Monday, March 18, 2013

May I Have a Copy of the Agenda Please?

This sure is some freaky, tiring shit. Bad week overall. Much crying (though I suppose that could be seen as an improvement as I had been well-trained not to do so?) and leaving of work.

It’s like a civil war inside me, and I don’t know who is winning at any given moment, or even always which side I’m on. So much smoke and fog and pain and I don’t know what I’m supposed to be doing and I just want it to stop.

On the one hand I’m thinking: I have achieved so much, I have such a great spouse and friends and kid, and I like myself. I’ve developed ways of living in the world that make me feel like a good and valuable person. Clearly whatever happened in the past can’t have affected me so much, right? Can’t I just forget it? And then I remember that I have nauseating panic attacks at the very thought of romantic physical affection, which, hm, seems odd and unfortunate, and even before that was true there were things I strangely hated (e.g. making out) and places that hurt, and I have spent years and years approaching a sense of being truly present in the world without consistently or even frequently achieving it and wishing I could be like other people …

Not that I have a choice at this point. There’s no un-knowing something. Once the connections had been made, the game was up. But I wish I had a schedule, you know? Like when you’re at a kid’s concert and you think you’re going to die from boredom interspersed with embarrassment but at least you have the program and can check off each performance and know that there will be an end to it.

I have the feeling that I have so successfully cut communication off between the bad bits and the parts of me I like that I might have, er, a bit of a struggle opening those channels back up. But in the meantime the tiny chinks that have broken open are leaking this noxious gas out and there aren’t any windows to open.

Work is, surprisingly, going okay, especially considering I’m giving approximately 50% effort. I see now that my need to keep constantly busy is likely not the healthiest thing, but I also become overwhelmed with guilt when I don’t work as hard.

My husband is being so great. Sample text exchange:

Ditto my friends, who in addition to supporting me in innumerable ways send me things like this:

I showed that to my therapist and he cracked up.

And you all. Thank you so, so much for listening and advising and not being judgmental. This blog is probably as valuable as the therapy. And a lot cheaper.


beenthere said...

I imagine you've probably read Judith Herman's "Trauma and Recovery" but if not, I highly recommend it. I found it very grounding and a very useful, super smart perspective. And, more to the point, she talks about phases of healing from CPTSD, which isn't exactly like an agenda but is sometimes close enough to calm me down, anyway.

For me it has now been three and a half years since I connected the dots, as you nicely put it, and started my own recovery work. The last three months have felt like a quantum leap forward in terms of feeling present, feeling able to have feelings but not be undone by them, feeling able to do a whole lot of things really.

I love the badge! What awesome friends.

parodie said...

Your support team is absolutely right! Be kind to yourself, and keep telling yourself that it will get easier, and probably sooner than seems likely right now.

You have made a sudden HUGE shift in how you understand yourself. It is normal for that to be completely overwhelming, unmooring, and for it to be hard to imagine how you can get a handle on it. Although this is a weird analogy, I wonder if it isn't a bit like how people with new babies often feel completely overwhelmed (with panicky thoughts of "this will be like this forever" which are both true and not-true).

No idea if that's a helpful analogy, but it's what I've got. You are amazing. Good luck.

Anonymous said...

This process will be a roller coaster ride.....many ups and downs. There are no shortcuts. Just hand in there and the end point will be well worth it. Your external life is good and that's why you can now focus on getting the internal life to match it.

jill said...

One thing that had me almost bowing out of therapy was that the panic attacks and anxiety got so much worse. But my therapist explained that it was normal because of all the feelings that came up with the memories and talking. Once I accepted it was okay to get worse before getting better, I continued the work. And it got better.

It will for you too.

Becky said...

When I started really digging in I was a special ed teacher. I wound up having to take medical leave for a couple of months, limped through the last couple of months of school and then took a year off to work in a children's store and sub. It's really rough. You're learning a whole different way of interacting with the world. You are probably growing whole new neural pathways. A medical leave wouldn't be the worst idea. When I wasn't working, I could see my therapist 3 times a week and really make some strong headway. Subbing was really ideal for my situation. I was able to keep a toe in the water and maintain a sense of purpose but also was able to hide out when I was going through really sticky patches. I don't know if some sort of per diem work might be an option for you?

You'll come through this stronger than you were but the middle part is really, really hard. It's like having a really, really bad broken leg- you got given the mighty nice drugs and felt no pain for a bit, now it's time for your therapy and it will hurt like a mofo while you learn new ways of using your muscles but someday reasonably soon you'll be up to a marathon.

Beth said...

Jill's comment really speaks to me, and I just want to second it: I've been wrestling with my anxiety recently, and the more I face it head-on, the worse it gets. I have to believe this is at least partially because the coping mechanisms I've been building up since I was a small child are being proven ineffective.

So if one major coping mechanism is making my anxiety invisible so nobody knows and can make me feel bad about it, and my spouse (because he is my SPOUSE) sees my anxiety coming a mile away, THAT'S SCARY. Even though he only uses that knowledge for good.

Your husband is right, and sounds like a good egg: cut yourself all the slack. And just keep going; you'll get there.

OMDG said...

Your husband rules. Cut yourself some slack for goodness sakes!

Blue said...

I kinda think i love your husband. keep that one. he's alright! :-)

ozma said...

Kids' concern metaphor is so perfect. When's this going to be over?

I think you should you make yourself a program. It will be over--soon.

I do wonder if medical or partial medical leave and an accelerated therapy schedule doesn't make sense.

I wonder if other things could work too besides running--like meditating, yoga and the like. Brain regulating methods. They won't make the noxious gas go away but they are good for panic, anxiety problems.

Please cut yourself massive slack I don't know how many years we are talking but I think you may have between 20-30 years of slack to catch up on. That's basically a year off on the beach--it's a mind boggling amount of slack you should be cutting yourself.

And now is a good time. If you can't do it for you, it will probably also be good for your family for you to give yourself as much as you need to heal.

Anonymous said...

I felt like I had to rebuild from nothing - ground zero, starting with the things that were incontrovertibly true. I made lists of those things, and ran through them whenever I started to come unglued. Which was more than hourly at times. I PROMISE you that it will smooth out, and you will integrate or reintegrate, and sort of weave all the parts into the full tapestry of your life. Love and peace on the way. From, Lifer

anne nahm said...

No wisdom. Think you are brave and wonderful, which might not translate if I lurked.

Sarina said...

I haven't checked in for awhile. Sorry to hear about your turmoil - glad you are finding support around you and that you are finding your way. Those men in your past are horrible, horrible people. You are being brave and working hard - definitely something to salute. Take care.

Carrie said...

Even though you're doing a wonderful thing, for the moment it sucks. I'm echoing everyone else, including TH, and telling you to cut yourself some slack. Honestly, think of all the amazing coping skills you've mastered over the years to get you where you are. They did the trick, you're even able to share with all of us all the blessings in your life to this point...
But, now they're not doing the trick because you want, and deserve, more. You're not able to escape from this the way you once were because as you've said, you can't un-connect the dots. So, while you're working on figuring out how to deal with all of this and coming up with new coping mechanisms shit is going to get messy.
Do exactly what you need to do to get through this, even if that means taking a leave. A leave, or less hours are a blip on the radar when you look at this in the big picture of your life and your happiness.
I'm so glad you have such a wonderful support system, and that you know you can turn to them.
Keep going!

Kim said...

well, just a thought and not trying to undermine your experiences - but just to say that it is possible to not like the thought of having sex and not to have experienced any abuse.I think shame on any level surrounding the topic - especially with anything bodily wise. Also, being with the same guy every day. Sorry but it can be boring sometimes when it is the same moves being made and they are not completely in tune with what you like. Plus being in the forties and not trying to get pregnant. i had plenty of motivation for sex then but not without that motivation - also dwindling estrogen levels influences sex drive. So, just want to say that there are a lot of reasons why someone could have a low sex drive and not all to do with abuse issues. Definitely not saying that doesnt add to it - but just dont let yourself be talked into it being worse than it is.

Anonymous said...

You're doing great. It's hard, painful work and it feels like it just won't ever go away sometimes. It will get better, I promise. Just keep at it, keep processing, keep talking, keep putting one foot in front of the other. Keeping you in my thoughts and sending lots of good juju your way. xoxo


Anonymous said...

dr. Mama, I feel so honored and privileged to be one of the readers you shared your story with.

I have a very similar story. I was able to confront one of the abusers as an adult and it was so liberating, and empowering, I can't even tell you. It was this moment in which I realized, "My life is my own, it's not tied to something that happened in the past." From that moment forward I felt like the hero of the story and not the victim.

I am glad that the exchange student has you in her life and that you can counsel her. Please tell her that telling the authorities what happened will make all the difference to her recovery.

-victoria pond

Jennifer said...

"and I have spent years and years approaching a sense of being truly present in the world without consistently or even frequently achieving it …"

I think many thinking people feel this way at one time or another, or at most times, even.

Hang in there. You are doing great.

DoctorMama said...

you are all just so kind and insightful and just - great.

‪beenthere‬ - I’d read a little of it but not a lot – thanks for pointing me to the phases of healing. Helpful. (When I read about this in general I find I either flip through like “not applicable, not applicable … ahhhh! Sob sob sob.”)

parodie‬ - I LOVE that analogy. And the “both true and not-true.”

jill – yes! it’s the free-floating anxiety that buzzes in my head at work. I have cut waaaay back on my precious coffee

‪Becky – I like the broken leg analogy too. Not simple for me to cut back – but! Over the past year I have cut back in terms of time where I definitely have to BE somewhere. Partly, I think, in the knowledge that this might be coming.

‪Beth‬ - “the coping mechanisms I've been building up since I was a small child are being proven ineffective” – yes.

‪Old MD Girl and Blue – I know right?

‪ozma‬ - “20-30 years of slack to catch up on” is probably accurate :-/

Carrie‬ - “less hours are a blip on the radar when you look at this in the big picture of your life and your happiness” — excellent perspective to try to keep in mind

Kim –I’m glad you said this. It would be great to do away with shame having to do with not wanting sex for anyone, history of abuse or not. And in medicine when we have a woman who is here for decreased libido we have a mournful little joke: “We need to write a prescription for New Guy.” And no worries re: being talked into something – neither I nor my therapist is into that. I actually first tried to address all the things working against wanting sex for me (IF treatment, baby, breastfeeding, getting older, etc.) and only got worse. The main clue for me, I suppose, is that the thought of sex with anyone gives me nauseating, heart-pounding, terror, and it is exactly the feeling I had back then, and it didn’t start until I had multiple instances of “having” to have sex while trying to get pregnant – followed by “having” to have sex to make sure my marriage was okay (which was NOT my husband’s idea; this was all my own internal pressure).

victoria - "My life is my own, it's not tied to something that happened in the past. From that moment forward I felt like the hero of the story and not the victim." – yes – and makes me tear up.

Lifer, anne nahm, Sarina, dRC, Jennifer – thank you.

L. said...

About the dichotomy you mention of personal achievement vs. these other things that clearly don't seem right to you--well, they're not mutually exclusive, right? You can be both--you are, by definition, I suppose. But maybe your thoughts around slotting to yourself into one or the other have to do with...

...a need for control, which I think a lot of this post is about. Makes sense, we all do, especially when one part of life is so definitely NOT in control. But, maybe you would find some peace in surrendering a bit, in trying to take moments to let that go somewhat? Personally I would always rather try to take the helm, but sometimes I've found freedom in saying fuck, this is obviously completely out of my hands, I guess this raging river is going over the cliff and I'm just going to have to hang onto the barrel with both hands and see what happens next...

Anyway one more quick thing. I recently picked up The Dialectical Behavior Therapy Skills Workbook. I am dysthymic but don't usually find self-help books all that useful, had been feeling fairly OK, and had always thought of DBT as something for personality disorders, but this particular book came really highly recommended for depression and I got curious. The recommenders are right, it is great. I wondered if you might find it helpful because its focus is on dealing with waves of strong emotions and not being able to handle them. It begins with some great self-distracton and -soothing techniques, which made me think of your question about a soothing object. Maybe it's worth taking a look to see if it would prove helpful in navigating some of the unpredictable emotional responses you're experiencing?

Best of luck. You are awesome and you can do this. You are doing it!

Anonymous said...

This is a testimony that i will tell to every one to hear. i have been married four 4years and on the fifth year of my marriage, another woman had a spell to take my lover away from me and my husband left me and the kids and we have suffered for 2years until i meant a post where this man Esango Priest have helped someone and i decided to give him a try to help me bring my love Husband home and believe me i just send my picture to him and that of my husband and after 48hours as he have told me, i saw a car drove into the house and behold it was my husband and he have come to me and the kids and that is why i am happy to make every one of you in similar to met with this man and have your lover back to your self. His email: he is a good man and straight forward human

Anonymous said...

Look at some of the utubes on:
"Eye Movement Desensitization and Reprocessing (EMDR) is a treatment for posttraumatic stress disorder (PTSD)."


Anonymous said...

They have several interesting talks on NPR on ptsd and they go over various methods and treatments and meds: Here is an example

or you can go to NPR
and search ptsd and see there is a lot of info out there

There are also several Ted talks- found at

Anonymous said...

I just ran 5.56 miles in one hour and 42 seconds while visiting the in-laws in Michigan. Just wanted to thank you for turning this indolent sloth into a runner. A year and a half ago I was 30 pounds overweight with high blood pressure and high cholesterol. At my last physical, cholesterol is normal, blood pressure is normal and I've lost about 15 pounds. I am no longer that bloated, shambling couch creature and you deserve a lot of the credit. Thanks. - Mike

Anonymous said...

FWIW, I did DBT for some similar issues (I was not diagnosed with a personality disorder) and those therapists do have some pretty effective strategies for dealing with PTSD. One of the strategies: You write out the narrative of The Event(s) and you read it once a day until it becomes boring. It can make you feel worse initially but ultimately it helps end the unwanted intrusive memories and does help set you free.

Anyway, I reread your recent posts, Dr. Mama, and I was impressed again by how competent, sane, nice, and effective you are, and what a good writer. You are a force for good in the world.

I also was thinking about your writing, and I'm struck by how compelling your "how to" manifestos are. This will sound odd, but the "how to stop a nosebleed" post was one of the more memorable pieces of nonfiction prose I've read in recent years -- and I've never had a nosebleed! I don't even know anyone who suffers from nosebleeds. I didn't even realize they were much of an affliction.

What was compelling about that piece and many others you've published is the "you can deal with this!" competence that comes through so powerfully.

Anyway, I can see how it might be really alien and uncomfortable for someone like you to feel overwhelmed and unsure and like she needs help. You've probably spent your whole life from early childhood on being supercompetent.

Which, you know, makes it all the more impressive that you're honestly addressing these issues now. Thank you so much for writing about your life here. I'm grateful to you. -victoria

Anonymous said...

I'm going to second the EMDR rec. While I did not experience the kind of trauma you did, I starting going to a therapist at Jefferson's Integrative Medicine program when I was in infertility treatments and at the point I would try anything. The therapist I saw did this (weird to me) muscle memory release thing that didn't feel like anything when I was doing it, but sure seemed to ameliorate a lot of problems. The therapy was always half regular talking therapy and then half muscle memory treatment.

I continued going to see her several times a year whenever I needed a tune-up. Then, last year, after I was present during the death of a very close friend, I started perseverating on the images of that day. My therapist did a few treatments of EMDR and it really helped, I did not forget the images, but I stopped perseverating and was able to deal with grief without being impaired by it.

I have been very impressed by my therapist's ability to use treatments that seem strange to my western medicine-oriented mind to such good effect. I'm not suggesting you ditch your current therapist, who sounds really good, but if you can add in some EMDR, it might lessen the flashbacks. --Mary