Rejected

Late last month I saw my shrink. It was one of those days where I woke up drowning in self-loathing. As I wrote about in this post, I showed up to my appointment about ten minutes late and was a sloppy incoherent mess of emotions. I mostly just cried and rambled before leaving in an admittedly abrupt and tantrum-y way. My frustration was not with my shrink, it was with myself and how dysregulated I felt at that time.

She called the next business day and left a voicemail saying she wanted to check in. She also offered a couple of times for our next appointment and said we should talk about “how you want things to proceed from here.” She mentioned that my medication seems to be more or less “squared away” and she’s wondering how this would “work best for me.”

It was a nice enough voicemail but I had a bad feeling about it. I mentioned this whole scenario to my therapist who suggested I schedule a follow-up sooner rather than later and suggested that my shrink was simply trying to open a dialogue about our work together.

Perhaps.

Meeting Yet Another Shrink

So, as I mentioned yesterday, we met with a new potential shrink on Monday. It was weird and creepy when I got there because a circuit had blown, so the hall lights and air conditioner were off, which meant I stepped directly off the elevator into a dark, hot waiting room.

Then these two therapists walked out and started discussing the situation and it was obvious that neither of them wanted to actually deal with it. They mentioned that the superintendent should be called, but then the man therapist was like, “Well I could call, but I have a phone session…” and the lady therapist was like, “I mean, okay, but I have a client in session right now...” and it went back and forth like this until they just walked away from each other passive-aggressively.

Then another man opened the door and was like, “Hey, it’s dark out here! How long have the lights been out?” and I told him I had no idea because I just got there, but that two other people had spent a few minutes discusssing the situation without actually coming to a solution. He just said okay and shut his door. Then he re-opened it two minutes later and was like, “Okay Andi, come on in” as if he we totally knew each other. Very strange.

He was your stereotypical machismo male doctor, which I don’t love. I find it very intimidating. He was fast-paced and kinda fidgety. He kept getting up to check on the status of the lights and air-conditioner and also to get more paper from his pad. At one point, I noticed he was sweating and I was just thinking he should stay seated and grab the whole pad, so he didn’t have to keep getting additional sheets. Then maybe he’d be calmer and less sweaty?

Burnout

Right now I feel completely burned out in almost every aspect of my life. I have exactly two weeks left before finals are over. I have two practicals exams next week (both at stupid early hours), then one practical exam next Monday and three final written exams in a row next Thursday. Yikes.

I don’t even think I’m nervous for the actual exams. I know this shit. Sure I need to review well and go in prepared, but I don’t really have any reason to be concerned or stressed. But I do feel a little worried because I have been struggling so much to concentrate. And it seems to be getting harder for me to recall the specific information I need when I’m asked – as if I’m processing things slower or something. I honestly think my brain is just so utterly fucking saturated with information that it literally feels heavy. And so there’s all this shit to sort through in order to find the exact knowledge I’m trying to access.

I also had session this afternoon and I felt so all over the place and yet absolutely nowhere. Another “throwaway” session. I’m trying not to panic about it, although I want to.

I did bring up last session and how she offered a phone check in if I needed it. I asked why she offered it. I’m sure she gave a really great answer, but I honestly can’t even remember what she said. Something about how I seemed upset and she wanted to help me contain my distress. I think she also said something how possibly other parts within the system wanted to speak their minds (she specifically said Julia, which actually makes a lot of sense when I think back and also – props to her for using Insider’s names. I like that).

Probably. But I don’t know how to do that without everything unfolding into absolute chaos. It’s hard enough for me to contain myself. Trying to contain other Parts is…messy. She said we could work together towards that goal. Sure.

Dr. White

Today I had a consultation with a potential new psychiatrist.

(What happened with Dr. Bird? Good question. She literally just never responded to me again. Even though she changed my medication, I guess she never felt the need to follow up on that. Or even send me a bill for the consult.).

The therapist I’m seeing now found this woman’s name through colleagues or something. She’s both a shrink and a psychologist, so I think she generally does both therapy and medication management, but she also charges nearly twice what I pay right now per session, so no thanks. Also, I like the therapist I’m seeing right now so I want to stay with her.

The shrink (I shall call her Dr. White) said that she wanted me to know she’s never met the therapist. I was confused, but I said, “Yeah…I mean, I assumed as much.” and she responded, “Well, I don’t generally work with clients unless I know their therapists.” I just rolled my eyes and said, “Well whatever then!” Because, honestly, if you don’t want to work with clients unless you know their therapist, and you just admitted you don’t know this therapist, WHY DID YOU SCHEDULE A CONSULT WITH ME?! Ugh!

I think she sensed my disgust because she quickly said, “But we’ll just have to get to know each other.” Fine, lady. Whatever floats your boat.

Dreamy

Although I’ve been feeling better overall, the last couple of nights have been riddled with nightmares. I prefer not to call them that, so usually when I’ve had such a night I just tell my wife that my sleep was “dreamy”.

I take a medication specifically to keep my arousal response from becoming too activated, and it works…sorta. I seem to have less terrifying dreams with less horror and violence. However, I’ve noticed the intensely graphic and severe panic-inducing dreams have been replaced with dreams that are still rather distressing, but much harder to actually wake up from. So the result is these drawn-out scenes that create a lower arousal response, but for a much longer time. So although I’m technically asleep for a fairly decent amount of time, the actual sleep I’m getting is very low quality.

It took all I had to make it through my three hour class this morning. I thought I was going to pass out on the spot about 24 times.

Also, these dreams don’t even seem to be mine lately. Last night’s dream was entirely related to fear and anxiety around eating. The two nights before that were related to high school and a life formerly lived. Since I am not a part with disordered eating and I don’t even have my own memories from our time in high school, it would seem other parts are working out their shit during sleepy times. Thanks, guys.

Or, it could be this asshole introject part that has a tendency to “send” terrible thoughts, emotions, sensations, memories, and dreams to the rest of us for the sake of creating internal chaos. Which wouldn’t be particularly surprising considering the relationship we’ve begun forging with a new therapist. He’s not a fan of such things.

So, really, I have no idea what the hell is going on. All I know is that every single time I fall asleep, I spend the majority of that time in and out of nightmares that range from annoying to frightening. I was hopeful this medicine would help more, but apparently sub-hyperarousal is the best I’m gonna get for now.

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).

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.

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…