Permission To Be

The knots in my muscles
Were my cage armor
But you smoothed them out
Taught sore muscles to relax
And set the demons free

My massage on Thursday was bittersweet. The therapist did a really excellent job of massaging the areas that really needed it. She succeeded in getting muscles to relax that had been clenched for so long, I’d forgotten what it felt like not to be tense.

Physically, and to some extent emotionally, it felt wonderful. But those muscles held thoughts and memories that were too difficult for me to deal with at the time. As they came flooding back, the primary emotion I felt was guilt. I felt guilty for everything.

As I realized this, I tried to figure out who it was I needed to apologize to. Deep, very deep, inside, I found the little girl who is hurting so much. I apologized – for not protecting her, for not listening to her, for siding with the people who questioned and ridiculed her.

And she forgave me.

It’s not your fault. You were hurt just as much as me. My pain is your pain, my anger your anger. We’ve both been wronged.

I find it easier to feel guilty than to accept that reality. If I’ve done something wrong, at least there’s something I can do about it: I can punish myself. Take that away and all I have is sadness and anger. Unquenchable anger I cannot direct at anyone.

To a child, the adults in hir life are gods. Any anger they provoke is best turned inward; better to suffer one’s own wrath than theirs. I learned that one the hard way and spent most of my life thinking I’d deserved to be physically and emotionally abused. I’ve been emotionally, and at times physically, abusing myself.

Fox and I visited with a couple of friends only hours after the massage. We played two board games. Through a combination of luck and (dare I say it?) excellent strategy I won the first game twice. The second game is very complex and challenging and I was struggling with severe depression symptoms, so I (felt like I) wasn’t able to use as good a strategy. I was winning for most of the game and came in second out of four players – despite being on the verge of tears, having trouble making decisions, and thinking I was doing poorly because I hadn’t advanced in certain areas as much as the other players had.

I think, deep down, I was proud of myself for doing as well as I did. I’m proud now, as I write this. But at the time I didn’t – couldn’t – feel it. Instead I felt guilty for winning the first game because my success required that my friends didn’t do as well, and therefore were disappointed.

I started the second game with a strong strategy, but backed off in response to innocuous comments about how it was affecting the dynamics of the game; without that strategy I felt lost, like I was constantly trying to catch up. I couldn’t see how well I’d done or that it was a good thing; when I realized I’d managed to come in second I felt worse.

I noticed a disconnect between my thoughts and emotions / emotion-related bodily sensations that I found very disconcerting. I mentioned it to Wakana during our session on Friday and told her about feeling guilty when I won the games.

She tied it into my experiences growing up (and my relationship with my mother). From what I remember, at least, I really lacked adult advocates. The staff at the after school program punished me when the other kids knocked down the zoo I’d been building (Breaking and Entering). The teachers and principal at my elementary and middle school didn’t know what to do with a gifted female student who consistently got much higher grades than her predominantly male classmates. They tended to penalize me – by not calling on me, taking away the book I was reading because I was bored in class, and raising the other kids’ grades to be comparable to mine without giving me any praise or benefit for doing as well as I did. They didn’t stand up for me when I was bullied by the male students, but punished me when I retaliated.

When I entered high school I wanted to remain as anonymous as possible to avoid the wrath of my peers. I had some friends whom I unfortunately didn’t have many classes with; I didn’t make friends with the other students in my honors and AP classes. That was a mistake; I felt ostracized most of the time and resented by my “friends” for consistently earning first honors.

My experiences in college taught me that I’d focused on academics to the detriment of my social and emotional development; though I still did well enough in school to graduate magna cum laude I feel like I’m wrong for “boasting” about it. I know it’s an accomplishment, but it doesn’t seem like something most people in most settings would appreciate.

The graduate classes I’ve taken so far have been wonderful because I’ve felt about average to perhaps above average among my classmates – definitely not the smartest, most capable, or most talented person in the room. I’ve felt like my contributions have been appreciated AND I’ve learned a lot from my classmates.

The undergraduate classes I took while in graduate school expanded and enriched my understanding of the world a great deal; I feel very fortunate to have taken them. I learned a great deal in them, from the other students as well as the course materials. But I did notice a difference in the level of critical thinking I’ve become accustomed to, compared with what is expected at the undergraduate level. I often felt very different from the other students because of this.

Maybe masquerading as an undergraduate student wasn’t the best idea. It taught me to once again hide a very significant portion of who I am, to deny one of my greatest strengths. I’m smart. I love to be challenged intellectually. I’m very good at learning – not only ingesting knowledge, but thinking critically about it and applying it to situations. I’m also very good at doing research, organizing the information, and drawing conclusions from / making an argument based on it. I have at least 8 years of experience. References available upon request.

So I’ve focused on my academic development to the detriment of my social and emotional development, lacked support in developing healthy, honest relationships with the majority of my peers, and learned to hide the very thing that has been my primary strength in some weird misguided effort to “fit in.” I like to think that I would have done very well in school anyway, because I’m naturally good at learning and take pleasure in producing well-written (and edited!) papers.

But I did most of it – especially in my younger years – because it’s what my parents needed. They needed their daughter to get straight As, so I did. An A was never an accomplishment (until I reached college). It was making ends meet. Getting by. Survival.

Wakana beckoned me to the piano to sing and express how I felt about all of this. She started playing chords and asked if they sounded appropriate to how I was feeling; I just kind of went along with it because I felt like I didn’t have an opinion, and if I did it didn’t matter.

I apologized for not being the perfect daughter. Wakana sang that there is no such thing as perfect, and started repeating “I’m enough” in the defiant, insistent voice that comes out when we’re practicing setting boundaries. She tried to get me to join her, but I couldn’t say it with conviction. I asked it once or twice before breaking down into tears.

The whole world says I’m not enough, and I’m afraid to show them the truth because it goes against the dominant values in society. I don’t want to be further ostracized. I don’t want to be hurt any more than I’m already hurting myself.

Relaxation: There’s an App for That

I’ve been taking some steps toward taking better care of myself, largely relying on the apps that are available to me now that I have an Android tablet.

Icon for the app "Stop Panic and Anxiety" by Excel at Life

Icon for the app “Stop Panic and Anxiety” by Excel at Life

The app I’ve found most useful so far is called “Stop Panic and Anxiety” and is available for free. It plays “audios” (streamed from the internet, which admittedly is not always ideal) for panic assistance, emotion training, and relaxation. I’ve been listening to one of the relaxation audios – essentially, guided meditation with music – to help myself fall asleep at night. My muscles seem to melt as I listen to it and I start to feel better. It should help even more if I listen to the other audios (not the one I use to fall asleep) at different points during the day.

Icon for the app "Depression Inventory" by Handcarved Software

Icon for the app “Depression Inventory” by Handcarved Software

I’ve also been using 2 other free apps, “Depression Inventory” and “eMoods”, to track my symptoms. My score on the Depression Inventory has been remaining steady in the mid-40s, securely in the “moderate depression” range.

Icon for the app "eMoods" by Yottaram LLC

Icon for the app “eMoods” by Yottaram LLC

eMoods is nice because I can track some contributing factors (medication, hours slept, verbal therapy, etc.) as well as my depression, irritability, and anxiety. I’m not entirely sure how useful tracking is right now as I’m not really seeing any change, and it can be very easy to keep giving the same responses. I think eMoods would be more useful if I had a way to measure my anxiety and irritability, as I’ve been using the Depression Inventory to measure depression. Back to the app store!
(eMoods is intended for people with bipolar and also measures elevated mood.)

Icon for the app "Assistant" by Speaktoit

Icon for the app “Assistant” by Speaktoit

Another app I’ve been using is “Assistant”, which I found by searching for Android equivalents of Siri. It’s the only one I’ve found that lets you set reminders that repeat every day (but not weekly, e.g. every Thursday). In theory it’s very useful, except that I find it way too easy to just ignore the reminders. If I pay $3/month or $20/once I’ll be able to teach it my own commands, customize its appearance and voice, etc. I’m still debating whether I think the upgrade is worth the cost. It might be if I can teach it what “every Thursday” means – and decide to stop ignoring the reminders!

Finally, I’ve renewed my commitment to actually using all the prepaid massages I’ve accumulated at Massage Envy. The way their membership works, you pay about $60 per month and can get a 1-hour massage at no extra cost (other than tip/gratuity). Any additional massages you get that month are at a reduced cost. If you don’t use your prepaid massage one month, it carries over to the next. And so on.

I let so much time pass between massages that I estimate I have about 13 prepaid massages available to me after using 2 of them on hot stone therapy on Sunday. I can’t afford to keep paying the membership fee while I’m not working, but if I cancel my membership I’ll lose the prepaid massages and have wasted hundreds of dollars! Ideally, if I use the massages they will help me feel well enough to find and keep a job; then I might be able to afford to continue my membership. Otherwise, I’m hoping to gain some benefit while using up my existing massages so I can cancel my membership guilt-free.

The massage on Sunday was good, but I left feeling a bit disappointed. I think the biggest factor was that the muscles in my scalp and face were very tense, but my therapist didn’t massage them because doing so was not part of the hot stone therapy (nor, I learned later, one of his areas of expertise). It was very hard for me to feel relaxed and rejuvenated when my jaw was sore from clenching, even though I’d enjoyed most of the massage and felt the muscles that were massaged relax. I also think (and realized then) that I was wearing depression goggles: it’s really hard to feel good about something when you feel completely drained and sad.

The most useful part of Sunday’s appointment actually happened afterward. I politely told the receptionist that my face and scalp were very tense, but the therapist had not massaged them, and asked why. She suggested a different type of massage and went out of her way to schedule me an appointment with the best therapist available on my preferred day who specializes in the technique. We made it a 90 minute massage (using 1.5 prepaid massages), with 30 minutes of cranial sacral massage and an hour of full body. Based on the recommendation of the hot stone therapist, I might request that the hour be spent on just my upper body.

Ironically enough, Massage Envy also has an app. It’s not compatible with my device, though, and several of the reviews advise against using it because it’s not for making appointments. That’s okay, though, in this case I think I’d much rather talk to a human being.

Ziya’s Day

I had a positively wonderful massage at my local Massage Envy today. The therapist who worked on me recommended medical massage to relieve the tension in my back; we compromised by dedicating the 1st half of the massage to medical and the 2nd half to relaxation. Without me saying a word about my diet and exercise habits (or lack thereof), she was able to tell that I was dehydrated and suffered from malnutrition based on the areas and degree of tension in my back. She said I needed to drink more water, eat more fiber (beans & vegetables), reduce my sugar intake, and start exercising. She also realigned my right leg and both hips, literally helped me breathe more easily, and (I thought) improved circulation to my arms.

I opted for aromatherapy during my massage, namely the “Anxiety Release” blend. The aromatherapy in conjunction with massage helped me to relax, both physically and emotionally. Though the therapist said I “slept like a baby,” I was actually awake, listening to the relaxing background music and feeling the massage with my eyes closed. I was also thinking quite a bit about what I can do to take better care of myself.

Thinking clip art#1

Obviously I need to do the things the therapist recommended, including getting massages regularly (for now, every other week; I’m hoping to be able to reduce that to once a month by the time I’ve used up all the pre-paid massage hours I’ve accrued).

I also need to take one day off each week, a day dedicated entirely to my mental, physical, and spiritual health. It will be a day when I do not have to do anything for Mom – unless it is an emergency. A day to relax, get a massage, turn off the computer and other electronics, express my spirituality and creativity, and really focus in on my health. On this one day per week I am thinking of abstaining from foods with added sugar, and limiting my diet to whole fruits and vegetables, beans, nuts, eggs, and maybe milk. I’ll be happy to spend time with loved ones on this day, as long as that does not interfere with me focusing primarily on my well-being.

CaptureMay

I love the idea of my day for all this being Wednesday because it’s smack in the middle of the week! What better way to put myself at the center of my own life? Wednesday should work for now, based on my and Mom’s schedules, but if necessary I can change it to another day. However, I will not compromise having one day per week to myself – unless there is an emergency.

I hate tracking food (and planning meals), but I need to get a realistic idea of how I’m eating in order to improve my nutrition. I’ve used SparkPeople in the past and find it mostly good for tracking and to some extent receiving motivation to live a healthy lifestyle. There are a lot of ads that get annoying and send messages I’m not entirely confident are healthy, but using the site is otherwise free of (monetary) cost. I did have to spend a lot of time looking up nutrition info on other sites, though. :-/

My biggest gripe, though, is that it doesn’t really give one the information needed to track the “nutrient” I’m most concerned about right now: sugar. I could track my fructose and sucrose intake, but the site provides no guidelines regarding how much of each I should consume. “Sugar” only exists when you’re viewing or inputting nutritional information for a specific food; it is not a “nutrient” you can track, nor are there clear guidelines – on SparkPeople or in general! – on how much of it one should eat in a day.

Based on this LiveStrong.com article and the daily range of calories recommended to me by SparkPeople, I figured out that the maximum amount of sugar I should consume in one day is 31 grams. Just the 2 chocolate chip cookies I had hours before my massage contained enough sugar to put me over this limit for today.

I'll use an Excel spreadsheet to track sugar in foods I eat, excluding the natural sugar found in fruits.

I’ll use an Excel spreadsheet to track sugar in foods I eat, excluding the natural sugar found in fruits.

It’s not something I expect to be able to adhere to every day, but I hope that at least intermittent tracking will hep me to become more aware of what I’m putting into my body. Maybe it will help me makeĀ better choices more in line with my need to be healthy and live a fulfilling life!

Aromatherapy Treatment of Anxiety and Depression: More Research Needed!

I did some research in peer-reviewed scientific journals about the efficacy (effectiveness) of aromatherapy as a treatment for anxiety and depression. Most of the articles I read seem to support it as a complementary treatment – that is, to be used along with traditional treatments such as psychotherapy and medication. There is a need for research that 1) separates the effects of aromatherapy from that of massage and 2) examines the relative efficacy of specific essential oils. Lavender is an essential oil that might help with anxiety, depression, and sleep disorder.

Here are my notes on three review articles:

A review of 16 studies from 1990 to 2010 found that aromatherapy can safely be used as a complementary therapy to reduce anxiety (Lee, et al, 2011). More research is needed to understand how best to implement it (e.g. massage or inhalation) and why it works biologically.

A review of 6 studies from 2000 to 2008 found that aromatherapy-enhanced massage can safely be used to improve mood in people with depressive symptoms (Yim, et al, 2009). A substance found in essential oils, citral, “produces relaxation and antidepressant effects” (192). It is unclear whether particular essential oils are more effective than others; additional research is needed.

Perry & Perry (2006) examine use of aromatherapy in a variety of disorders, including sleep disorder, anxiety, and depression.

Sleep Disorder – “In one study, a blend of basil, juniper, lavender, and sweet marjoram was applied by hand massage; satisfactory sleep increased from 73% to 97% of patient nights […]” (264). Lavender is the essential oil most discussed in the treatment of sleep disorders.

Anxiety – There is limited support for use of aromatherapy to treat anxiety, but of the essential oils, lavender seems most promising.

Depression – There is some support for the use of chamomile, citrus, and lavender. Controlled trials are needed to confirm efficacy.

For more information about aromatherapy, including safety and quality information, visit the National Association for Holistic Aromatherapy.

References

Lee, Y., Wu, Y., Tsang, H.W.H., Leung, A.Y.., & Cheung, W.M. (2011). A systematic review on the anxiolytic effects of aromatherapy in people with anxiety symptoms. The Journal of Alternative and Complementary Medicine, 17 (2), 101-108.

Perry, N. & Perry, E. (2006). Aromatherapy in the management of psychiatric disorders: Clinical and neuropharmacological perspectives. CNS Drugs, 20 (4), 257-280.

Yim, V.W.C., Ng, A.K.Y., Tsang, H.W.H., & Leung, A.Y. (2009). A review on the effects of aromatherapy for patients with depressive symptoms. The Journal of Alternative and Complementary Medicine, 15 (2), 187-195.