Excited

Tomorrow I start my second clinical affiliation. I was super nervous about how I’d manage full-time clinic with therapy three times a week. Turns out the physical therapy office I was assigned to is literally three blocks from my therapist.

Huh. Interesting how that worked out, eh?

I finally got my schedule from my clinical instructor. I was originally assigned a week of mid-shifts, but I asked to switch with my fellow student so now I have a schedule that allows me to go to therapy right after my internship on Monday, Wednesday, and Friday.

I am very looking forward to getting back into a regular routine. Therapy has felt sporadic and far away lately. We’ve been mostly puzzling our schedules together, trying to make the pieces fit as best we can. I was totally checked out emotionally during finals week, so I kinda feel like I haven’t really been in therapy since late November. We did have one phone session while I was away, but I was so distant and walled up that it didn’t really feel like much of anything.

But she came in to see clients on the 28th and that session was fruitful. I felt very relaxed and spoke openly about how much I’ve been struggling with my eating disorder. I think she was relieved that we were finally really talking about this in a way that allowed for more options. Since I was going to see my psychiatrist later that week, she asked if I would be willing to share about this with the doctor as well.

Update

School is back in session.

The first day was long and terrifying. The second day was long and exhausting because I had to go to session in between classes. I had exactly enough time to commute there, have a one hour session, and commute back. I made it to class with one minute to spare after running from the train in pouring rain.

Not super fun.

Yesterday was long, but better. The first-day scare tactics my professors love to employ wore off a little and they were more chill and seemed genuinely enthusiastic about the material. I’m already beginning to feel less anxious and more excited about my classes this semester.

And I finally found out my first clinical assignment. It’s about a 25 minute commute via subway train and I’ll be going on Fridays, which means I only have to reschedule one therapy session per week. My clinical director paired some of us up and my partner is a classmate I really enjoy being around. We’re both meeting with the clinic director on Monday to talk logistics and find out the hours we’ll be working.

Very exciting, very scary.

Emailing The Therapist

As I’ve mentioned recently, my schedule is about to become a total clusterfuck.

I actually only have two classes with two labs this session, but since we also have our first clinical affiliation coming up, we can only hold those classes on two days of the week. Thus, we have to fit twelve lecture and lab hours into two days. Wednesdays are reserved for affiliation seminar (whatever that means), studio hour (whatever that is), and Physical Therapy Club (of which I am the President).

Therefore, the yet to be assigned clinic hours will happen on the remaining weekdays. As I understand it, we will have clinic on Monday and/or Fridays and it could be all day or half the day – which could be either morning, afternoon, or evenings. And we don’t yet know where these clinics are, so my commute could be twenty minutes or two fucking hours. We have no idea.

I also have to go to physical therapy 2-3/week for the next six weeks to treat my own janky hip/leg/back/everything. And, of course, I have psychotherapy 3x/week. Plus yoga class and regular gym time. And there should probably be time to sleep, eat (meh), study and occasionally talk to my spouse and friends (social life? haha). Also, although I attempted to respectfully resign from my job in the Anatomy Study Hall, I was told that was “unacceptable” and that I need to give hours. Oh sure! No fucking problem.

Anyway. I explained all of this to the therapist last week because she’s trying to figure out her Fall schedule. I was really overwhelmed by the task of fitting my schedule with hers so I just kinda blew it off in session. She gently reminded me that she can absolutely be flexible and make three sessions work around my schedule, but she does need some advance notice.

Day Four

Today is day four of this therapy vacation. That’s really not much time, but considering I’ve already missed two normal sessions, it’s kind of a lot.

I’m so not into this.

It’s not as bad as I thought it would be, though. I don’t feel as crazy or out of control as I did whenever I was separated from Zooey. As much as I feel afraid of getting through the remaining five days of vacation or what might happen when this therapist returns, I feel okay overall. I don’t love it and my thoughts are mostly along the lines of “Let’s not do this again for a while” but I’m okay.

Today, I’m okay.

I’m still having a crazy hard time sleeping. I don’t even know how long this has been going on – a few weeks? Months? Hard to tell. But being off from both work and school this month is throwing off my schedule and my body is a mess. I started on 25mg of Lamictal two weeks ago and now I’m up to 50mg, so I don’t know if that is helping or hurting. I think (?) my mood is better, but my anxiety skyrockets at bedtime.

That’s not unusual, but it feels unmanageable right now. I can’t tell if it’s the medicine, the change in schedule, or just my usual anxiety. Sometimes when I have less to do in the day, I literally just burn less energy and thus I’m more riled up at night. The Lamictal came with a warning label that it could cause drowsiness, so I opted to take it at night. But the shrink never told me when to take it, so maybe I was supposed to take it in the morning?

Really Good Day

Final grades are in. Killed it!

Also: nearly killed myself. Phew. Glad this particular session is over. Next set of classes starts in two days. I already have some chapters to read and handouts to complete. It will have to wait until tomorrow. Today was a day of no obligations. Which turned out to be a really good day.

The first news was that grades has been posted and I got all A’s, meaning I somehow managed to maintain that damn 4.0. Apparently my classmates did not fare so well, which is both disappointing and glorious. I’m sad for them because I do genuinely wish well on people. But listen, I am happy to be the outlier who helps shape that bell curve. Just saying.

Then River weighed herself (as she does every single morning) to see that we finally broke through this weird plateau and reached the second goal weight that she’s set for us, which made her very happy. She has five goals in total, I believe. The third and next one is another 14lbs lower, so this is a short-lived victory. But, still, something to be happy about I suppose. Even if only for a brief moment.

Actually, there’s a lot more to that and I hope I can articulate it on here someday because I think it’s pretty important stuff.

More Space?

Finals are over. They went…okay. Not good, not bad, but I prefer to walk out of an exam feeling a little more confident than I did on Thursday. Grades are due on Tuesday, so I’ll find out how I did soon enough. I won’t lie – I really wanted to hold onto my 4.0. But I’m also reassuring myself that (1) this shit is HARD, and (2) I literally worked as hard as I could have. I did my best.

Class doesn’t start again until the 18th. I’ve been doing almost nothing except watching something on Hulu, HBONow, or Netflix (including season 3 of “Orange is the New Black”!). It’s been glorious.

I did, however, also get to the gym both days this weekend, which hasn’t happened since …February? My body already feels better. I need to prioritize actual gym days. I never miss yoga class, but I find that cardio and strength can be just as calming and centering for the system. It allows certain parts to get out a lot of their energy/rage/aggression/whatever.

In Friday’s session with the therapist, she (again) mentioned the idea of having “more space” (i.e. more time). I recoiled at the idea (again). But we talked about it. She asked what emotional reaction I was having to her suggestion for more time. I explained that it just feels risky. What if I end up STILL not being able to ground myself or get back into adult brain by the required end-of-session point? What if the system is still uncooperative? What if it’s still not enough and she grows ever more resentful because I’m not reaching the outcome she hoped for in a reasonable time frame?

Also, the very fact the she thinks I need more time than two one-hour sessions per week sorta supports Zooey’s whole termination thesis that I “need more intensive treatment”. Which, I won’t lie, pisses me off.

The therapist responded that she fundamentally disagrees with almost every point Zooey made about my treatment (win!). She further explained that sometimes people appear or feel “needy” until their needs are, you know, met. She wants to be able to help do that. Her proposal is for the same two sessions per week but for 75 minutes, instead of 60. That would be an extra 30 minutes per week.

She feels this extra time would allow the Others to come out and speak more freely. She said, “There’s a lot of you! With a lot to say! I think that maybe if we could create some more space for people to talk and share, it might really help all of you.”

I can’t argue with that. But still, it makes me nervous. I think I’m just afraid that all of this trauma and darkness is ultimately uncontainable. What happens when she realizes that?

Then again, what if I don’t accept the extra time and then whenever there’s a crisis (or whatever) she holds it over my head that this is why we need more time?

Halfway

I am now halfway through my final exams. I’ve finished all three final practical exams and I have three final written exams left. Those are all on Thursday and will be back-to-back for what is essentially a four hour test.

I believe all of my practicals went well. One was great. One was good. And one was tricky. I felt good about my actual execution of skills, but the decision-making part was sloppier than I’d hope for. Unfortunately, we won’t be getting any of our grades until after the written exams. (Maybe that’s for the better, so we don’t all freak out if we did poorly on a practical exam?)

My anxiety has been ridiculous lately (despite remaining on the higher dose of Klonopin while I search for a new shrink yet again). I felt a lot of the pressure shift off my shoulders once I finished today’s exam, but I still feel tremendous tension and intensity around preparing for the written portion. And then there’s only six days off before I start the next two classes.

I think part of the problem is sleep (or rather, the lack thereof). I’ve really been struggling to get good quality sleep. I have been able to fall asleep somewhat quickly, but I’ve been having tons of shitty nightmares.

I had another nightmare involving the therapist last night. It took place in my early teen years. I was at some campus of sorts. A hospital complex, maybe? My family members had appointments at other clinics and I knew I wanted to go to therapy, so I somehow convinced my parents to drop my off at the building with the therapist so I could see her.

I was young. She was herself. But she somehow didn’t know anything about my abuse. I told her I wanted to tell her something important.

****TRIGGER WARNING****

Not Cool

A few weeks ago we changed our Friday morning sessions to Thursday afternoons. This all had to do with school nonsense and Andi told the therapist we’d only need to change days for the month of May.

But then the schedule for finals changed and they added an extra open lab so we can’t do Friday morning session this week, either. Andi left a voicemail with the therapist to explain this and said, “So if Thursday afternoon still works, I’ll just see you then. If not, please call me back so we can figure something else out.”

She called back. I answered. She said Thursday afternoon was fine and that “…actually, Thursday afternoon is going to have to be fine for a little longer. But we can talk about that more in person.”

I just said, “Um okay… Bye.”

Wtf? Not cool.

I know I’m a fairly volatile person with a low threshold for almost any emotion whatsoever, so I’m sure this is not even something to be pissed about, but still. I’m pissed.

I Don’t Want To Do This

Everything is so weird and just wrong right now. I can’t quite figure out what it is. Maybe it’s nothing. Maybe it’s just mental illness doing its thing. Maybe it’s the System falling into a new form of chaos. Maybe it’s exhaustion.

Either way, it feels awful.

My first two final practical exams are done. The first was rough overall, but my execution of skills was flawless. The clinical decision making part, however, was a little trickier. The second was easy and I totally nailed it. The third is on Monday and the one I’m most worried about.

I also had session on Monday afternoon and it was just shit. I had a hard time settling in because my brain has been so occupied with school lately that it can be difficult to transition to therapy. I mentioned this and I slowly talked my way through the chopped up thoughts I did have about how things have been going in sessions. I’d actually come to (what felt like) an important realization about the process. I shared that, but the therapist didn’t seem to connect with what I was saying, which was disappointing. And to make it worse, I felt like she challenged what I said and I ended up feeling pretty crappy about the whole thing.

She was asking about the System and that was a mess. It’s hard for me to even talk about because it is incredibly activating. We have survived this long because we have always presented as one single integrated person. Even when one Part does something that the Others don’t necessarily agree with, there’s no finger-pointing. So Rachel would never say that Julia cut herself. And Julia would never blame River for not eating. No names. No blaming. No System.

This, to my understanding, is the basic essential rule of survival. I don’t know who set it, but I know everyone follows it. Parts didn’t even start using their names on the outside until I realized there were parts. For three decades, whoever was fronting just went by Andi.

And now I’m disrupting that by sharing things. Sharing names. Talking about Parts and their complex inner world.

I shouldn’t be doing this. Who is it benefitting?

Finals

Tomorrow marks the beginning of finals week. And by finals “week”, I mean “two weeks”.

My first exam is at 10am tomorrow morning. It’s a practical on therapeutic procedures.

A few things I need to remember: lock the traction table (and unlock…and relock), give the patient the emergency stop button, hook the rope before the patient is in the cervical harness, OR clean the ultrasound head (twice) (and remember to grab the alcohol swaps with the sensory tools), OR say that I took the patient’s blood pressure and measured the circumference of their affected and unaffected limbs for comparison, OR check the damn intensity dial on the diathermy drum. ALSO: ask about potential pregnancy, metal implants or pacemakers. And wash my hands! Twice!

That probably doesn’t mean anything to any of you, but…just cross your fingers that I remember! 🙂