Mental Hygiene

Negativity is like a virus. Even if you are vigilant about taking your meds, challenging irrational thoughts, praying, meditating, and practicing self-acceptance, forgiveness, and compassion, it just takes one negative comment--one careless psychological sneeze--and you're contaminated.

I've had 3 people sneeze on me today. In an effort to avoid contaminating you with too much negativity, I'll just tell you about the most egregious of the 3 incidents.

I had my follow up appointment with my psychiatrist today. Thank goodness I only have to go twice a year. It's a 3 and 1/2 hour drive round trip for a 30 minute appointment, and there's very little about that 30 minutes that is therapeutic. While my psychiatrist knows his drugs, he's not a particularly good therapist, to put it mildly. Which is OK, I guess, because I have a therapist. But I have to talk about something.

Because I have chronic sleep issues due to my night-owlness, I confessed that I've been struggling with regulating my sleep cycle now that I'm not working. Every time I tell him what time I go to sleep and wake up, he makes this judgmental face that looks like he just sucked on a lemon. Then he proceeds to tell me what the research says about the importance of waking up at the same time every day, especially when you have a history of depression. How I need to get morning sunlight, I shouldn't take naps, I need to be more disciplined, blah blah blah.

I am not good at constructive criticism, but I did manage to say that I'm trying. That I spend an inordinate amount of time obsessing about sleep. So much so that it probably interferes with my sleep. He can read my blog if he wants proof.

But I wish I could say something more honest. Something like, you make me feel like crap when you make that stupid face and give me a lecture on sleep hygiene that I already know by heart because I am a clinical psychologist, in case you've forgotten.  Every time I see you, you just give my inner critic ammunition to tell me how I'm failing at sleep hygiene and that I suck. You are supposed to be helping me with my mental health--not making it worse. Oh, and by the way, your waiting room smells like mold and you need to clean your freaking office and water your damn plants. It doesn't reflect well on you that your plants are dying! 

But I don't want to come across as being too negative.

Does anyone ever give their doctor honest feedback when they do something unhelpful? I try to imagine what my reaction would be if a client brought to my attention that my facial expression conveyed blatant disapproval of what a terrible job they're doing of trying to get better. It would be a shock, no question. But I don't want to convey disapproval and judgment, so I think I would want to know. I think I would try to be more aware of my facial expressions. But as I mentioned in a previous post, we are terrible predictors of how we will act in the future. So maybe I would just be pissed off.

Maybe I can think of this as an opportunity to practice constructive criticism. Maybe I'll talk to my therapist about it and see if she thinks it's worth it to say something. Not what I wrote above, of course. But something.

Or maybe I could just tell him that my latest blog post is dedicated to him so he should read it. That would be hilarious!

I'll let you know what I do. In the meantime, I encourage all of you to do your part in preventing the spread of negativity. Please remember to cover your mouth before your criticize. (And not in that passive-aggressive way where you cover your mouth while you fake cough and mumble something critical under your breath, either. You know what I'm taking about.)

 I think this doodle looks like germs.

Interventions

I'm not good at confronting people. Which is ironic, because one of the things I do in my job is coach students on how to confront their friends about having an eating disorder. And I think I give pretty good advice, too. But I guess I'm not as brave as these students are. 

Because confronting their friend will most likely put a strain on their relationship. It's rare that the person who is being confronted says, you're right. I do have a problem and I want to get help. Thank you for saying something. Confronting them may just be one step in a long series of steps toward getting help. It may not get the person into the counseling center right away, but it may plant the seed of recovery in their mind. 

I've had many clients with eating disorders acknowledge that even though they would have denied having a problem at the time, they still wanted someone to say something about their 30 pound weight loss. And I've heard many clients in recovery say that although they were mad at the people who tried to help them at the time, they played an important role in the process of accepting their disorder.

I know all of this, but I'm still afraid to do it. Maybe they'll be angry and yell at me, and I hate being yelled at. Or maybe something else will happen that will feel terrible, but I can't put into words what it is that I fear. So I have to think about what day I want to ruin. What day I want to be incapacitated. I haven't found that day yet. But I need to, because I gave my word that I would say something. 

I don't even have to do it in person, since I live so far away. I just have to make a phone call. And in my defense, I have tried to call a few times, but the whole time I was praying that he wouldn't answer. Luckily for me, he didn't. He never answered and never called back, which is unusual. Perhaps he knows why I'm calling, and he doesn't want to have this conversation, either. Which makes it that much harder to force it to happen.

I ordinarily pride myself on accepting challenges, mental toughness, and doing the right thing. But in this case, nothing has motivated me to move closer to having this conversation. Not prayer, or meditation, or talking my therapist. Not even guilt and shame.

So I thought I'd blog about it and see if that helps. I'll let you know.

The Emotional Life of Your Brain

I just finished reading The Emotional Life of Your Brain, and although I started losing interest towards the end, it presents an interesting view of personality that is worth sharing.

Based on brain research, Davidson identifies 6 dimensions of personality:

1)  Resilience (fast or slow to recover from adversity)

2)  Outlook (negative or positive)

3)  Social Intuition (puzzled or intuitive; A.K.A. emotional intelligence)

4)  Self-Awareness (opaque or aware)

5)  Sensitivity to Context (tuned out or tuned in)

6)  Attention (unfocused or focused)

If you are interested in where you fall on each of these dimensions, click on the link above and you will find a short survey. Here were my results, which probably won't surprise anyone who reads my blog:

1)  Resilience: fast to recover

2)  Outlook: positive

3)  Social Intuition: very intuitive

4)  Self-Awareness: very self-aware

5)  Sensitivity to Context: very tuned in

6)  Attention: focused

As with most personality dimensions, the goal is to move your set point closer to the middle. In practice, however, one end of the spectrum is usually more desirable than the other. Here are the advantages and disadvantages of each extreme:

1)  Resilience: Being too fast to recover may make you less compassionate and seem unfeeling and insensitive to others. Being slow to recover makes it difficult for you to function and you may focus more on your pain than on other people. But usually people try to learn how to be more resilient.

2)  Outlook: A negative outlook puts you at risk for depression and annoys other people. An overly positive outlook makes it difficult for you to learn from your mistakes and postpone immediate gratification. But usually the goal is to develop a more positive outlook.

3)  Intuition: Being too intuitive may make it difficult to function because you're constantly picking up other people's negativity. (Hmmm. That sounds familiar). People who are at the puzzled end may have problems in all aspects of their lives in which they have to interact with other people--which is essentially all aspects of life.

4)  Self-Awareness: Being opaque makes you prone to missing signs of illness and make you unable to take care of yourself. Being too self-aware can make you a hypochondriac. But in general, it's better to be self-aware.

5)  Sensitivity to Context: Being tuned out might make you feel and act in ways that aren't appropriate to the situation (e.g., anxiety disorders). Being too tuned in can make you prone to losing touch with your true self because you are constantly changing your behavior to fit the social situation. But usually people try to be more tuned in.

6)  Attention: Being too focused annoys people because you don't pay attention to them when you're doing something. And you tend to "not see the forest for the trees." Being unfocused puts you at risk for ADHD. But usually people want to learn how to be more focused.

Guess what the best way is to move toward the resilient, positive, intuitive, self-aware, tuned in, attentive end? Meditation! My favorite meditation guru is Jack Korfield, and on his webpage he goes through the 5 basic meditations:

1)  Meditation on Compassion

2)  Walking Meditation

3)  Forgiveness Meditation (which I really need to practice)

4)  Sitting Meditation

5)  Lovingkindness Meditation

Jon Kabat-Zinn also teaches meditation for Mindfulness-Based Stress Reduction (MBSR), but you have to pay for his stuff. You could also seek out a therapist who specializes in MBSR.

So there you have it--your cheat sheet for "The Emotional Life of Your Brain." It took several months for me to get through the book, so feel free to make a donation to the Federer Fund if you found this helpful. Tickets to Grand Slam or ATP Masters 1000 events are also acceptable.

This doodle sort of looks like a brain. And it has 6 different colors--one for each personality dimension.

2014 Blog for Mental Health Project

“I pledge my commitment to the Blog for Mental Health 2014 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.”  
A Canvas of the Minds

Sometimes we make the most important decisions in our lives without consciously knowing why we made them at the time.

I knew that I wanted to become a psychologist since I was in high school. At the time I wasn't fully aware of being depressed in the clinical sense. Being anxious was so much a part of my personality that I didn't think I had an anxiety disorder. And I definitely wasn't aware of any mental illness in my family. I had no idea at the time that depression, bipolar disorder, and anxiety would impact every aspect of my life--in both positive and negative ways.

It's probably not surprising that I have been negatively affected by mental illness. But as I write this post, I realize that there have been positive things about it, too. I have learned the most important lessons in life through suffering and loss.

Even as a therapist, when I heard clients make comments about how they had a bad week, it didn't fully register how horrible that week was for them. In part because clients don't elaborate unless you ask them to. Unless they are certain that you really want to know. And because they are embarrassed about it. Ashamed, even. But after going through my worst depression 5 years ago, I have much more compassion when clients make these offhanded comments.

I admit, during that period there were times when suicide would cross my mind. But there were two things that kept me from seriously entertaining it. One is that my dad would be devastated, and I feared he would never recover if I went through with it. 

The other reason is that if I took my own life, it would undermine everything I ever said to my clients about how pain passes. That one day when they look back they will realize how strong they were at the time. That they will learn lessons from their suffering that it takes some people a lifetime to learn. How can you believe anything your therapist said if she committed suicide? That would be the ultimate betrayal.

So I spent months willing myself to get better.  I went back to therapy, started meds again, meditated and prayed, and forced myself to play tennis and spend time with friends. And I did get better. And everything I said about realizing my strength, becoming more compassionate, and acquiring wisdom were all true. I would have never chosen depression, but we usually don't choose the experiences that teach us the most about life.

People often ask me how I can listen to client's problems all day long. In all honesty, I can't imagine what else I would do for a living. It feels more like psychology chose me.  And when I hear a client's story, I always have hope that together we can change the plot for the better. After all, I always root for the underdog. I am the eternal optimist. And I never back down from a challenge.

There was a time when I would never have told this story about my struggles with depression and anxiety to my students or clients. Or even friends and family. But now I want to share it with the world, because every act of courage benefits someone else. My blog is proof of that.

Patience Isn't Always a Virtue

I looked it up. While it is included in some lists, in Catholicism the 7 virtues are faith, hope, charity (the theological virtues), prudence, justice, fortitude, and temperance (the cardinal virtues). Since I at least grew up Catholic, I'm going to use this list, because I'm not patient at all, and I don't want to be unvirtuous.

My greatest strength is probably fortitude. I never give up in a match, even if I'm down 0-6, 0-5. I continue to play tennis, even though it makes me throw up. I will do everything I can to make a relationship work, even if it's a lost cause.

Last week I had a client who started antidepressants and experienced a sudden onset of suicidal ideation, which sometimes happens in young adults. As she was describing what it felt like, I realized that I had experienced the same thing when I got back on meds, even though I was not a young adult. But I was on a higher dose than I was before. In retrospect, it turns out it was too high; I had a lot of side effects that I had attributed to the depression.

I didn't think much of it at the time because I always have some suicidal ideation when I'm depressed, but it was definitely different. It was what psychologists call ego dystonic. As my client put it, my brain told me in the most illogical way that suicide was the next logical step to whatever I was thinking. If I didn't have the energy to walk over to the fridge and get a milkshake, my brain would say Well why don't you just jump off the balcony, then? It freaked me out. I would yell back. No! I don't want to do that! I want to live! 

So I fought the thoughts off until the meds kicked in. At the time I thought I was weak, but when I recognized myself in my client's story, I realized how strong I am.

Patience, on the other hand, is a different story. Patience also requires strength, but in a quieter, more peaceful way. And as you know if you've been reading my blog, I am loud and obsessive. You can't will yourself to be patient the way you can will yourself to save break points. In fact, although this blog is about practicing other quiet, peaceful things like self-acceptance, compassion, gratitude, and forgiveness, I have never included patience in that list until today. Probably because it seems impossible to achieve--even for a warrior like me.

As I mentioned in the post on obsessiveness, I can only focus when I meditate about 5% of the time. But it still works. I am definitely less anxious, better able to tolerate my emotions, and more compassionate. Maybe patience is the same way. Maybe if you at least have the intention of being patient, even if you suck at it, it will still work. That's what they say in Buddhism--in a less judgmental way, of course.

Might as well give it a shot. Whether or not it's a virtue, it's still a good quality to have.

Obsessiveness

I don't know if you've noticed, but I'm kind of obsessive. I can't blame people for being annoyed with me. Sometimes I annoy myself.

I'm an excessive planner.  For example, because of my GERD and exercise-induced asthma, I'm constantly obsessing about what and when to eat. Last night I made rice at 1 a.m. while I worked on this post because it will save time and decrease the likelihood that I will throw up on the court tonight.

Sometimes obsessing is a memory device. Like I'll repeat a sentence that I want to say over and over until I see the person. Writing it down helps, but I can't always do that--like when I'm driving. Lots of obsessing while I'm driving.

You know how I said that blogging is my new boyfriend? Well, I'm kind of a stalker girlfriend.  I will check my blog stats repeatedly--hundreds of times on the first day I publish a post. Thank goodness it can't break up with me.

Sometimes I obsess like it's a hobby. I might obsess about my next blog topic.  Or what my strategy will be in my tennis match. Or when I can schedule my next haircut and if I want to try something different, like get bangs.

Obsessing is the most painful when it is fueled by the inner critic or drill sergeant or perfectionism. Then it's this relentless voice pointing out all my flaws (Your arms look fat in that picture!). Or when I'm not being productive (Get out of bed and do something!). Or how stupid I am for making a mistake (You shouldn't have dated that loser!).

There are things that help. I take antidepressants, which also help with anxiety. And when the obsessing gets out of control, I take Ativan. I used to obsess for days rather than take the Ativan, but my psychiatrist reframed taking it as a way to have control over my anxiety. And I'm all about having control.

I also practice mindfulness meditation.  You're not supposed to judge how well you meditate, so I will just say that I obsess about random things for 95% of the time while I'm doing it. But it seems to work, nevertheless.

I tell myself the same things I tell my clients. I remind myself that I don't know what will happen and I can't prepare for every possible scenario. To take one worry at a time. That no matter what happens, I will be able to cope with it. And that I have an excellent memory and won't forget.

Most importantly, I try to accept that this is a part of who I am. Some people may not have to deal with obsessive thoughts, but everyone has to deal with something. This is my thing.

Since blogging has helped me accept other aspects of my personality, I thought I would try blogging about my obsessions. Sometimes it helps just to say them out loud. And it's an added bonus when readers say they can relate.

I still obsessed all the way home about what to eat before and after tennis tonight and how to end this post, though. Oh well. I guess practice makes perfect.

Anger

Have I mentioned that I have problems letting things go?

That's why I obsess so much. And why I stick with knitting projects that make my life miserable. And why I try to make relationships work at all costs. And why I have a hard time forgiving myself. 

It's also why I can hold on to anger for so long. I know some people like anger because it's more empowering than feeling hurt, but I hate it. It's downright painful. If I could will myself to let go of anger--or any emotion, for that matter--I would. And even though I know better, I still get mad at myself for not being able to stop being angry.

Recently I had a friend tell me that when you get older you become more forgiving of yourself. That might be true for normal people, but I'm no so sure it's true for me. Because I've heard women say the same thing about being in their 40's, and I'm pretty sure I'm just as self-critical and guilt-ridden as I was in my 20's and 30's.

I am having a hard time letting go of my anger about my last relationship, even though I'm glad that it's over. I have made a concerted effort to turn to my friends and share how I feel, but in all honesty, sometimes it just makes me angry at them.

Most people aren't very good at saying helpful things. Which is why I wrote the post on good intentions. I'm trying not to take it personally. Not everyone can be a good listener. I would be out of a job if everyone were. But it's still frustrating to try to talk to someone about how angry I am, only to feel worse afterwards.

I've tried other things, too. I've prayed. I've meditated. I even apologized for being angry. Which doesn't make any sense, really, but I was desperate for some shift in the intensity of my anger.

Today I tried 3 new things. First, I gave myself permission to be angry for a day.  Which had the unintended effect of making my anger seem forced and difficult to sustain. Sort of like the whole reverse psychology thing--although psychologists don't actually call it that. 

I also looked at a journal entry from right before the breakup. It reminded me that there were a lot of things that I tried to be OK with because I thought my anger and sadness and anxiety were a product of my neediness. Or a result of being too demanding. Or were figments of my imagination. 

Now I realize that I felt those things for a reason.  I'm mad at him for letting me believe that my feelings were my fault. And I'm mad at myself for not trusting my feelings.  But reading that journal entry reminded me that my feelings are always legitimate--even if they don't make sense at the time. So I have renewed my commitment to honoring my feelings.

The last thing I did was to give myself permission to blog about my anger. I have thought about doing it for some time now but decided against it until today because I thought it would be too negative. Even though I write a lot about negative things, I try to end on a positive note. I didn't think there could be a positive note to end on in a post about unrelenting anger.

But then I remembered that the point of my blog isn't to be positive. The point of my blog is to be honest. And my anger is just as much a part of me as anything else.

And you know what? I actually do feel better...for the moment. So blogging about it helped after all.

I don't really have any art work that reflects anger so I thought I would feature some self-promotional art work instead.