Positively Selfish

One of the hazards of working in the helping professions is burnout. People who are drawn to helping others run the risk of giving too much of themselves. In my case, however, I run the risk of burnout in my personal relationships more so than I do at work.

There are a lot of advantages to working in a counseling center. Even though you don't make as much money, you have access to a lot of resources that you don't have in private practice. I have colleagues, the student health center, deans, RA's, and peer counselors who share the load. The most stressful periods of my job are predictable and time-limited: they occur around the middle of the semester and end around finals week. There are boundaries that are built into our schedule, as well. Appointments are 50 minutes long at the most. We don't schedule clients past 5 pm or on the weekends. Students go home for breaks. We don't see students after they graduate.

My personal life is a different story. Many of the people I love have emotional needs that they expect me to fulfill. Appointments are not time-limited. I am on call 24-7. I usually cannot terminate these relationships, nor do I want to. I have a hard time saying no to whatever they ask of me. And in many cases, I do not feel I am getting back as much as I am putting into the relationship because their emotional resources are more limited than my own. Which is not their fault. It's just unfortunate for me.

That is part of the reason why I want a hiatus from loving and caring for anyone or anything new. No dating. No pets. Just me and my plants. I'm burned out; I want a more solitary job in my personal life.

I was telling my therapist the other day how this makes me feel selfish. She told me that I'm being honest with myself--more authentic. That we need another word that conveys positive selfishness. Which is kind of sad, really. What does it say about our culture that there would be no word for a healthy focus on oneself?

She nominated the word selful. Full of oneself, but in a good way. More like being whole. But it doesn't roll off the tongue the way selfish and selfless do. Plus it looks weird. So I am open to suggestions.

The Inner Infant

So my inner child, Sophie, has a younger sister. She is an infant and doesn't have a name yet. While my relationship with Sophie is pretty good, I confess, I'm a terrible mother to my infant. But I'm working on it.

It's easier to enjoy Sophie because she is playful, funny, cute, and full of energy. But like most kids, she can be a brat and gets on my nerves sometimes. And she doesn't like it when I'm alone. She's afraid something bad will happen to us. She advocated for my last relationship and was terribly anxious whenever she thought we might break up. It took awhile before I learned how to comfort her and assure her that I can take care of her by myself.

I only became aware of the infant about a year ago--mainly because I was neglecting her so badly it was affecting my health. I wouldn't feed her when she was hungry. I wouldn't soothe her when she was upset. I yelled at her when she cried for no reason. If Social Services could have seen how I was treating her, they definitely would have intervened. After awhile I was having so many physical problems that I was forced to attend to her needs. It was starting to affect my tennis.

I've had to get to know my infant the same way any parent gets to know their child: by paying close attention. You don't automatically know which cry is the hungry cry, the poop cry, or the tired cry; you learn from experience. She is usually upset when I wake up on the weekends because I sleep in and throw off her feeding cycle. So if I'm feeling depressed or anxious when I wake up, I get something to eat because she's probably hungry.

Or she could be crying because that's what infants do when they wake up--especially after a nap. It's funny that we just accept that young kids cry when they wake up without understanding why and without being mad at them for it. I wonder at what age we start expecting people to have a good reason to cry.

I guess some people do acknowledge that they're in a crappy mood when they wake up and turn to things like coffee, cigarettes, and drugs to calm them down. Those are not good ways to comfort a baby, though. And maybe they're not ideal for us, either, really. But that's for another blog post.

She also gets upset whenever I'm rushing around, which is essentially all the time. She is very sensitive to transitions: leaving for work in the morning, rushing to a tennis match, rushing to the grocery store. I have no idea why. Maybe my stress upsets her. Or maybe I'm neglecting her when I'm on the run. This is the distress that is the hardest for me to be compassionate about.

So now there's this mantra I have to say multiple times a day to soothe her: It's OK. Everything's going to be OK. You're fine. Everything's going to be fine. And when I'm frustrated, I add although I have no idea what you're anxious about!  It's a process, accepting that she deserves to be upset and comforted, even when it doesn't make sense to me.

I know this probably sounds silly to some of you, but it works really well. I use this analogy often with clients as a way to get them to pay closer attention to what they need, to honor their feelings, to have compassion for themselves, and to learn how to take better care of themselves. It can work surprisingly quickly, once you reassure them that having all these parts doesn't mean they're crazy.

So if you ever find that you are arguing with yourself, or that you're frustrated because your thoughts/feelings/actions don't make any sense, you might want to ask what part of yourself you might be neglecting.

Self-Compassion

My compassion reserves are running low. In my last relationship I took the words of Jesus and Buddha literally about how we should be able to love everyone. It was practically a 3 year exercise in compassion. But by the end I wondered if perhaps I had misunderstood what they meant about loving others. It was a lot of work to have to channel Buddha and Christ just to tolerate being in his presence. I feel like I'm experiencing a backlash now. All those feelings I tried to deny are coming out with a vengeance. I guess I was supposed to have compassion for myself, too.

I'm not very good at self-compassion. Every time I try, the Inner Critic berates me for whining about my problems when I have a good life. I don't know what pain is. I'm not living in a war-torn country. My life hasn't been devastated by natural disasters or school shootings. All of the people I love are still alive. Who am I to complain? 

But surely I must have the right to honor my feelings. My suffering must count, too, if God cares about all of us. So I'm going to write about what's upsetting me, without apologizing for it or justifying it or willing myself to be positive. 

This week I will be moving closer to divorce. Filing forms. Getting documents notarized. More tears. More snot. You would think there would be a limit to how much it's possible to cry over something. That 4 years would be more than enough time. I used to pray to God--plead, even--to tell me what I could do that would allow both of us to be happy. Leaving seemed like it would just make us both miserable. And it has. And I don't see an end in sight for me, at least. I'm trying not to blame God or myself. But in this moment, my faith in a happy future is wavering and I feel like I deserve the pain.

I have 2 family members who are currently on the opposite ends of the bipolar spectrum. My brother is trying so hard but still feels terrible.  It hurts me that he's hurting. My dad is manic. Mania feels great for the person experiencing it, but it's hell for the rest of us. But what power do I have to make him see?  If he were my client, I could make him see our psychiatrist, get him on meds. But as a daughter, I am practically useless.

I'm afraid to answer the phone when my parents call. Which makes me feel horribly guilty, because I know their time on earth is limited and I will regret not talking to them more when they're gone. But the call is almost always about something bad. Something I'm expected to fix. Or something I don't want to do. At minimum, I'm supposed to be a receptacle for the stress, but I can't take it. It's too much. I'm not able to function afterwards.  

So I have to be strategic about when I call or when I answer. It has to be a time when it will be OK if I fall apart. But since it's hard to choose something where there's a good chance you'll fall apart, I often forget to call altogether. Which makes me feel even guiltier and reactivates the vicious cycle. I wish it could be easier. I wish there were some way I could be a good daughter but also protect myself. 

It takes a lot of work to maintain my health. Since I have GERD, allergies, and exercise-induced asthma, I have to take shots, nasal sprays, pills, steroid inhalers, rescue inhalers. I'm not supposed to have coffee and chocolate. I can't eat or drink 3 hours before exercise or bed time. If I drink too much during a match, I'll even throw up water. It's frustrating to have to worry about throwing up every time I play. Or brush my teeth, even. But giving up dental hygiene and tennis are not options.

My mental health is always hanging in the balance. It's work to maintain my sleep cycle because of my night owlness. I can't miss any of my drugs. I can't miss Ativan for even one night. I meditate, pray, journal, exercise, and all of the other self-care strategies. But despite my best efforts, I can never make it to the end of the term without burning out before I cross the finish line. I can't handle the stress of my life. I can't get out of bed right now. It makes me feel weak. Inadequate. Unable to do the basic tasks of life.

Just got a call from my lawyer friend that my paperwork looks good to go, so I guess I'll be filing for divorce this week for sure. If you believe in God, feel free to say a prayer for me. If you don't, send positive vibes my way.

Meds

The first time I started anti-depressants I was 30. By this time I had been depressed for at least 15 years on and off and anxious non-stop for about 30 years.

Obviously, it would have made more sense to start them sooner, and people told me that, but I was anti-meds up until this time. I was in a research program that strongly favored psychological interventions. Meds were just a product of the money-making pharmaceutical industry and were over-prescribed. People were more likely to relapse when they stopped taking meds. Blah blah blah.

Most of my resistance was really because I was stubborn. No one could have talked me into taking them any sooner.

I finally decided to try them after my husband and I had moved again after a year. Before we finished unpacking, he was already obsessing about buying a house. I knew at some level that we weren't going to make it, which triggered a depressive episode.

I started on Paxil and sure enough, I felt better immediately. So much better that I wondered why I had allowed myself to suffer for decades when I could have just put myself out of my misery by taking the freaking pill.

Still, after being on them for a year and a half, I stopped taking them--with my doctor's approval. And I was OK for awhile. But then we bought a house and my husband wanted to find another one a year later. My marriage was moving closer to its sad conclusion.

This time I took Lexapro and stayed on it for much longer. When my life finally seemed stable, I tried going off them again. As soon as the meds were completely out of my system, I felt the depression slowly creeping back. I was a little more irritable. It was a little harder to tolerate stress. My thoughts were a little more negative. Occasionally I was emotionally explosive. And finally, I was barely able to get out of bed.

It turned out to be the most severe episode I had ever experienced. It seemed out of the blue at the time, but now I know that it was because my dad was also experiencing his most severe depressive episode. Even though I didn't talk to him much, I felt it. That whole super-empath thing. Damn empathy. So annoying sometimes.

I can honestly say that this time the meds saved my life. The depression and anxiety were so debilitating that I spent most of my time lying on the couch, willing myself to keep living, counting the days until the drugs kicked in.  And when they did, I was immensely grateful for the pharmaceutical companies that came up with drugs that allowed me to be myself again.

All clients want to try therapy without drugs, and we always do.  And sometimes that's enough.  But sometimes it's not.  And the process of going on and staying on meds for as long as necessary--which might not be for life--is long and arduous.  But when they finally take them, they are thankful that they did and wonder why it took them so long.

But they still want to go off them.

I don't criticize them for this, because my path to acceptance was longer than theirs.  I used to beat myself up over my stubbornness, but the reality is, you can't be ready until you're ready.

It takes a long time before we are willing to give up suffering.

Fear of Sadness

Most people find it difficult to tolerate negative feelings like sadness.  This task is even more difficult when you suffer from depression, because any time your sadness feels too intense or lasts too long, you worry that the depression is coming back.  And if you've ever been depressed, you know how terrifying the prospect is of going back to that dark place.

Your loved ones also become hypersensitive to your sadness, which just exacerbates your fears.  If you're feeling down, they ask you if you're taking your meds, or if maybe your meds need to be adjusted.  Don't get me wrong--I'm all for meds.  I've tried to go off them several times, and each time I got depressed again.  But it's unfortunate that once you've been depressed, every feeling has to be scrutinized for potential pathology.

There's also this added sense of failure associated with relapse.  Like you should have been able to prevent it this time, since you've been there before.  And even though you recovered before, you fear that if it happens again, you won't be so lucky the next time.

And even if you do recover, you fear that the wait will be agony.  I fear depression much more than anxiety because when I'm anxious I can take an Ativan and I feel better immediately.  But antidepressants don't work that way, so there's not much I can do to feel better right away when I'm depressed.

Whenever I am afraid I'm becoming depressed, I journal about my fears, my sense of failure, and my pain.  And when I look back at these entries, I realize how strong I am.  There are a lot of things that suck about depression, but I have no doubt that it has made me a stronger person, even while it tries to convince me that I'm weak.

But how do I know when I'm sad versus depressed?  To be honest, I don't always know.  Sometimes I feel depressed for a day.  Sometimes I feel sad for what feels like an eternity.  The line is not as clear-cut as we'd like to think.  But regardless of whether it's sadness or depression, the best I can do is to control what I can control.  This includes therapy, meds, stress management, and self-care. 

And most importantly, for me, it means practicing self-acceptance--of my sadness, my depression, and everything else that makes me who I am, for better or worse. 

Listen Carefully

Last night I gave a presentation to some students about how to provide support to those who have been affected by the accident last November.  My advice is simple yet difficult to do:  listen carefully.

Most of the time we're too focused on ourselves to listen to what others are saying.  We're thinking about what we want to say, what we don't want to say, whether the other person is listening to what we're saying, what we're going to do once this conversation ends.  You get the idea.

As I got better at listening, I noticed that people put out feelers about important aspects of themselves, just to test the waters--to see if anyone notices.

Once I was watching my ex play in a basketball tournament, and I had to sit with a bunch of wives I didn't know who were also watching their spouses play.  I was having the usual conversation when I meet someone new.  What do you do for a living?  I'm a psychologist.  Oh, I bet you're psychoanalyzing me right now!  Yup.  I've got you all figured out. 

This was not the response she expected.  But she still asked more questions.  Do you specialize in anything?  Eating disorders, multicultural identity, positive psychology.  Interesting!  I had an eating disorder once.

Of course this got my attention.  It was my turn to ask questions.  At first I worried that she would be offended by my prying into her mental health history, but it was the exact opposite.   She had never told her story to anyone.  Back then no one talked about eating disorders.  Bulimia wasn't even a diagnosis.  She wanted someone to hear what she went through.

This is always the response I get when I follow up on those feelers that people throw out there.

There's nothing magical about being a good listener.  Anyone can do it.  The best way to get better at it is to pay closer attention to yourself.  We spend so much time trying to will ourselves to think, feel, and do what we think we should think, feel, and do that we don't really know ourselves.  This is often what I do therapy:  teach people how to observe themselves without judgment.

It's not easy to do.  It takes practice.  This blog is one of the ways that I practice listening to myself, and you can see how hard it is for me to do so in a nonjudgmental way.  But I am trying to treat myself the way I would treat anyone who I care about deeply, and I suggest that you do the same.

Because hopefully you are someone who you care about deeply.

In Need

I don't like the word needy. I much prefer the word crazy to needy.  Crazy can have many meanings, and not all of them are negative.  Sometimes crazy can be a compliment.  At least that's how I interpret it when I'm feeling good about myself.  Neediness, on the other hand, is never a compliment.

I admit I am sensitive to the word because I have been accused of being too needy, too demanding.  I have tried to correct for this, but I don't know how to distinguish my unreasonable demands from my needs. 

I've tried to deal with it by giving my partner the benefit of the doubt.  If he couldn't give me what I needed, then perhaps it was a demand that I mistook for a need.  How important is meaningful conversation anyway, really?  How much contact is actually necessary for the survival of the relationship? 

This approach hasn't gotten me very far.  I seem to have overshot my mark.  My therapist tells me that I cannot disavow my needs in order to make my relationships work.  Sounds good to me.  But how do you separate the needs that are necessary for survival from the ones that make people accuse you of being needy? 

Let's say that you came across a boy who you met in the woods while hiking one day, like the wild boy of Aveyron.  You feel bad for him so you invite him over for dinner.  But he's really hungry, so he eats all the food in your house and still wants more.  Obviously, you wouldn't blame the kid for this.  You wouldn't accuse him of being too hungry, because it's not his fault he was abandoned in the woods to fend for himself. 

Psychological needs are no different.  Neediness is the product of prolonged emotional starvation.  You may not be able to give the person what they need to feel satisfied, but that's not their fault.  It's not yours, either.

But it feels like it should be someone's fault, doesn't it?  Someone should take the blame!

I prefer to reframe a needy person as someone who is in need.  Perhaps their needs are so great that I can't help them.  That's OK; I don't have to be able to help everyone--although I do still try. 

I am trying to think of myself as someone in need, too.  I am just learning what these needs are, because I've spent my life focusing on other people.  There are a lot of them, and they have gone unfulfilled for a long time.  I'm not blaming anyone for this, but I'm trying not to blame myself, either. 

I'm just trying to make my way out of the woods.

Night Owl Syndrome, Part 2

I started this blog with a post about the stress of trying to regulate my sleep cycle.  Particularly since it was the beginning of the year and I had been off for 3 months--plenty of time to revert to my more natural night owl state.

I am in the same predicament this week, except that my sleep cycle is even more out of whack than usual.  In addition to the normal job stress and abrupt transition into having nothing to do at the end of the term, I was also dealing with the fallout from the student death and extended periods of loneliness and isolation.  I fell into a pattern of going to bed at 4 am and waking up at 4 pm, with a few hours of wakefulness in between.  And as usual, I was racked with guilt and self-loathing about this.

My dad and two of my brothers are also night owls.  While my family was together over Christmas, my dad hardly slept at all, and when he did it was well past 2 am.  One of my brothers went to bed around 6 am.  The other brother woke up around 6 pm.  Yet they did not appear to be racked with the same guilt and self-loathing as me. 

Which is the reason why I originally started this blog.  Accepting who I am, including my obsessive tendencies, problems with guilt, and wacky sleep schedule, takes continuous practice.  If I neglect to do it, I fall prey to depression and anxiety.

And writing about how I was feeling during that period definitely helped.  It was cathartic.  It helped me to remember what I tell my clients. It provided me support, positive feedback, and extra angels.  And some of the most depressing posts were among the most popular ones, so I know I'm not alone.

Perhaps I should start recommending blogging as an important component of self-care.  Right up there with sleep, exercise, food, and mindfulness.

Last night I went to bed before 1 am without having to rely on extra Ativan.  And I woke up at 7 am because I had a doctor's appointment.  That's as close to a "normal" sleep cycle as it gets for me.  So going back to work has been a good thing.  Still,  if I didn't have to go back this week, I wouldn't have. 

Fortunately, sometimes you are forced to do things that are good for you, whether you want to or not.  

Empathy

Sometimes you can have too much empathy.

One of the reasons why it seems like I want to save the world (which I don't--just the people I've met) is because I can feel other people's pain as though it were my own.  When they are hurting, I'm hurting. So it's really for selfish reasons that I help other people; I don't like being in pain.

When I worked in day care after I graduated from college, the children who had the most difficult time adjusting were the ones who were attached to me.  In case you are worried about your children being in day care, rest assured that there were some kids who loved it so much that they didn't want to go home. 

But not these kids.  These were the kids who cried from the moment their parents dropped them off until they picked them up in the afternoon.  And this would go on for weeks.  It actually drove me crazy.  I didn't feel positively towards them at all.  Which is why I could never understand why they were attached to me.

Now I think it's because I could feel their pain, so I would break the rules and hold them all day because it's the only thing that comforted them.  And it turns out that being held is one of the best ways to soothe people.  So next time you're feeling upset, ask for a hug from someone you care about.  Or do something that feels like a hug, like take a warm bath or wrap yourself up in a blanket.

Sometimes I feel like I'm a receiver that picks up the emotional equivalent of radio waves.  I'm bombarded by all of these feelings, all the time.  Sometimes I don't even know where they're coming from.  I wish I could just turn the receiver off every now and then, or at least turn down the volume.  Anything to have some relief from the constant noise.

The best solution I've been able to come up with is the yes and no thing: yes to what I want, no to what I don't want.  I need to choose the people who I'm around more carefully.  If it's someone who doesn't take responsibility for dealing with their own feelings, I need to stay away.  I can barely deal with my own feelings.

It sounds cold and calculated, but I always tell clients that if it comes down to you and someone else, you have to pick you, because there's no guarantee that anyone else will.

So from now on, I'm going to try to pick me.

Photo courtesy of  Maria Roman

Yes and No

Being alone isn't as bad as I thought it would be.  Relationships are an area where I take on challenges without asking myself whether it is worth the effort, so it's a nice change of pace to have energy to expend on myself. 

When I was in school, the reason why I was a good student is that I did what teachers told me to do.  It never occurred to me that not doing the reading or homework and not studying were an option.  I also try to fulfill my job responsibilities because I'm afraid that if I make one mistake I'll get fired.  

I think it's partly due to my Catholic upbringing.  I'm a rule-follower to begin with, but I also fear that if I break the rules I will go to hell.  If I call a ball out, I'm afraid I'll go to hell because I wanted the point so badly.  So usually I just call everything in, which is sometimes to my advantage because my opponent wasn't expecting to play a ball that was a foot out.

I used to have this prayer where I would ask God to forgive me for all my sins, intentional and unintentional, because I thought, what if I've sinned and I didn't realize it?  Then I couldn't ask for forgiveness and I might go to hell.  So I figured this prayer covered all the bases.

Most of my relationships weren't of my choosing.  If someone liked me, I would date him because I thought that would make him happy.  Feeling ambivalent was not a good enough reason to say no because my feelings didn't count.  And it's hard for me to end relationships because I'm not allowed to hurt anyone.  Although I often ended up hurting them, anyway.

This is also the reason I became a psychologist and feel compelled to save the world.  If someone is hurting, then it's my job to help them if I'm able to do so.  It doesn't matter if I want to do so, whether I like the person or not, how stressed I am, or how much energy I have to expend.

My superhero family members also share this sentiment, as I mentioned in a previous post.  They are even more extreme in terms of putting other people's needs first, even if it hurts them.  So I really haven't had good role models for setting limits.

But thanks to this blog, I'm beginning to set limits.  I've quit that crazy writing job where I was spending 10-12 hours on articles that gave the most superficial advice possible for $25.  I ended a relationship and am learning to be alone.  I have narrowed down my extra-curricular activities to tennis, knitting that dress for my niece, and writing/promoting my blog.  Which is still a lot, but it's an improvement for me.

My new rule is to say yes to what I want and no to what I don't want.  I said this 3 years ago, but sometimes it takes awhile to do what you know you need to do.  So I'm trying not to beat myself up about that. 

So from now on, it's yes and no.  Hopefully.

Self-Care

Remember how I said I was following all the stress management guidelines and still feeling overwhelmed?  Well that day there was a car accident with 11 students involved, 1 who died and 3 who are still in critical condition.  The entire college community is grieving, and we have been slammed at the counseling center.   

Every day, multiple times a day, I preach the importance of self-care, which includes:

• Sleep: I get at least 6 hours but could use more.
• Eating:  I never skip a meal and eat relatively healthy.
• Exercise:  I try to play tennis 3x/week and stretch before bedtime.
• Down Time:  I give myself plenty of down time.  One of the perks of living alone.
• Putting your needs first:  I am terrible at this. 

In my defense, most helping professionals are pathologically helpful and run the risk of burnout.  In fact, if there were an award for Most Likely to Help Other People Until You Collapse, the physicians in my family would be competing for first place.

I forced my dad to read the blog about him, and after he read it he admitted that spending decades on call 24-7, covering every physician who went out of town over the holidays while we stayed home, probably contributed to his depression.  When my dad was sick, my mom saw both of their patients and took care of my dad.  My brother recently had sinus surgery and was told to take off at least a week from work but went back after 3 days.

So relatively speaking, I'm actually a slacker in my family.

I have been feeling the loss of not having someone to come home to, someone who I can talk about my day with.  I have made an effort to reach out to friends, and they have been incredibly helpful, but it doesn't take the place of having that person who knows everything that's going on with you on a day-to-day basis, whether they want to or not. 

So I'm doing what I can to take care of myself.  I went to dinner with friends last night.  I was dead tired but it was a rare opportunity to see my tennis mom, who recently abandoned me by moving to South Carolina.  She reminded me of the hazards of my "save the world" mentality.  I defended myself by saying that I'm not trying to save the world--just the people I meet.  It just so happens that I'm meeting a lot of people right now.

And I'm going to a movie tonight after I go into work to facilitate a debriefing session.  I'm a little worried about being too drained afterwards but I'm making an effort to do something other than sit at home alone all weekend.

And I'm writing this blog.  This is the one place where everything gets to be about me.  I get to talk as much as I want without being interrupted, there are people who are interested in what I have to say, and the feedback is almost always positive.  And for this I am thankful.