Healer, Heal Thyself

I came up with a music therapy intervention that not only meets the criteria for at least one part of my piano improvisation midterm, but is also useful for me in my everyday life! I was playing an ostinato (repeated musical pattern) in Mixolydian and kept thinking: “this wants to be a movement intervention, but it’s so tranquil.” I kept imagining myself slowly raising my arms above my head and inhaling, then lowering them and exhaling – like one might do as part of a warm-up for yoga.

Everything I’ve been learning about improvisation, psychotherapy, music therapy, and improvisation points to the same essential guideline: Work with what the client is giving you. My mind was giving me a movement, so I decided to go with it. I played the ostinato in my left hand, used my right arm to do the movement, and sang instructions with the melody that felt most natural. I added turning to one side, back to the center, to the other side, and then back to the center again.

Then I changed up my playing and added my right hand. Initially the music (including my vocal melody) had been very flowy and tranquil, “holding.” I changed it to be more like playing a drum, with shorter sharper notes and pauses between chords, “driving.” It also became slightly faster.

I sang instructions to step side to side and clap, similar to what one might expect in step aerobics. There is an option to increase the tempo (speed), depending on the client’s response and how much time there is for repetition (I need to keep it short for the midterm). I suppose other directions, such as forward and back, and possibly even turning one’s body as one steps, can be added.

After a short time, I returned to the original “holding” music (including vocal melody). I sang instructions to turn to one side and then the other first, then ended with the instructions to raise and lower arms. This gives the exercise a nice symmetry and is intended to help the client remain calm and focused. The whole thing takes about 2 minutes.

Music therapy students are encouraged to be specific regarding which clients would benefit from an intervention, what needs it addresses, and how it meets those needs. It didn’t take me long at all to realize that a simple movement activity like this would be very helpful for me: an able-bodied individual with anxiety and depression, who can follow verbal directions and typically lacks the energy and motivation to exercise.

Everyone (including scientific research) says that physical activity is a highly effective “treatment” for depression, possibly the most effective. I’ve experienced its benefits firsthand, when my symptoms have been mild enough to allow me to do it. The problem is, an intervention doesn’t work if it’s inaccessible to the client (for example, I’d need to modify my instructions – or even come up with a whole new activity – for someone who uses a wheelchair). So, even if exercise could cure depression it doesn’t, because the symptoms of depression prevent exercise.

Which is where my intervention comes in. I could totally see Wakana doing something like this, particularly on a day when my energy and motivation are so low I ask to meet via Skype. I can hear her voice saying, “Stand up, we’re going to do something about this;” I can feel myself groaning as I drag myself out of my chair and scowl at her – annoyed, but secretly hoping that whatever she “makes” me do will provide some relief.

It starts out holding, comforting, with very simple movements that don’t take a lot of energy and can feel good as soon as I start doing them. It’s meeting me where I am: in need of emotional support. The amount of movement, energy, and coordination required increases gradually. When used as a live intervention, the therapist can adjust the level of challenge to meet what the client is capable of at that time. It can be recorded and used by the client (e.g. me) as a daily movement activity that is a million times easier than going to the gym, taking a walk, or even playing Wii Fit. Hopefully it will provide enough energy to encourage additional exercise.

Physical movement aside, I believe listening to the musical intervals (the specific sound created by playing two particular notes simultaneously or consecutively) in my intervention can be intrinsically healing. The Anthroposophical Concept of Intervals describes them in terms of 1) inner or outer focus, 2) movement or stillness, and 3) balance or tension. I find that my musical self-expression, especially when my symptoms are at their worst, tends to involve mostly intervals that are associated with inner focus and tension. There is definitely a place for these elements – in life and in music – but sometimes we need a break from them!

When I was creating this intervention I intentionally chose intervals that are associated with 1) both inner and outer balance as well as 2) active movement outward. Whether I move my physical body or not, use of these intervals reassures me that I am safe and I can direct my energy outward. In other words, these intervals directly contradict the distortion at the core of my mental illness. They free me to be the healthy Self I always am.

All that, in two minutes! I love music therapy.

I Dream of Jarvis

I’ve been having a difficult time since my and Fox’s legal marriage ceremony. The worst was when I broke down in tears in the shower, plagued by thoughts such as “I’m a waste of resources.” It’s not the words themselves so much as really believing them, not having anything left in me to try and refute them. How does one refute one’s own brain, anyway?

I was lost.

Wakana said it was because I allowed myself to become too enmeshed with Fox, going along with what he wanted and making excuses to neglect my own wants and needs. “You’re acting like Mrs. Fox Tamesis!”

She encouraged me to keep asserting myself, to demand to be recognized as a separate person, to act like a separate person, to prioritize my own needs. She helped me to find a practical outlet for my emotions: writing and performing songs about the things that get me so angry, I finally feel alive and motivated to do something. This would enable me to express myself and practice the music skills I need to develop in order to feel confident applying for internships, while also possibly influencing how others think about the topic. (I have yet to actually act on this, by the way.)

‘Cause that’s the thing, I know how to recover from anxious depression. I’ve written about the different aspects that go into it for almost a year now. I have most of the tools at my fingertips; the only part that might be a bit difficult for me to access is medication because first I need health insurance, then I need a good in-network psychiatrist, then we need to work together to find something that works for me.

But the rest? It’s just a matter of changing my entire lifestyle and staying consistent with it, especially when I want to do it the least. No single thing I can’t do.

Reading books and applying their wisdom about how to change my thought processes, check. Forcing myself to smile when I notice myself frowning (it really feels much better – physically first, then emotionally), check. Taking SAM-e, Omega 3, Vitamin D, and a B-complex first thing in the morning, easy peasy. Exercising until I start to sweat, piece of cake. Eating mostly healthy foods and having dessert foods as a treat … that’s a little bit harder, but I can do it. Going to bed and waking up at decent hours, sure! Thanking the universe for the good things in my life, fun and simple. Listening to music, fantastic. Heck, I can make my own!

Actually, I could probably do all these things in one day and still have time to watch Star Trek: Voyager
with Fox. The problem isn’t knowing what to do or even doing one or all of them.

The problem is doing it consistently. The problem is doing it when I wake up hating the world and myself. The problem is doing it when my brain gets stuck in its awful feedback loop that paralyzes me and leaves me feeling like crap. Whatever I feel the most guilty about (e.g. Schmoozer‘s suffering and death), it makes me relive the moment of my horrendous failure, the crushing guilt, the devastating grief, the simmering anger. It rips me to shreds and leaves me lying there bleeding.

“Exercise is great for treating depression.”

“Think of one positive thing.”

Don’t get me wrong. The people who say these things are trying to help. They care a great deal. And I appreciate that they’re trying to help me. I want to take their advice, not just complain about it.

But they’re not here to remind me of these things when I need them the most, such as before my brain gets stuck. When I just woke up. When I’m on Facebook instead of exercising.

I think I said it best in my reply to someone’s comment on my post, A Cure for Anxious Depression:

I’ve been increasingly feeling like I need someone to get me going in the morning, get me to exercise, make sure I’m eating healthy (including cooking for me when I don’t have the energy) and taking my supplements, remind me to think those positive thoughts. But I can’t ask my mom to do it and I think that would be a lot to ask of Fox, especially since he could use the encouragement, too. Hiring someone to do those things isn’t really an option; I’d practically need the person to live with me.

I’ve been thinking about this a lot. Even if it is possible to hire someone to live with me (that would get awkward, considering Fox & I have a one-bedroom apartment!) and dedicate all their time and energy to making sure I’m doing what I need to take care of myself, there is no way in hell I’d be able to afford their fee. No way! And besides, it seems a really cruel thing to ask of another human being.

Enter Jarvis, stage left. He’s an artificial intelligence who helps Tony Stark do absolutely amazing things in the Iron Man movies. He helps design Stark’s suits, is essentially their operating system, and is there interacting with Stark throughout his adventures. A constant companion who is calm, provides useful information, never gets angry, never berates Stark, and even reminds him of things like the importance of sleep. He’s always on, always paying attention; he always seems to notice and care when Stark is having a hard time.

Oh how I wish I had something like that! Something that would wake me up in the morning with a reminder of what’s good in my life and encouragement to have a nice healthy satisfying breakfast. Something that would tell me when it’s time to take my supplements and exercise and go to bed. Something that would be able to tell when I was feeling so sad and/or anxious it was interfering with my ability to function. Something that could say just the right thing to stop the feedback loop and bring me back to reality. Something that could come everywhere with me, a constant companion, who would exist solely to meet the needs that weren’t met when I was a child and can’t be met in my current, adult relationships. Something I could program on the days when my brain is working, to compensate for when it isn’t.

I’m pretty sure such a program doesn’t exist – yet. But the pieces are there, scattered about in existing technology, just waiting to be combined and used.

Going back to the metaphor in my last post: There are blocks of varying shapes and sizes; bins full of zebras, giraffes, and lionesses; straight and curved train track pieces that all fit perfectly together; and in the palm of my hand is the engine of the train. I even have some ideas about how to get started.

But this time I’m asking the other kids to build a zoo with me, so we’ll all get to play with it once it’s finished and no one will want to knock it down.

Dear readers, you are the other kids. If any of this sounds at all intriguing, please contact me! The best ways to do so (in this order) are to comment on this post, fill out this web form, or email ziyatam@hotmail.com. I could really use some help from one or more people experienced in computer programming and/or software engineering.

What do you think about using a computer program or app as support for improving mental health?

What would you want such a program or app to be able to do?

How can we make the program or app accessible to everyone?

Re-Igniting the Spark

I randomly decided to re-join SparkPeople today, and it was so worth it!

One of the first things I did was join “teams” focused on dealing with depression and anxiety, which I’m hoping might provide some additional information and social support. I also joined 7 other teams, set a plethora of goals, and proceeded to track everything I ate. And guess what – it’s telling me I need to eat more – calories and protein, to be exact.

Fox and I made an epic grocery shopping trip, during which we spent way too much money and – by conservative estimates – walked for at least an hour! Boom! That’s 1/3 of my exercise goal for the week! Booyah!

We came home with plethora of fresh fruits and veggies, yogurt, frozen veggies, and minimally-processed meat. I had a delicious apple (“Oh Spock! This is amazing! Why don’t I eat apples every day?”), and a little bit later, we cooked.

Namely, we made delicious tacos: ground beef, cheese, and bell peppers in spinach wraps. And Fox made a huge Caesar salad, which we enjoyed before the tacos. It was actually too much food – I doubt I’ll be hungry again in time to eat that last bit the tracker is saying I need. I loved every bite and felt really good eating it – in part because it was fresh and in part because I’d done half the work to make it. (When we cook, we cook as a team.)

I’d forgotten how much I love cooking. It’s so much fun, and so rewarding. 😀

Best of all, we have leftovers, so we get to enjoy our delicious cooking again!

And something about getting points for doing basic things I should do anyway (such as taking a few minutes for relaxation) makes them seem so much easier. “Yeah, sure, I can do that. It’ll only take a few minutes, and it will feel good.” That’s what I really like about SparkPeople – it’s not just about losing weight. You don’t have to make it about weight at all (though the weight-loss ads are kind of overwhelming). My goals are to get at least 8 hours of sleep a night and listen to music at least once per day and actually go tend to my garden each day and cook at least 3 times a week (and so on …).

And if it kicks my butt to exercise, all the better. If it inspires me to make healthier food choices, all the better. I’m feeling really good about this decision, really hopeful. Today felt wonderful – and it was just an ordinary day in which we ran some errands. Nothing special.

I know from experience that I’m high from starting something new. Over time – probably before long – my enthusiasm will wane. I wasn’t planning to get too involved in the community aspect of the site, but maybe I will. If I make friends, then they can encourage me to stick with it when I don’t want to be bothered, and I can do the same for them.

You’re welcome to visit my Sparkpage – and friend me, if you’re on SparkPeople. Let’s see where this rabbit hole goes!

Taking the First Steps

I finally started training for the overnight! Here’s how things have been going:

2013-03-04-calOn Monday I made my first efforts to actually WALK. It was a beautiful day: sunny, with gorgeous blue skies, not terribly cold, but a bit windy. Fox and I walked about 0.8 miles from his home and then came back the way we came, for a total of approximately 1.6 miles – a 10th of what I need to be able to do in 85 days.

I would have been able to go farther if it hadn’t been for time constraints and the difficulties I had when we were going uphill for the second half of our walk. The exertion caused me to breathe more heavily – that was fine, I would have been surprised if that hadn’t been the case. My nose was stuffed and I had no way to clear it, so I was forced to breathe through my mouth and cope with post-nasal drip. The resulting discomfort hampered my enjoyment of the walk; I learned that I should always carry tissues. A decongestant might not hurt, either.

On Tuesday I walked 2.8 miles in a loop near my house, despite being rather tired. I had to push myself, my muscles and joints hurt, and I got a blister on my heel. I was struck by how far a mile is when one has to walk it, especially if one is in pain. However, I think I found a relatively healthy balance between pushing myself to complete the walk and knowing my limits; I took breaks as necessary.

I took off from walking on Wednesday and Thursday. My plan on Wednesday was to give my blister time to heal. On Thursday I thought I would walk – but the weather was gross, so my only walking was the trek across campus.

Week 1 of training for the Out of the Darkness Overnight

Week 1 of training for the Out of the Darkness Overnight

On Friday I decided to do some strength training with my fitness ball. It comes with a workout guide including instructions and illustrations for:

  • Ab Crunch – central abs
  • Oblique Twist – central abs, obliques
  • Jack Knife – central abs, obliques, lower abs, lower back
  • Pelvic Raise – central abs, lower abs, glutes
  • Outer Leg Lift – outer thighs
  • Push-Up – central abs, chest, shoulders, triceps
  • Opposite Arm / Opposite Leg Lift – central abs, lower back
  • Hover – central abs, lower abs, lower back

I am a beginner, so (per the instructions) I did 12 reps of each of the exercises above that are in bold. I tried, but was unable to do, the Hover. Balancing on a giant ball is hard.

Most people "fall off the wagon." Apparently I fall off the ball!

Most people “fall off the wagon.” Apparently I fall off the ball!

Out of the Darkness: This won’t happen overnight.

So, for anyone who doesn’t know, the Out of the Darkness Overnight is a 16- to 18-mile walk that takes place overnight; it is an endurance event (to raise money for research and programs to prevent suicide and help survivors).

theovernight.org

theovernight.org

I’ve never done anything like this before. I’ve done a 2.5-mile MS Walk (National Multiple Sclerosis Society). I’ve done Relay for Life, which was overnight but had a track I could walk as many or as few times as I wanted; I spent much of the night not walking. Never before have I walked for hours and hours on end. The most I’ve walked at once is 5 miles.

The idea of walking all night scares me. I wouldn’t have signed up, if I’d really thought about it beforehand. To be honest, I’m kind of glad I was impulsive.

This is a nice kick in the pants to make the lifestyle changes I need to be healthier – both physically and mentally. Thinking about what I’ll need to do to prepare for this event has helped me realize: When I said I was “walking to save my own life” yesterday, I meant it literally. It’s gotten to the point where my idea of “physical activity” is walking to class, and “eating vegetables” is putting tomato sauce on my pasta. I’ve developed a habit of having Pop Tarts for dinner because I can grab them from a vending machine before class. (They’re probably the most hunger-satisfying, not-absolutely-horrible-for-you option in said machine.) Last night my “dietary success” was having nachos after class – because the menu listed calorie counts and the alternative I was considering had twice as many! It’s not that I don’t know how to live a healthier lifestyle. I need motivation.

countdownWell, Ziya, this is it!

Starting today, I have 16 weeks to prepare. 16 weeks to go from eating Pop Tarts and getting out of breath from a brisk walk across campus, to being capable of walking 16 to 18 miles in one night.

… somehow …

Today I am starting small. I am learning to become more aware of when my body needs water. Too often I let it go until my mouth is unbearably dry, just because I’m too lazy to get up and refill my glass! That will not do at all. So, my primary focus for this week will be on (re-)learning to keep water near me at all times and drink it frequently, before I feel thirsty.

I’ve also been meaning to start planning my meals ahead of time. I keep putting it off because I find the process very tedious, but I’ve seen how well it works for other people and how poorly not planning has (not) been working for me.

My primary reason for wanting to do this is to make life easier on days when I need to eat away from home. If I have healthy food with me, it will save me the stress of trying to make remotely-healthy choices that aren’t too expensive – while hungry. Of course, in addition to planning my meals, I’ll need to make preparing them ahead of time a priority. Half the reason why “eating vegetables” means putting tomato sauce on pasta is because that’s a very easy, mindless thing I can do when I’m too hungry and distracted to cook properly.

theovernight.org

Stretching is crucial.

Finally, it seems stupid to put off any kind of physical-activity-related preparation until next week. This is the part I find hardest to embrace, so I’ll start really small: my legs have been screaming at me to stretch them! I’ll start doing the stretches in the Overnight: Stretching Guide at least once per day. Perhaps I can also get up the guts to look at their Training Program (PDF), which includes a 15-week option.

Why am I craving pizza bites?