on the Burns Depression Checklist from September 16 to October 16, 2014.

There are several factors I believe have contributed to my improved mood. Reading The Drama of the Gifted Child inspired some profound healing in the last full week of September. The most conventionally “sane” way to word it is probably that the emotional and presenting-myself-to-the-world aspects of my psyche became more integrated, so I can acknowledge, express, and act upon my emotions more easily. This helps me to feel more alive; all the energy that went into suppressing my emotions is now available for, well, whatever I want to do. It’s wonderful and amazing and just… Wow!

I started taking the Lamictal my APN prescribed on Monday, September 29th. This is represented visually on the graph above by a vertical purple line. I’ve been taking the Lamictal consistently at about the same time every day for over two weeks. I hesitate to say it’s working just yet, but so far I’m feeling very positive about it. In addition to the Lamictal, I started taking Omega 3 and Vitamin D supplements on October 8th.

Additionally, Fox was offered a job that he’s really excited about, and not just because he finally has income! His energy levels have skyrocketed since he started working; that’s been a huge inspiration for me. I get the time to myself that I’d been craving, and when he’s home I’m thrilled to spend quality time with him. We actually have things to talk about because we’ve been having different experiences all day! There are adjustments, as always, but overall it’s been a real boon to our relationship. I wasn’t kidding when I said the sexiest thing he could do was get a job…

Finally, the dates that have a blue horizontal line under them in the graph above are days I spent with Banji. This past weekend was particularly wonderful; we got away from the stress of our respective lives and got to spend a few days talking, making art, playing music together, and enjoying the fall foliage. I went about 24 hours without using a computer or smart phone and it was amazing! I had all this time; I didn’t know what to do with myself! So I colored in my sketchpad, took a walk outside, tried to sneak around like my Skyrim character, and interacted with living breathing 3-dimensional people using spoken words, vocal inflections, and facial expressions. And laughed, oh, the laughter! I even cooked and cleaned up afterward!

By the time I got home I was a bit tired of socializing and just wanted some time to myself. I tried to play The Sims 3 – not the best or healthiest choice, I know – and ran into all sorts of crazy glitches. I got very frustrated because people kept interrupting me, especially my mother. I try so hard and I think she does too but I still find our conversations to be emotionally draining – especially when she’s hounding me about the things I still need to do for the wedding. That just makes me want to shut down and block everything out even more!

Considering the abrupt change from vacationing with Banji to feeling emotionally drained at home without her and not coping all that well, I’m optimistic to see my scores gradually climbing from 13 on Monday to 30 yesterday. It’s less disruptive than the wild oscillations I’ve experienced in the past; I expect that I can bring the score back down (representing a reduction in depressive symptoms) by practicing some of the things I enjoyed so much while on vacation: less time in front of the computer, more time engaged in creative pursuits. Another way to reduce my symptoms is to actually do the things Mom’s been hounding me about, because then she won’t feel so anxious anymore, so she’ll have less emotional garbage to heap on me. This solution has the added benefit of completing the steps necessary to successfully prepare for my wedding. Win-win!

In addition to the overall lower scores, I had a truly amazing thing happen last week. For the first time since I’ve been tracking, and otherwise for I have no idea how long, I had 8 consecutive days without suicidal thoughts or urges. It was wonderful! (My “relapse” yesterday was triggered by a very specific situation that has been dealt with and is easily avoidable; if I choose to write about it in this blog I’ll do so in another post.)

A graph showing Ziya's (standardized) scores on the subcategories of the Burns Depression Checklist from September 16 to October 16, 2014.

Ziya’s (standardized) scores on the subcategories of the Burns Depression Checklist from September 16 to October 16, 2014. There are multiple instances when the purple line drops to 0 and disappears, indicating multiple consecutive days with no suicidal urges!

Considering the presence of other, shorter periods of time with no suicidal thoughts or urges earlier in the month, I’m optimistic that this has the potential to become my new norm. And that, oh wow! It’s not just about wanting to live. It’s wanting and being able to live while also being true to oneself. It’s having multiple options; seeing the full complexity of a difficult situation instead of just the discouraging parts. It’s knowing where my toolbox is, seeing the tools when I open it, having the confidence to use them, and making creative use of duct tape.

What I Need is What I Fear is What I Need

Wakana (my music therapist) has been helping me learn to assert myself, particularly in the realm of acknowledging, accepting, and acting on my emotions. I’ve learned to express my needs and wants, politely disagree, and set boundaries. I’m still working to develop these skills; it will probably be a lifelong process. But the foundation is there, and I feel pretty good about building on it.

The thing is, most of my work has been in the realm of one-on-one interactions. I have individual music therapy with Wakana. Our marriage counselor helps Fox and me have more intentional, supportive interactions with each other. I’m learning to assert myself in conversations with my mom, or situations in which Mom is accompanying me as I interact with another person (such as my dress fitting), or appointments with healthcare professionals.

I get lost in group situations. Even spending time with friends, there’s usually some point during our time together when I feel overwhelmed, overlooked, and unheard. I was barely able to participate in that one support group meeting I went to (no, I haven’t been back yet). Forget about being heard and acknowledged when my family is involved. I think about having most of my and Fox’s families all in one room just over a month from now and it seems like the worst idea I’ve ever had. If it’s not a disaster, it will definitely be overwhelming. I will probably be disappointed by at least some of them. What was I even thinking?

I really need to develop social skills. It’s not just me, people with psychiatric and/or mental health issues tend to have underdeveloped social skills. I’m inclined to believe that lack of a healthy home environment, same-age siblings or cousins, and appropriate modelling interfered with my ability to develop my social skills – particularly when it came to interacting within a group. I was also bullied and ostracized at school, which further limited my ability to practice social skills in a peer group. This in turn had a harmful impact on my mental health. I don’t know to what extent this hypothesis can be generalized, but we’re social creatures and society is the environment we have to adapt to.

Lack of social skills means we need group therapy and opportunities to practice interacting in structured group activities, so we can have some semblance of support in developing those skills. Actually, part of why I like tabletop gaming so much is because most games structure group interactions and lend themselves to turn-taking, so everyone gets some opportunity to be the center of a attention – seen and heard – for a short time.

Most of the psychological services I’ve been able to find in my area focus on the individual. Individual therapy, opportunities for individuals to submit their creative works to be posted online, classes individuals can attend and learn from that may provide some opportunity for group interaction, but that isn’t the primary focus. I have enough individual stuff going on, I really need to work on my social skills in a group. Why can’t I find one?

The answer is: because I’m afraid to find one. There’s a support group that meets weekly that I could be going to, but I keep finding some excuse not to go. I have briefly joined and enjoyed participating in at least 3 additional groups I can think of right now, I but stopped showing up after just one or two meetings, even though I’d had a positive experience.

I don’t know if it’s that I don’t fit in or I don’t want to fit in, or something else entirely. Maybe I want to abandon the group before it has the opportunity to abandon me – or worse, consume me. I don’t want being part of a group to mean losing my autonomy.

Being in a group situation takes all of my energy; I feel like I need to be at my best to come out of it feeling anything other than drained. To put it in terms of Spoon Theory, interacting in a group takes so many of my spoons that I can only do it on days when I have more spoons to begin with; most of the time it requires me to borrow spoons from the next day. Just getting out the door on time looking presentable can take several spoons. Sometimes, by the time I’ve introduced myself, I just don’t have the spoons I need to follow a conversation, navigate the complex thoughts and emotions that fill the room to the point where I don’t know which ones are actually mine, formulate responses, and get people to pay attention and listen to what I have to say. How can I develop social skills for interacting in a group if I don’t have enough spoons to exist in that group, never mind trying to learn something?

I need a group activity that restores spoons, such as creating music or art. Music in particular is a completely different way of interacting: you’re listening and “speaking” simultaneously, so everyone gets heard. You are a part of something bigger than yourself, you can hear it and that makes it so much easier to feel and internalize. Every part matters, even – no, especially! – the supportive, “background” parts.

I have less experience with art, but being creative is energizing. Focusing on my own artwork gives me a socially acceptable way to back out of the group activity a little bit to recharge without leaving it completely. It opens up the possibility of positive interactions, such as commenting on an aspect of someone else’s artwork (e.g. use of color) that I like. People are more likely to have and express more positive emotions that I don’t find overwhelming – I might actually get a high off them. I can also communicate something visually, so I don’t have to rely quite so much on the verbal communication I find so challenging.

Trying to find an arts-based group geared toward mental health in my area has been like hitting my head against a brick wall. Either I don’t know where to look, or they just don’t exist. I could reach out for help; that might be my best chance of actually managing to find something.

There are quite a few art-related groups in my area on Meetup.com; the difficulty I’m facing is selecting one I feel comfortable joining and might actually go to. Looking at some that seem promising, I feel like I’m going to cry because I simultaneously want to join in the fun and question my ability to do so. Will I be accepted?

Mental Illness Awareness Week

In honor of the work NAMI does, the first full week of October (10/5-11) is “Mental Illness Awareness Week.” People are encouraged to wear green, there’s apparently a solid green ribbon, and depending on your location there may be various events to raise awareness. People are also encouraged to “Tell your story and help inspire others!” – just be aware that the submission guidelines give NAMI permission to add or delete information as they see fit.

The phrases "It's time," "Mental illness affects everyone," and "Go green for Mental Illness Awareness Week" on a green background. There is a solid green ribbon in the center of the image.

Image from http://www.nami.org; Visitors are encouraged to post this as their Facebook profile picture and another image from the site as the banner on their timeline.

I have to admit, I’m not feeling particularly “inspired.” I’m pretty sure my “story” would be rejected because I don’t want to try to spin it (or allow it to be spun) to be a “message of hope” for other people. Frankly, I don’t think we need to spread “hope,” we need people to understand the harsh realities we and our loved ones face: the stigma, the uncertainty, the pain of thinking we’re getting better just to have another horrible day, the difficulty accessing mental healthcare, the ways in which our illnesses impact our relationships, etc. – basically, the stuff mental health bloggers post about year-round! If people really want to raise awareness, they should link to us. (Note: NAMI prohibits links to personal blogs or websites in their “You Are Not Alone” submission guidelines … but there’s nothing to keep someone from posting whatever links they want on their own social media pages, etc.)

Some places to get started (besides this blog): A Canvas of the Minds, Blog for Mental Health, The Mental Health Writers’ Guild, and Broken Light: A Photography Collective. I’ve selected these sites to link to here because they in turn link to individual bloggers who write about a wide range of mental health related topics. I welcome additional suggestions in comments!

Understanding our experiences is a good start, but it isn’t enough. We need to work together to change them – which means changing social, cultural, and especially institutional norms to be healthier for people (especially children) so we don’t get mental illnesses in the first place. I think most if not all of the “stigma” around mental illness exists because talking about it ultimately requires us to question and challenge norms that form the cultural and more importantly financial foundations for our societies, including: valuing people for their economic success, unattainable standards of beauty, pressure to conform to gender roles from birth (particularly masculinity), various intersecting systems of privilege and oppression, etc. etc. etc.

When I told Fox I was uncomfortable sharing my story – because it’s not the after-the-fact, good depressive “success” story they want to hear – he said it’s the story people need to hear. The here-I-am-right-in-the-middle-of-the-storm story. The I-don’t-know-how-long-I-can-hold-on reality. The “actually, I’m the one who could use some hope, because a big part of my problem right now is that I don’t have any.”

I’ve had mental illnesses on the “mood disorder” and “anxiety” spectra for most of my life, and I’ve been consistently living with diagnosable symptoms for over 4 years. I don’t even know what my diagnosis is, and frankly, I’m inclined to think that’s for the better. It’s frustrating to be unsure what to even say I have, but it means I and the people trying to help me can focus on my individual needs and what I’ve found to be helpful (or unhelpful). It means we can move past labels to the underlying psychological structures and processes that may have been adaptive at one point in my life, but came at a cost I can’t afford to keep paying.

In a word, it means I can focus on my own personal growth.

I think it’s great that in addition to Mental Health Awareness Month in May, there is a week in October dedicated to, well, basically the same thing. I kind of wish they didn’t call it Mental Illness Awareness Week though – because an illness is something outside of or other than oneself that affects one (hopefully temporarily) and needs to be treated, if possible, cured. It’s very easy for people to say “Well, I don’t have this illness, so this issue isn’t relevant to me;” if someone they care about has one or more mental illnesses, they may not even be aware of it (unlike with a less-stigmatized condition, which people would probably talk about).

Additionally, I haven’t found it helpful to think of my previously-adaptive, now increasingly problematic patterns of thought and behavior as an “illness” that is separate from and/or imposed upon my self. If anything, I’ve found it to be harmful; it means there’s something “wrong” with me that needs to be “fixed” in order for me to “function” in society, and until that happens I’m worth less than “healthy” individuals.

These patterns of thought and behavior, whether I like them or not, are part of me. I created them to protect me. They’ve helped me meet the demands placed on me by parents, other family members, teachers, employers, etc. They’re part of how I learned skills I still find useful, that are necessary if I ever want to have a career and other things that people associate with “functioning” and having a “normal” and/or “meaningful” life. Getting rid of them wholesale as part of “curing” my “mental illness” would be a disaster.

What I need, as mentioned earlier, is to grow. Part of that is letting go of the things that are hurting me or aren’t helping me any more. A lot of it is changing things that are adaptive in some ways, harmful in others. For example, my perfectionism: I place a very high value on creating the very best product I possibly can – such as well-written, relatable, informative blog posts. I put a lot of effort into accomplishing this, and gain a lot of satisfaction from doing so. Great. When I apply it to academic papers, the result is usually a grade of A. Fantastic. But I need to stop allowing my desire to produce the best quality product to keep me from starting the process, or to cause me to neglect my other needs and responsibilities during the process. I need to stop basing my self-esteem on how others respond (or don’t respond) to my work. I need to develop an inherent sense of self-worth, a concept I frankly don’t understand because it’s never been an intrinsic part of how I understand myself or the world; it’s not part of how I was raised or the society I was raised in. We value and celebrate people based on what they do, and deny people access to basic needs – never mind “rights” – because we don’t see them doing enough to “earn” it. The closest I can come to understanding inherent self-worth is to try to apply my belief that other people deserve to have their basic needs met no matter what to myself.

If there’s anything to be aware of during Mental Illness Awareness Week, I think it’s actually the message from NAMI that yes, it affects everyone. Everyone has to develop some unhealthy patterns of thought and behavior to survive in a society that was built by the privileged and wealthy to continue benefiting themselves at the expense of everyone else. These patterns influence how we treat each other and raise our kids and perceive ourselves. Some of us just show it more; we become the mirror no one wants to look at because they when they do, they see what they don’t want to know about themselves. I wish I could say something like “It’s not that scary,” but to be honest I still find it very difficult. I guess all I can ask is for people to pick up the mirror and pass it around, so we all have the opportunity to look. Wear green and post a selfie. Send out the message that this is important.

Great, Ziya can express zir emotions spontaneously again … well, most of the time. Unfortunately, Ziya’s mom still can’t tolerate that. You know, one of the people – to an infant, practically gods – whose behavior required Ziya to create and hide all zir emotions behind the Censor in the first place… Yeah. Now Mom is no longer a god, but rather a person with a lot of her own psychological issues on whom I’m financially and sometimes somewhat emotionally dependent, who sometimes tries to help and understand me/my depression and sometimes …

We spent 2 days with her. 2 days. Not even the whole day. Late lunch on Wednesday, an appointment with the florist yesterday, that’s it. Explosions. She can’t deal with my emotions. While were at lunch Fox received a phone call, during which he was offered the job he’d just applied for! We were all thrilled; Mom offered her congratulations. Oh no! Ziya dared to smile, use inflection in zir voice, and hug zir spouse!!! In public!!! This could not be tolerated. “Okay, you two, quit it. C’mon!” *sigh*

Talking to the florist went well, just a ton of information. Later in the evening, we wanted to use Mom’s credit card to acquire an item for the ceremony – she’s supplying about half our budget, so instead of putting it on my card and having to pay interest and get reimbursed, we thought it would be a lot simpler to put it on her card.

Well, Ziya was still recovering from interacting with Mom and Fox earlier in the day, and getting very frustrated with logging in and out of sites, forgetting passwords, having to enter and re-enter card information, etc. Ze kind of had a bit of a nervous breakdown, not quite crying with tears but sobbing and … you get the idea.

Again, Mom couldn’t handle it. She actually yelled at me to “Stop it!”

Not good. Suicidal thoughts triggered by concern over our financial situation and difficulty communicating with Fox about it. I hate having to make joint decisions because I feel like I can’t act on what’s worrying me; I feel helpless and trapped and hopeless and if I can’t do anything about this horrible situation I’d rather just die so I don’t have to feel the pain! Later I was reading and enjoying a webcomic and Fox reminded me about my paper and it reminded me so much of my mother pushing me to do my homework (at the expense of my emotional well-being) that I broke down completely. Internalized voice of Mom: “Stop being so melodramatic!”

I’d almost rather have the Censor back. Almost.

I don’t think she’s really gone. I think that aspect of myself has been integrated. I still have some control, though maybe not as much as I would like especially given my current circumstances. I can still do things like edit my writing and empathize with people and look beyond my own wants and needs when considering how to respond to a situation and be polite. I’m just more likely to feel and express my emotions … even when it means getting into arguments with Fox and getting yelled at by my mother.

I’m an adult. She has no right to yell at me like I’m a disobedient child. Parents shouldn’t yell at their disobedient children, anyway. All it does is teach them to be mean to people, especially themselves. She was very mean to me.

We have a marriage counseling session we should leave for now and I still have a blanket over my head. Literally. I need family therapy with my mom and/or my mom to go for therapy. I don’t want to work on my relationship with Fox right now, even though it could certainly use some work. I just want to rest, alone, without anyone to see me.

In my mother’s words, I’ve “trashed” the place again. The clutter has returned. It’s not enough.

A New Hope

Last week was a whirlwind of internal change and things happening. I actually wrote Drama of the Gifted Child last Monday; I had intended to write more about how my current situation is actually quite good for me, but then Tuesday happened and I re-read what I’d written and decided it felt complete enough to post.

an image of part of a calendar showing last week, with text indicating what important experience happened for Ziya each day

an image of part of a calendar showing last week, with text indicating what important experience happened for Ziya each day

On Tuesday I read a scholarly article titled “The Abject Self: Self-States of Relentless Despair” by Kathleen Adams, which can be found in the International Journal of Group Psychotherapy, Vol. 61 (2011), Issue 3. It did a great job of explaining why sometimes I feel like a functional adult named Ziya with relationships and interests and goals, etc. – and other times I feel like a terrified, helpless child who has no past or future and knows only despair. It’s because I am both those things; there are actually separate neural circuits in our brains that create different self-states in response to different situations. Abjection – a preverbal state of reaching for an unattainable object, being rejected, and fearing annihilation – can be one of them.

I finished reading the article just before my music therapy session with Wakana, so it and The Drama of the Gifted Child (by Alice Miller) provided great material for us to work with. I told her about my birth experience (as I’ve pieced it together from information Mom gave me, my understanding of our relationship, and conjecture) and she suggested we address it through music. I kind of plunged head-first into the deep end, feeling … the words “despair,” “like I was lost,” “hopeless,” “terrified,” “utterly rejected,” and “alone” don’t quite do it justice. I was simultaneously staring into, being drawn into, and reaching out from the void. I feel it now as the discomfort in my eyes that I associate with crying, even though most of the time when I’m aware of it I don’t actually cry. Something’s trying to get out.

I felt the emotions I’ve turned to food to pacify my whole life. And then she reached out to me, looked me in the eyes, told me she was right here with me; I could reach out and touch her. She was so full of hope, life, curiosity, compassion. She brought me back into the light, the living world, my adult body. The ability to rationalize and use words to describe my thoughts and feelings instead of just expressing them.

“Are you okay?”

I described a scene from Star Trek: Enterprise in which they go on a rescue mission to try and help Vulcans who got lost in The Expanse, a region of space that basically defies the laws of physics. The Vulcans had essentially become zombies, slaves to their aggressive urges and “darkest” emotions. The protagonists were unable to help the Vulcan zombies; they barely escaped with their lives. The most humane thing they could do was put the Vulcans out of their misery.

“I feel like I’ve run into a room and slammed the door. I’m holding it closed but it’s only a matter of time. The zombies are on the other side, trying to break in, and I’m terrified of what will happen when they do.”

In a word, rage. I thought she’d ended it too soon. I was afraid that, if I “opened the door” and expressed my emotions, at best I would destroy our therapeutic relationship, and at worst I would actually hurt her. Those feelings subsided when she explained why she had done it: she didn’t want to re-traumatize me.

On Wednesday I finally went to the dentist to try and have something done about the tooth that’s been causing agony in the whole right side of my face and ear for weeks. It was a rather unpleasant experience, but I asserted myself and expressed my needs. I should eventually get to see a specialist who will perform a root canal, and in the meantime I have antibiotics that are wreaking havoc on my body and hopefully helping it fight off the infection that’s been causing the pain. I can’t wait until I no longer have to take a pill every 8 hours!

On Thursday I had my third appointment with the APN. We had a lot more time and were able to actually talk about things that were important to my treatment. She was going to prescribe a different drug, but I asked her questions about it and reminded her of the experiences I’d had with Zoloft and Wellbutrin. She took some time to review her notes from our prior meetings (we’ve been meeting once a month) and decided to go ahead and prescribe the Lamictal. We didn’t get to talking about gradually increasing to a therapeutic dose; I just have a month’s worth of 25 mg tablets and an appointment to see her again in another month. She advised me to wait until I’d finished the antibiotics to start taking this new medication.

Friday morning I was writing in my paper journal and something extraordinary happened. I started using “we” instead of “I” to acknowledge that, however you want to explain it, there are multiple selves (or aspects of self?) bouncing around in this body. “We” were still expressing “our” views as though they were unanimous…

Until a dissenting voice spoke up: “No, I don’t want to clean up the clutter, because it helps me feel safe.”

We talked a bit about order and chaos (by writing in our journal), and how now that we’re adults we don’t have to live in chaos and fear anymore. “Whoever hurt us is gone.”

It seemed to be going well until the word “embarrassed” got used. Then the dissenting voice became very justifiably angry, calling at least one other out for being ashamed of and hiding zir.

“You said this was about freeing emotions, feeling and expressing them spontaneously. Well, I’m very angry! That’s going to happen ‘in public.’ What are you going to do, stay in the house ALL THE TIME? Stop hiding me! Stop denying me.

“I EXIST AND I’M FURIOUS!!!

“And now the floodgates are open and I’m out! You’re not going to shut me down again. [...] You cant suppress me anymore if you want your precious ‘mental health.’ You will be depressed if you keep suppressing me. I’m really mad at you. I keep trying to tell you but you won’t listen to me!”

“You’re the judge, the critic, the warden…”

“No! YOU are!!! You’ve kept me from expressing myself our entire fucking life don’t you see?”

“Yes, it’s true, I’m sorry.”

“‘I’m sorry?’ That’s it? Our whole life.”

“I was trying to keep us alive.”

“Well you almost KILLED me!”

“It wasn’t safe.”

“YOU weren’t safe.”

“You weren’t safe either. You said you needed the clutter to hide in. I don’t think you felt safe. You needed me.”

“I guess I did.”

“You don’t need me anymore. Look at you, standing up for yourself like this. How assertive! Getting your needs met. Expressing yourself. You’ll go far in the world. So far.”

“Don’t leave!”

“But if I stay, all I’ll do is hinder you.”

And just like that, gone. Whoever was in control of the body before is gone, and I’ve taken their place. I don’t even know their name, preferred pronouns, nothing. This whole time – a young adult’s entire lifetime – I’ve been a crying child shoved in the corner of the psyche and largely ignored; now I’m in charge. A whole life to live, so many decisions to make. There are other people here to support and guide me, but our former leader is gone.

We gave “her” a Viking funeral, the ship, flaming arrows, fire out at sea, sung lamentations, everything. It was quite beautiful. And then I ascended Pride Rock and looked out on a glorious landscape touched by the rising sun and sang a song that was so full of life and joy and vitality…

Then I had to get dressed and go somewhere and the weekend was its own whirlwind of socializing one day, then trying to settle down and finally write the paper from my summer class (oops!) the next. I was kind of useless – sad and lethargic – on Monday, but I did some research and cleaned my desk, so I actually have some space to work. Considering how I’ve responded to such abrupt changes in the past, I’d say I did pretty well. I kind of got some whiplash; I didn’t crash.

I also decided to start taking the Lamictal, even though I still have about two days’ worth of antibiotic left. I was feeling rather anxious about it, but I haven’t spontaneously combusted, so I think I’m going to be okay. I hope.

The Drama of the Gifted Child

TW: descriptions of physical and emotional abuse

Reading The Drama of the Gifted Child by Alice Miller has helped me put a lot into perspective: I’m actually very fortunate and blessed to be precisely where I am in my life, right now. It may not match my ideals of being successful in a meaningful career, living on my own, and starting a family – and that hurts, a lot! – but it gives me the foundation I need to be able to build those things while also being true to my “inner child,” my genuine self.

book cover – The Drama of the Gifted Child: The Search for the True Self by Alice Miller – links to Amazon.com

If I take Miller’s argument to be true for me – and it probably is, because I relate very strongly to it – my parents were unable to love me as I truly was from very early in my life, possibly birth. My mom recently revealed to me that my birth was a very stressful experience for her – involving pressure from in-laws, feeling unsupported by my father, and concerns about her own health. The hospital staff separated me from her – now understood to be one of the worst things you can do – and brought me back when it was “time to breastfeed!” I was “fussy” and she didn’t know what to do, was probably uncomfortable trying to figure it out with someone watching, and the field of lactation consulting didn’t exist at the time.

Right there, in what was probably my first interaction with my mother as a separate human being, my emotions (“fussiness”) were a problem that interfered with our ability to bond and my ability to have a basic need met (food). Never mind that she probably wanted to love and nurture me, and I imagine she did the best that she could, given the circumstances. When I was traumatized from the birthing experience, hungry, and at my most vulnerable ever, I needed to look into her eyes and see unconditional love (and have my brain be flooded with oxytocin). Instead… I probably saw her pain, insecurity, frustration, and sorrow – in that moment I wasn’t what she had hoped I would be. (And great, she was stuck with me for 18 years, at least.) The very first thing I did was let her down. For all I know, trying to imagine an experience I can’t even remember, she might not have even made eye contact with me.

Image Description: Mother holding infant and frowning, not making eye contact even though the baby is looking at her. from News In Health: Understanding Postpartum Depression December 2005 National Institutes of Health

Mother holding infant and frowning, not making eye contact though the baby is looking at her.
National Institutes of Health

This is the part where I’m supposed to get angry with her for letting me down, but all I feel is a deep sadness and emptiness that I find intolerable. (Like a fussy baby?) It’s a beautiful day, let’s enjoy some time outside. How can you wallow in these emotions on a bright sunny day like this? I took a look outside at the glorious green grass and the sunlight glinting off the beautiful green leaves on the trees and felt a cool breeze and smelled the crispness in the air that means it’s autumn. Mmm, these are the things that keep me alive! And now I’ve settled back down at the computer with some food. Silencing my inner newborn’s cries with a burger and fries – an adult approximation of formula.

This is what Miller would call repeating the harmful behaviors my parents imposed on me, behaviors that prevent me from expressing my “unsavory” emotions and keep my true self in torment. I’ve used food to avoid feeling difficult emotions for as long as I can remember – from accepting chips and sour cream as a substitute for emotional bonding while watching TV with my mom, to stuffing my face at social gatherings to smother my feelings of anxiety and isolation (from being surrounded by people I didn’t think could understand me, and who wouldn’t accept the real me). More recently it’s helped me finish papers for school (that earned grades of “A”) and write particularly difficult blog posts.

In short, I adapted. I had to, because when I felt my emotions I couldn’t help but express them, and doing so put me in very real danger. I remember my father becoming terrifyingly angry, dragging me from the first floor of our house to the third, spanking me for several minutes on my bed, and paying no heed to my pleas for him to let me go use the bathroom; I wet myself, long after I’d stopped having any of the normal childhood issues with such things. For most of my life I was convinced that I’d done something horrible to deserve it – until only a couple of years ago when I learned that it was physical abuse. Maybe I’d done something for which I should have been redirected, disciplined, possibly given a “time-out” to consider how I could have responded more appropriately… it doesn’t matter. He hurt and humiliated me.

It was like I wasn’t even there; my feelings and my needs didn’t matter. All that mattered was his anger.

My mother wasn’t aware that my father had done that to me. But she did know something that I did not: he also slapped me. It was horrifying to learn there was an episode of abuse I don’t remember – if there’s one, how many more are there? What else did he do to me? It was also horrifying to learn there was an episode of abuse she didn’t remember. I would hope she would have remembered if he’d talked to her about it, so I’m inclined to guess that he didn’t. My father didn’t tell his wife that he had lost control and beaten the shit (well, pee) out of me. That would have been the first step to taking responsibility for his actions and trying to avoid such behavior in the future.

He never took it.

So, you’re probably thinking: Ziya, all these things you’re writing about are pretty horrible. What makes you say you’re fortunate to be in your current situation?

Well, in a nutshell, I’ve been in therapy for about four years now, and I’ve learned a lot about myself. There was a time when I thought my parents were wonderful for pushing me to focus so much on academic success and having a successful career. I was at the top of my class, went to the best high school my mom could afford, went to a rather prestigious university with a semester’s worth of credits already under my belt, completed a double major and a minor, and graduated magna cum laude. I needed my academic adviser to convince me not to do an honors thesis because I didn’t want to do one, but thought I should because I was so used to being an overachiever.

But my social skills are nowhere near as developed as my academic ones, and I have a lot of social anxiety. I miss out on great opportunities to make friends and otherwise have fun socializing. I feel isolated and lonely. In college, the semester I was the happiest was the semester I got the lowest grades because I decided not to do my absolute best in all my classes, but rather focus more on developing my social skills and enjoying extracurricular activities. (I was also taking Wellbutrin, but it caused increased irritability, dry mouth, and other side effects I strongly disliked. I made the rookie mental health consumer mistake of going off it cold turkey when I thought I was “better.” I thought I could leave psychiatry behind me…)

I used to be so proud of all my academic achievements – okay, I still am – but that pride came at the cost of believing that they were what made me a worthwhile person. (Miller calls it grandiosity.) The more time I spend as an adult, the more I realize that my grades matter less than, well, the skills I’m not as strong in and have trouble accessing when my mental health symptoms flare up. If the thing that makes me worthwhile isn’t really worth much in the real world, what does that say about me?

In therapy I realized that part of why I got such good grades in school (besides being very good at academic learning) was because it was one of very few things I had control over, and it provided some of the stability my home was otherwise lacking. My parents would have awful fights – but at least I would bring home a report card they could be proud of and display as proof that things were going well in their lives; they’d reward me with the affirmation that I took in place of love and craved like most people crave air.

In one therapy session I likened this process to Kudzu, “the vine that ate the U.S. South.” It is not indigenous to the Americas, so the local flora have no defense against it and there are no insect predators. It climbs up bushes and trees, covering the whole trunk and leaves until they can no longer access the sunlight. Countless plants have become corpses supporting this vine, no longer able to exist for their own sake. In my metaphor my parents urged me to grow ever taller, reaching for the sun, so that they could climb my trunk and spread their leaves high above the obstacles imposed on them by their own life circumstances and relationships. But in the process, they smothered all my access to air and light.

kudzu vines covering a vaguely anthropomorphic figure that looks like it's reaching up to the sky with both arms - and the surrounding area image by Markus Griesser

kudzu vines covering a vaguely anthropomorphic figure that looks like it’s reaching up to the sky with both arms
image by Markus Griesser

There was a time when I thought my childhood had been very happy and I missed it, horribly. I think my image of my childhood was based on my memory of the home-cooked dinners my grandmother served every night, and the whole family gathered around the table, complete with our golden retriever’s head in my lap. That was quite awesome and I was more physically fit, so I could run and climb and ride my bike and roller skate and play sports. I suppose I can still do those things, but not as well and not without a lot of physical discomfort and difficulty breathing. I was also less inhibited and had less access to electronic entertainment back then, which made it easier for me to have fun playing outside. And I truly believed that I could grow up to be anything.

Therapy has helped me face the reality that, while there were definitely positive experiences, I did not have an overall happy childhood. Perhaps you could say I had a neutral childhood – the best and worst parts of it kind of cancel each other out. It certainly wasn’t idyllic. According to Miller, people who seek therapy often think their childhoods were happy. Therapy enables them – us – to remember and re-experience the parts of our childhoods that were too painful to remain in our conscious experience. The goal is not to “correct” the experience, but rather to express the emotions that had to be repressed at the time in order to survive. Only by expressing and accepting these emotions (and having the world, e.g. the therapeutic relationship, not end) can we begin to heal.