Emotion Regulation – What is That?!

In Dialectical Behavior Therapy, there is a massive emphasis on Emotion Regulation. In fact, along with Mindfulness, Distress Tolerance, and Interpersonal Effectiveness, Emotion Regulation is a pillar of DBT. Put simply, Emotion Regulation is a set of skills you can use to prevent yourself from getting into extreme emotion mind. Now, that may sound a little overwhelming at first. I know it did to me. But feeling overwhelmed is exactly the sort of thing that Emotion Regulation can help you navigate.

If you’re living with a mental health diagnosis (or diagnoses), I’m willing to bet that 20170417_234240.jpgyou’ve experienced strong negative emotions that have scared you. Maybe you’ve even acted on those emotions. The fact is, a lot of us are afraid of our feelings, especially when they are “negative”. Why? Because we’ve been conditioned to fear them. If you grew up in some miraculous, Utopian society and family where you were free to express every emotion you felt without punishment or mockery or belittlement, chances are good that you do not often struggle with overwhelming emotions. But, by virtue of our culture and family dynamics, most (none?) of us were able to fully express every emotion when we were growing up, or even now as adults. Perhaps you’ve learned over time that anger is “bad”, that sadness is “not allowed”, that crying is “weak”, or even that being overly joyful is “rude” (if you were ever told to “be quiet” for innocent childhood play, you know what I mean). We start to feel these things we’ve been programmed to repress, and then we say “I can’t feel that!” “Don’t think about that!” “This is not ok and I need to stop!”. 

LET’S TRY A LITTLE EXPERIMENT: DO NOT, UNDER ANY CIRCUMSTANCES, THINK OF A POLAR BEAR. Don’t picture a big white bear walking across a glacier, digging into the icy water with his black paws for some fish. Don’t picture that long white fur swaying with each step. Don’t picture that black nose set at the edge of a white face. DON’T THINK OF A POLAR BEAR.

What were you thinking just then? Were you picturing a polar bear? I was as I wrote that. Do you see what happened? When we tell ourselves “I can’t think about this!” “I can’t feel this!” What we actually do is unnecessarily magnify the very emotion we’re trying to avoid. We’re making it harder. We’re making it worse.

These patterns become ingrained in us. We learn to fear our emotions or we become out of touch with them completely. In either case, we end up bottling them until they simply cannot stay stuffed down any more and they explode out of us like some stupid emotional confetti at a terrible party where no one’s in charge and everyone’s freaking out and running away from the shower of undesired specks of paper. The fact is, if we become disconnected from or afraid of our emotions, we lose the ability to be comfortable with the things we feel. This discomfort translates to feeling like we have absolutely no control over our emotions. Feeling out of control is a bit of a self fulfilling prophecy: emotions will dictate your actions and reactions if they feel “too big” to handle.

20170418_021416.jpg

Here’s the thing, though: EMOTIONS ARE NEUTRAL. We assign identifiers like “pleasant” or “unpleasant”, “good” or “bad”; but, at the end of the day, emotions are nothing but information. As an analogy, if you put your hand on a hot stove but can’t feel the heat, you’re going to leave your hand there as it blisters and burns. You may continue to place your hand on hot stoves and, later, wonder why your palm looks like a broiled sirloin. This is like being out of touch with your emotions – you can’t get the important information the heat and stove are giving you. Conversely, if your emotions completely overwhelm you, you may feel the heat and notice the burning, but not understand that it’s because the stove was hot. You might develop a habit of avoiding placing your hand on any surface for fear of sustaining another injury. The fact is, you need to feel the burn of the stove and understand the context so you can identify exactly what hurts and why, and pull your hand away before it’s seriously injured! Otherwise, you’re moving through life with incorrect information and making ill-informed decisions that don’t actually address the cause of your suffering.

You may say, “Wait a minute! Some feelings are objectively bad!” I would argue that statement. Some events are painful, yes. Some actions we take based on our emotions can create suffering, yes. But, in and of themselves, emotions are not “bad.” Pain is, unfortunately, a part of life. It comes with the package. If you’re a living human being, sometimes, you are going to hurt. Sometimes, you are going to be sad. Sometimes, you will be angry. Sometimes, you’ll be lonely. But here’s the thing: it’s OK to be sad, it’s OK to be angry, and it’s OK to be lonely. It’s uncomfortable, yes, but it’s OK. And, in and of themselves, not one of those emotions can cause you physical harm. There’s no reason to be afraid of feeling. The trick to Emotion Regulation is learning that you can be sad without crying, and you can be angry without yelling or throwing something across the room, you can be lonely without feeling rejected – just like you can be happy without laughing.

When we accept emotions for what they are – information about a certain situation or circumstance – we can take steps to increase our tolerance and control of uncomfortable emotions. Really, we only get ourselves in trouble when we fail to accept our emotions as they are.

Personally, I’ve struggled with this concept. I’ve viewed many emotions as “threatening” and “bad” many times in my life. Living with Bipolar and PTSD can really throw your off your gauge. For me, when emotions feel too overwhelming, I tend to try to avoid them or ignore them or distract from them – this is where things like self-harm and substance abuse come into play – OR I let them become a feedback loop of negative self talk and they consume me – “You’re a loser”, “You’re pathetic”, “No one will ever understand what you’re feeling”, “It’s hopeless, these feelings keep coming back. This will never end.” These thoughts fuel depression and can lead pretty quickly to struggling with urges to isolate from friends and family, to avoid any and all social obligations or interactions, and even to suicidality.

These attitudes and responses come from repressing emotions for too long. Those repressed feelings and emotions can quickly become “too much” for us to handle, and every time we engage in avoidance or in letting them consume us, we reinforce20170417_233939.jpg the idea that we have no control over them. It is impossible to make rational decisions while emotionally overwhelmed. So the trick is to learn how to interact with our emotions in a healthy way, and treat them as what they actually are: information, a natural product of consciousness, non-threatening, and a part of us (not some unmanageable force outside the realm of our control).

We need to recognize that we can be aware of our emotions without fearing them and we can experience emotions without acting on them. And, with time and practice, we can shed the burden of that conditioning, the weight of the idea that certain emotions are “bad” or “uncontrollable.” We can be free to experience and express our feelings in ways that are not harmful or consuming or overwhelming. When we can place appropriate value on emotions (which is a skill many of us have simply never learned), then we can notice, acknowledge, and let go of the emotions that are not serving us in the moment. (For example, if you’re stuck in traffic and late for work, you’re likely feeling frustrated and angry – but you do not have to spend the entire drive swearing and punching the steering wheel and growing angrier and angrier until “that fucking commute just ruined my whole goddamn day and I’m so fucking pissed at everything and everyone!” You can notice that you are angry and frustrated, take practical steps – like calling your boss or coworkers, if possible – to alleviate any anxiety which may be fueling your anger, and then let the anger pass, recognizing that you’ve done all you can and continuing to stew isn’t going to get you anywhere.) ***A NOTE: I’m a New Englander. Keeping my cool in traffic is a skill I have decidedly not mastered yet. It’s an apt example, though. 

What, exactly, does that look like?

20170417_232042.jpg

These are the three sections of Emotional Regulation, as listed in The Skills Training Manual for Treating Borderline Personality Disorder by Marsha Linehan

Whether we’re detached from our emotions or completely overwhelmed, the first step is literally learning to identify what we’re feeling. Untangling the knotted nest of feelings we either can’t identify or can’t separate from the massive mess of overwhelming suck we’ve got cluttering our brains. Then, we’ve got to figure out what emotions actually are, what they do for us, and how we can use the information they give to benefit us and our growth. The second step is to learn actual, tangible skills to decrease our vulnerability to becoming overwhelmed or cut off from our feelings, and then learn the skills to increase our positive experiences with emotions. These together can help us find balance and strength. Finally, when emotions are still truly painful and overwhelming, it’s all about mindfulness and “Acting the Opposite.”

Over the next three weeks, every Monday, I’ll be sharing a post digging in to each of these three areas. Maybe together, we can learn a little bit about Emotion Regulation and tricks and tips to move, slowly but surely, out of extreme emotion mind.

__

A few final words on the developments happening here on Parallel Dichotomy – I’ll be following a new posting schedule: Every Monday, you can expect a resource post (like this one) sharing techniques and coping skills I’ve picked up either professionally or through my own treatment experiences; every Wednesday, you can expect either a Journal Share or another bit of personal experience and reflection; and every Friday, you can still expect the weekly “Friday Finds” posting, in addition to a Self Care Service Stop post. My progress in the Mental Cleanse Challenge will be included in the Self Care post at the end of each week until that challenge is finished. I’ll be keeping Tuesday and Thursday open for guest posts – if you’d like to contribute to Parallel Dichotomy, please email me at paralleldichotomyblog@gmail.com. Any and all pieces pertaining to Mental Health, either from a professional or personal position, will be considered for publication. Each guest post will include links to your various sites and a biography section so readers can get to know you a bit better! Finally, I’m excited to announce that I’ve created a Patreon Account – if you enjoy this blog and would like to support its continuation and expansion, please consider becoming a Patron. I’ve got some really exciting guest spots and collaborations coming up, including some Podcast appearances! Parallel Dichotomy is growing and, as a Patron, you’ll get a chance to come along for the ride! You’ll get exclusive access to content and tangible goodies! As this project grows, so will your access to perks! I’m holding my first 50 Patrons, regardless of the amount pledged, in a special category, so as this evolves and things like merchandise become available, you’ll each get some free swag as a personal thank you!  

As always, Thank you for reading! Please leave your thoughts, questions, or concerns in the comment section below, and feel free to hit me up on Facebook and Twitter!

Mental Cleanse Challenge – Therapy and Journal

Today’s challenge is a little more personal than the other ones I’ve been sharing in that it’s not necessarily a “tool” to share with you. If you want to read the more practical self-care posts I’ve done, check out G.L.A.D./ What’s Not Wrong? and 50 Things to Do, Become, or Be. And, if you want the run down on this challenge, check that out here.

While today’s tasks were not “tool based”, it was quite an important day in my little world! Today, I had my first appointment with my new therapist, and I think it went well! It was an intake, so it was like flying a drone over the landscape of my life and getting the distant, overhead synopsis of the general lay of the land. This meant giving a bullet point style recount of basic trauma’s I’ve experienced, running over the hospital and the things that brought me there, and symptoms of PTSD, Depression, Anxiety, and Bipolar and how each of those things manifest in my life – so it was a pretty heavy duty conversation to just have and leave. I understand it was necessary, but listing everything “wrong” with me with someone taking notes on the computer was a little disconcerting. Add in giving the overview of traumas I’ve sustained and I’m pretty done with people for the day.

IMG_20170405_144525_426000

That said, she was really  empathetic and seemed genuine. It’s the first time I’ve met with someone since all this started that my work history wasn’t either tossed to the side and ignored or used in a condescending manner against me (as in “Well, it’s just policy. You know all about that because you worked in the field.” in response to me trying to advocate to get into treatment sooner). She was actually familiar with the group home in which I worked by name and reputation. So, her response when I told her was, “Oooh, so your work was keeping you hyper vigilant, too, because those boys can get pretty rough sometimes from what I know.” When asking about my work and schooling, she seemed to actually view those experiences as strengths, rather than this unknown anomaly that she couldn’t integrate into treatment. And that was really refreshing, because my career in mental health has been such a huge part of my identity for the last five years that having it ignored or thrown in my face repeatedly has been pretty discouraging.

When I got home, I wrote about it in my journal and also made note of a few other things that have been going on. I’ve been slacking on entries in my physical journal, so I’m going to try to get better at that. I think it’s very helpful, both for processing the treatment journey and as keeping an in-the-moment log of thoughts and events should I ever write a book or something. (Hey, a girl can dream, right?)

So, that’s day four of my Mental Cleanse. What have you been doing today to help in your recovery or for on-going self care? If you want to share it, I want to hear it! 🙂 Leave a comment below or hit me up on social media!

On Shoveling, Fathers, and Forgiveness

If you live in New England, you’ve probably seen a lot of posts about shoveling and snow today. As I write this, I’m sitting cozy in my bed, wearing a hoodie that once belonged to my Papa, acutely aware of the fact that there is a minimum of 2 feet of snow covering the ground outside. Why am I acutely aware of that fact? It’s not all the Facebook posts. It’s the fact that I spent about 2 hours today shoveling it.

Growing up in New England secured shoveling as a familiar task to these arm and leg muscles. Now that I’m a bit older, I can safely add back muscles as an affected area, too. Despite the physical strain (and the pain I will no doubt feel tomorrow), I’ve always enjoyed shoveling. It’s quiet. It engages your whole body, but is so repetitive, it leaves plenty of time to let your mind wander. It’s nostalgic, in a strange way. For me, each shovelful of snow scooped up digs up memories along with it. Tossing that snow to the side leads to a lot of reflection on the past.

When I was very little, snow storms meant playing in the banks my Papa made as he shoveled the driveway down to the cement. That was one of his things. He shoveled with a precision no plow could ever hope to achieve. Don’t believe me?

Look at these shots of his handywork in the snowstorm of April 1997.  IMG_20170315_184753_151

That’s no photoshop or trick of the light; this man, at the age of 77, did that single-handedly with his $20 orange shovel from Hoxie’s (an Ace Hardware/ convenience store up the road). My Papa’s idea of shoveling was insane perfectionism personified.

I, too, have channeled my perfectionist tendencies into shoveling, though not in the way my Papa did. (Back road living simply doesn’t allow you to shovel down to the ground, as the dirt is frozen and uneven and there are sporadic clumps of grass in the way). My perfectionism was in my strength. I was in a constant, unspoken, competition with my brothers, to prove that I was just as strong, to prove that I could do anything they could do. I took pride in my ability to clear the driveway without help. It validated my strength. It also elicited a genuinely proud “Wow! Good job, Sheil!” from Tom, my stepfather. And isn’t praise from one’s father what every child wants more than anything?

As I was shoveling today, listening to the same ’90’s music I listened to through my Walkman back when I was shoveling with Tom, I started thinking about how complicated my paternal relationships have been. I guess the association of shoveling and being praised for it and the idea that it’s traditionally a “man’s” job got the thoughts churning. I thought of that snowstorm in ’97, I thought of snow fights with Tom, I thought of times sitting in the snowy woods alone thinking about my life and God and the nature of love and fathers when I was a kid (I have always tended to wax a little philosophical, I suppose.)

I’m not even sure where to start digging in to those complex connections.  I guess I’ll start at the beginning.

IMG_20170315_190755_004 (1)

These three photos are all precious to me. There’s my mom and my biological father with little 6 month old me, then one year old me and my Papa, and finally 13 year old me and my stepfather, Tom.

My dad wasn’t around when I was a kid. He struggled with heroin addiction and Bipolar 1 and was in and out of jail for most of my formative years. I don’t want to sound silly or overly sensitive or anything like that, but having basically no contact with my father left me feeling pretty lost as a kid. My mom did her best to assuage this by answering my questions with honesty when I asked, but the truth is, not having your dad around leaves a sort of hole in the core of your self image. Father-Daughter dances were out of the question for me. Father’s Day was confusing. (It still is, sort of, honestly.) No one “gave me away” at my wedding. When I was in school and the other kids would talk about their dads and ask about mine, the reactions to the fact that I had a stepfather were almost always shame inducing. (Baptist school, remember.) And, as kids are prone to do, the curiosity would get the best of them and they’d ask, “Yeah, but what about your real dad?” And that shame would grow along with the burning in my cheeks. Because I never knew what to say. And almost none of the other kids had any frame of reference for someone not knowing their father. I felt, deeply and at a very core level, that there must be something wrong with me. And all of the talk of “God the Father” was simultaneously alluring (maybe God can fill this hole) and discouraging (I don’t even know what that word really means.) When I would pray to God to fill the hole and be my father (a prayer I uttered frequently) it never seemed to work. Maybe I’m saying it wrong, I would think. Or maybe I’m just not meant to have any father at all. 

I want to be fair, despite my father’s absence, I did have father figures.  Papa was my constant growing up. In truth, he was the biggest and most influential father figure I had. He taught me how to ride a bike, tie my shoes, play basketball, throw a punch, sail, and gave me my sarcastic sense of humor. Though he lived 300 miles away for most of my life, I talked with him and Nana on the phone every single night when I was a kid and visited them every school vacation. As I grew older, if I was in trouble or needed advice, Papa was the first one I would call. He loved me as his own daughter, and I never doubted that for a minute. But, try as he might, he could not fill that hole of not having a “real” father.

Then, there was Tom. Though he told me explicitly not to call him “dad,” he was also a father figure. While there were many times in my life that I was scared of him, I also have a decent stash of good memories – camping in the White Mountains in New Hampshire, driving around listening to Pink Floyd, watching Star Trek,  and playing Monopoly and Poker are some of the highlights. Tom was not an overly affectionate man, though. At least not to me. The picture above is one of probably 5 hugs I received from him in my childhood. And I cherish that picture as I cherish the good memories of Tom I have.

When I was admitted at Dartmouth, part of the intake process was explaining what brought me there, which meant going into some of the specifics of what caused my PTSD. After a few days on the unit, a nurse was checking in around something (I can’t remember what exactly, my first few days there are pretty hazy from a lack of sleep coupled with med changes). What I do remember, very clearly, is this nurse saying, “This man, if you can even call him a man, Tom… god, who does that?” She spat out his name. She had no regard for the fact that maybe I had some good associations with this guy along with the bad. (As children who grow up in chaotic or abusive homes often do.) I felt that old creeping shame at her comment. I’m not allowed to love Tom. I shouldn’t love him. But I do. And I realized in that moment that all these complicated feelings from when I was a kid didn’t just go away because I grew up. That sad, ashamed little girl is still alive and well in this grown-up’s body.

Now, I need to make something explicitly clear. I love my father. I’m happy to say that I’ve been in touch with him for the past 10 years, and I have been very grateful to get to know him and to have him not only in my life, but also in my daughter’s life. But having him in my life starting at 19 cannot undo the fact that he wasn’t there when I was 9, or 16, or when I went to my first prom, or when I graduated high school with honors, or when I was accepted to college.

I loved my Papa. For my entire life, he was there, and I placed him on a pedestal. (I imagine the same pedestal that most kids place their actual fathers.) His ability to perfectly shovel the driveway is the exact analogy for how I viewed him and everything he did: perfect. In my little girl eyes, he was absolutely perfect. But, as an adult, I can see that he was not without his faults and struggles. He faced many adversities in his life, and his mentality was to just keep shoveling through. Keep your head up and just keep pushing. And he occasionally did things that caused me pain. When I was a child, he told me not to tell others about what was happening at home. Hearing from him, the man I trusted and loved more than anyone, that I needed to be secretive and keep everything to myself did help cultivate that shame I felt so deeply. And, of course, eventually, my Papa was not able to “keep pushing”, and he left us in the messiest way possible when he died and took my Nana with him. Which was, and remains, the biggest curve ball this life has ever thrown me.

And, yes, I love Tom. Truly, despite everything. I love him for being there when I dislocated my knee in seventh grade. I love him for the time he and I hiked into Sawyer Pond a day before everyone else to set up camp and woke up with the sun to go swimming and cook oatmeal over the campfire before the rest of the family arrived. I love him for the entire summer that he spent introducing me to classic films like Casablanca and Cool Hand Luke. I love him for the time he said, “I promised you when you were 6 years old that if Pink Floyd ever toured again, I’d take you. I don’t think that’s going to happen, so I’m doing the next best thing.” and we took a trip to see the Australian Pink Floyd Show play in Manchester, New Hampshire. I love him for the times he threw me across Kiwanis Pool when I was a kid, and the times he’d “A-Bomb” splash me and my friends from the high dive. I love him for every joke, every laugh, every happy memory he gave me. But there are plenty of bad memories, too. PTSD-inducing bad memories. And those can’t be simply ignored or brushed over.

But I love him because I recognize that, through everything, he was doing his best. And my Papa was doing his best. And my Dad was doing his best. They were all doing their best. It wasn’t ideal. But it was what I had. And I can’t change that.

Psychologically, I understand now why I always gravitated toward tasks of physical strength, like mowing, moving heavy furniture, and yes, shoveling. Because, from my frame of reference (Baptist) those were “man’s” jobs, and if I could prove to myself that I was strong, maybe life without a “dad” was a little less scary. If I could handle doing those things on my own, maybe I’d be ok.

My relationship with my father, and with my stepfather, and even sometimes with my Papa, wasn’t at all what I hoped and prayed for when I was a kid, and there’s still that little girl inside of me wishing things were different, trying to make sense of everything and find her place in this world. Trying to balance the good with the bad, and internal strength with the ability to fall apart and borrow strength from others when she needs it.

And maybe it was her outside today, shoveling for hours through high drifts and layers of packed, heavy, wet snow and memories and thoughts and feelings. Hoping with each motion to prove her strength. Hoping to validate her adulthood. Hoping to prove to herself that she’s ok, even though she didn’t grow up with a “father.” Hoping to live up to her Papa’s standards of working hard and pushing through. Hoping with each scoop and each heave, to get somewhere closer to the truth, to understanding, to acceptance, to forgiveness, to healing.

 

 

 

 

 

 

 

On My Experiences With Our Screwed Up Mental Health System

This is not a jovial or lighthearted post. This is a venting post. I may even venture into ranting territory. I would like to apologize in advance for doing all of the complaining and none of the problem solving. I recognize that that can be non-productive. But I’ve got some issues with our mental health system which have been festering for months, now, and I really just need to give voice to my lived experiences. That said, should any readers have thoughts or suggestions to improve my current situation (or, what I’m sure, is the current situation of many more like me), please share them! And if anyone knows of any resources which may be helpful, send them my way and I’ll be sure to link them so that, hopefully, others in similar situations will be able to find some useful tools here. I’m feeling pretty out of options at the moment, myself.

I’ve been struggling to come up with an adequate metaphor for our mental health support system, and I still am. I can label it – consistently inconsistent, frustrating, slow, over-complicated, etc. But a really good metaphor? Maybe a maze. Yeah. A crazy-house-mirror-maze. Only the mirrors are shattered in some areas, so you’re gingerly tiptoeing on broken glass, trying to make your way out without getting lost or injured; trying to walk the line between self-advocacy and being perceived as “overly-demanding/rude/aggressive” (because these are “behaviors” which will get you put on hold, disconnected, or asked to “calm down” in a condescending, but slightly foreboding tone that promises you’ll be in trouble if you continue to “overreact” to the situation).

If you know me, you know that I’m all about being polite and patient. Sometimes to a fault. You also know that I know many case managers personally and professionally. I am currently one semester shy of my Bachelors in Social Work. I was literally studying to become a case manager. I’ve also been on the receiving end of “self-advocating clients” who were, truly, being belligerent and unreasonable more than one time. So, I am not speaking broadly about all case managers in this post. I have also carefully considered the facts of the situation and believe that my current frustration, anxiety, and general agitation are justified and valid, which is why I am sharing my thoughts and experiences with you now.

I have absolutely no desire to be disrespectful, or to make what is already an immensely difficult job harder by being a “problem client.” But I have, over the course of 5 months, been put through the wringer on several levels, and, as the Cold War Kids said, “Hang me out to dry, you’ve wrang me out too, too, too many times”.

I am currently diagnosed with Post Traumatic Stress Disorder (PTSD) and Bipolar Affective Disorder (BPAD). I take medications to manage both diagnoses, and, in a perfect world, I would also be having sessions with a regular therapist once or twice weekly for further stabilization and management of my symptoms. But this is not a perfect world.

Here are the facts of the past five months of my life and my interactions with my primary doctor, the PHP and IOP programs I attended, the State of Vermont, and the crisis case manager I’ve been seeing at a local mental health organization until my insurance kicks in:

  • In early November, my life circumstances changed drastically, resulting in me living truly abuse free for the first time in…well… ever. And I was essentially hit in the face with 28 years of trauma and abuse. I developed severe PTSD symptoms.
  • In Mid-November, I did not sleep for 10 days straight. I did not eat. I lost 12 pounds in those 10 days. I was wired. I was having flashbacks and dissociative episodes like it was my job. I was depressed, but it was agitated depression. I could not sit still. I could not focus. I was making reckless and unhealthy choices. I was a complete and utter wreck. I went to Urgent Care on day 5 of no sleep, which happened to be a Friday. The PA I saw there was wonderful. She called the local mental health organization and was told by their crisis response that I’d be able to see the psychiatrist on Monday. She gave me a small RX of Lorazepam to help me sleep. Even with the Benzo, I did not sleep. I was doped up, but I was still wired and jittery.
  • Monday came. I was told I did not have an appointment with the psychiatrist, but the referral was in. All they could do for me was get me in to see a crisis counselor. The extent of the crisis counselor’s advice? “I get insomnia sometimes, too, and I count backward from 100 to sleep.” (I think I showed immense restraint in not yelling at her.)
  • I went back to Urgent Care that night. They told me if the Lorazepam wasn’t allowing me to sleep, there was nothing else they could do. They established an appointment with my PCP for mid-week.
  • I finally crashed on Wednesday night and slept. I crashed hard. I became very depressed, very low energy. This depression continued for a month. 
  • My PCP started me on a very low dose of Zoloft, and made another referral to the same psychiatrist.
  • I’ve been trying to get in to see this psychiatrist for 5 months, and I’m told it’s pretty much the only option available to me as psychiatrists in Vermont are difficult to come by.
  • Waiting on referrals, going to appointments only to be told I needed to wait longer, having my PCP assure me the referral was in and active while the mental health agency insisted it was not – these were all major contributing factors to me spending a week at inpatient.
  • After discharge from the inpatient unit, I spent the next month and a half in PHP and IOP. The case managers there promised me, up and down, that there was no way in hell they’d discharge me without adequate aftercare established, including therapy and psychiatry. Not only was I discharged without those appointments established, I was also discharged with no insurance and no means to maintain my medications.  
  • We only discovered that my insurance had lapsed on my second to last day of IOP. That was a Friday. I applied online for State insurance first thing Saturday morning. I called on Monday. I set up an appointment with Community Action to try to help get my application expedited. I tried so hard to be on top of my game and not be discouraged. The person I spoke to at Community Action, whose entire job is literally to help people get State Insurance, told me over the phone, “You’d be better off calling them directly. But have a book. And a phone that won’t run out of charge, because you’ll be on hold for a long time. I can’t see you in person until Friday, but I’ll set that appointment and if you don’t come, honestly, I’ll just be happy to get a break.” Verbatim. To me. Over the phone. I get burn-out, but how far past “done” do you need to be to say that to someone calling you for help? 
  • I called the State people, and I’m very pleased to report that that phone call was not nearly the hell the Community Action person made it sound like. I only read three sentences of my book before a real person answered. That real person, though, told me I was looking at an up to 30 day wait. Running out of medications with no money to get the final refills, no appointment to get further refills written, no therapy appointments set up, and nothing with the psychiatrist, either.
  • All of the back and forth and the apparent inability to communicate among my primary care doctor, the physician’s assistant I saw at Urgent Care, and the mental health agency for a referral to psychiatric services ended up costing me my career (and with it, my health insurance, which is creating the current stressors I’m facing) and my schooling, because, let’s be honest here:  if I had just been able to see someone back when all of this started, the more intensive interventions would have very likely been unnecessary and I would probably be writing this blog in my spare time between work and homework and mom-ing. (Ok, really, I probably wouldn’t have time for this blog. So, maybe that’s the silver lining.)
  • Today, the crisis coordination case manager I’ve been seeing in the interim until I can get established insurance and regular therapy sessions calmly told me I’m in serious jeopardy of not being able to maintain my medication routine until insurance kicks in, because of the out of pocket cost and because my primary doctor is unwilling to fill the types of psychiatric ‘scripts one needs to manage BPAD. In addition, insurance and all that aside, I can’t even get on the calendar to meet with the psychiatrist until I’ve met with my PCP and received a referral. A referral to the psychiatrist. You know, the very same referral that has, according to my PCP, been sent no less than three times already.
  • Today, I mentioned to my interim crisis case manager my concern that there may be a mixed-state episode in my near future based on what that’s looked like in the past (those 10 days without sleep, et. al.) and some current symptoms I’m experiencing: Screenshot_20170313-192328She responded by asking, “How did you even get a Bipolar diagnosis? That’s not Bipolar. I’ve worked with a lot of people with Bipolar and what you’re explaining isn’t Bipolar.” (How did I get diagnosed? By sitting down with a fucking psychiatrist and telling her exactly what I’m telling you, that’s how!)    
  • This interim counselor is not aware of this fact, but it took me a solid three weeks to even accept the Bipolar diagnosis. I was very resistant to it at first and did my fair share of pushing back against it before actually accepting the fact that the psychiatrist I was seeing through the PHP knew what she was talking about and was there to help me get well and stay well. So hearing the case manager (who, by the way, is NOT an MD and has spent a grand total of 75 minutes face-to-face time with me in the last 2 weeks) not only question the diagnosis, but essentially state flat out that I do not have BPAD was not only infuriating, but also incredibly invalidating of all of the work I’ve been doing toward accepting and attempting to manage the diagnosis.

But I can’t say that. I can’t say any of it. I have to hold it back, because if I start to say these things, I’ll likely end up yelling them at this point and getting myself in trouble. Because when you’re meeting with or talking to these particular caseworkers, you’re not allowed to be upset. “Upset” is for Therapists. “Medication concerns” are for Psychiatrists. “Referral requests” are for Primary Doctors. Polite acceptance, it seems, is all the Case Managers with whom I’ve been working have room for. And I am so far beyond “polite acceptance”. I am frustrated. I am angry. I am saddened by the stated of things.

You’ve heard of jumping through hoops? I’m bouncing around among five different agencies/offices and perpetually being told to talk to someone at one of the other phone numbers. It’s like a line of people holding the hoops through which I must jump, but every time I jump through one, the fucking person holding that hoop just moves to the back of the line and waits for me to jump through again.

It feels, in many ways, like this system is designed to allow people to fall through the cracks. If I wasn’t a stubborn, persistent, determined, sometimes pain-in-the-ass person, I would have completely given up on this by now. As I write this, I am discouraged, yes. But I am also genuinely scared. I’m scared that I’m going to have to taper off the medications which are still not even at full theraputic value in my system yet. I’m scared about all of this waiting leading to a destabilization and possibly another hospitalization for me. I’m scared of the implications of all of this. I see the “cracks” for what they actually are: gaping holes. And I’m terrified of the fall.

And, to end, I’d like to acknowledge a few things about privilege. In some ways, yes, I am in a position of disadvantage in our society: I am a woman, I am currently a single mother with no income, I’m an abuse survivor, and I have substantial mental health diagnoses.

But, in many other ways, I am very privileged. I am white. I am a Natural Born U.S. Citizen. English is my primary (and only) language. I am perceived as a cis-gendered, straight person. I am educated. I have access the internet. I am literate. I have some knowledge of and familiarity with the system which I am attempting to navigate. I have a steady work history. I have a car and a license. Despite being unemployed, I am not at risk of homelessness. I have family and friends supporting me in many different ways.

All of these factors place me at a great advantage over others who are attempting to gain support and services through this same system, and if I’m having so much difficulty with it, please take a moment to consider how hard it must be for those who do not possess the same privileges.

Our system is broken. And with the current administration’s plans for the future state of health care in this country, it is at risk of becoming irreparable. We need to fix it. We need to fix it before it’s too late.

On Meaningful Connections

This is not what I intended to write this evening. It’s actually the emotional opposite of what I intended to write. See, I’ve had an exhausting day of phone calls, waiting rooms, and non-productive meetings in an attempt to get everything situated. Red Tape is real and my god does it get in the way of things. I planned to write a rather scathing commentary on the impact of burnt-out workers, seemingly insurmountable hurtles, and the general way the system treats you as a number and a clipboard-check-list rather than as a human being on motivation to even try to get help and support. But that’s not what I’m going to focus on tonight, because I need a little positive energy and I’m just going to cultivate it for myself.

Rather than focus on people who seem to see me as “another case file,” I’d like to talk a little about meaningful connections and their importance in recovery and maintenance of mental wellness.

First, I have family members who have really stepped up in different ways to show their love and support. My mom has been immensely helpful in many tangible ways, from financial assistance to childcare, and emotionally, too, by just generally being around if I want to talk. My Uncle calls me frequently to check in. My foster sister, who I hadn’t seen in years, came up to visit me for a weekend and it was like we never missed a beat. She helped me in a lot of tangible ways, too, and I’m seriously looking forward to the next time I get to see her.

I’ve said it before, and I’ll say it again: I have some fantastic friends. Friends who showed up for me even when I was actively trying to push them away. Friends who gave me “space” when I did push them away but were there for me the minute that I, much like the Prodigal Son, came crawling back beaten and filthy and out of options. I do not feel I deserve such unconditional love and support, but I’ve been blessed to receive it nevertheless.

I named this blog “Parallel Dichotomy” because the two words are, by definition, mutually exclusive. Carl Jung had a concept he called the “Tension of Opposites,” holding two seemingly incompatible things in balance. This has been a theme throughout my entire life. In this post, I’d like to focus on one particular example: if I’m being honest with myself, I’ve always had this internal pull toward self-destruction, but I’ve denied it’s existence and kept it mostly in check by my need to be perceived as responsible and reliable. As with any aspect of Self, though, the more you deny something, the more it tends to pop up at very inconvenient times and in very unexpected ways. “What you resist, persists,” as the saying goes.

This has been the case for most of my life, I think. Too afraid to be honest with myself about my feelings and thoughts, I avoided them at all costs. I denied my anger at others, and thus, took it out on myself through self-harm rather than expressing it in a productive way. As I got older, I tended towards drowning my sorrows in alcohol, especially when alone, rather than facing my feelings head on. I tended toward indulging my self-defeat in private while publicly projecting a persona of strength and confidence. I tended toward being resistant to medical professionals (or support of any form, really) while holding a career in mental health support. I tended toward a lot of maladaptive stuff, and masked it all with a smile. I basked in the light of others telling me how strong I was while really, I felt weak and broken. I enjoyed the pats on the back I would receive for each accomplishment, all while feeling, at my core, that I didn’t deserve any of it. And whenever anyone would get too close to seeing the “real me,” I’d pull away. Only now am I beginning to recognize these patterns and work to consciously address them.

My friends, though, saw these patterns for what they were far sooner than I did. When I was in college the first time, I very nearly had a breakdown which likely would have required hospitalization were it not for such wonderful friends. Actually, I nearly had two: one slightly less acute episode my Junior year of college, and then the spectacular, blazing fire of self-destruction that was my Senior year blow-out.

In each case, I had friends step in and intervene. Junior year, my high school friend Kim was literally available for texts and phone calls every day, any time of day. That, in conjunction with therapy, was sufficient to get me through what I thought was intense depression and insomnia. (Interesting aside, around age 20 tends to be when the Bipolar switch gets flipped, and looking back on that month and a half or so and discussing it with a psychiatrist, it’s now clear to me that that was my first real mixed-state manic episode.)

Senior year, I was in a state of complete willfulness. I was just going to do my thing, get through the year no matter what life threw at me, because I was stronger than my depression and anxiety and trauma and dammit, nothing was going to stop me from graduating! I’d just act like everything was good, “fake it ’til I made it,” and self-harm and drink as stress relief. As I am now 28 years old and still do not have my bachelor’s degree, you, astute reader, have probably deduced that this approach was unsuccessful. See, there was no way in hell I could juggle everything life was throwing at me. Thankfully, I had these wonderful people called “friends,” you see, and one of them in particular realized I was on a very slippery slope, took away anything I could possibly use to hurt myself, and essentially dragged my ass to therapy (*cough* Paige *cough*). She also refused to leave me alone until everyone was sure I’d be OK. (There was a whole fiasco with anti-depressants making me hallucinate and a Halloween ER visit in which literally all of my closest college friends showed up, piled into the car, and hung out in the ER waiting room while Paige sat with me in the actual exam room. Again, friendship at a level I did not deserve. And another aside, such a reaction to an SSRI should have been a red-flag for Bipolar, but the doctors missed it.)

Many of these people are still around today, despite me really falling off the face of the earth after I found out I was pregnant, burying myself in work and my marriage and parenting, and generally being a shitty and unreliable friend.

As I gingerly claw my way out of the pit of self-hatred and self-destruction once again, this time actually learning ways to avoid the pit all together next time (a foreign concept to me), many of these friends have come back into my life in full force and demonstrated that even though I suck at picking up the phone, they are always there for me.

My friend Paige (the same Paige from Senior Year), who literally lives across the country now, supported me by listening to me vent, cry, get mad, and sometimes, just bitch and whine from October (when things were just starting to slip) on. She came to my house for almost a whole week right before Christmas and dealt with me and my flashbacks and panic attacks and dissociation which, at that point, were so bad they disrupted just about everything we tried to accomplish. I talked to her on the phone leading up to me going to the hospital and she gently encouraged it. And she talked to me every day I was in the hospital and in the ensuing weeks and months. She’s one of those good friends I’m not sure I deserve. (Ok, she’s one of the best friends possible.)

And then, there’s Cassie. Now, Cassie has known me for over 15 years. She’s younger than me, but she’s always kind of played “big sister” in a way. In 90’s kid terms, she’s always been the Cory to my Shawn. That self-destructive tendency I mentioned earlier? If Cassie wasn’t in my life in middle and high school, I’m honestly not sure where I’d be today. I’m quite sure, though, that I wouldn’t be taking positive steps to improve my well-being and over all quality of life. Because Cassie has always possessed the ability to steer me away from the stupid choices and toward the right ones. Gently, with compassion, without being forceful. She’s the person who is always on the other end of the phone if I call. I spent the weekend prior to my hospitalization at Cassie’s house, and she spent the weekend making phone calls, doing research, letting me sob on her lap, holding me while I rode out panic attacks and flash backs, comforting me after nightmares, and, ultimately, convincing me (with the help of Paige and Kelly – another fantastic friend I have) that the hospital was the way to go because things needed to change and I needed help and, despite my Irish stubbornness, I couldn’t do it on my own, or even with friend support and once-a-week therapy.

Once at the hospital, I had five different people who called me almost every day to check-in, and I learned about another very meaningful connection – peer support and the importance of spending time with people on a similar journey. It might sound weird at first, but I made some fantastic friends while on the psych unit and at the partial hospitalization program. And I plan to maintain those relationships, because spending time with people who “get it” is essential to success, I think.

And, as of today, I’m beginning to connect with other mental health advocates as well. Bloggers, YouTubers, and Twitter Kings and Queens. I’m feeling a little more confident about putting myself “out there” as a vehicle for impacting change and shifting perceptions about mental health struggles and successes. I’ve mentioned before that I have a drive to be a force for good in this world and a desire to have a positive impact. This has not diminished, I’m simply shifting it toward a more healthy (for me) platform.

The scathing post about some of the reactions I got today from “support” people will come at some point, but it felt important, tonight, to focus on the good people in my life, and I dedicate this post to all of you.

On Moving On and Bumper Sticker Wisdom (That Actually Helped Me)

(Photo – I wanted a selfie while admitting myself to the psych unit… because that made sense. My wonderful friend humored me. This picture is denial incarnate, I think.)

Today was my final day of Intensive Out Patient treatment. This is a massive transition for me, as my life for the past 2 months has consisted of some form of group therapy almost every weekday. In January, when I admitted myself to the psych unit at Dartmouth, I was not anticipating the length of the journey upon which I was embarking.

In Dialectal Behavioral Therapy (DBT), there is a concept called Radical Acceptance. The basic idea is that you have to accept reality for what it is. If you accept reality, while there may be pain, you will not suffer. If you refuse to accept reality for what it is, then you will suffer. Another way of putting it is “willingness verses willfulness”. Willingness is the ability to accept where you’re at and do what it takes to get better. Willfulness is rebelling against or refusing treatment.

I struggled with willfulness at the beginning of my treatment. Though I voluntarily admitted myself to Dartmouth, I spent the first two or three days I was there insisting that I could not learn anything from the group therapy because I had a strong  professional understanding of the topics being taught.

** A slight aside on my professional identity: I have spent the past four and a half years of my life as a residential instructor in a group home. My job was teaching emotional regulation and life skills to dual diagnosed individuals (think Autistic/Schizophrenic; Bipolar/Fetal Alcohol Syndrome, etc.) . In that capacity, I was very familiar with the concept of DBT as it is a resource offered to many of the clients with whom I have worked.

Back to the Dartmouth Psych Unit, sitting in a DBT group as a patient felt pretty unnecessary to me. On my third day on the unit, I had a good conversation with my nurse for the day. She told me that I needed to shut off the professional part of my brain, the part that “knew” DBT skills intellectually, and I needed to have “beginner’s mind” when approaching the material and consider how those skills could be applied to my current situation. This perspective helped me overcome my willfulness on the unit; but I was still willfully in denial of the scope and impact of the struggles I was facing. I was convinced I would return to work and school in a matter of days and that this little detour to the hospital would have no long-lasting impact on my life.

This, as it turns out, was a completely irrational belief. You can’t qualify for admittance to a psych unit one week and be back to business as usual the next. There’s all this follow-up care shit you have to do. (It’s not really shit. But that’s my angry, willful Bostonian coming out.) For me, aftercare was a month of Partial Hospitalization and two and a half weeks of Intensive Out Patient (IOP). Finishing up IOP, though, is also not the end of my journey to wellness. Now, I’ll be working closely with my PCP, therapist, a psychiatrist, and Voc Rehab to try to really get things evened out and get my life back on track. And I’m very excited to continue to learn and grow. Right now, though, I’d like to take a few minutes to reflect a little, if you’ll indulge me.

In the past two months, I’ve learned a lot about myself. I’ve learned that I have Bipolar Affective Disorder. I’ve learned that my PTSD symptoms don’t have some magic cure, and that I’ll have them, to some extent, for the rest of my life. I’ve learned that I have an unhealthy tendency toward numbing my feelings with alcohol. I’ve learned that the way to manage many of my symptoms is to set and follow a schedule (something I despise). I’ve learned that medications are essential for the foreseeable future at the least, and possibly for the rest of my life. Prior to each moment of learning were several moments of willful denial.

“Fuck off, I’m not Bipolar!”

“The PTSD isn’t a big deal. It will pass.”

“I’m not taking any meds heavier than Tylenol.”

“Schedules are boring.”

“I’m a night person. I’m not going to start being in bed and working on sleep by midnight.”

“I don’t even need this program.”

“Drinking with friends isn’t a fucking issue. I can drink whenever I want. Who are you to take away my social life?”

The above are all actual things I’ve said out loud to my friends and/or treatment team over the past two months. Honestly, there have been moments that I’ve been truly insufferable, I’m sure. But, one by one, I’ve moved away from my denial and toward acceptance. And you know? Accepting things as they are instead of getting angry about how they “should be” has truly helped me stabilize and engage fully in treatment, and I have come a long way.

Treatment isn’t over yet, though. And there are some immediate hurtles for me to try to jump over. I’m hoping I’ve got enough momentum to clear them. My insurance lapsed mid-February, which is making follow-up care tricky to coordinate and getting prescriptions refilled impossible at the moment. (I’m working on that, though, with both my PCP and a local mental health organization, and should hopefully have that resolved in the next few days.) But, it’s definitely a stressful note on which to leave the intensive, wrap around support of the IOP program. (There will, in the future, be a separate blog post all about the ridiculous struggles of finding and maintaining affordable, quality mental health care.)

For right now, though, I just wanted to take a few minutes to share with you some bits of what I like to call “bumper sticker wisdom” that I’ve learned in the last two months that I’ll carry with me for the rest of my life:

“Sometimes good is good enough” (for your inner perfectionist)

“Yeah but your yeah buts” (For the moments your self talk is not helping you.)

“Check your lens” (Also for the moments your self talk sucks and your inner critic is dictating your perception of yourself and others.)

“Your shit; my shit.” (For the moments you may struggle with being able to differentiate between your responsibilities and other people’s problems)

“There is no bad mindfulness practice, there is only practice or no practice.” (Even if you’re REALLY distracted, and being mindful is hard, as long as you practice bringing it back to the present, you are succeeding in practicing mindfulness.)

“Act Opposite” (This one is from Cognitive Behavioral Therapy – you feel like staying in bed all day because you’re depressed? Do the opposite, even if you only make it to the kitchen and do 10 minutes worth of something before going back to bed.)

“Use the 10 Minute Rule” (This is maybe exactly what it sounds like, you do something you are avoiding for 10 minutes at a time. Got an inbox full of emails you’re avoiding replying to? Set a timer for 10 minutes and start reading and responding. Wherever you’re at at the end of that 10 minutes, you can choose to stop or continue based on how you’re feeling, but at least you made a small dent.)

“Action Precedes Motivation / If You Wait Until You Feel Like It, You’ll be Waiting a Long Time.” (Mood dependent behaviors are going to keep you stuck in your cycle of suck. You’ve got to do something to break the cycle. 10 Minute Rule is great here.)

“It’s Simple, but not easy.” (All of these things seem simple enough, maybe even like oversimplifications of the struggles you’re facing. But no one is saying it’s “easy.” Doing this work is fucking work. But it will help improve your situation over time.)

“Distress Tolerance: Getting Through a Bad Situation Without Making it Worse.” (I literally have a card of go-to healthy coping methods I can use when things really suck. I also have a list of favorite activities – I call it my “kit-bag”)

“G.L.A.D. / What’s Not Wrong? Journal” – One thing you are Grateful for today, one thing you Learned today, one thing you Accomplished today, one thing you took Delight in today, and two or three things that are NOT wrong in this moment. Write it out every day. Keep track. Over all, it will help challenge those deeply entrenched thoughts of “My life sucks”, “Nothing good ever happens to me”, “Why bother?”, “Fuck it”, etc.

And finally, remember that we are all working as hard as we can, and we have been working as hard as we can, but recovery is based on finding a way to work better, not harder.

So, I’m onto the next step. Wish my luck in this insurance fiasco. I’m told going off my meds due to not being able to refill them at this specific point may undo all the work I’ve done in the last two months, and I’m really not trying to have that happen.   I have several meetings tomorrow, so I anticipate a more technical/ resource filled post at some point.

Movin’ onward and upward, as they say.

On the Good Days

Today was a really good day. Sweatshirt weather, sunshine, Vitamin D, time spent with a friend (who I actually met while at inpatient treatment), and connecting to a lot of really cool resources in my area! I spent a good chunk of the day exploring Burlington with my friend and taking pictures. As I’ve mentioned before in this blog, photography is my absolute favorite form of non-traditional mindfulness.

In the type of treatment I am receiving, mindfulness is considered a necessary component to successful application of the tools I’m learning, but it’s a big struggle for me. I’m working now on getting more comfortable with traditional mindfulness practice (focusing on my breath, doing progressive muscle relaxation, guided meditations, etc.) but it’s definitely difficult. This is a PTSD thing. See, the idea of closing my eyes in a room full of people and blocking out external stimuli is in direct conflict with the hyper-vigilance that comes in the PTSD gift basket. Focusing on my body and breath actually tends to cause me to panic and dissociate, because, physically, it reminds me of trying to stop crying in dangerous situations. When I was a kid, my stepfather would say that often-uttered phrase “Stop crying or I’ll give you something to cry about.” Except, he meant it. If things didn’t turn around quickly, someone was getting hurt. So, I’d focus really hard on calming my breathing to stop the tears. That’s what deep-breathing has traditionally been for me. Combine that with closed eyes in a crowded room, and there’s just no way in hell I’m able to participate. So, I’ve needed to be creative in my mindfulness practice, and photography is, by far, my preferred method.

You have to look at the things around you – really look. You have to consider the angle and lighting and how to best convey the feeling or message you’re hoping to put out there. You have to pause to take the actual photo. It’s being completely present in that specific moment. It’s expression. It’s everything I love about mindfulness practice and nothing that trips me up.

So, I spent all afternoon today soaking up the unseasonably warm weather with a friend who provided great company, laughs, and meaningful discussion, taking pictures, and exchanging resources and book titles and apps that we have both found helpful in our respective journeys so far.

There is something to be said – a lot to be said, actually – on the importance of peer connection and support in recovery. Now, my friends and family have all been fantastic supports, and I do not, by any means, want to minimize that. But, unless you’ve been inpatient, you can’t truly understand inpatient. You create inside jokes based on the group facilitators at the hospital, you have a sort of slang built from the bumper-sticker phrases you learned to go along with your therapy, a sort of short-hand you can just toss out at each other when one of you is having a rough time. I’m very happy to say that I’ve kept in touch with three people I met while at Dartmouth, and those relationships have been very helpful in keeping me on-track in my own journey to wellness. Those relationships, though, due to distance,  are mostly limited to on-line interactions (Facebook). Having one of those peers in this area and spending actual face-to-face time connecting with someone who “gets it” is a rare gift, I think. And I’m very grateful to have the opportunity to stay connected with him!

So, today marks the first day since I started this intensive treatment that I’ve honestly hit every box on the little “Wellness Goals” check-list: social connection, group support (acupressure treatment at Turning Point), mindfulness, exercise (we literally walked all over Burlington – close to 5 miles for me, according to my phone), sunshine and fresh-air, completion of some wellness tasks (I was energized from the day out and was therefore able to get some serious cleaning done around my house, I worked some more on my discharge paperwork, and I am writing this blog post), ate a healthy meal (sort of – that was actually a bit of struggle for me, I suppose, but I had a shake and a banana and some peanuts, so that’s something anyway), took all prescribed medications on time, and am on track to head to bed at a reasonable hour and hopefully get some good sleep tonight!

I write a lot about the idea of balance. When you focus on the good days, they kind of help balance out the bad days. It’s just a mater of maintaining that balance. And that’s the task on which I intend to keep working!

***If you’d like to see the pictures I took today, feel free to hop over to my Instagram account at https://www.instagram.com/sheilajay47/?hl=en

On Mountains and Dichotomy

Mountains have been a recurring theme for me over the past few months. They hold a symbolism I can’t seem to escape. When I was in the hospital, one of my friends (who is a queen of metaphor and puns and all other things creative expression) kept referring to my journey as a hike up a mountain. When I asked my husband to leave, I thought I was getting ready to climb a steep hill and the journey would be tiring and painful but over soon enough. When PTSD hit, it turned out that hill was a treacherous mountain. When Bipolar came to light, that hike up that treacherous mountain was suddenly happening in the midst of a terrible rainstorm. But my job, my one focus, needed to be to continue the climb. Because, my friend promised, the view from the top would be so beautiful and amazing and worth every single twisted ankle and slip and slide and every moment of complete and utter exhaustion and pain.

Independent of my friend, one of the group leaders at the hospital used the mountain analogy for recovery, reminding all of us that there would be times that we felt we couldn’t take another step forward, and it was ok to rest as long as we didn’t build a house there and call it home. There would be times when the path was so steep and slippery that we would fall and slide down the mountain a little bit, and that was ok, too, so long as we tended to any injuries and then got back up again and continued the climb. The group facilitator also summoned the image of the view from the top of the mountain, and how very worth it it would be to reach the summit.

Earlier this week, in a mindfulness group in which I am participating as a part of my treatment, we did a guided meditation in which we were asked to picture a mountain. Mountains have also, not unreasonably, been popping up in my dreams a lot lately.

Today, I had to drive about 40 miles away to pick up my car. I was the victim of a hit and run a week and a half ago and the nearest-to-me-insurance-company-partner body shop happens to be up in the middle of no where. (Welcome to Vermont, friends.) As I drove, I saw the most beautiful mountain range. The skies were overcast but clearing and sun beams were breaking through and lighting the mountains and valleys in a way I have never seen before. Unfortunately, there was no safe spot to pull off and snap a few pictures, otherwise I definitely would have and this blog post would be a lot prettier. But, as I looked at the sun touching those jagged, snow-covered peaks, all of the talk of mountains over the past few months began to truly resonate.

I spent the whole drive there and back thinking about the nature of mountains. The dichotomy, if you will. When you think about a mountain, what comes to mind? Do you think of spiritual leaders like Moses connecting readily with the Divine? There’s a strong tradition in the collective myths of humanity of mountains being the place where the earth connects withe the heavens and, thus, mountains have traditionally been considered places of spiritual significance. (Not only of Judeo-Christian significance, but going back to the Greeks with Zeus and likely inspiring all of the pyramids prevalent in so many ancient societies.)

In many tales, mountains are also a place of great trial and suffering. (I’m looking at you, Frodo and Samwise.) The pinnacle of the hero’s quest to self sacrifice or self actualization (respectively, I would argue – but my analysis of the imagery in Lord of the Rings is probably best kept for another post).

That said, I live in New England, and it’s winter (minus the current global warming, spring like temperatures we’re experiencing, but the topic of the slow death of the earth at humanity’s hand is probably also best left for another post). When mountains are mentioned around these parts this time of year, the immediate thought that comes to mind is winter sports. Some, I’m sure, would argue that winter sports are a spiritual experience (especially my snowboarding friends) – being “one with the powder” and such – but really, it’s recreation. (Sorry to minimize, guys, but smoking a bowl at the top of the lift is not quite the type of “burning bush” moment to which I am referring.) At the end of the day, it’s a recreational experience. It’s exercise. It’s fun.

All of that to say, mountains hold a somewhat contradictory nature in our collective consciousness. On the one hand, many of us are drawn to climb them, to explore, to see the summit, really just to say we did. This allure is, for me at least, undeniable. The flip side, though, is that mountains can be deadly if you’re not properly prepared. Even if you are a veteran hiker with all the right gear, if you get off-trail, your life is in very real danger.

Mountains are viewed as the example of steadfastness. They stand immovable, yet are formed by shifting fault lines and the general instability of the ground upon with they stand. Back to my snowboarding friends – they are a place of immense fun, a playground of snow and tricks and endless rides, yet if you attempt a run on an untouched surface of the mountain’s face, you may trigger and avalanche and be buried. Mountains are considered staples of our landscape, unchanging; yet, a rock slide can completely alter the shape of a mountain forever. (Anyone remember The Old Man on the Mountain in the Notch?)

The dichotomy of mountains has been intriguing me all afternoon. I think that “climbing a mountain” is a very apt metaphor for living with mental illness and for the “hero’s quest” we are all on, I believe, toward self discovery and self actualization. When you look at the mountain, in the thunderous rain, and you see the signs warning you that the trail is muddy and overgrown and covered in gnarled roots and may be flooded out in some areas, you don’t want to climb it. You start looking around desperately to see if there’s a trail lift that can carry you smoothly to the top.

I admit, when I first went to the hospital, I thought I was hopping on that lift and everything would be good from there. I thought I’d sit back passively and let doctors and meds smoothly carry me to that beautiful view everyone kept talking about. When it turned out that the hospital didn’t have access to the lift, they sent me off with hiking boots and a walking stick and rations for a few days to go to the partial hospitalization program.

This is where I hop in the lift! I thought heading in. It wasn’t. They gave me a compass, though, and sent me off to the Intensive Outpatient Program, which, they promised, was a good point to resupply.

Ah! Surely this is where I get on the lift! But it wasn’t. It turns out, there is no lift. There is no easy, bump free ride to the top of the mountain. In fact, the only way to get there is to climb. And it’s a hell of a climb, let me tell you. But, the good news is there are resupply points and there are shelters and there are trail markers and if you just follow them, stay supplied, and keep going, you will hit the summit eventually.  And maybe, once there, you will have some semblance of a spiritual experience – getting to know yourself on a deeper level. Getting to know the “you” you were before the world fucked you up. Getting in touch with your higher self. Or your higher power. Or the universe. Whatever you want to label it. It might not be a burning bush moment, but it will be well worth the climb. I believe that fully. But, as you begin and commit to your ascent, remind yourself of the duality of the mountain. Stay safe. Stay well stocked. Stay on the trail. Because the mountain will kill you if you’re not mindful.

If you lost me in the metaphor – doctors appointments, meds, therapy, friends, peer supports, etc. are excellent places to restock and rest and make sure you’re still traveling with functional equipment.  And they are essential.

On Consistency and Acceptance

So, I’ve sucked at writing lately! I have, like, three drafts of blogs on different topics started and saved, but it just doesn’t seem like the right time to post any of them yet. (However, things for you to look forward to – if you look forward to my posts – include such exciting topics as dealing with a devastating loss and what it’s like to check yourself in to a psych unit!)

Tonight, though, I just wanted to write a little bit about consistency. Consistency is a constant struggle for me. Most people don’t see it. I’m perceived as reliable and dependable and all those other things that one may equate to “consistent,” but the fact of the matter is, schedules and steady production of content (of any form) are decidedly not my strong points. This is one of the reasons it took me a while to start this blog.

Creativity and expressive outlets come in waves for me. Initially, I’m the sun scorched sand soaking up the incoming tide, but eventually I’m over saturated and the tide is on it’s way out anyway, so I just watch it go. Maybe that’s a Bipolar thing, maybe it’s a product of never having the ability to stick with extracurricular hobbies for too long due to familial obligations, I don’t know. But it’s how I seem to be wired.

A few months of intensive poetry writing, a few months of photography, a few months of playing guitar, a few months of writing fiction, a few months of writing non-fiction, a few months of keeping a journal (yeah, even when the end result is completely private, I suck at sticking with it.)

But the thing is, the best way to manage my situation is with a certain degree of schedule-following and consistency. It’s a learning curve for sure. A steep one at that. For someone who is perfectly happy staying up until 4 am and getting 3 hours of sleep a night for a few weeks in a row and then sleeping 12 hours a night with naps during the day for a few weeks and then bouncing between the two extremes day by day for a while, scheduling is not a strength. This is something about myself which I need to accept and work around.

There’s a lot of acceptance that comes with a substantial mental health diagnosis, actually. Acceptance that is not easy to reach. When I was first hit with PTSD symptoms, it was like a five story brick wall collapsed on me. 28 years of shit all at once. And it very nearly crushed me. When I first found out I’d inherited what, it turns out, is the very prevalent family trait of Bipolar, it felt like some deadly projectile shattered my windshield while I was driving 80 down the interstate. My entire perception of myself and my situation changed. See, even when I was in the waiting room at the emergency department, I was cracking self-deprecating jokes to the friend who took me there – saying things like, “Well, we always knew one of us would end up in the psych ward.” To a certain extent, humor is a really good coping mechanism; however, it’s also frequently a method of minimizing the severity of a situation. It’s a form of denial. When I was going into the psych unit, as far as I knew, I wasn’t Bipolar. I was just having an acute moment of difficulty in my life. And adjustment to a traumatic past that would pass. I was going to leave the hospital in three days, go back to work and school, and be completely fine. I honestly believed that. Now, I’ve got this metric shit-ton of crap that I want absolutely nothing to do with.

I don’t want PTSD or Bipolar-whichever-number-I-actually-have. I don’t want to still need so much support two months after leaving the hospital. I don’t want to need to call my friend from the side of the road because I’m on the verge of dissociating for no fucking reason and I need help grounding myself before I can finish driving home. I don’t want to take meds. I don’t want to follow a schedule. I don’t want to have to dig deep into my past and all the ways it fucked me up. I don’t want to have to integrate the feelings I dissociated from when I was a kid. I don’t want any of it. But I’ve got it. I’ve got all of it. And now I have to face it and work on it and feel it and deal with it.

And a big part of that, for me, is wanting to be consistent with this blog. Even if no one reads it, it’s important to me. It’s important that I verbalize this stuff and get it out there and it’s important that I stick with it. I want a tangible, measurable story of my progress and setbacks. I want something to look back on. And I want to put something out there that, just maybe, can help one or two other people.

So, continuing this blog with as much consistency as I can muster is what I’m going to do. If I miss a day or two, it’s not a reason for me to blow off the next 4 days (which is kind of what just happened.) If you’ve been following so far, sorry for the lack of posting. It may happen again, but I’m going to try really hard to make sure it doesn’t. It’s not only a part of my schedule, it’s a part of my journey to acceptance. And that’s more important, I think, than anything else I could be working on right now.