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Friday, November 15, 2024

Shrinks Behaving Badly

Posted by fxckfeelings on January 23, 2012

For those of us in the helping professions who overestimate our ability to help, (off-hour phone) calls for help can become a big problem. Whether you’re soft and sympathetic or blunt and tough, there’s no problem you can’t make worse by taking too much responsibility for messes that are beyond your (or anyone’s) control. If, on the other hand, you know the limits of your powers, you can respond to calls pleasantly, do your job, and still help someone without hurting your own sanity.
Dr. Lastname

While most mental health clinicians would feel guilty admitting this, I’ve been in the biz for long enough that I don’t give a shit and I need to vent. Most of the crisis calls I get from my psychotherapy practice are senseless and irritating; they’re from patients who feel bad because they forgot to take their medications, or drank too much or when they shouldn’t, or allowed their demons to wreak vengeance on their enemies, the nearer the better, self best of all. A few call me because they’re feeling suicidal (but won’t go to the hospital) and just want me to make them feel better, which is hard when it’s late and I’m tired, and often impossible just because I don’t have that kind of power. I try to be civil, but their calls leave me feeling helpless and wondering whether I’m doing any good. Discussing their responsibility for their behavior is useless, because it usually makes them mad or apologetic. My goal is to figure out what to do with crisis calls that are really a useless pain in the ass.

Many crisis calls you receive as a shrink do a good job of showing off a patient’s worst behavior. It’s like having partial custody of a colicky child.

It’s not that their distress isn’t real and severe—it is, almost always—it’s that it causes self-defeating behavior, like drinking or mouthing off or retreating from the world, which creates a jam that is extra hard to get out of.

Bad feelings cause bad behavior, bad listening skills and bad regrets about going into the therapy business instead of owning a Toyota dealership. WAIT! There is more to read… read on »

Symptomatic Meaning

Posted by fxckfeelings on January 9, 2012

Horrible thoughts and feelings are supposed to make you feel as if there’s something horribly wrong, and there is, but it’s not necessarily with you. Even when your brain is giving you strange signals and your mood is in the pits, you’re the same old person with the same old values. Judge yourself by what you do with symptoms of mental illness, not by the way they make you feel or think, and you will never have reason to doubt yourself or despair.
Dr. Lastname

I was diagnosed with major depressive disorder and anorexia nervosa purging type a few years ago. Both of these issues had pretty much consumed my life during the years leading up to that diagnosis and have continued to be impairing ever since. I started cutting myself two years ago (it has become more frequent this past year), and I’ve had several panic attacks in the past several months. Fortunately, my overwhelming desire to commit suicide has subsided, although I still think of suicide and my death in general fairly often. In addition to my own issues, I have watched my mom slip into a state of psychosis during the past two years, triggered by the death of her father. She has become so depressed, delusional, and violent that my parents separated and sometimes I don’t even feel safe staying in the house with her—a few weeks ago my dad and I had to stop her from going through with a suicide attempt. The police were called, and I had to hold her arms down while she was clearly in a psychotic rage. At one point, she tried to stab my hand to make me let go. She was taken to a mental health facility where she stayed for a week, and now she’s furious at us for making her go there and hasn’t been much better since then. I feel like I never get anywhere with therapists because they just prescribe medicines that make me feel numb to any emotions or focus on my eating disorder so much that I never get to work through these other issues. I feel like my life is unraveling and it’s gotten so bad that, honestly, I don’t feel like I even want to fix it. My goal in telling you this is to figure out a way to help my mom and how to get through school while I’m dealing with this.

It may seem strange to hear this, for someone who suffers as much as you do from depression, anorexia, and the burdens of taking care of a very sick mother, but I think you’re doing an amazing job.

Yes, you’re chin-deep in shit, but you haven’t drowned, and that’s a remarkable accomplishment.

Your depression hasn’t made you hate people or blame them, and your anorexia hasn’t caused you to pretend you’re not sick, so you must have a solid hold on reality. There you are, with all your pain, finding the love to help your mother and the energy to go on with your studies. You’ve got good values and a big soul. WAIT! There is more to read… read on »

Upper Management

Posted by fxckfeelings on January 5, 2012

Whether you take pride in controlling your health with the latest developments in modern medicine, ancient holistic treatments, or the dictums of Xenu, you’re making the same basic mistake in thinking that you control your health. Depression is especially insidious, because there’s no amount of will power or even therapy that can make for a perfect solution. So gather techniques wherever you may using whatever works to deal with what ails you, just remember that the goal isn’t finding a cure, but the best methods to help you cope.
Dr. Lastname

I have suffered from anxiety and depression much of my life. My most recent (and most devastating) bout was a couple of years ago, when I worked with a therapist and managed to heave myself out of it without the use of antidepressants (which I had been on in the past and want to learn to live without.) Now I find myself slipping back in. My biggest issue seems to be that I put too much stock in what others think of me or might think of me (I’m really good at fabricating things people might be saying about me.) I also had a baby last year, which has prevented me from pursuing my career fully, so when I hear of the successes of others (or see them on Facebook) I get very anxious and feel that the universe is unjust. I want to be a good mom, and I want to be good at my job, but I feel I am failing at both and resenting others who are great at either. I was made fun of a lot when I was a kid and I think I still carry some of this baggage around, like whatever decision I make is the wrong one because I’m basically a loser. How can I focus on myself and my own life without worrying about what everyone else is up to or what they may think about me?

While you already have a good idea of what to do about your negative thinking, you still need to protect yourself from two bad ideas that you express here. Unfortunately, those two ideas are also your “goals.”

First, disavow yourself of the notions that you should be able to stop depression without using medication and that you should find a way to be less, for lack of a better word, insecure. In doing so, you won’t be giving up—you’ll be giving yourself some relief. WAIT! There is more to read… read on »

OCD 101

Posted by fxckfeelings on December 29, 2011

Being thoughtful is good, but being thoughtful to the point of painful obsession is having OCD, with fearful thoughts that stick in your brain and won’t go away unless you do something sort-of-magical and sort-of-stupid that gives you a moment of relief (before your fears start again). The good news is that it happens to good people who learn how to manage and live with it, which can happen much more easily if you can abandon the worst obsession of all—finding a way to cure the OCD altogether.
Dr. Lastname

Please Note: Monday is also a fxckfeelings.com holiday. Happy New Year (and again, if/when it’s unhappy, you know the drill).

I’m a current student and I’ve sort of self-diagnosed myself as having an unusual kind of OCD. It started out four years ago when I was studying for an upcoming major exam. I had always been one of the few top students, but at one point in time in the midst of hours of straight studying, I couldn’t absorb any more info, and in a fit of frustration, a ball of emotions welled up and I actually said harshly in my mind to myself, “you shall FAIL!”, even though I’ve always tried to avoid such negative thinking. What came next was an unshakable, unexplainable, and annoying-yet-scary series of feelings, thoughts and emotions for the next few days and weeks. After that episode, I developed an irrational apprehension about me having “ruined” myself and my academic ability. To get myself back to my normal, anxiety-free mind when studying or doing anything related to studies, I imagined “transferring” the whole chunk of this mental mess on other stuff, whether it is the faces of people who did badly in academics in my field, to those I don’t like, etc. Still, my mind would automatically be inclined to have these random obsessions appear in my mind while studying, and it’s really prevented me from fully unleashing my full academic ability in subsequent grades. I really felt restrained and trapped by this, and my goal is to eliminate this strong-rooted (it’s been 4 years) mental condition that happens whenever I study and then makes it almost impossible.

Some OCD thoughts are crippling but come out of nowhere, like fear of contamination or making a mistake. While they often lead to compulsive rituals, like repeated hand-washing and fact-checking, you manage to keep studying. So, while you’re suffering, you’re still lucky.

The fact that your obsessive fears are tied to school may make them easier to deal with, because, unlike germs, school (usually) doesn’t go on forever.

School is built on mental constructs that attract obsessions like lint to a dryer vent; it’s got grades, grade-points, and exams that hinge on a word or the instructor’s interpretation of same. It invites obsession and obsessive argument, which can be torture, but at least it has an end date. WAIT! There is more to read… read on »

The Kids Aren’t All Right

Posted by fxckfeelings on December 19, 2011

When grown kids need permanent parental support, it’s hard for those parents to feel like they’ve succeeded. Every parent worries that they’re not doing enough for their kids, but for those who have adult kids with problems, that worry is amplified by anxiety and guilt. They can take over management, however, by assessing their responsibilities rationally and keeping their worries in check. It’s not healthy to care for and protect your children too much, but the only parents that fail are the ones that don’t care enough.
Dr. Lastname

Helping my daughter pay the rent on a bigger apartment seems to have lifted her out of her depression and she’s much more active at her job, but she’s still not making enough money and I’m running out of cash. If I tell her that she has to take a roommate, I’m afraid she’ll just crawl under the covers again and we’ll be back where we started. It shouldn’t be that hard for her to make enough money, but it is. I’m mad and I’m stuck. My goal is to get her to make more money and/or understand that I can’t keep supporting her like this.

While you may think you’re giving your daughter money out of love, you’re actually doing it out of fear. That’s trouble, because when you give money out of fear, you’re usually being mugged.

Fear makes you forget long-term risks, like what you’ll do after you run out of money and the consequences for you, her, and other people who depend on you. Your love is infinite, but your finances aren’t. WAIT! There is more to read… read on »

Guilted Cage

Posted by fxckfeelings on December 15, 2011

Feeling you’ve made a mistake is usually an instinctive reflex that has nothing to do with sober judgment and/or actual responsibility and a lot to do with guilt. You feel you’ve made a mistake when things turn out badly, or your efforts fail, or you’re still in pain, so you feel obliged to give yourself a good kick…which usually makes things worse. It’s not that we’re incapable of examining blame and responsibility rationally, it’s that self-flagellation gets rid of guilt faster than self-reflection keeps us from accepting a guilty verdict.
Dr. Lastname

I have been struggling with performance anxiety for years. It was particularly difficult during university, where I saw three psychologists, including a campus counselor, who, while supportive, weren’t helpful. It got much better though when I was able to take control of a treatment group I was facilitating, where I could design the program and run it the way I wanted to. I enjoyed being the therapist who helps others, and the experience gave me confidence. Still, the anxiety has not been extinguished in all situations—when teaching and presenting at conferences, the anxiety in these two areas is just as high as it was previously. I have been managing this for a long time and I do not feel motivated to continue to place myself in situations where my anxiety is raised again so high that I experience nausea, stomach pains, dry mouth, etc., not to mention the exhaustion I feel after the anxious-provoking event has finished. I do have some mild/moderate social anxiety—I don’t like socializing in big groups unless I know the people, and this prevents me from making new social contacts and networking for my profession. I am well versed in exposure therapies and ACT and have used these to get me to the point I am at now, and I continue to use them. However, I don’t think my anxiety will ever improve beyond where it is now and I am too exhausted to continue to try. I guess I’m stuck and don’t know if I should try to find a specialist to help me to continue to force myself to network, push myself to present at conferences, and become an academic psychologist or move into working as a clinical psychologist in a private practice, where I would work more on my own and I would be happier and more relaxed but also know that I am avoiding the events that are anxiety-provoking.

Maybe being in the mental health business makes you feel more responsible for controlling symptoms of anxiety and becoming a role model for good mental health. It’s ironic, given that most people in our field are the worst role models for mental health. If we were totally sane, we’d just go into dermatology and rake it in.

If you are driven to perfection, it’s causing you to forget that certain symptoms, like anxiety, tend to be incurable, and that, if you’ve reached the point where you can’t make them better, it’s because you’ve done an amazing job of managing them and pushing yourself to the limit of what you can bear. WAIT! There is more to read… read on »

Irreconcilable Diseases

Posted by fxckfeelings on November 14, 2011

When you love someone who gets mentally ill and doesn’t recover, you may not only lose that part of their personality you loved the most, but also get stuck with a double dose of what you liked least. After all, it’s one thing to vow to be there in sickness and in health, but sickness and negativity and mania are usually more than most people bargain for. If your spouse’s mental illness makes your marriage unbearable, keep a lid on your negative feelings by respecting the burden life has put on both of you and refusing responsibility for putting things back the way they were. Once you can accept that sad reality, it’s time to figure out whether there’s room in your marriage for you, your spouse and the disease, or if your old vows no longer apply.
Dr. Lastname

My wife suffers from non-medication responsive depression (we’ve done ECT’s, every med in the book, and she has a psychiatrist). She’s bitter and short to family; she goes off on the kids and then can turn around and be nice. I do all the work around the house, get the kids to activities, etc., and I’m wearing out. She comes home from work and just logs on her lap top and sits in front of the TV while I get dinner and clean up. She shows no affection towards me and I feel like a servant. When I complain or push her, she talks about killing herself and putting herself out of our misery (she’s been hospitalized several times) or just hurting herself (sometimes she cuts on her arms and legs). I’m getting to the point where I don’t like her anymore. She just seems to have given up. Nothing interests her, nothing tastes good…she gets no enjoyment from anything. What can I do? She’s in her forties, now, but she struggled with depression in her twenties and this current bout has been going on for 5 years. Her doctor and therapist are really committed to her, but it seems like she doesn’t care, like she enjoys being miserable. Sometimes I feel like I’m spiraling down with her, but I’m not going to give up. If I just stand by, she seems to just sink lower, but I can’t leave, because she’s said that the kids and I are the only reason she’s still alive.

If you’re like most married people, you become dependent on your spouse for a positive response, no matter how independent you are as an individual. You married her because you respect her opinion and take pleasure in her approval. You make her happy, everyone feels good. You see the problem here.

So it’s normal to feel bitterly disappointed and deflated when depression turns her into a grouchy, nasty, unappreciative, unaffectionate black hole who threatens suicide if you criticize her and never does her share.

It’s not just the lack of approval from her that’s bothering you, it’s the overabundance of disapproval, of you and everything else. WAIT! There is more to read… read on »

Friend Finder

Posted by fxckfeelings on November 10, 2011

Depression puts a strain on relationships, as does any illness, but it also acts as a filter through which only the worthiest of friends emerge. After all, one of the great rewards of a good friendship is feeling helpful and supportive to a sick friend, and one of the reddest flags of a bad friendship is someone who isn’t capable of either. So when depression tells you that you’re a burden to your friends, remember that, like most of what depression says, it lies. You’re never a burden to a true friend, particularly when you’re struggling, so if someone can’t be a good friend to you when you need them the most, then good riddance.
Dr. Lastname

I need to face the fact that I have trouble getting close to people. I recently had a close relationship with a guy I was crazy about, but I often get depressed and, when it happens, I get quiet, and he couldn’t stand it. I’m good at functioning when I’m depressed, it’s never stopped me from getting my work done, and I push myself to hang out with friends, but I can’t help the fact that I don’t have much to say and that I don’t really feel like laughing. I kept telling him it wasn’t personal, but he didn’t really believe me. My goal is to figure out how I can find a partner if I can’t really interact very well.

The biggest negative thought you can have when you break up with someone is to believe it’s because there’s something wrong with you, either because your boyfriend said it or because that’s what your brain is telling you.

Nobody says, “it isn’t you, it’s me,” and means it, so you shouldn’t, either.

Remember, it’s deep human nature to blame ourselves for crap that happens, be it a failed relationship or a failed baseball season. It’s your job, however, as your one and only chief protector, to put this assumption to a logical test. WAIT! There is more to read… read on »

First Responder

Posted by fxckfeelings on November 7, 2011

Frequent readers of this site know that, when confronted by a crazy person, (or asshole ™), one should react the same way they would if they were getting charged by a Grizzly bear; don’t run, stay calm, and play dead. This is hard advice to follow when that crazy person is someone close to you whom you care about and normally count on to be sane, but if you take their symptoms personally and react to those symptoms with strong emotions, they’ll come at you harder than they would some stranger on the street/in the woods. With some people, the illness consists of surges of fear, anger, and despair that cast them and you in leading roles in a suicide-bomber psychodrama; with others, the fear is more centered in thoughts than feelings, which means less drama and less spite, but more crazy ideas that can’t be reasoned away. Either way, the challenge is to remember the difference between the person you love and the craziness going on, make no sudden movements, and wait for the attack to pass.
Dr. Lastname

When my wife is feeling fine, she’s a reasonable, hard-working, dedicated woman who believes in helping others, but then she gets into this grim, obsessed mood and knocks herself out and then gets mad about how people don’t respect or appreciate her and she just doesn’t care any more. Yesterday, she told the boss she didn’t care if he fired her, because she didn’t care. If he fired her, it would damage a career she really cares about and, besides, we need the money, but when I tried to tell her she needed to shut up, she told me she didn’t care about our marriage or about living any longer, particularly if I didn’t support her. What do I do to stop her from hurting herself?

As we’ve said before, there are a lot of people out there who either don’t believe in mental illness, or do believe it exists but don’t really understand what it is. The former usually believe in Xenu, the latter are baffled by “Hoarders.”

Either way, the easiest way to explain mental illness to those types is to describe the disease as a demon, and yes, it’s a sad fact that people are quicker to understand satanic possession over an actual illness, but such is the biz. WAIT! There is more to read… read on »

Separation Anxiety

Posted by fxckfeelings on October 27, 2011

Intimate feelings should be a side-effect of relationships, not the other way around. When that intimacy becomes an end in itself, you forget, not just the other reasons why you’re spending time with someone, but the other things you need to be doing for yourself, your job, and the other people in your life. So the opposite of a strong attachment isn’t necessarily to break away, but to regain your sense of who you are and what you value the most, whether or not you’ve come down with a chronic partnership.
Dr. Lastname

Approximately three years ago I realized my psychiatrist preferred other patients and liked other patients more than me. That realization was incredibly devastating to me. I want to deal with this reality, however, my psychiatrist keeps denying this is the reality and will not openly admit he does indeed prefer other patients. Part of me that hopes (wishes) this truly is not the reality (him preferring other patients) and I TRY to believe that what he says is the reality! However, I simply can’t believe him. I have told him I can’t believe something that I think isn’t true. Even though he has helped me immensely in many ways, and I’m extremely attached to him, I have lost trust, confidence and faith in my psychiatrist over this issue. I think he is preventing me from having the opportunity to deal with reality by denying he prefers other patients. I have a need to hear him say, “Yes I do prefer other patients and your observations/perceptions about this have been accurate.” I think if I hear him say these words I could actually work to deal with it. Since he’s obviously not prepared to say this, MY GOAL is to somehow “detach” from him, stop therapy with him and move on and forget about it.

When you do therapy right, a shrink is like a thesis advisor, helping you explore the toughest issues in your life until your work is complete.

If you lean on therapy too much, however (sometimes through no choice of your own), a shrink is a crutch, which makes deciding when and how to end therapy much more complicated. Remove the cast too early, and you still can’t walk on your own. WAIT! There is more to read… read on »

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