Tag: psychotherapy

wondering if it was all a dream

by Midnight Demon, posted in depression, mood disorders, suicide

wondering if it was all a dream

I took yesterday off from blogging. I was in too much emotional pain to get my thoughts together. I emailed my psychiatrist today to tell her how I was feeling. I see her Friday but my last message to her was about how suicidal I was. I wanted to tell her that has lifted a bit but I still have a profound depression that is rearing its ugly head. I also wanted to let her know I got my fucking menses again. For the past several weeks, I have been dealing with the self-hate of being TG. Now having my menses are just fucking with me and my self-worth. I came pretty close to doing something this time. I had the suicidal impulses and that to me was scary. I didn’t do anything, other than take an extra Ativan to calm down the perturbation/impulsivity. Most of the suicidal thoughts are gone since I started menstruating, which isn’t supposed to happen because I am on pills to stop the fucker. But I still am in tough depression.

So I emailed my psychiatrist and told her, plainly, what was going on. I bet she probably figured out before I did that my suicidal tendencies were due to hormonal shifts. I did tell her the next time it happens, I might not be so lucky. One would think that because I have no job, that writing has become more than a hobby for me, and that I keep myself occupied, I shouldn’t really be depressed. MYTH! I could be deeply depressed even if I was working a full-time job. I know, I have been deeply depressed for years when I was working full-time. Now my writing has taken a little more of a hobby capacity. It has become my livelihood. You could say that I am living because I blog. But after a while, I can’t think of something fresh to write about and the depression hinders my thinking. I panic when this happens. I never know when a depressive episode is going to land me in the hospital. I know my hospitalizations have decreased over the years but I still need one a year, lately. It is just a way for me to recharge my batteries. I hate going in because it sucks waiting in the ER for a long time. I get bored and have to try not to use all the battery on my phone because reception sucks and it drains it all. I usually bring myself to the hospital because I don’t want my family to know. Should I be in the hospital because of this last suicidal episode? I don’t know. I am not feeling like ending my life as much as I did this weekend. My therapist was confused about the texts I sent her. It wasn’t a clear SOS. But then, I always become deceptive when I am suicidal. You can’t kill yourself if a professional knows the 411. Course, if I sent the same message to my pdoc, it probably would have landed me in the hospital. My pdoc doesn’t mess around.

I still wonder why I am still here. I should be dead with how heavy the suicidal thoughts were a yesterday. Course yesterday feels like it was ages ago. I am not saying I lost time. I was fully present throughout the day but now that I have my stupid menses, those heavy thoughts are no longer there and I am wondering if it was all a dream. Every time I get those experiences, I often wonder afterwards, was it a dream. But I know from the texts and blogs I wrote it wasn’t.

My therapist read the therapy and coffee blog that I sent her. She is a little embarrassed about it because I make her sound like a nut job. That wasn’t my intention. I asked her if she wanted me to take it down. She said no because I am free to write whatever I feel like writing. But now I am wondering if I should write a blog about lyrics and therapy. I worked hard on the coffee blog. I would hate to take it down.

Therapy and Coffee

by Midnight Demon, posted in blogging, depression, mood disorders, suicide

18-July-14

Coffee and therapy

Last night I read blogs about how a therapist lost a patient to suicide and how he got through it, two years later. It started to get me thinking about my journey with my therapist. Though this isn’t a linear story and is not about what went on in therapy, it is a story about how coffee brought me closer to my therapist and formed a bond that we didn’t know about at the time.

I was not always a Starbucks coffee drinker. Like many Bostonians, Dunkin Donuts coffee was sufficient. But once you have experienced a full bodied coffee, you can never go back to their coffee. My therapist’s office had an Au Buon Pain French bakery across the street. They sell great coffee. After having their coffee, I really couldn’t go back to Dunkin. I started drinking their coffee and found that I like it much better than Dunkin, even if it cost a little more.

A funny story about the Au Buon Pain coffee. Usually by mid-session I would be finished with my coffee and I would play with the cup, mainly playing with the protective sleeve by picking at the corners. During one session, it was getting intense, and I was playing with the empty cup. Some how the lid flew off in the direction of my therapist sitting across from me. We both laughed at the symbolism and meaning of with this lid. But I guess the lid meant more to her as she kept the it after session that day. It was just a plastic coffee lid to me but she found a treasured object. When we started exchanging gifts sometimes after my 30th birthday (my birthday falls near Christmas), I received the lid back with a corny message. She had placed it in a picture frame and on the back was the message. I am unable to find this frame at this time and I don’t remember what the lid said. I just laughed.

I have a sensitive stomach so it wasn’t too long before my gastritis would act up over my one cup of coffee a day. I think it was around this time that I switched to Starbucks. I figured I couldn’t go wrong with espresso diluted with milk. At first, I couldn’t tolerate the switch as it has been forever since I had a glass of milk. But after a while I got used to it and I am now a full time Starbucks junkie.

It didn’t matter what office we were at, there was always a Starbucks I could find. I swear I have an internal GPS Starbucks locator in my brain. When she first moved to Framingham, 30 miles from her Cambridge location, she said there weren’t any Starbucks nearby. I found two within two miles of her office. I would always have my mocha during sessions. During one session, the lid came off again and this time I spilled my drink on her fancy rug. I felt so bad. Starbucks had changed their covers to flimsy plastic and it didn’t fit right on the cup. This time, my therapist didn’t keep the lid.

I think I have consumed more Starbucks coffee over the years than any other establishment in my area. I now make their coffee at home, which further debilitates my staying in the house. But then, I will only drink Starbucks coffee. Occasionally and in a pinch, I will have Dunkins or Au Buon Pain or even the local convenient store coffee. I still have remained a loyal customer even though the price of their coffee has gone up over the years. I used to solely drink their espresso drinks, but since they out with the Clover system, which makes one cup of coffee at a time, I have gone back to coffee. It is cheaper than the espresso drinks. I have yet to try espresso by itself, however.

Through all the coffee consumption, I still have the same therapist. She has been with me for the past 13+ years. Next month will be technically our 14th year. I say technically because I had my first session with her in 2000 but because she didn’t take my insurance at the time, I couldn’t see her. When I changed my insurance the following year, I called her up and was happy to find that she still was accepting new clients.

Her vacation this year will be welcome. I need a break from her. It’s not that she is doing anything wrong, it’s just that I need some space. I know that I’ll probably write her letters while she is gone. I have always written her letters to say what I cannot talk about. Mostly I write to vent and then I forget what I write. They (researchers) says it’s a cathartic response. And most of what I write is cathartic. Of the more than 700 blogs I have written over the last two years since starting my blog, the only ones I specifically remember are the papers I have posted. The rest I may remember from a tag or title but sometimes, I have found, the title isn’t what the blog is about.

My therapist started her practice at the middle of Mass Ave in Cambridge. She moved down the street several times until her final destination was 30 miles away. Each move, I went with her. She could have stopped seeing me at any point in the consolidation of her practices, as she called it. Course it was very difficult when her final destination was Framingham. I don’t have a car so we communicate mostly by phone. I try to get my sister’s car at least once a month to visit her but it sometimes doesn’t work out because of my pain levels. And usually, I will get a coffee before starting the trip. It’s anywhere from 45 mins to an hour and a half from where I live to her office. It all depends on the traffic. And which route I go. I mostly go one route that is through several towns rather than go the direct route, which is the highway. The highway would be faster but I have had one too many tire blow outs and I am just too afraid now to go that way. It has traumatized me to the point I will only go if I have a very reliable car. My last tire blow out, I thought I was going to get killed because I was stuck in the middle of the road and a semi was coming in hot after me. Since that day I only use that highway only if I absolutely have to.

As much as my therapist is a “PITA” (Pain In The Ass), she is also stubborn. We will butt heads frequently about sessions to my safety. Since she calls me a suicidologist, I have often brought in tools to help with the suicidal thoughts and ideation. Before then, we just used with the “no harm contracts” which suck. Now we use a Crisis response plan. See this blog to find out more about it. It’s good I see a stubborn therapist. The only thing I hate is that she NEVER allows me to cancel a session anymore. I used to be able to cancel whenever I didn’t feel like going in. Those days are long gone. If I cancel due to a legit reason, say my father’s doctor appointment, I need to reschedule. We always meet twice a week. Very rarely do I see her once a week, though when my suicidality, peaks it could be three time a week.

There was one session I really didn’t want to see her. She called me and asked where I was and I told her I was home. This is after I canceled our session. She bribed me with a mocha to come to her office. Who does that?

Weird dreams again and the SSF

by Midnight Demon, posted in chronic physical pain, depression, mood disorders, psychache, suicidality

I am having a horrible day. My day literally started at 0100. I slept for a few hours, from 2200 to 0100 and I was up for the night. I went back to sleep around dawn. Was up for a few hours and then tried to get back to sleep around 0800 or 0900. Fail. I finally gave up around 1130. In the times that I did sleep, I had another weird dream about children and elevators. It was winter time and we were going to take the children sledding but the elevator malfunctioned and we ended up at a hospital that was at an airport. I don’t know what that is about. Absolutely makes no sense. Other than me possibly wanting to get away either through an airport or a hospital admission. I don’t know.

I had therapy and we talked about the weird dream and me not sleeping. I told her I am getting to my wits end. The heat is not helping. I still have to clear a path for my bro in law to install the AC. Maybe I will do that after I write this blog. We also talked about my suicidality and the need to attempt suicide. I don’t know why I feel like this. I just feel like everybody will be better off without me. I just feel so low and useless. I know my sister needs me because I have to pick up my niece next week. She doesn’t have the after school program anymore. But I just hope my ankle doesn’t flare up other wise I will be in pain and I am not looking forward to that. I just wish I wasn’t in pain every single day. I have not had a “day off” from pain in weeks.

So because I am thinking of an attempt, my therapist is taking out the old SSF to assess where I am at. She will do this assessment tomorrow. The SSF (Suicide Status Form) is an assessment used to assess and evaluate suicidality. In addition to this assessment, it also lists goals of treatment that both the clinician and client agree upon. The beauty of this assessment is that it allows collaboration in the treatment of suicidality rather than have the clinician be the expert. And the assessment is easier for the clinician as it also lists all the necessary documentation you would need for a session such as Axis diagnosis, progress notes, and date of next appointment.

The SSF was developed by a suicidologist, my idol, Dr. David Jobes. He developed this assessment so that clients that were suicidal did not get “lost” in the system and were treated as equals in their treatment, rather than have treatment as usual. To learn more about this, check out his book on the subject, Managing Suicidal Risk. It is a great book and also teaches you how to score the assessment at the end of the book. There are also classes you can take. His assessment tool follows under his framework, CAMS, Collaborating and Assessing Management of Suicidality. I write a lot about his work on my blog because I can’t stress the importance of suicide prevention. And this is one tool to do that.

So my therapist is pulling out this assessment tool on me tomorrow. I am not happy about it. I know how to “cheat” on it as I am the one to bring it to her attention. She is not proficient in promoting it despite my several attempts for her to go to Jobes’s workshops. She feels, like many therapists, that her training is adequate (it’s not) and she does not want to be a suicidologist. I am not asking her to change her ways, just add to her skill set. Every time she brings it out, I cringe because I know she doesn’t use it all the way through and that pisses me off. I feel like it is a waste of time because it is not used properly.

Finally, a little motivation

by Midnight Demon, posted in depression

Finally, some motivation

I woke up at a normal time, between 0800 and 0830. It is the first time in I don’t know how many months that I slept that “late”. I actually woke up rested and rearing to go, despite this cough from hell that I have. The weatherman said there will be downpours later in the day so I went to the post office to mail out my last two signed books. They have been sitting on the edge of my bed for weeks and now that they aren’t there, I am kind of sad. I am out of the copies that I purchased for myself. I only have one more book and I think I am going to keep it, unless someone buys it off me. One of the books that I mailed out went to the Netherlands. I have a friend there that was interested in my book.

After the post office, I did nothing but play on the computer. It’s sad that I haven’t sold any books so far this month. I only sold 7 last month. I was getting on a roll of selling one per day and then it just stopped. I am going to try and do more to promote my book but it’s so difficult as I don’t know what avenues to go down. I think I have to target the right audience but I don’t know how to find it because my book is so limited. It’s not like it is a romance novel. It is a book about my struggles with suicidality and how I thought about ending my life numerous times over the years. Not a book that screams “buy me”, unless you have been there or like reading stories of struggle.

After my therapy appointment that went ok, I still had energy so went to Starbucks for coffee. I tried writing notes from the Experiences of Depression book but after a few dozen pages, I got bored. I still had to do a few more errands so I stopped writing to go to the meat market to get burgers for dinner. I then went to the square post office to pick my mother up some stamps. I didn’t tell her I was going on the first trip. Oh well. I like the Square office better because it is bigger.

I have therapy again tomorrow. I don’t know why I asked for an additional session. I think I go to therapy just to pass time. Sad and pathetic I know. But as long as she has time available, I will take it. Besides, I like to know what Freud means when he talks about “objects”. The Experience of Depression book was talking a lot about it and I don’t know what the hell it is in reference to. Does it mean a person or an actual object like a teddy bear? Or in Freud’s case, a pacifier?