Still Struggling

I was a bad therapee yesterday.  I had therapy at 9.  I had been okay, I had talked to my PNP prior to therapy and was feeling good.  I adore my PNP so talking to her always makes me feel better for a little while.  But when I headed out to therapy, my anxiety hit me.  I have no idea why I was anxious, but by the time I got to therapy, I was really anxious.  All I can figure is that it was related to therapy. I’m not sure what triggered it though.

Unfortunately, it was one of those appointments where I was really struggling to stay present and connected.  Grace did a lot of talking, which was fine, she was explaining some stuff and reflecting stuff back to me.  And if you ask me now what she said, I really couldn’t tell you.  I know we talked about peers and feelings, I know that we talked about something about yoga and self-care, I know that when I left she said we would go over two homework assignments on Monday.  But…the details about all of this is fuzzy because I just couldn’t stay focused.  Like, I remember one of the assignments she said, but not the other (but I am going to guess which one she meant). And I can’t remember at all the details about what she said about self-care.  Nor can I really remember the peer conversation other than the fact that I was really unhappy talking about it.

So, What makes me a bad therapee?  The fact that I knew I was having a hard time staying present and focusing.  And I almost said something to her, but I didn’t.  I just kept trying to force myself to attend to her and hear what she was saying.  Only, clearly, it didn’t work.  I am really frustrated with myself for not doing a better job of communicating my state of mind with Grace.  Actually, I feel pretty critical of myself for basically wasting a whole appointment because I couldn’t stay present. Fucking stupid.

You know, I was going to summarize the rest of the day, but I realize that it is all pretty fuzzy.  I did a project in art therapy that I am going to take pictures of today so I can post them tomorrow.  The directive was, “Where are you in the recovery process?”  Oh right, we had our Gender and Sexuality group.  Someone read her homework assignment and I wasn’t really able to give her much feedback because as soon as she stopped reading, I couldn’t remember what she had said.

The other thing about yesterday is that from lunchtime on, I felt uncomfortably overfull.  As if I had eaten too much.  And I am not sure what was up with that because I had not eaten too much.  And the feeling lasted all afternoon and when dinner came, I had no appetite and had to force the food down.  I am going to guess that this was a psychosomatic event.  I say that, because aside from feeling overfull, I totally felt like my body had gotten bigger.  Like, I happened to put my hand on my stomach and I was startled as to how much bigger it had gotten (since the morning.)  Intellectually,  I know that  my stomach didn’t get bigger in 6 hours.  But my distorted perception was that my stomach was bigger, and I looked at my legs and my thighs were bigger too

And then lastly, my mood, which had been feeling a little bit better, dropped again last evening.  I was home alone and it was quiet and I just felt the weight of the depression settle on me.  I know I refer to my depression as being on me a lot.  Have you ever had an x-ray and they put one of those really heavy vests on you to shield parts of your body from the x-ray?  That is sort of how I experience my depression settling on me.  It is just feels like a heaviness in my mind and body.  Like the depression has weight and substance.

I also realized last night that the woman I live with is gone all weekend and that I need to be extra careful to not isolate.  And I am a high isolation risk this weekend.  I feel more depressed, I am struggling with the departure of my peer.  I will be alone in the house.  It will be sooo easy to just stay in bed all day.  However, I already had plans for a friend to come over tonight, so tonight is taken care of.  Tomorrow, I will make myself go to yoga in the morning and to the grocery store too.  And today, I will make a plan for the rest of the weekend.

Tenuous Improvement

It is possible that the edge has been taken off of my depression.  I always hate this part of relief from my depression, because I never know if it is actually going to last.  It is frustrating because I had felt such a substantial decrease in my depression over the past few months that this exacerbation has been really hard.  And…as I start to feel better, I am just waiting for the other shoe to drop.  Will I continue to feel better? Will I crash again?  How soon will I crash again?  It’s like I can’t have hope that feeling better may last.  I also think that the improvement is so delicate that it would take very little to push me right back down.

My PTSD was active again over the weekend, but not as bad as it had been.  One of my peers actually asked about it yesterday, and I felt really touched.  Like…she actually heard how much I was struggling and cared enough to check in with me about it.  It kind of made me all warm and fuzzy inside.

Grace would probably use that interaction to illustrate the point that connecting with people is good for me…But one positive interaction with one peer does not prove the point.  Mostly, I just can’t accept what my peers say as supportive.  I mean, I have been doing this group therapy stuff so long now that I have heard the support over and over again.  Lots of it is just words with no follow-through.  And at this point, the support just never makes me feel better.  So, why bother?  And Grace doesn’t listen to me when I tell her there’s no point in talking about my struggles in group.  She has some very strong ideas about me needing connection.  I have some very strong ideas about it too.  If you can imagine, our ideas are kind of at each end of the spectrum.

Truthfully, connection just doesn’t seem safe to me.  I don’t want to put myself out there, I don’t want to be vulnerable, I don’t want to be disappointed.  Shit…that’s probably just me stuck in old patterns and then reinforcing them with my stubborness fear of being disappointed and hurt.

Today, programming doesn’t start until 3. I am feeling the loneliness of the before-programming-time already and it is only 8:30.  This is the depression litmus test.  Either I will start to feel like shit or I will hold my own until 3.  I do have an errand to run because my nutritionist wants me to add some cookies into my meal plan.  Cookies!!!  I think she is trying to kill me via my anxiety!

Come to think, I have two little projects started (projects make me very happy) and maybe I can get a couple of supplies while I am out to keep working on them. I also have homework to do today…That will keep my mind occupied too.  I am working on my treatment challenges/goals/objectives for the next month and I also have three writing pieces to do: What is the status of my body image right now?, What do I need both internally and externally while doing trauma work? and How does denying I have needs keep me stuck?

Yikes!  So much processing to do.  It is overwhelming just writing it down.

Containment

I guess today is a post-therapy blog.

Therapy was….welll….therapy.  We always have to talk about feelings and stuff.  Ugh…and needs.  That every person has needs, which means I have needs, even if I don’t want to have needs.

And we talked about emotions and emotional flooding (being totally maxed emotionally, beyond the point of being productive.)  And we talked about containment.  Ways of containing the emotions by writing down a couple of words to ease the emotional overload, with the intent on going back to the trigger when one is no longer overloaded.  Or of writing what needed containing on an envelope and sliding it under Grace’s door for containment and returning too later.

And then that lightbulb went off in my head…..

The AT, an envelope, containment…This has happened before.  And it worked.  So, I have hope that it will work with Grace too.

Other than that, today has been tolerable. Having therapy this morning got me moving out of bed and into my day.  I am trying hard to not go back to bed.  Yesterday, I stayed out of my room most of the day.  It seems less isolating to be upstairs.  Plus, I have the dogs for company.  I cannot express how much it means to me to have these dogs in my life.  They may not be my dogs, but they do me a lot of good.

Now, I am going to make lunch.  I can feel a bit of the depression starting to settle around me, so I am going to keep busy and see if I can deter it for a while

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Shame and More Shame

So…First things first  The new therapist gets a name:  Grace. (note to self…update blog shorthand.)

I really chafed yesterday when Grace was telling me that I have issues in the group and with group dynamics.  I know she bases this on what I have said, so there must be truth to it…But I like to think that I know how to negotiate social stuff, so I am feeling a bit touchy about it.  I am feeling touchier about the fact that she wants me to check in with the group and talk about my struggles. And despite my trying to convince her that this is not necessary, she thinks that I should.

I struggle though, because I don’t think my issues in the group are that big.  One of Grace’s concerns is that I am not connecting with people in the group, as evidenced by my isolating a lot and turning down peer requests to get together.  What do I have to say to that?  I do have connections with a couple of people in the group.  Okay, literally with two of the dozen or so of us in the group.  They were folks who I felt really connected with in PHP and basically, it was a long week while I was in IOP and they were still in PHP.  But they came right after me and things are better.

The rest of the group?  One person is very quiet (like scary quiet) and rebuffs my every attempt to talk with her.  I even sit right next to her in groups and she hasn’t thawed at all.  Another peer, I cannot connect with anymore because our relationship was toxic in PHP.  Another peer has talked about connecting with me, but never follows through. Yet another peer appears really nice and seems really supportive, but she also sometimes comes across as forced with her insight and at times is passive aggressive.  Of the folks left, I don’t really know one and she is discharging soon anyway, one is a man that reminds me so much of my dad that it has been a huge barrier for me, and the other…She seems nice and genuine, but she intimidates me a bit and so I haven’t really approached her.

Plus there is the whole shame thing I feel after last week.  I am sooo embarrassed to be vulnerable in the group that it is not funny.  (This is probably why Grace wants me to talk about it.  Secret shame feeds shame. Outing shame decreases it.) What I really want to do is apologize for last week.  And say how stupid I was for being so reactive and so defensive. Yes, I can say that I was/am ashamed. But then all my peers will give me positive and supportive feedback and encouragement, and what will that do?  It’s not going to make me feel better. And actually, I will also get frank and blunt feedback, which also is not going to make me feel better.  It will just compound my shame.

Basically, I feel like I can’t win, so why bother?

And then there is the text I got last night.  I had been getting together frequently with a former treatment peer.  And the past two weeks, I haven’t been in a place to get together and haven’t been responding much to her texts.  Clearly, I hurt her feelings because she sent me this text, “I feel like you are ignoring me.  If you don’t want to talk to me, just tell me and I’ll leave you alone.”  So, now I have managed to alienate someone that I really like and enjoy spending time with.  I don’t even know how to respond to her…What can I say that will make it better? Like, I want to tell her that I have been so depressed that I spent most of the weekend in bed.  Or that adjusting to IOP has been really hard and I haven’t had much energy for anything else.  Or that I am just crashing emotionally and don’t have much mental space for getting together.  But all that is just excuses and there is no point in telling her.  And I am ashamed for being a bad friend and hurting her feelings and I don’t know how to fix it.

Ugh…Everything makes me feel ashamed/embarrassed/socially inept right now. I don’t know what is wrong with me.

The next question is; What do I do about all of this?  For the moment, I am just avoiding all of the group stuff.  Will I check in during group?  I am leaning towards no.  However, I respect the opinion of my therapist a lot so I am not sure.  And what will she think of me if I ignore her advice?  Will I try to connect more with people in the group?  That sort of feels like a recipe for more embarrassment, so again I am leaning towards no.  And my friend that I have now alienated…Do I try to fix that?

And do I acknowledge that all these interpersonal dynamics I am struggling with are important?  Because what I want to say (and have tried to convince Grace) is that I don’t need connection.  Her response has been, “Heidi, I haven’t met anyone yet that doesn’t need connection.”  My counter is, “Well, you hadn’t met me yet.”

Have I mentioned that I am really struggling lately?  Yup.  Life sucks right now.

Interpersonal Issues

Yesterday, a treatment friend and I got together to run a couple of errands.  As she was driving, she commented that she and some of my peers were concerned about me.  She explained that basically, she had been nominated as the one to talk to me about how I had not been myself and have been overly sensitive and defensive lately.  And that my level of defensiveness was akin to when they had been with me in residential treatment in July and August.

Ouch.

Of course, I have known that I am falling apart and been a miserable mess.  This isn’t news to me.  I just didn’t realize that it was showing up as me being super defensive.  Of course, her talking to me about it made me….Defensive.  But I tried really hard to listen to her because I know she was coming from a place of concern.  Basically, the whole rest of our errands, I tried not to burst into tears and I felt profoundly depressed and damaged. I also felt embarrassed and now I know everyone is watching me and every move I make is being filed away.

This morning, I had therapy which was hard.  I get tired of everything being hard all the time and I get tired of crying.  I do like my new therapist and I think I am adjusting to her. I think it might be easier to trust her than I expected.  I have mixed feelings about this as it doesn’t feel safe.  But she seems safe, so maybe I should just roll with it.

I also saw my dietitian and much to my relief, the appointment went really, really well.  I am so glad because I don’t know if I could handle much more upheaval.  Not only did it go well, but we discussed an issue I had regarding calorie counting over the weekend and she was very kind and compassionate and offered me an opportunity to do the next right thing…which I did.  We even ended the appointment with a hug! (She asked and I accepted.)

The rest of programming, I was hyper-aware of myself in the groups.  I was careful with what I said.  Oh…and I ended up having to present in a group, which I totally didn’t expect. (Someone else was supposed to present, but wasn’t prepared.)  I picked a nice safe piece to read, an optimistic piece, so that the feedback wouldn’t be stressful and so that I wouldn’t be put in a place where I would be defensive.  Was that the best choice?  I don’t think I’ll answer that.  Of course, I didn’t really have much else to share, so it kind of was what it was, iykwim.

My therapist seems to think that I have a problem interacting with/in the group.  She probably is basing this on things that I said and my behavior over the weekend…I have to think about it some because she wants me to check-in during a group about it, which I am loathe to do.  More on the group interaction issue tomorrow.  Tonight, I need to work on some homework before bed.

 

What I need to tell my new therapist:

I am really struggling right now and everything I am feeling is overwhelming me.  It’s like I can’t get any break from my emotional intensity and I am just cracking under the strain.  I don’t know how to manage all of it without feeling like I am losing my shit completely.  The strain is so much that my brain isn’t working right and I drop things, and I stare at my phone and can’t remember how to use aps, and I can’t do much outside of programming other than just isolate in my room.

I am not self-harming to manage my feelings, though I would really like to because in the short run it makes me feel lots better.  But I am not doing it and that makes things really hard.  I am also not using my emotional pain as an excuse to engage more in ED behaviors.  I am struggling with the same behaviors I was struggling with before this emotional overwhelm started.

I am using peers for support, although the level of support I need right now is not appropriate to foist off on my peers.  I also sometimes think that using other emotionally damaged people for support is sort of limited in its effectiveness.  How much support can I get from people who are as fucked-up as I am?

I have noticed, what is perhaps a trend, in which I tend to have a PTSD exacerbation on Friday evenings.  It has happened two Fridays in a row now.  I have flashbacks and intrusive thoughts and hypervigilance.  I can’t fall asleep and then I sleep fitfully and wake up repeatedly.  Then the intrusive thoughts and images continue all weekend and I am exhausted and feel like shit from being poorly rested.

I need a go-to person when you aren’t there.  Or I need to figure out a way to see you on Fridays.  Of course, this isn’t an option because you don’t work on Fridays and I don’t think you do outpatient work like some of the other therapists do.

I have thought about doing a weekly outpatient session with Kyla to get me an extra bit of support, since she does them.  But when I asked her about it 3 or 4 weeks ago, she wasn’t taking more clients.  But more importantly, I think that seeing her would be a hindrance to our relationship.  I know that I would save things to talk to her about that I should be addressing with you.  I also should probably stick with you because your style is very similar to the AT’s style.  Kyla’s style is so markedly different from you two that it is like comparing apples and pinecones.  It is taking me time to step away from Kyla’s style and adjust to yours.  It will be a smooth transition from you to the AT, which will be important when I go home.

What I need is help.  I don’t even know if I will need it for a long time, maybe it is part of the transition, or maybe I should just stick it out as-is and things will get better.  But I feel like I am getting worse instead of better.  I am not even holding my own.  Several days ago, I felt like I was floundering.  Now, I feel like I am drowning.

Something is not working and I feel like I really need support.

Go Ahead, Invalidate Me. and Ridiculous

Go ahead, invalidate me.  I’m used to it.

So, I am still a wreck.  I don’t feel so deeply depressed as earlier this week, nor is my PTSD anywhere near as activated….But I am still barely hanging on by a thread and really unable to manage much.  At least this morning, I remembered deodorant, which is an improvement over the past week.

Yesterday, at programming, I got upset because I felt misunderstood about something (about what is engaging or not engaging in recovery oriented behavior).  I get frustrated sometimes because everything is judged as, “This must be your ED talking and trying to be manipulative.  This is not you being genuine.”  You know what?  Not everything in my world is run by my ED. <gasp> I know…How can that be?  I mean, my whole life and being is an ED, right?  Yup, I am a completely one-dimensional walking eating disorder (can you hear the dripping sarcasm?).  So, I felt unheard and judged and so I cried.  Only, I wasn’t able to bounce back from the crying, so I sat there and cried for the whole hour of that group.

You know what?  I work really hard to make recovery focused choices.  And I don’t feel anywhere near as wedded to the ED as I used to be.  I know it is tenuous, but at the moment, I feel like I am mostly in charge.  And I don’t feel like my ED is sitting on my shoulder whispering to me.  I’m not saying it is gone, but it is more like it is in a chair near me, watching my every move and making snide comments and offering “solutions” to my problems…but it is not perched under my ear and constantly funneling “advice”straight into my ear.

I don’t feel like anyone understands or recognizes that.  And even if they did, they would say, “Well, that’s probably your ED talking and trying to trick you into thinking you are in charge.”  But what if it isn’t?  I mean the goal of all this treatment is to get me making more decisions from my Self.  From my actual core being.  What if it is starting to work? Look, I’m not saying I’m perfect, and I’m not saying that I don’t want to restrict or that I wasn’t skipping snacks and under-portioning meals just a handful of days ago…But I am saying that I think I am getting better and I really could use some support in that.

And you know what? I’m going to screw up.  I am going to backslide and have really bad meals and probably really bad days and handfuls of bad days.  That is why I am still in closely monitored treatment.  But I feel like my progress is barely recognized and questioned.  And that no one understands that I am not in some glorified, “I’ve got this” sort of state.  I feel more realistic than that.  But look….I am making progress.  I can make decisions based on me.  Why can’t anyone see and support me in that?

It’s funny though…Some of my peers do see it.  Maybe it’s because they have known me longer and seen my progress.  I don’t know.

All I know is that I feel like the staff totally doesn’t understand me and that when I need recognition and support for making progress and trying to do the right things, I am torn down and questioned and invalidated.  It hurts.

The one person who is beginning to understand me, my new therapist, she is never there.  I see her twice a week for an hour. She only works three days a week.  I feel like I can’t get the support I need from her.  And I don’t have any back-up support people like I did at PHP.  I just feel alone and lost.   Hell…I just feel abandoned.  I want connection and support, and I can’t find connection and support.

And my dietitian? Forget it.  I have written but not yet posted a blog entry about her use of the word,”ridiculous” to describe some of my ED stuff.  I was offended and hurt and felt totally judged.  And I haven’t posted it because I have been trying to figure out if I am just being oversensitive.  You know what? I don’t need to filter myself.  It’s my blog, I can say what I want.  Here is that post, I wrote it Tuesday:

Ridiculous

ri·dic·u·lous

rəˈdikyələs/

adjective: ridiculous

deserving or inviting derision or mockery; absurd.

I have to be very careful right now because I am really trying to figure something out.  And I am feeling very…ummm….judged.  I think sometimes that words choices make a huge statement about what someone is saying.  In treatment here, the nuances of wording is often point out, because what you say and the words you can used to say it can be very telling…indicative as to what you are really feeling or what you may be minimizing or how you really see something.

Yesterday, the word ridiculous was used twice to describe aspects of my eating disorder.  The first time, I just sort of caught the word.  The second time, I was staring at some purple candy in my hand, my orthorexia was crooning to me, my brain was saying, “This won’t actually kill me,” and I was resisting the urge to eat the tiny Nerds one by one.  Eating them that way would have felt safer to me.  FYI, eating Nerds one-by-one counts as an food “ritual” if you have an eating disorder.  And as I was working on this exposure and fiddling with my Nerds in my hand, I confessed my urge to eat them one-by-one.  And somewhere along there, the term “ridiculous” was used to in a sentence to describe my behavior.

Ridiculous.  It didn’t feel very compassionate.  By no means do I want coddling or babying, but respect and compassion? Yes, I at the very least, expect respect.  Sitting there struggling with Nerds….Did I need judgment (because I felt really judged) or compassion?  I do have an eating disorder.  I do engage in irrational thought processes about food, calories, exercise, food dyes (i.e. purple Nerds) etc.  I understand that everything I say and do does not always make sense.  I am also working my damnedest to overcome these compulsions.  And it is fucking hard work.  But when it comes down to brass tacks, I have a mental illness.  It is not a cop-out to say that.  Which you know if you know me. But it is the truth, I have a diagnosed eating disorder, i.e. a mental illness.

So…Ridiculous.  Is my behavior ridiculous?  Is it deserving mockery? I don’t think so.  Is it absurd?  This one is trickier.  My thoughts and behaviors are disordered and at times irrational.  But absurd? Isn’t that kind of loaded with judgment?

Okay…So, I am processing this all out because the person who used the word ridiculous, is my new dietitian.  And I am trying to figure out if her using that word is truly disrespectful or if I am just being too sensitive.  Or maybe there’s a little bit of both.  I don’t know.  It felt disrespectful.  Maybe that’s all I need.  My gut says that telling someone that their behavior/thoughts are ridiculous, especially as that person is actively, like in the moment, trying to practice a new behavior, is just not respectful.

Or I am being too sensitive?

Oh yeah, and speaking of my eating disorder, I am sooo really struggling right now.  I am just an emotional wreck and that has spiked some ED behaviors and I am not happy about it.


Okay…so that’s the post.  I know the “right” thing to do is to talk to my dietitian.  But I feel like she is kind of judgey and won’t understand me.  I don’t know…several things about my appointment on Monday were misses on her part.  I don’t really feel like trying to connect with her.  As a matter of fact, I just plain want a new dietitian.

I just wish something at IOP was easy because I am getting sick of floundering.