Friday, September 20, 2013

20 things : the group

1. I feel such a sense of relief, having experienced the first iteration of the Survivors of Suicide support group last night.

2. I was worried that the group was only going to be heavy, crushing, scary, and not show its helpful aspects immediately.

3. I want to give an indication of my experiences without breaking the confidentiality of others... so no details about other group members. Which means that I probably won't blog about the group much other than this first week.

4. I feel I owe it to those who were extremely concerned after my last blog entry to show that I am feeling somewhat better. I feel guilty about making others extremely concerned. I don't think the last blog entry was particularly extreme, considering all I've written about. Joanna's voice echoes in my head right now we are not responsible for other people's feelings. We are responsible for our own feelings.

5. But sometimes, with loved ones, the boundaries blur. About who is responsible for what. So I write this entry, in part, because of that. To reassure others, and to assuage my own guilt.

6. I mostly want to talk about the philosophies of the group leader regarding suicide. To me they are unusual and comforting at the same time.

7. She believes that suicide is not, in fact, preventable. She has research to show that with or without psychiatric treatment, the suicide rates remain the same.

8. She believes that suicide is its own illness, a  massive failure of the frontal lobes' executive function--separate from depression, bipolar disorder, and so forth.

9. She believes that the idea that is prevalent in society "suicide is preventable" leaves the survivors with a huge amount of guilt over what they could have, should have done to save their loved ones.

10. This idea is, in one way, immensely comforting to me --because I am still obsessed with what I should have done to help my mom. If only I had been more aggressive about talking to her doctors. If only I had taken charge and flown her up to Pittsburgh.

11. You see, I'd had this idea that at some point, I would have to move her up here and take more of an active role in her life, sorting out her myriad problems for her. Because her decision making skills had been going downhill for decades, plural. Talk about failure of executive function.

12. But we could never have lived together, ever. Because of how toxic our relationship was when we were that proximal. It was not good for me.

13. I had been trying for years--half my life--trying to and succeeding in repairing the damage that --to be frank --she either caused or set me up for.

14. So I had been putting it off --offering to move her to Pittsburgh --b/c I knew it would cost a lot of money to set her up and she has none. I also knew that much of the time it would be like taking care of a child. And I also knew that the relationship had the potential to quickly turn into me = caregiver and she = a mean, combative, even at times violent child.

15. And I've been struggling with this idea of I PUT IT OFF FOR ME ME ME. And so I let her die. I chose me over her.

16. Ironically, I wonder if my relatives in Georgia thought they were doing the same thing when they moved her down there. Like they could swoop in and fix a truly unfixable situation.

17. My mother had a real talent for inspiring this kind of We Will Save the Day kind of help... and then TOTALLY resisting 99% of the help. It. Was. Truly. Maddening.

18. The DBT version of helping me with my survivor's guilt is : waterfall. I may have blogged about this before. Joanna asked me one day to come up with an image that would snap me out of the rumination (dwelling-on) trajectory that I've just described.  I came up with waterfall. Not because it was a beautiful example of mother nature's creation... but because it was beguiling yet destructive. If you stand under Niagara, you will be crushed. The water surges forward under its own power, cutting a channel into the rock because that's what it does. You are just a brittle bag of bones compared to the power of the waterfall.

19. According to our SoS group leader, my mom's brain slowly stopped being able to make the decisions necessary to keep her alive. Complex decisions, but also decisions that we all take for granted. It is a radical idea. However, I'm considering it. Not only do I want to believe it because it lessens my guilt, but it also makes so much damn sense when I look at the course of her life over the past twenty years. If you think about it, it actually connects to waterfall. Well, okay, it does for me.

20. So that's what I got from my first week of group. I'm glad there are only 20 things. It tells me when I can stop writing. B/c I'm exhausted now. Whew. Time to hop in the shower and start my day!

Wednesday, September 18, 2013

20 things : what to do with the dead

1. My mom's death day (like the opposite of birthday) is coming up on Saturday.
2. I am looking for distractions.
3. The first person whom I asked an opinion about distractions said that I should think how I can memorialize or honor her instead.
4. I don't know if I'm ready to do that.
5. Maybe I will take her ashes out of seclusion and find a place in the house for them.
6. On Thursday, that is TOMORROW, I am joining a support group called Survivors of Suicide. It is the first session.
7. I am grateful for this opportunity to talk about what happened, because I don't really talk about it with anyone, except Mike or therapist N sometimes.
8. Not with friends, certainly not with family.
9. I don't know how to begin the conversation or what I would say.
10. I do envy other people's ability to talk about the dead.
11. Perhaps I am imagining this ability.
12. I think the not-talking-about-it has kept me corralled in a certain area of my mind, so to speak.
13. I don't even feel comfortable blogging about it.
14. Like : that time has passed. Like : no one wants to read that.
15. My favorite cactus died last week.
16. I couldn't tell if it was b/c of over- or under-watering.
17. I think it was under- but the internet says to under-water a cactus is much less common than overwatering. I conducted obsessive internet research but found no good answer.
18. I wanted to conduct an autopsy, but instead I had Mike take it out to the faraway trash, pot and all. I couldn't bear it.
19. My anxiety and OCD started to get so extreme on Tuesday that I only went out of the house to take down the used cat litter, and that made me so paranoid I was hyperventilating by the time I got back. 20. This morning I have already predicted my own death in five ways. The OCD is an unwelcome divination.

EDIT: After having gotten some unexpected responses to this entry, I want to clarify #20. Obsessive-Compulsive Disorder leads the individual to have compulsive, uncontrollable thoughts--obsessions. It is common for those thoughts to be troubling, even violent, in their content. The person with OCD deals with the stress elicited by those thoughts by acting out compulsions or tics. Stereotypical compulsions would be hand-washing, checking 20 times to see if one has locked the door, etc. My OCD is torturing me with death thoughts this week b/c of the anniversary and b/c I am joining the support group. It does not mean I am acting violently toward myself or anyone else. Deep breaths.

Monday, September 9, 2013

Water and No Water

When I was a kid living in rural eastern PA, we had a well. As a child, I didn't really understand the mechanism of the well, just that it was underground and through a series of pumps and pipes, provided all the water for our house. I think it may have also required electricity to run. Which means that when the power went out, so did the water. 

I remember the feeling of panic that took hold of me whenever the power went out or there was a mechanical problem with the well. The panic was connected to the sudden scarcity of something I took for granted. Bear in mind too, that for someone with OCD--which I've had it since I can remember--it's important to keep clean. No water for going to the toilet, no water for washing hands, no water for taking a shower. Frightening brown sediment would rise up into the toilets and sometimes the sinks. I didn't know when the water would come back on, only that the forces were completely beyond my control. 

I can hear Joanna-therapy-voice interject here: sometimes a child is just born sensitive.

One time I remember my panic was overwhelming, and my mom tried to distract me by reading a book about horses together. A love of horses was one thing we had in common. This book had all different breeds of horses in it, their historical origins and the countries they came from accompanied with fantastic illustrations. I remember Lipizzan horses capable of astounding grace, stocky Clydesdales, tall and rangy Tennessee Walking Horses, Arabians with their unusual concave faces... although the panic never went away,  the stories slowly replaced it in the forefront of my mind.

[I wonder what my parents thought about my panic. I wasn't diagnosed with OCD until I was 18 and certainly neither of my parents knew what it was before then. What did they think of my strange tics and ongoing anxieties that rarely seemed to ease up?]

* * * 

This morning when I was in the shower, suddenly the hot water cut out and there was just this unmitigated torrent of cold water sluicing down on me. This can happen in apartment living of course... one just has to shimmy to a corner of the tub that is mostly out of the shower stream and wait it out... but this torrent went on and on... finally I dove in and turned off the water entirely. I turned just the hot spigot back on. Nothing. Somewhere a pipe knocked dully. 

Perhaps in response to my stream of compound-complex swear words, Mike asked if I was okay. I imagined the cold shower causing all my muscles to seize up and the fibro ache lasting the whole day. I requested a washcloth so that I could rinse off from the tub faucet and not the shower. 

When I turned the cold water spigot back on though, there was no water coming out of there either. More distant knocking of pipes. I had the feeling there was no water anywhere nearby, although Mike said there was still some coming out of the kitchen sink--probably what was left in the lines. He brought me a bowl of water.

We called the management office and they said that maintenance had to shut off the water for "an emergency repair downstairs" and they didn't know when it would be back on.

* * * 

No Water changed The Plan. 

Regarding The Plan: have I mentioned my recent strategy to tamp down my constant panic with structure? I visualize each of my days as a box. Each day has A Plan. As The Plan is executed, I picture little colored strata start to fill the box. At the end of the day I have made it through. The box is filled. 

Where did I get this visual? I think there was a video game in the eighties involving colored lines slowly filling in or draining out. If anyone knows, leave it in the comments. 

So I have this strategy, but I'm not great with changes in The Plan. For today, The Plan was housecleaning in the morning, vacuuming, washing and wiping, doing the catboxes, in the meantime having loads of laundry going on the second floor. Additionally, I told myself had to rock today's Plan, because I was practically useless yesterday: semi-functional in the morning but in the afternoon and evening, tearful and trapped in a pit of self-judgment.

Last night in the middle of hysterical sobbing I thought look at my fucking life now --my mother did this to me. One last strike so we could both go down together. These thoughts are pretty close to my worst thoughts: the fear spiral that leads to places too dark to blog about.

How strange that she could be so kind one day, so unmerciful another. I mean it: how strange. I thought it was strange at eight. At thirty-eight my mind still can't get around it.

I think of that eight year old girl, vulnerable and not in control of her world, trying to provide structure with rituals, which came along with horrible tics. Today, I lost my shit when the water went off. 

* * *

When I taught at University, I shepherded my students through a campus lockdown because there was a shooter on the grounds. There were three incidences of gun crime at this school during the six years I taught there. This never kept me from going to work. 

If you would have asked me, I'd have said yes, it's scary, but there's nothing I can do about it. The people who are in charge of doing something about it are doing something about it.

Fast forward 2.5 years and I'm totally couchlocked, blogging about waters and wells and horses and my child-self because I can't even execute PART of today's Plan. See, it has to go a Certain Way, follow a certain procedure and it can't with no water and... and... I feel like eight-year-old-me.

All I can do is deep-breathe and say it's scary, but there's nothing I can do about it. The people who are in charge of doing something about it are doing something about it. But I can't get off the couch.

Sunday, September 8, 2013

20 things : Opposite Action ftw / wtf

1. So, opposite action is a DBT concept wherein, even (or especially) if all one's emotions are screaming that one does a behavior that isn't helpful, one does the opposite behavior.

2. I realize that if you are reading this and have never worked a recovery program with behavioral elements, it may sound like I'm in a cult or something. For those of you who have known me since 1995 or so, you know this therapy has helped me greatly before, and now it's helping me rebuild again after what happened last year.

3. For some reason my immediate grief response was extreme social anxiety, bordering on agoraphobia. In general, the action-urge for anxiety is to avoid the thing that makes me anxious.

4. [Note that avoiding was a useful and protective device at a certain point in human evolution. Is that a saber toothed tiger waiting for me in the brush? I'd better hide until it passes by.]

5. People make me anxious. Thus, 99.875% of them I would rather avoid.

6. But then I'd never leave my house. Which is sort of what happened in April when I had that relapse bit.

7. Needless to say, never leaving the house would end up with me bitter, angry, ever more phobic, and possibly dead before my time b/c isolation leads to the Circling Thoughts.


8. Exposure therapy is a thing they do for OCD and phobias. For example, if a person is deathly afraid of dogs, she might start out looking at pictures or videos of dogs, then move to, I dunno, five minutes of a dog on a leash in the same room with her... And end up where she can pet the dog or have it lick her hand and such.

9. The idea is that the patient participates in increasing levels of exposure. She sits with the frightening experience until her fear comes down. Allegedly, her brain can't maintain a fear response with the volume cranked to 11 for an extended period of time. When her brain processes the fact that nothing bad is happening as she looks at the video of the dog, the anxiety will "naturally" start to abate.

10. Although I've had OCD all my life, I had never done an exposure before starting my second round of DBT in 2012. Honestly, I was a cognitive-behavioral therapy hater for a long time because of one bad experience when I was a teenager.

11. I don't want to overdramatize, but every time I go outside, it's basically an exposure.

12. When contemplating the recent (about two weeks ago now) ending of intensive outpatient treatment, I wrote in my therapy journal my continuing recovery just seems like a lot of self punishment, with much alone time and extensive amounts of exposures. Basically, at my worst, I don't want to be with others, nor do I want to be with myself.

13. My prediction has panned out, sort of. But I haven't launched myself into the downward spiral of fear that indicates I am at my worst. I'm managing to mitigate the alone time pretty successfully, but it's challenging. The exposures continue to feel like sandpaper scraping a fresh wound.


14. When I interact with most people, I just don't feel like I'm behaving humanly...  I'm frantically searching for what a human says, how a human moves in the space of the world. And when I get it right, my internal response is somewhere between whew that was close and I've Accomplished Something.

15. When I (feel like I) get it wrong, my breath stops and my head starts spinning. And I want to be home immediately.

16. Home is usually far away. But not as far away as it was when we lived on the south side.

17. Although it is painful, I can see the ways in which my anxiety is coming down. I'm more spontaneous. More talkative. More gracious to others and also (er, sometimes) to myself.

18. I even went to the coffee shop to write yesterday. That was impossible... basically up until the time it was possible. I didn't know if it was gonna work, but Mike suggested starting out with prompts and exercises instead of a blank screen / sheet of paper and that was super-helpful.

19. The thing I have to fight against, or as my DBT therapist would say gently push away, is my rabid desire to be better than I actually am, even though recovery is a process, and rationally I know that.

20. Going to the coffee shop and writing was a HUGE deal. But there were many small unglamorous accomplishments that led up to it.... perhaps I'm writing this entry to myself as well as to you. It's very hard for me to acknowledge the small steps that lead up to the bigger ones. I mock myself, like, whoa, big deal: I went to the supermarket. When it really is a big deal dammit.

That is all.