A Year Ago

A year ago today, I called a therapist named Zooey. I’d been looking for a new therapist and at this point had interviewed at least six. I’d just had an absolutely awful consultation with a woman who didn’t even wear shoes during the hour I was there. I called my “Mom” to discharge some of my frustration with the whole process and she reminded me that I used to go to the bookstore after each session with my old therapist when I lived upstate. It was where I processed my emotions and thoughts, especially if the session had been tough.

So I went back to the drawing board and started my search over again. This time, I focused on therapists that my insurance covered, but that also had offices near my favorite bookstore in NYC. Zooey’s name stood out because my mentor in college had the same (real) first name. So I googled her and found her Psychology Today profile and her website. She sounded absolutely lovely and listed trauma and abuse as issues she worked with. So I called and left a message. She called me back within the hour and we set up an initial appointment. Then she sent a follow-up email with directions to her office and said she looked forward to meeting me in person. I was very impressed with her already, just from the phone call.

Yet a year later, I’m going through the exact same process all over again. I can’t believe we didn’t even last a year. That makes me so sad and admittedly embarrassed.

I really hope this doesn’t become an annual ordeal of searching for a new therapist.

Dr. Bird

I saw a new psychiatrist today. She was so incredibly educated and knowledgeable on trauma and dissociation that it was startling. She’s literally been doing this work longer than I have been alive. She actually noticed our switching/dissociation right in session and pointed it out on the spot. It was impressive, but scary because people don’t usually notice such subtle shifts and we felt very exposed to have her pick up on it so quickly.

She’s also a psychotherapist and she offered to do both medication management and therapy, but I don’t think that’s going to happen. At least not right now. I cannot handle doing intense DID work every single week for one thing. And for another, her fee is very high. When we have insurance coverage again, I would consider seeing her more frequently, but maybe every other week or so while also seeing a “regular” weekly therapist. I know several people with DID that have this arrangement and it makes a lot of sense to me. But we shall see.

She had a lot of great ideas for medication options. We didn’t change anything today, but she did add a short-acting beta blocker to help with anxiety. She said that if I tolerate it well, she can prescribe the long-acting version and that should help me wean off the benzodiazepine (which would be great because I hate being on anything sedating).

She pointed out that the benzo has a hypnotic effect that encourages dissociation, so although it lowers my anxiety, it’s also probably lowering my threshold for dissociation and that could be causing all of the late evening/night switching.

She also mentioned something about adding an amphetamine during the day to help reduce switching when I’m at school or work. I’m not sure how I feel about that, but I’m willing to do more research. It would admittedly be nice to feel more confident that we won’t unexpectedly switch at important professional moments.

She gave me a lot to think about. My brain feels very saturated right now. But I am definitely going to keep her on as my shrink for now.

Welcome to the team, Dr. Bird (her internet pseudonym).

Pathetic

I miss Zooey. A lot. I don’t think about her quite as much as I used to, but when I do, it just hurts so much. The range of emotions I’ve felt over this termination have just been so extreme and exhausting. I think I initially tried so hard to be okay with what happened that I didn’t allow myself to be angry with her or to put the blame on her. Not emotionally anyway. Rationally, I’m able to recognize that she acted in a very unprofessional way. I know, logically, that her behavior was unacceptable. But emotionally, all I feel is shame and embarrassment.

I mentioned this a bit in session with the therapist I’ve been seeing recently. I told her that when I re-read the termination letter I wrote to Zooey, all I feel is shame. I actually went over the printed letter with a highlighter and marked all the parts that cause me to feel pathetic and stupid when I read it now. There was a lot of yellow. The therapist said that she can see absolutely nothing about my behavior or decisions or reactions that would qualify as “stupid” or “pathetic.” I admitted that it’s not exactly rational, it’s just what I do when I’m hurt – I turn it inward and blame myself. Because, really, when was it ever safe for me to be legitimately angry at the people who were hurting me?

At the time I wrote the letter, I was trying to be as authentic and honest as possible. And I was. But in hindsight, I’m so angry with myself for the way I went about it. I’m pissed that despite how badly she hurt me, I still put Zooey’s feelings above my own in that final session. I still tried to take care of her. I still wrote a letter to try and make her feel okay with what was going on. I was authentic, but only halfway. I left out the part where I think she’s a total shit for abandoning me out of nowhere after she committed to seeing me through this journey. I left out the anger. And I did it to protect her and to try and preserve what was left of the relationship.

At this point, I can’t even explain why I miss her. I’m so disenchanted with her. She hurt me and she didn’t seem particularly bothered by doing so, so honestly? She’s probably not even a very good person.

Yet still, I miss her. Every day. How pathetic am I?

Tough Day

This was a tough day. I woke up with a migraine. I would have given anything to stay in bed, but I had a group project meeting to attend and then work from 1-6pm. I seriously considered bailing out on both, but I somehow found the strength and motivation to get out the front door. Now it’s 11pm and I really should wind down to make sure I get enough rest for tomorrow’s midterm, but I can’t because I feel so unsettled.

This time of year is hard. January is a tough month – it just sorta hangs there, being cold and dark and boring after a series of holiday-filled celebratory months. Then February hits with it’s coldest-month-of-the-year bullshit and by the end, I’m just a puddle of blah. By the time Spring starts to make an appearance, the sudden onslaught of sunlight makes my brain explode and my anxiety skyrockets.

It’s also trauma anniversary time for me. This period of time from mid-January to the end of February is riddled with anniversaries. There are so many of them throughout the year, but this particular series is awful. Even when I’m completely oblivious to the date, my body (and the system) somehow always knows.

It always remembers.

Denial

My wife and I went to see “Cabaret” tonight. The show is fun, sexy, dynamic, and interactive. It’s set up like you’re in an actual night club. As it opens, you’re excited and everyone’s laughing and it’s a blast. But then, as it progresses, you realize that these characters’ lives represent so much more than a simple story. “Cabaret” ultimately reflects the state of the world leading up to WWII. Although it takes place in Berlin, Germany, the characters individually represent the people and environmental conditions that allowed Hitler and the Nazi Party to exterminate over six million people.

I bring this up on this particular blog because WWII, particularly the Holocaust, has always resonated very deeply and powerfully within me. I don’t remember when I first learned about Hitler or the mass genocide he orchestrated, but I do remember when I began to understand the complexities of how such an atrocity could occur. And that was something I found very relatable. I certainly do not mean to minimize or be insulting, but I want to be clear that yes – I am drawing a comparison between my own traumatic childhood and the heinous acts committed against the Jewish (among other) people. Why, or even how, could I do such a thing? Because the very same elements that allowed the Holocaust to occur allowed my abuse to occur.

Adolf Hitler was an exceptional orator who used fear and charisma to convince ordinary people that Jews were the enemy of Germans and would result in their inevitable downfall. As a teenager, I used to refer to my biological mother as “Hitler of the household” because I felt that she led her very own dictatorship within those walls. She was extraordinary in her ability to spin tales and gaslight the people around her into believing things were just as she said they were. It was very easy to to lose yourself amidst her lies and manipulations.

Since the people surrounding my biological parents found their façade so compelling and believable, they were somehow able to overlook what I know was obvious to them. But they found ways to deny it. I once read a book that interviewed Germans who witnessed Jews being marched through their towns and put on cattle trains to their deaths. When asked what, exactly, they imagined was going to happen to those Jews, the people stated that they believed what they were told: that the Jews were being segregated and moved to separate areas for housing and employment. They knew – somewhere inside themselves – that this was likely not true, but most chose to ignore the dissonance and accept the lies funneled to them through political parties. I do not blame them. It would have taken incredible courage to go up against the Nazi Party during such a time.

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Right Now

Despite the approaching blizzard, I did see the therapist today. That’s make five full sessions. And I’d be lying if I said I didn’t like her.

She’s smart. She definitely exudes much more strength and confidence than Zooey ever did. She seems very attuned to what I’m saying and I can see her actively connecting the dots and trying to pick up on patterns. She catches the small details I try to brush off as irrelevant (or seem irrelevant to me as I’m speaking) but upon further examination, end up being not so small details. She has a very subtle warmth and empathy that feels less threatening and suffocating than previous therapists.

I like her just enough to keep seeing her, but I don’t feel drawn to her the way I did with Zooey. I think part of that comes from my own lack of trust and willingness, but I think it’s also because of the way she sets boundaries. She has a way of keeping things contained inside that room, within the 50 minutes allotted for my session. It doesn’t even feel like there is space to step outside of that little bubble. Historically, I would have found it unbearable to have such limited access to a clinician, but after what happened in December, this feels very safe and relaxing to me. I doubt that will last forever, but it’s nice for right now.

And right now is about all I can do. I told her the story of firing Dr. FF. She laughed at the appropriate moments in the story, but then quickly honed in on the seriousness of not having a prescriber. I told her I made an appointment with someone else – a very experienced female psychiatrist who specializes in trauma and dissociation. The consultation is for tomorrow morning, so unfortunately, Winter Storm Juno WILL be interfering with that appointment, but I already called to reschedule.

As I was talking about all of this shrink nonsense, I sorta shrugged it off as no big deal. I’ve never felt the need to have a psychiatrist that actually fit with me because that has always seemed impossible. My experience with psychiatrists goes beyond sub-par into the world of traumatic. But as I mentioned before, I DO care about how I spend my money. So that made me seriously reconsider who I would pay to write those scripts. The therapist responded by saying she thought it was actually great that I sought out someone more qualified to treat me because I deserve that kind of care. She also started saying it would be good for me – in the long-term – to have someone more skilled and knowledgeable.

I literally interrupted her mid-sentence and said, “I’m not doing ‘long-term’ right now! There is no ‘long-term’ as far as treatment for me… There is only right now’! I can only do right now.” She very calmly replied, “Okay. And I can understand that. So how about I worry about the long-term for the time being and you just worry about the right now?”

Sounds good to me.

Scared

Barring any blizzard-related travel issues, I have my fifth appointment with a therapist tomorrow. I do not call her my therapist, because she doesn’t feel like mine. I don’t want her to be mine.

I honestly don’t feel safe or comfortable referring to anyone as an actual legit part of my treatment team right now. This termination, especially the particular way it unfolded, has left me even more weary and skeptical of clinicians. I used to mistrust them on the basis that as a collective profession, they’d let me fall through the cracks an impressive number of times. Now I also don’t trust that, as individuals, they know themselves well enough to provide proper treatment for me.

And I’m scared to trust again. This therapist (blog pseudonym TBD) says she wants to work with me, even given all the drama and trauma and being dumped by Zooey. I don’t believe her. I believe that she believes she wants to work with me. But I have absolutely no faith that she will stick with me once shit gets tough. And why should I? Zooey said all the same things – that she was committed, that she could handle it, that I wouldn’t scare her off with my trauma, that she was invested, that she wanted to work with me, despite it all. And look how that played out…

So I’m not really even sure what I’m doing. I go to each session and mostly just process what’s happening right now, with school and relationships and (of course) Zooey. Which is fine, because that needs to be dealt with and talked about. But I feel this rock solid wall being rebuilt around myself. It seems to grow stronger with each new session. The system is re-fortifying the security around our castle because they – we – are terrified of being hurt and rejected and abandoned all over again.

Therapy cannot happen without trust or safety. Sure, you can do a lot of superficial talking and smooth over some of the surface issues, but so much of the “real”, life-changing work is dependent upon the strength of the therapeutic alliance. I know this wound is still fresh and I hope that over time, it will continue to heal. But how the hell am I supposed to move forward in treatment right now when I am so terrified of revealing literally anything that is real or true?

What a damn mess.

Forgetting

It’s been 40 days since my last session with Zooey. I’ve interviewed 14 therapists, either by phone or in person, in that time frame. I haven’t yet settled on a “permanent” new therapist, but there’s someone I am seeing “exclusively” to determine if we’re a good fit. She seems to think so, but I’m fairly certain she’s just being naïve like all my former therapists were.

Anyway, 40 days is not that long. Unless, of course, you used to see a person every 3-4 days. Then it suddenly seems like a very long time. I realized today that I’m gradually beginning to forget Zooey. The memory of her face and her voice and her gestures is beginning to fade. The visual memory of her office seems less sharp. The actual physical memory of being in that space with her is so far away it’s nearly inaccessible.

I have two saved voicemails from her, but they sound so different from her normal way of speaking in session. I can’t remember her laugh that well anymore – a laugh I adored. I can remember the little verbal crutches she uses (mainly “um” and “you know”) but I can’t hear them in my head as clearly.

I also have a photo of her. It’s from her website. I printed it to have a hard copy nearby for individual system members to see and feel comfortable with. It was a really great way to introduce her to various parts, actually. But now I can’t bear to even look at that photo. It hurts too much. Plus it looks completely different from how she is in person anyway. And that just makes me sad.

So then I wonder if she’s forgetting me (us) too? Does she remember what my voice sounds like? My laugh? Is her image of me beginning to fade away as well? She has a photo of my wife and I that was on the Holiday card I gave her. I wonder if she ever looks at it just to remember me? I wonder if she doesn’t look at it for the same reason I choose not to look at her photo. Does she try to remember? Does she even care? Does she want to forget? Did I ever matter at all?

So That Happened

So I saw my psychiatrist yesterday. Sorta. I’d originally had an appointment scheduled for January 5th, but then I had a school thing that day, so I rescheduled to the 22nd. I was dreading it like crazy. I just had a feeling it would not go well. And man, was I ever right.

A little backstory: I had been off all psychiatric medications since 2010. Then, when I began seeing Zooey, shit started coming up and my symptoms worsened. By April, she’d started mentioning medication. I assumed she’d probably keep mentioning it until I tried something, so I agreed to see one of the doctors she works with at a local psychiatric Emergency Room. I actually liked this physician a lot, but it turns out she was leaving private practice in June. Great.

I was in the process of trying to find someone new when I was hospitalized for three days in August. Turns out the hospital staff cannot discharge you unless you have a follow-up appointment with a psychiatrist within one week. So they threw me in with some random second-year resident at their outpatient clinic and called it settled. Whatever. As long as he can write the scripts, I honestly didn’t care.

But that, of course, meant that my psychiatrist was now also a co-worker of Zooey’s. And he made a point of reminding me of that whenever I didn’t 100% agree with him. It was this strange “Mommy and Daddy” dynamic that I brought to Zooey’s attention (and, of course, we never actually discussed in any depth). It was super annoying to have him constantly using my relationship with her as leverage, but as long as those scripts kept coming, I figured it was tolerable.

Yesterday, however, was just a mess…

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Untreatable

A friend of mine shared an interesting article from The Atlantic entitled, “How Patient Suicide Affects Psychiatrists.” Obviously the main focus is on clinicians’ responses to losing a patient to suicide, but it also explores the world of the chronically suicidal, a.k.a. “the untreatables.” One quote in particular resonated with me:

“I completely fell apart after my therapist quit, because I relied on her very heavily…I got really attached to her, and it’s so hard when someone you care about, that you trust, decides not to work with you anymore. It makes you feel like they think you’re never going to get better. It felt like she gave up on me.”

As much as I’ve been trying to convince myself that Zooey didn’t “give up” on me, I know I don’t really believe that. When I was first diagnosed with Borderline Personality Disorder (BPD) back in 1999, I had no idea what it was. When I asked about it, no one would even tell me. All I remember about it was that the hospital staff often used the phrase “Borderline” as a catchall derogatory term used to encompass all resistant or difficult patients. I felt like this horrible label had been slapped on my forehead and from that point on, I was one of the infamous “untreatable” patients.

It also made my treatment teams very lazy. The classic symptoms of Borderline mirror that which are found in individuals with a history of trauma. Not only did I have a trauma history, but I was in the throes of abuse while a patient at these facilities. At first they showed a little bit of interest in the “why” of my behavior. But once that Borderline label was slipped into my chart, all the questions stopped. Because no matter what the question was – the answer always seemed to be “because she has Borderline.”

I eventually graduated to a diagnosis of both BPD and Bipolar Disorder. That’s when the parade of medications made it’s way into my life and wreaked havoc on my body. They didn’t work, primarily because I do not, in fact, have Bipolar Disorder. But the stigma and the horrible experience of being deemed “untreatable” has always stuck with me.

I believe I took all that baggage with my into treatment with Zooey. Naturally. So perhaps I projected my fear of her deeming me unworthy of treatment or incapable of recovering so strongly and so frequently that it became a self-fulfilling prophecy. I wonder if I didn’t unintentionally/intentionally push her to the breaking point because I’d always assumed she’d just get overwhelmed and walk away anyway.

But even if I did, the point of therapy is to “act out” some of the earlier experiences of your life that caused you to create disruptive or destructive patterns of coping. This enables you to step back and examine those patterns and then make changes to healthier, more effective methods. I should have been able to push Zooey and then push some more – to test her and see if she was the real deal. And push, I certainly did. Maybe I pushed her too far, but honestly? That just tells me she wasn’t the right therapist for me.

Because I AM treatable. The last year has proven to me that I can make the difficult decisions and choose a new way of living my life. Maybe I didn’t do it at a comfortable enough pace for Zooey, but that doesn’t mean I wasn’t progressing. It doesn’t mean I’m not capable of healing and living a life that isn’t constantly invaded by the aftermath of trauma.

Yet, there’s still that doubt. That little dark seed planted so many years ago that refuses to die out. And so as I continue this process of finding (and committing to) a new therapist, I often find myself asking the same old question: “Am I even treatable?”