To Lose a Tooth

I went ahead and had Root Canal Molar removed today. It was surprisingly straightforward: I went in and said I wanted the tooth extracted. They sent me for an emergency examination, during which the student dentist asked me about my previous visits, etc., then called the instructor over to review the case. It was the same instructor from the first time I’d been examined at this facility. He looked over the information, then said they shouldn’t have sent me to emergency and that he was going to expedite the process. (I assume he called my insurance.) Several awkward minutes later, I was on my way to oral surgery.

The instructor who examined me made some comments about “people sometimes change their minds” and “it’s a shame, all the other teeth are present” that were… awkward. Whatever her intentions were, it seemed to me like she was sticking her nose in my business and trying to manipulate me. I’m really not happy about having my tooth pulled; I would have preferred to save it. But the root canal just wasn’t viable; the endodontist couldn’t access the tooth well enough to do the work. And I couldn’t continue living with the problems it was causing. I needed to do something about it, and this was the option that was available to me. After living with intolerable pain for 7 months, receiving even this less-than-ideal treatment is a positive thing!

I won’t go into gruesome detail. Suffice to say the extraction was unpleasant and felt wrong on some fundamental level, like part of me was being ripped out… oh, wait, it was! I was pleasantly surprised that not only could I close my mouth during the procedure, it was actually beneficial and relieved uncomfortable pressure on my jaw. (I thought I’d have to hold my mouth open.) It didn’t take long at all; the assistant described it as “atraumatic.” When it was over I got to see my tooth, complete with some goo on the tip of the root that the assistant said was the infection. I felt relieved to have that out of my skull.

I felt a bit shaky and woozy immediately after the procedure, but I was glad to have it done. I became somewhat irritable as time went on, particularly because I had to bite on gauze to stop the bleeding and that was causing my jaw to hurt quite badly. Then the adrenaline and anesthetic wore off, leaving me feeling drained and in a lot of pain. It’s like a part of me is missing, and there’s a gaping wound in its place. (Actually, that’s exactly what’s going on….)

I eventually decided to remove the gauze; it seems to have stopped bleeding. I took some ibuprofen and am sipping warm black tea (without sugar). It’s very soothing. Now instead of an obnoxious dull ache that spreads from the area, causing jaw pain, ear aches, and headaches, I get to experience a wide variety of pain. The gum is irritated. The jaw is sore (but not particularly stiff – we’ll see how it feels in the morning). There is an occasional throbbing pain that’s sharper and more interesting than the dull ache was. The ibuprofen is taking the edge off, so I notice the pain but I’m not overwhelmed by it. Hopefully I’ll be able to sleep tonight.

It’s kind of ironic. Originally I didn’t even know there was a problem with Root Canal Molar. Especially when my gum infection worsened, I wanted Endangered Molar out of my mouth! But it’s still there, and (according to the dental insurance representative I talked to on Friday) the periodontal referral has been sent to a supervisor to expedite its review. Contrary to what they told me two weeks ago, my dental insurance received the referral on January 26th and just let it sit around for a month, while my jaw bone continues to rot. I should have a decision by tomorrow – something tells me I’ll have to call them to find out what it is.

My hope is that I’ll be able to receive treatment and get to keep that tooth. Now that I know what it’s like to have one tooth missing, I really don’t want to lose two right next to each other! But, in the end, there’s only so much we can do. “What will be will be” and all that.

Progress

Last night’s class was great! Whereas in the past I’ve been terrified to show imperfection and extremely critical of myself, last night I was eager to receive feedback. I was uncomfortable about the class watching last week’s video of me acting as therapist in my small group, but the instructor pointed out something I’d facilitated without being aware of it. This element had been very effective in supporting the goals for the group: free expression and interaction among members.

Then we broke up into groups for hands-on experience, with the task of dealing with “problem group members.” The instructor recommended lyric analysis; for once(!) I immediately knew which song I wanted to use. Another group member was a bit better prepared and group consensus seemed to be for her to go first, so she did. I’m kind of wishing I’d gone first because the instructor came in while she was leading and gave a lot of useful feedback. The whole thing got video recorded, which meant (unbeknownst to us) that there was not enough memory left on the device to record a second mini-session. (Spoiler: So there’s no video of me leading.)

I left plenty of room for one of the other group members to go next, but there was an awkward silence as we all looked at each other. So, I volunteered. Perhaps I could have been a bit more direct about my desire to take a turn leading, but that’s working against an entire childhood, much of my adolescence, and even some of my (young) adulthood spent learning to step back and “give the other kids a chance.” (Including teachers refusing to call on me unless I tricked them into thinking I wasn’t paying attention.) I may have taken it to a bit of an unhealthy extreme, but I’m working to correct that…

I felt so good to go because I wanted to go, not because I had to. I felt ready. I presented the song in the way I felt comfortable with and that left me free to focus on connecting with the group members as we sang. I facilitated a verbal discussion that helped one of the group members come to her own conclusions that were supportive of her therapeutic goals, despite initial rejection of the primary imagery in the song. I tried several strategies to engage a silent group member without losing the ones who were participating. Even though she was quite successful in remaining disengaged, I felt good about the creativity I’d employed and eager to keep working. She later told me that it had been very difficult for her to resist engaging with the group, and that the only way she’d managed was by diligently avoiding eye contact with everyone.

Best of all, I felt accepted by and connected with my small group-mates, and comfortable in the class as a whole. I feel like I’m back on track and more alive than ever!

Letter to the Mother of a “Schizophrenic”: We Must Do Better

Featured Image -- 3668

Originally posted on Beyond Meds:

By Will Hall

Letter to the Mother of a “Schizophrenic”: We Must Do Better Than Forced Treatment and Laura’s Law

mandalaA few months ago I met your son. He said he would be waiting for us in the Berkeley park near where he sleeps outside at night, but at the last minute he called and was in San Francisco. He said he was at “the Mrs. Doubtfire house” with a photograph of his best friend, and that the photo showed numbers and codes predicting Robin Williams’ suicide. He found the house where Williams made one of his films, and was trying to talk to the owner. It was all part of a complex plan, marked mathematically in signs and omens he was collecting.

We drove across the Bay, worried. Were we too late? Would he be arrested and end up in the hospital again, this time for trespassing and harassment…

View original 2,938 more words

Dr. Jekyll Experiments with Whole Tones

I’m taking a course in piano improvisation for music therapy, which is both really cool and nerve-wracking. We get to go far beyond the conventions of traditional Western music, to explore musical expression more broadly. We’re simultaneously learning to appreciate the emotional effects of intervals (the specific sound created by playing two particular notes simultaneously or consecutively) and developing a working knowledge of “alternative” modes and scales. It’s nerve-wracking because one never knows when one will be called upon to do this brand-new thing in front of the entire class, and I tend to lack confidence in my piano skills.

The solution is, of course, to practice – both to improve my skills and confidence, and to play with all the new toys that are being handed to me each week! I was feeling rather bored yesterday, alone in my messy apartment without Fox to help me focus my energy. I’d already played The Sims 3 for a few hours and wanted to do something different, so I decided to improvise on piano for a while.

I practiced the whole tone scale, which does not have any half-steps and creates a very dream-like feeling. On the piano it can be played by choosing a key to start on (e.g. middle C), then skipping a key between each one you play. There are two basic whole tone scales; you can start and end on any pitch in either of them.

Whole tone scales for piano starting on C-natural and D-flat. Together they use every key within a minor 9th on the piano.

Whole tone scales for piano starting on C-natural and D-flat. Together they use every key  on the piano within a minor 9th.

I started out by just playing the scale that starts on C-natural, first in the right hand and then in the left. My right hand began to try making more creative melodies, while my left searched for some kind of accompaniment (which in my mind means playing at least two notes simultaneously, preferably with a rhythmic pattern). I made the conscious choice to avoid intervals that are considered consonant (peaceful) in Western music, prioritizing dissonance (tension) and sounds that were unfamiliar.

That led my music to become quite harsh, expressing a mix of anxiety and anger that was almost completely nonverbal. I abandoned the whole tone scale and other ways of organizing pitches (specific audible frequencies) into what is conventionally considered music, relying more and more heavily on tone clusters. There were rhythmic elements and patterns in my playing, but no real meter (a way of organizing rhythm). In other words, I was literally banging on the piano with open hands and had very little intentional control over individual fingers. As time went on, the improvisation became increasingly chaotic.

Themes emerged in the music such as a “rumbling” in the lowest register that I sometimes played with both hands, sometimes with the left hand only. The right hand would flee from this dark ominous rumbling and scramble “up” the piano into the high register, where the sequences of pitches I played were rather frantic. I had the mental image of struggling to climb a slippery rocky incline where I couldn’t find a secure grip. The abyss and/or some horrible monster waited below. At times there was a call-and-response structure to the music, in which one hand would play something (while the other hand was silent), then the other would respond with similar rhythmic patterns (while the first hand was silent).

I quickly interpreted the dark ominous rumbling to be the voice I hear when my depression symptoms are at their worst, telling me I’m worthless, alone, etc. The self-destructive urges that at best undermine my short-term goals and at worst tempt me toward suicide. My inner demon, my true mental illness, my internalization of the abuse I’ve experienced, etc. etc. etc. It has no redeeming qualities, yet I allow it to seduce me.

The right hand could only scramble so far up the keyboard before it had nowhere else to go, so it would come back down toward the rumbling, sometimes joining it. There was no rest, no slowing down and organizing, no creating intentional patterns, no stability. I think my attempt to explore beyond Western music became an excuse for avoiding it, thus depriving myself of most if not all of techniques I currently have in my repertoire for restoring stability, calm, and a sense of wholeness (which I should be using music to promote). I was “up the creek without a paddle” – because I’d intentionally left both my paddles at home.

There was a part of my mind that urged caution, reminding me that I was alone with no one to pull me out of the abyss if I needed them to. I was not with Wakana in therapy, where an exploration like this might prove useful – and could be done safely. It urged me not to go too deep, to come back, to be careful and compassionate toward myself.

But another part was fascinated. It wanted to sit back and observe and analyze everything that was happening. It assured my cautious mind that I could handle this, that it would pull me back when necessary. This is the part that’s enabling me to write about my experience like an objective researcher writing a case study. I think it’s the part of the human psyche that finds serial killers so fascinating. – and, admittedly, part of why I study psychology.

I found the whole experience so interesting, I decided to intentionally cause it to happen again so I’d have an audio recording. If only I hadn’t deleted the file when I hit my first obstacle to transferring it from my phone to my computer. I’d really love to hear what I played, and to analyze it…

The title of this post is a reference to the musical Jekyll & Hyde, which is based on the novella The Strange Case of Dr. Jekyll and Mr. Hyde by Robert Louis Stevenson. In the musical, Dr. Jekyll begins experimenting on himself in order to find a way to remove the evil in his father’s soul. He instead creates Mr. Hyde, an alter-ego who embodies and acts upon all of Jekyll’s “evil” urges – unchecked by morals or concern about his standing in society.

A double exposure image featuring Richard Mansfield as both Dr. Jekyll and Mr. Hyde, taken by Henry Van der Weyde circa 1895. Public domain image downloaded from the Wikipedia Commons.

A double exposure image featuring Richard Mansfield as both Dr. Jekyll and Mr. Hyde, taken by Henry Van der Weyde circa 1895. Public domain image from the Wikipedia Commons.

I’d be tempted to say I write about my “Mr. Hyde” on this blog all the time, but I only disclose part of it. I can admit to suicidal thoughts, habits I know are unhealthy, the temptation to give up on everything, frustration in relationships, anger, guilt, etc. I don’t use this blog to share my thoughts that are racist, wish dishonorable death upon certain politicians, objectify others for my own sexual gratification, devalue other people’s perspectives, etc. To do so would be inappropriate and harmful. I only mention these things now because I believe they are some of the human tendencies Mr. Hyde represents – and we each have our own version of him. We can’t separate him from the “good” part of our psyche, but we can limit his influence on our behavior. Perhaps we can even help him change to be less “evil.”

I think the more important character to examine is Dr. Jekyll, the one who unleashes Mr. Hyde. In the musical his stated intention is to cure his father, who is comatose. He isn’t allowed to experiment on other humans due to the risks involved, so he experiments on himself instead. The song “This is the Moment” reveals that his motivations aren’t really all that altruistic; he’s motivated by pride. He wants to prove himself, to prove “them” wrong. He’s not really being heroic. He’s being reckless.

Watch Robert Cuccioli perform “This is the Moment” on YouTube

Okay, so maybe the first time he transforms into Mr. Hyde it’s an accident. He had no way of knowing that would happen, right? Fine. The problem is that he keeps doing it, over and over, until he loses control. He prioritizes his research over his Self – and the safety of others.

You’re probably wondering what all this has to do with whole tones. Well I started out by practicing whole tone scales, then trying to improvise with them, but I was reckless. I didn’t do anything to ground myself, like going ahead and using a consonant interval (C and E) or playing one of the ostinati we’d practiced in class. (“Ostinati” is the plural of “ostinato,” a short musical phrase played over and over.) Without a predictable pattern, comforting intervals, something to keep me calm and ordered, I had no protection from the chaos.

Okay, so I banged on the piano for a while and made a lot of noise. It was during the day. Anyone who heard it was probably just a bit annoyed by it, then went on with their lives. I might have been the only one who heard it.

The problem is that I knew it was risky to allow my musical improvisation to become so chaotic, but I did it anyway. I felt unsafe – otherwise I wouldn’t have had thoughts urging caution; it wouldn’t have mattered that I was alone. I knew I was unleashing powerful forces I wasn’t prepared to deal with on my own. But instead of stopping the improvisation and moving on to something safer, I decided to go back, to go deeper into the abyss.

I’ll admit, it was kind of fun to romp around. When I needed to come back, I moved myself more and more toward consonant intervals. I played a G-major chord, regained conscious intentional control over my fingers, and explored tonal music for a while. I don’t remember exactly how I felt when I ended the improvisation, but I thought I was okay.

I wasn’t okay. My mind was in utter chaos. The light was too bright. There were too many colors and sounds. The clutter in my apartment that I can usually block out (or even find comforting) was overwhelming. Every thought splintered into several more. Each word brought on an association: an image or a song. That association would lead to another and another and another… it was all going too fast! I couldn’t focus my energy. I could barely move. All I could do was sit and put my head down and try to find something that wasn’t stimulating.

I texted Banji and told her: “I feel like I’m in the middle of a crowded room with hundreds of conversations going on around me, ten TVs set to different channels and blasting, ten radios also set to different stations and blasting, and there’s no escape!” She replied, “hugs,” and I sent her more texts describing how it had happened. I felt the tension melting away as I did so. Eventually I decided to take a shower, which provided sensations I find comforting (and pleasurable) and that brought me back into my body: in a word, grounding. My mind picked one (or maybe two?) thing(s) to focus on. I was even able to read a chapter of Yalom (The Theory and Practice of Group Psychotherapy) during a Skype homework session with Banji.

I’m going to take it as a learning experience. At first I thought maybe whole tone improvisation was contraindicated (not a good idea) for me, but I think the more important lesson is the importance of grounding. There needs to be some kind of home base that can be referenced at any time and provides the foundation for the music experience.

More importantly, I can’t experiment on myself – no matter how much what I learn might benefit my future clients, or how “fascinating” it is. My safety has to come first; I need to recognize and respect my own boundaries.

Medical Update

I ran out of Lamictal because my appointment with the APN on Friday was cancelled for reasons outside my control. The receptionist said the “other doctor” would refill my prescription that day. Nada.

I called today around 11am and the same receptionist said the APN would take care of the prescription within the hour. “I’ll call you.” Four hours later, no call. I called back at 3pm and she said “by the end of the day.” I had important things to do today, so I couldn’t sit around waiting for it. But, according to the voicemail I just listened to, it’s waiting at my pharmacy.

I called my dental insurance to find out if there was any update regarding my periodontal referral for my Endangered Molar. I had received authorization for a consultation only; the periodontist (whom I saw on January 22nd) had to request authorization to actually treat me.

The dental insurance representative said they hadn’t received any such request from the periodontist! It’s been almost four weeks! And to make matters worse, she tried calling the office three times and kept getting a busy signal. She said she’d leave a note for someone to try again later.

When I’d met with the periodontist, she seemed to be on my side. They said “we’ll call you to make an appointment,” so I was a good patient and waited. They made it seem like any delay would be because of the insurance. I trusted them! I feel betrayed.

In related news, I went to get a root canal on Root Canal Molar last week. The endodontist-in-training attempted to perform the root canal, but had difficulty accessing it for several reasons – including but not limited to my inability to open wide enough for her to reach the back top of my mouth. Apparently the tooth is also rotated toward my cheek, making it even harder to access. We both put in our best effort, but all she really ended up doing was beating me up.

We’re officially at 6 months since I started having unbearable toothaches, and I still have yet to receive treatment! The bone damage near those teeth keeps getting worse; I can see it as a growing dark area in the x-rays.

I have an appointment to go back and try the root canal again… In two weeks… But I’d really rather not. We’ll need at least a couple of painfully long visits just to complete the root canal, then another 2 or more for the crown – if it’s approved – and there’s a chance I may have a problem with it later and have to come back again…

No, just no! That’s not happening! I’d rather just get the damn thing pulled and be done with it! I don’t even want to replace it with anything.

So now I have to convince the endodontist-in-training to refer me for an extraction and wait for that to be approved… I just hope I can communicate with her directly – and that she’ll follow through in a timely manner – without jumping through a million hoops. I can’t tell you how often I’m tempted to try and pull both teeth out myself!

But wait, it gets better! The sleep study that contributed to my crisis two weeks ago failed to reveal whether I have sleep apnea! The doctor had called me to discuss the study and, when I told him I’d slept much worse than usual, suggested we try an in-home study. I agreed and he said someone would contact me to set it up…

I was just thinking it was time to call them and find out what happened, when I received a letter from my insurance company saying they were terminating treatment by an out-of-network provider. The letter didn’t say what treatment; in fact, there is a sentence that doesn’t make any sense because the [insert colourful phrase in gorram Chinese here] who prepared the form letter didn’t bother adding what I consider the most important information! The only clue I had was at the very end: “cc Obnoxious Sleep Center.”

I was very worried that they would turn around and make me pay for the on-site sleep study (that had proven to be a waste of time and fucked up my head). I had trouble focusing on other things all weekend, I was so angry! I hated the insurance company for sending me an unedited form letter – instead of calling me to address the issue and offer help. I also suspected the sleep center of lying to me, billing my insurance for treatment I hadn’t received, etc. In short, it all made me feel very unsafe.

I called my insurance about the letter today. It had been intended to inform me that the in-home sleep study was denied because they don’t think I need out-of-state treatment. I explained that I wouldn’t be treated out-of-state, both the sleep center and my home are in the state that’s currently paying for my healthcare. But apparently the company (parent company?) that would ultimately receive the funds is based in another state. My results might have to be processed in another state, etc. To be honest, I understand why they wouldn’t want to pay for that. I just wish they’d told me in a more straightforward way!

The doctor who is ostensibly treating me was and may still be trying to get the decision reversed. As far as I’m concerned he’s welcome to continue (or not); I’ll follow through with whatever works best for me. I now have a list of names, addresses, and phone numbers that may or may not be accurate contact info for in-state sleep specialists.

I’d almost rather not even bother! But if I do have a sleep disorder, treating it could go a long way toward helping me function better in my daily life. I need all the help I can get – especially with two emotionally-intense graduate-level classes. I just need to consider whether trying to access treatment is worth the disruption it’s causing to my everyday life…

I’m considering the possibility that I might be better off going untreated, at least until my classes are over. Then I don’t have to play phone tag, listen to musak while on hold, reschedule my life around appointments that only add to my difficulties, and constantly feel like I’m beating my head against a wall. I estimate that more than half of my current stress would be eliminated if I weren’t trying to access healthcare (particularly dental) at this point in time. I kind of need to stay on my psych meds (I think), but perhaps the rest of it should be put on hold.

On a much more positive note, I took some steps toward finding a potentially-therapeutic group experience today. I met with the leaders of the “coming out” counseling group and told them that I’m trans*. They admitted that they’ve been having trouble finding members and expressed concern because the couple of clients they do have are cis, coming out as lesbian or gay. They would want to have at least one other trans* person in the group so there would be someone I could relate to on that level.

I appreciate that, even though it is a bit disappointing. At least they’re willing to work with me to find a group that might work, whether it’s the “coming out” one or another focused on general interpersonal issues. I expressed my interest in the latter and they said “if you don’t hear from us in two weeks, give us a call.”

They also encouraged me to join the extracurricular LGBTQ+ group I’ve been considering; that helped me overcome my reservations and actually show up for it today.

The facilitator was sitting at a table, surrounded my empty chairs. I walked over, said “my, what a lively group we have today!” and sat across from him. We talked for a bit about random things (completely unrelated to sexual orientation and gender identity) and had several awkward pauses.

Then he asked what I was hoping to get from the group. I told him I want a safe place where people will see me as I am: queer. He said that’s exactly what he intends for it to be, and what it had been in previous weeks when people actually showed up. His words were welcoming, but he seemed skeptical regarding whether he would see me again.

I think I’m actually more encouraged to return than I might have been if there had been a group. I felt like I bonded with the facilitator, and that makes me want to come back. I felt safe there; knowing it’s a safe place will make it easier to be there as part of a group. I feel less like I’m inserting myself into someone else’s party and more like I’m helping to establish the group. Next week we’ll be starting on the same page.

Reframing

many picture frames of different shapes and sizes, painted a variety of colors, standing up and leaning against each other. from magpieweekend.com

many picture frames of different shapes and sizes, painted a variety of colors, standing up and leaning against each other.
image credit: Becca at magpieweekend.com

Lately I’ve found myself reframing stressful experiences by highlighting the positive aspects, seeing them as learning experiences, or considering the new opportunities they provide. A prime example of this occurred while I was walking to class last Wednesday, feeling absolutely horrible about myself for being late. I thought about how I felt (almost suicidal), what had triggered it (fear that I would never belong in a group), how I would have responded in the past (stayed home, possibly hurt myself), and how I was behaving at the time (going to class!).

I wasn’t exactly in the best frame of mind to think positive thoughts about myself, but I imagined the instructor saying, “Wow, you were feeling that insecure and you still came to class? That shows a lot of dedication! This must be very important to you.” In other words, I imagined someone else saying something positive about me – the thoughts were my own and they contained positive self-talk, even though I couldn’t express and experience it directly as such. That’s… actually quite healthy.

Since then I’ve taken some time to put the whole incident in perspective. There were a lot of factors that made doing my schoolwork and showing up on time for class on Wednesday very difficult for me. I’d spent most of the weekend decluttering, a task that – while necessary and healing – I found very stressful. Fox had offered to join me in continuing that task on Monday, but instead we ended up shoveling snow. I stayed up all night in preparation for a daytime sleep study on Tuesday… during which I did not sleep. Lack of sleep alone probably would have been enough to undermine my ability to function on Wednesday, and I was already painfully aware of the 17th anniversary of my father‘s death on Thursday. I believe it may have predisposed me to cognitive distortions like only viewing the negative aspects of things, generalizing, and catastrophizing.

As much as I’d like to be functional at this time of year, it seems most adaptive to accept that I will need to take “mental health” days on and around February 5th – and to plan accordingly. At the very least, I need to do my best to avoid making extra appointments around this time, especially since I never know how the weather might impact my plans. It’s not a weakness, it’s making an informed decision and engaging in self-care.

Considering everything that was going on, I handled myself quite well on Wednesday. I actually got up, got dressed, and tried to go to class. I traveled all the way to the classroom door before my anxiety got the best of me. The class has a strict attendance policy, so I’d be lying if I said I wasn’t concerned about the consequences. But all I did was miss one class. That’s a very minor mess up in the grander scheme of things.

More importantly, when I got home I wrote a blog post about my thoughts and feelings. I expressed what was going on instead of allowing it to consume me; this kept me safe until Fox came home, hugged, and comforted me. Even though I couldn’t reach out to anyone directly, the public post let Banji know what was going on. She reached out to me and we had an awesome, healing conversation. The written record has also made it easier for me to talk about and reflect upon what happened. This blog is an awesome resource that I’ve created for myself and that you, my readers, have helped maintain as a safe space. Thank you.

The imagined conversation in my most recent post is a reframing of my Wednesday class as an opportunity for growth and healing. This is a big deal for me. Yalom (the author of our primary textbook) recommends understanding mental illnesses in terms of how they affect our relationships – both with other individuals and our ability to function within groups. He instructs (group) therapists to treat these difficulties, for they are the true pathologies clients face. In this class, not only do I have to function in a group where the expectation is that we’re all “normal” (to be honest, I have a hunch that at least 20% of us have mental illnesses – probably more considering we’re all studying to be therapists)… but I’m also studying myself as the “other” as I read and listen to class discussions about people with mental illnesses, “their” problems, and how to treat “them.” It’s all about what I need and often feel I can’t have, what I simultaneously strive for and run away from.

This class is the embodiment of my psychopathology, including (especially!) the internalized stigma. I’ve already had to drop it once; on Wednesday I thought that history would repeat itself. But in reality I have a choice, and that choice is mine alone. I can decide I’m not ready to face it so directly; far from “another failure,” this option opens all sorts of opportunities to me. I could focus more on activism, composing, write a book, find a job, volunteer, hang out at Fox’s workplace all day, read every book in the library … there are too many possibilities. I spend my life playing Skyrim because I’m overwhelmed by all the possibilities. But they’re there! And each one comes with its own challenges. Each one will probably cause me similar problems, all linked back to some aspect of my psychopathology. Each one holds some potential for personal growth.

Or I can keep going to class on Wednesdays and be in that group, whatever that means. I’m increasingly convinced that it needs to include coming out as having mental illness, even if the conditions are not ideal. I could be so vague as to say “I have a mood disorder” or explain that “I live with depression, anxiety, and occasional hypomanic symptoms.” I’m leaning toward the latter because it paints a more interesting, complex, and accurate picture.

I really hope that whatever I say will encourage the other students in that class who have mental health issues to speak up, because there’s no way I’m the only one. One of the readings for this week (by Yalom) was all about how the therapist needs the courage and confidence to be human in the therapy group – fallible, affected by group members, and in the process of learning about zirself through zir experiences in the group. Part of being human is having mental health issues – by Yalom’s definition, difficulty relating with others and functioning in groups, and even doing things that aren’t necessarily healthy in an attempt to be accepted by a group. Group therapy is therapeutic because it provides a safe place to stop doing those unhealthy things and try out new ways of being with individuals and groups – a space that is created and maintained first and foremost by the therapist. How can we create such a space for our clients, if we can’t do it for ourselves?

Before I can do it for my (future) clients, I need to do it for myself. I’m already a member of a group of student therapists who are learning to do group therapy and (probably) feel just as uncomfortable as I do. As much as I want to claim that I’m coming out to help and/or teach the other students in my class, what it ultimately comes down to is that I can’t struggle to pass as “sane” anymore. It hurts too much and requires too much energy. I need to be in the world and I need to be fully myself, including my mad self. Why not here and now?

Links:

Everyday Health: Cognitive Restructuring

Mind Tools: Cognitive Restructuring – with free downloadable worksheet