Processing Thursday’s Appointments

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Processing Thursday’s Appointments

The Nutritionist:

My nutritionist appointment actually went okay.  I wasn’t nervous like I thought I would be, but I expect that was because I was already emotionally checked out.

Wednesday night, I had decided I would not print out the text from my blog and show it to her…That I just couldn’t be that open (vulnerable).  And then not even ten minutes later, I got a text from my friend L which said, “Just had a chance to read today’s blog. I totally think you should print it out for [the Nutritionist].  She gets it, and it will help her to help you.”

Now, I really respect L and her thoughts.  And I decided that if L thought I should share the blog, then maybe I should.

So, after the quick ice breaking chit chat at my appointment, I started explaining my food issue with the Nutritionist and then I gave her the print out of my blog to read.  After she read it, she said she wanted to give me a hug (which I allowed) and told me that there is nothing wrong with me…That I am okay.  (I don’t remember her exact words as I was only half present.)  Then she said that it had been really helpful to read it and that she was glad to see that I had good insight as to what was going on with me and why.

And then? She didn’t judge me, she didn’t shame me, she didn’t anything me.  She took me exactly where I am right now.  She did some education with me about how super low calorie eating is not healthful but she did not belabor the point.  She was glad to hear that I still eat three meals a day.  And then she took a food “inventory” of what I am eating.  I eat pretty much the same thing every day…So that was easy. We talked about the limited food choices I make and how they are “safe” foods for me (safe meaning that I can eat them and still lose weight.), which is why I stick to them.  Then we made a list of the foods that I had been eating before that were “safe” too, but that I have not been eating.

She asked me to add an afternoon snack back into my routine.  Honestly, it terrified me…And she could tell, so she asked me how I was feeling about it and the reassured me that it would be okay and it would slow down my weight loss, not enough to be healthy, but as a step towards reaching healthy weight loss again. But…I didn’t do it on Thursday.  I rationalized that she meant I could start the next day. Then yesterday, I forgot.  Oops.

I am also supposed to add a little more variety to my meals (adding back some of the other safe foods).  It is crazy how much anxiety that causes me.  However, I am also supposed to work on some anxiety management techniques.

I felt like the appointment was helpful…I don’t know how I will do with following through but I at least feel like I am pointed in the right direction.

The Psychiatric Nurse Practitioner:

This appointment was an hour after my AT appointment and I walked in pretty fried.  However, I noticed that my PNP had added a small basket of stuffed animals on her floor and I could see that there was a stuffed bunny in it.  I haven’t mentioned it on my blog before, but I have a thing for bunnies and have had house rabbits in the past.  I don’t talk about it because each of them died quite suddenly from illnesses and I am still traumatized about it.  (And at this point it has been a few years since then.) But I digress…So I picked up the bunny and stroked its fuzzy ears.  And I absorbed the room around me…Her windows, her curtains, her plants, her desk and hand lotion and tea pot and calendars…And I thought to myself, “I am safe here.” And I kind of nestled down, comforted with that knowledge.

We talked about the flashback.  My PNP likes details on things, so she asked several questions.  I told her as much as I could, but I DO NOT discuss the contents of my flashbacks so she didn’t get that out of me. Although now that I think about it…I am not sure she even asked.

We talked about a zillion other things like we always do and then we wound our way to talking about meds.  And somehow the conversation prompted me to say that I feel irritable all the time and just plain bitchy (especially at home).  She reminded me that my Fetzima is a SNRI (serotonin-norepinephrine reuptake inhibitor) and that the N part of it can make one testy.  It can also give you energy and some get up and go…Which is why I started it…but it can make you irritable and bitchy.

And so…..I agreed to a med dosing change! Even on the first day that she mentioned it!!  I am increasing the Lamictal so that we can then decrease the Fetzima.  She does not want to just decrease the Fetzima without bolstering me with the Lamictal to keep my mood from dropping.  I don’t know what made me feel receptive to making an immediate change…but I trust her and if it makes sense to her to change the dosing, then it is okay with me.

The Art Therapist

I am still working on processing that appointment…Partly because I only remember it in bits and pieces…and even of those, I feel like it wasn’t really me who was there, and partly because I am not sure quite what was happening during the parts that I do remember.

 

 

 

Anxiety Overload and The Observant Art Therapist

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Anxiety Overload

I am just kind of skin-crawling with anxiety this morning. I don’t know what set it off…But it started during the night.  Maybe I had a nightmare that I don’t recall?  I do remember having a few dreams about work…or one long dream with a few different parts…The dream wasn’t the most pleasant, but then it wasn’t like a nightmare either. Bits and pieces I remember from the dream/s were that a patient threw up all over the floor and I slipped in it and fell and got soaked to the skin with vomit.  And I didn’t have any extra clothes to change into, so they made me wear a johnny.  And in another part, I was trying to get linens for making a bed (something that I do not actually do at work) and the bed linens were stored in cubbies that were up really high, so they were almost impossible to reach.  I did get what I needed though.

I kept waking up over and over last night…feeling antsy and hypervigilant.  Now, I am over-tired and super cranky and exhaustion-tearful.  Oh..right and I have to pull myself together and get out the door and off to work in an hour.  All I really want to do is to stay home and go back to sleep. We’ll see how the next 45 minutes go…If I can’t/don’t settle down some, I may have to lorazepam before work, because work itself is usually pretty anxiety provoking on it’s own…I think I might implode if I go to work already this triggered.

The Observant Art Therapist

The AT ended our session yesterday by doing all those things that your therapist does when they think you have dissociated.  You know…Asks you to look at the ceiling and describe what you see, asks you to look at the floor and describe what you see…Asks if you are present, etc.  And I was kind of annoyed because I didn’t feel like I had dissociated, though I did only feel sort of half present, which I said to him.  Then he wanted me to stamp my feet on the floor and I was irritated, since I was sure I had not really dissociated…So, I ignored his request.

The problem?  He was right.  I could feel it as I drove home and then after I got home and started thinking about the session…I’ve got big ol’ gaps. <sigh> So, I guess I had gone off somewhere else and not even realized it.  Of course that is part of dissociation…That you don’t necessarily know when you have checked out.  But still…Lots of times I have some awareness…Like the AT will be talking and he starts to feel far away and his voice sounds like it is from far away…..Or sometimes when he speaks, he startles me, which means I had traveled out someplace and he kind of snaps me back into the present.  But must be I dissociate in other ways too.

I wonder what the AT saw that made him realize that I had dissociated….A question for next session, I guess.

We did start to look at the sketchbooks.  It went okay until we hit a page where I had drawn pictures of my flashbacks (the sketchbook was from 2009/2010).  I couldn’t even tolerate the page being open and asked him to turn it.  I pretty much wanted to yell at him to turn it so that he would turn it faster…But I maintained my composure (despite pretty severe panic).  Other than that, we looked at some pages and when we saw ones that were not self-explanatory, I talked about the meaning of the drawing.  I actually remember most of the sketchbook stuff (or so I think anyway) but not much else at all about the session.

It will take us a while to get through the sketchbooks. And I don’t know what he wants to do about the pages that I can’t look at.

And I ended up with some homework….I can’t really remember what the assignments were (ahem…cuz I was dissociated when he gave them to me?), but I wrote them down as soon as I got home…So, I will have to look at it to refresh my memory.

More Randomness

I don’t know what is going on with me.  I feel very calm. And very disconnected.  I am having trouble falling asleep at night…and then I just dream and dream of being in danger…I had another dream last night about being on the edge of water, this time I think it was the lake and there was a huge dirt pile (like big enough to drive a car on) and I was driving on it and meant to take the road down to park but took the wrong road and was driving along this precarious outcropping of dirt and mud on the edge of the water. I was terrified that it was going to give way and I would plunge into the water and sink in my car and be trapped.  I got to a boat launch and then had to turn around the car and drive back on that same precarious edge.  Then the dream switched and I was climbing the dirt pile, but it was shifting under my feet and making the climb hard.  I also had something in my hand (I don’t recall what) and so only had one hand to support myself.  When I got to the top, there was like a look-out with a metal rail around it…but it was like a cage.  And there was a dog…I don’t know…It was a dream so it was weird.  The strangest thing is that during the whole dream, my sister was with me.  In the car, climbing the hill, in the cage….I don’t know what summoned her into my dream.

I have been contemplating something else…I probably should have mentioned it to the Art Therapist Monday…but I forgot.  I think I had a visual flashback last week.  I sure hope not because I don’t need that right now.  The thing is…I don’t know if I really had it or I dreamt that I had it.  And that is disturbing to me.  I am thinking it was not a real flashback because it was different…Usually my visual flashbacks are like snapshots and this was not like that…It was like a line drawing.  But it presented in the usual way I see my flashbacks.  But, it didn’t make me panicky.  So, maybe it was just in a dream….I wondered if that is part of why I got so mad last week and part of why I have now banned my child-self from therapy….Things were stirred up to the point of a flashback?  I don’t know…is a flashback actually a flashback if you have it in a dream?

I said before that I don’t discuss the content of my flashbacks…and I still won’t.  But I am acutely aware of the fact that if I try to discuss flashbacks with the AT that he has seen the pictures of them in my art journals…And I don’t even know if I can look at him without burning up with shame.  Of course, I don’t know how I ever look at him without burning up in shame…Everything about me is shameful.  Sometimes, I wonder if he knows this…if he sees me as ugly as I do. Ugly inside. Ugly outside.  Not worth trying to fix.

<sigh> I am rambling again…I wish I could keep my thoughts more structured…I feel kind of lost right now and like I am in an emotional haze.  And I just don’t feel quite in touch with reality.  If I poke myself, am I really there? Will I even feel it?