Posted by fxckfeelings on August 30, 2010
Someday, people with psychiatric problems will get safe, effective treatment without having to make difficult choices, and Thanksgiving dinner will come in a pill, and jetpacks will be available cheaply for every man, woman and child. For now, the state of the art is much better than it’s ever been, but it’s still primitive, and it certainly isn’t inexpensive. Until the silver bullet for curing mental illness is found, patients have to make innumerable tough decisions for themselves, weighing everything from side effects to costs. Or they can just bide their time until their jetpacks arrive to make everything better.
–Dr. Lastname
I decided recently to listen to my friends and family and see a psychiatrist about my depression, but I don’t know whether I’ve made the wrong decision, or whether I’ve just chosen the wrong doctor. Basically, I decided to get help because I feel helpless, but my doctor wants me to do a lot of the work myself and doesn’t really help that much. It’s not just he wants me to ask myself a lot of questions (and answer them—if I had the answers, would I really be paying him?—but also deal with my insurance company and read up on the medication he suggests (he tells me about them, sure, but he says I owe it to myself to read up on them on my own, and that doesn’t make sense to me since he’s a doctor, knows everything about the pills, and he could just tell me himself). My goal is to figure out whether therapy is worth it, or whether I’m just getting help from the wrong source.
I hate to sound like your psychiatrist, but ask yourself what you have a right to expect from treatment, given what you know about its limits and your resources for paying for it.
If you want, you can spin things positively by saying that you’ve heard about good new treatments that can really help and that you’ve got great insurance that you pay a ton of money for. Of course, you’d probably be full of shit.
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Posted by fxckfeelings on July 19, 2010
Today’s post tackles a common, yet heretofore-not-submitted question about therapy, namely, how to find good help without breaking the bank in the process. While it’s a simple question, the answer isn’t, so we’ve dedicated the entire post to helping those who want help with their mental illness, but don’t have a dime to spare.
–Dr. Lastname
I’ve been depressed for some time and could use some treatment, but my insurance has a big deductible, so I’ll be paying everything out of my pocket, which isn’t deep. My goal is to get treated for the least amount of money.
I’ll assume from your tone that depression isn’t making you suicidal or putting you at immediate danger of losing your job and/or family because, if it is, you need to forget about the cost of treatment and value the cost of your survival.
If depression is putting your life/work/family in danger, get a psychiatric evaluation, in an emergency room if necessary. Do not pass go, do not collect $200 (no matter how much you need it).
If that isn’t the case, there’s lots you can do to reduce the amount of money you spend on treatment…if you’re willing to spend some time, do some research, and use your common sense.
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Posted by fxckfeelings on July 15, 2010
We Americans love our stuff, but the lust for said stuff can cause individuals to behave badly (see: the demonic/orgasmic audience reaction to Oprah’s car giveaway). Usually, when someone goes overboard with longing for/accumulation of stuff, it’s a family member who steps up to put the breaks on, but when anyone, family or no, gets between someone and their stuff, things can get uglier than anything Oprah could imagine. If family members put limits on their responsibilities, however, there are still ways for stuff-addicted loved ones to break the stuff cycle.
–Dr. Lastname
My parents have decided to retire, sell the big house I grew up in and move into a smaller condo closer to my sister and me. The move makes sense—my sister and I are adults with our own families—but it’s brought up a sort of taboo issue for my parents, which is my mother’s attachment to stuff. She’s not a hoarder, but if my dad wasn’t around to put his foot down, I sometimes worry it could be, because my mother has trouble throwing anything away. She says that moving all the time as a child has given her a different appreciation of objects, and that it’s better to regret having too much stuff than to miss something you threw away and can’t get back. Problem is, there’s no room for this stuff in the new condo, they won’t have the budget for storage, and my sister and I aren’t able to put all of her old work files, souvenir spoons, and elementary school textbooks (seriously) in our basements. What I’m afraid will happen is that my father, who has always taken responsibility for managing their money, will try to get my mother to agree that they can’t afford to move and store her stuff when they move, she’ll keep complaining, and he’ll get nasty. How can we get my mother to learn to let go?
I know you and your father want to make your mother happy and have harmony, but it looks like she’s not eager to adapt a sparse, Zen lifestyle.
The problem is, trying to make someone happy when it’s just not possible usually causes more unhappiness. False hope is dangerous, no good deed goes unpunished, and stuff happens (sometimes in great quantities).
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Posted by fxckfeelings on July 1, 2010
When a relationship fails, you can either accept that you can’t really accept them, or accept that, no matter what you do, they can’t accept you. After all that acceptance, you think it would be easy to not let that person aggravate you, but the temptation to speak your mind will stick around as long as the other person does. Your last bit of acceptance is that you need to keep your mouth shut until you make up your own mind about how to go forward, then accept your decision and politely speak your peace. No exceptions.
–Dr. Lastname
My husband quit drinking four years ago. I supported his decision to get sober, but I’m disappointed with the result. He used to be a fun goofball, but now he’s a dull grump, and I don’t like his company (and he doesn’t seem to like mine, either). We’ve started to go our separate ways but he’s not interested in talking about it. My goal is to restore the chemistry of our marriage and the good parts of his character without driving him back to drink.
Having fun with your husband is not your top measure of a partner. If you want fun, go out and have a drink.
Acceptance, rather than fun or passion, is the most essential requirement for a long-term relationship, and now you know it. Oh, first marriages have so much to teach you.
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Posted by fxckfeelings on June 21, 2010
Much is made in both the personal and professional worlds about the value of communication. Speaking your mind to your loved ones isn’t necessarily the best way to work out family problems, and speaking easily at networking isn’t the best or only way to get ahead at work. Abstaining from communication is often the best choice, because on this site, we value shutting the fuck up.
–Dr. Lastname
I’m not crazy about my grown-up step-kids, but they’re not bad people, they just tend to be disappointed in me for some reason or other and then complain to my wife, who then tries to smooth out our relationship by telling me about their issues and urging me to talk with them, maybe with a therapist. She’s very nice about it, but every time I try to speak up about what actually happened or clear up a misunderstanding, I sound like I’m calling the kids unrealistic and self-centered (which they are) and it makes things worse. My wife doesn’t blame anyone, but it distresses her that I and her kids don’t get along better and I hate to see her unhappy. So how can I improve things with my step-kids when we really don’t see eye to eye?
Your poor step-headaches. They’re unhappy and assume that mom should play diplomat.
Instead of justifying their complaints with “I’m just being honest” they should really say, “I’m just being an enormous jerk.”
This is a good example of honest sharing by people who are honestly unhappy with you but haven’t given much thought to whether there’s anything you can do about it (other than by being someone else). They haven’t even considered whether making them feel better is your responsibility.
Unlike them, don’t assume it’s your responsibility to return the favor with an equal amount of honest sharing—not unless you want to give your wife a headache and enjoy a long, dirty bout of Greco-Roman mud wrestling.
If, as you say, the step-sort-of-adults want you to be someone you aren’t, and it isn’t a matter of your bad behavior, then you can’t make them happy or reach a better understanding by improving communications. If only you were behaving badly, you could make things better by improving, but you’re not, so you can’t, and you’re fucked.
Whether her kids complain to you or her, your job isn’t to work things out (unless you believe it’s really possible); it’s to live up to your own standards for being a respectful step-dad and keeping conflict to a minimum.
If you can’t make things right for your wife, you can respect her wish to improve family relationships while minimizing your exposure to criticism. The technique is simple, but requires you to shut up about your real feelings and give up on the idea that your wife can understand your predicament.
So let the step-kids complain all they want. If these were actually your kids, you would’ve imparted an important lesson to them early on: when it comes to sharing feelings, honesty is not always the best policy.
STATEMENT:
Here’s the formula. “I know your kids are not entirely happy with me and I’ve given careful thought to the problems they’ve shared with you. I intend to let them know I’ve heard their concerns and, to the degree that I can, I’ll make things better. If, as I suspect, some of their distress arises from differences in our personalities, we can’t expect it to go away or be resolved by discussion, but we can certainly learn to accept one another, avoid negative interactions, and make the best of your wonderful relationship with your children, which I am determined to support in any way possible.”
I know I’m good at what I do (let’s just call it finance), but I get held back because I’m terrible at networking and socializing in general. So much of my business is about going out and making connections, and I find talking to strangers, especially ones I’d like to work with or for, to be the most painful and awkward experience in the world. I get incredibly self-conscious, feel like I’m talking too much or too little, get distracted and antsy, and just want to go home or back to work. I also don’t drink anymore—I was never a drunk really, but I thought it held me back in college—so that makes my awkwardness even worse. If I don’t learn how to shmooze, however, I’m never going to get ahead. My goal is to get over my awkwardness.
Don’t hate your own awkwardness. People who have a heightened sense of shame about their social behavior become more awkward, which makes them more ashamed, and you’re spiraling into social phobia. It’s like stuttering; the more you think about it, the worse it gets.
It’s true that, when you’re in school, social awkwardness seems to condemn you to being a nerd loser who never gets laid. Fortunately, nerds have their revenge, and they get it, not by becoming socially gifted, but by entering a world that also rewards skills, reliability, and experience, and this boosts their confidence as they get older.
While networking is a big part of the business world (as you know, most business school tuition should include a bar tab), it’s not the only way to get ahead. You could get your job to pay for further business courses, or try to talk to/impress your boss one-on-one in a small talk, anecdote-free environment.
If small talk is necessary, you don’t have to be talented to learn how to do it; you just need to be humble enough to stumble through exercises that others could do easily. Again, accepting your disability makes it easier to manage it.
In the meantime, when you do find yourself at networking functions, don’t get tied up trying to be the cool guy you aren’t. Try for more one-on-one conversations, sip your Diet Coke, and enjoy a night out with your awkward self.
STATEMENT:
Here’s a statement to chart your course of self-improvement. “I value my achievements and values but recognize that I could use better people skills. There’s no point in criticizing myself for being ungifted in this area. I’m proud that I’m willing to work on my weakness if and when I think it’s necessary.”
Posted by fxckfeelings on June 10, 2010
Being a big dreamer is a mixed bag; sure, some people aim high and soar high, but many of us are too distracted to ever take off, or attempt to take off just to crash-land. The sad fact is, not all of us are meant to take flight, but there’s no shame in making the best of what you’ve got here on the ground.
–Dr. Lastname
On the plus side, I’m a pretty ambitious person; I have lots of dreams for different careers, adventures, academic pursuits, you name it. The problem is that I have problem with following through. Sure, it’s not easy to chase your dreams when you have a young kid (whom you’re raising alone), but I was like this before I had a baby, and now that I do have a child, I feel more compelled than ever to do something with my life and be a good example. I want to follow through with getting my masters in anything and making a good living, showing my kid that you can do anything you want. My goal is to finally follow through.
No matter how much you wish you could follow through more, you gotta ask yourself whether you’re a follow-through kind of person or not.
Some people just aren’t, so a congratulations/you’re screwed might be in order.
Maybe you believe the popular myth that everyone can be a follow-through person by just concentrating harder on following through, making an inspiration board and buying a dream-catcher something. Don’t. Not very inspiring, but the truth’s the truth.
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Posted by fxckfeelings on May 20, 2010
Writing looks easy; after all all you need is pen, paper, and maybe a table at Starbucks. Then there’s inspiration and an interesting topic. Plus a fully functioning brain, a supportive audience, and, of course, shitloads of luck. Oh, and a trust fund. It’s no wonder then that writing and depression dance a delicate pas de deux with one another, and that torturing yourself for not “succeeding” as a creative mind is a pretty useless, uncreative punishment.
–Dr. Lastname
I’m an older woman with two advanced degrees in creative writing (one from Iowa, la di da). My career, on the other hand, hasn’t risen beyond doing commercial writing, be it technical or ad copy. I get published in small journals here and there, but after my first novel got a handful of rejections, my agent dropped me, and I haven’t been able to finish another novel in order to get a new agent and sell the first. My limited number of published pieces has also made it hard to get a teaching job, even though I got degree number 2 specifically to enter academia. So now I’m stuck working in advertising, and while it’s a good steady job that pays well, it still kills me a bit inside. Nevermind that I’ve absolutely struggled with depression my whole life, and while I take a handful of medications to control it, it’s just an added level of difficulty. Nonetheless, with my illness under control but my dream still very much out of control, my goal is to make this job work so I can settle and maybe even be happy.
You could say writing is a stupid career choice, given the unlikelihood of making money, and that academia isn’t much better, given the current job market. It’s as stupid as counting on a career in the NBA because you’re good at basketball.
The truth is, a large part of being a writer isn’t a matter of choice; it’s who you are, and trying to find a life that fits. It’s not so much a bad choice as a bum calling, with inspiration necessary but never promising to come when called.
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Posted by fxckfeelings on May 10, 2010
Everyone wants a feel-good, look-good family, but most of us relate to the more familiar feel-bad families on TV (which look good, and feel better by the end of the show). Still, there’s a difference between your average dysfunctional family unit and your genetic/step-parent clusterfuck. When your family situation is in truly bad shape, you’ve got to be tough enough to accept what you’ve got, then focus on making the best of those impossible relationships, outsider opinions be damned. Unlike those TV families, real problems don’t get solved after a half-hour, not everybody’s pretty, and you have to ignore your ratings with the audience.
–Dr. Lastname
I need to stay married because, while I work a pretty demanding job, my wife stays at home and watches our two kids, whom she adores. The problems are, however, (and there are many): she doesn’t work because of a migraine disorder that’s so debilitating that she’s on disability, and she takes too many non-prescription pain pills for those headaches, and, while they don’t make her a bad parent (I know the kids are safe), they often make her, in your words, a really needy, grumpy asshole and an impossible woman to be married to. I never know when she’s going to kick me out of the bedroom, scream at me in front of friends, or nod off after dinner. Needless to say, she won’t try marriage counseling or cutting back on the pills and thinks I’m bullying her if I suggest we have a problem. I can’t leave her, because it’d break the kids’ hearts, plus, like I said, she provides childcare, which is not something I could afford on my salary, and if I lost custody of the kids, I’d be in a worse hell than I am now. I know I can’t leave, but I don’t think I can live like this much longer. My goal is to find a better way to survive.
You’ve got good marital reasons for staying vs. leaving (the kids, the kids, the kids, and money, but also, the kids). There’s no escaping the fact, however, that her headache is infectious, and you’ve got it, too.
You’ve obviously built up a good, solid tolerance for living with your wife’s problems without fighting all the time, and your values and perspective are great. Which is why you probably already know that your goal is impossible.
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Posted by fxckfeelings on May 3, 2010
Poor, well-meaning, dedicated therapists and the patients who love/destroy them. After all, it’s enticing to let someone persuade you that you’re their guardian angel and the only therapist that can help. It’s a fun ride for everyone, at least until you realize that you’re responsible for something you don’t control, and they’re even less responsible than before for dealing with reality as it is. While this is a shrink-based site, we are the first to admit that therapists are not perfect people, especially when they get in in their heads that they actually are.
–Dr. Lastname
I have a 30-year-old patient whom I’ve been seeing in weekly psychotherapy for 6 months and he had a terrible history of sexual and physical abuse and years in state care. Amazingly, despite all his trauma and several prior failed treatments, he settled into a trusting relationship with me. He tells me I’m the first person he’s bonded with, and he’s been able to stop using cocaine, and, for the first time, sees some hope for himself. The problem is that he just got a new job, and I’m not covered by his new insurance plan. He wrote me a letter telling me how much he feels his recovery depends on continuing the treatment we’ve started and I feel professionally obliged to put his welfare ahead of my financial needs, but I’d like to get paid. My goal is to do right by my patient, and not trigger the feelings of abandonment that underlie much of his negative behavior, but I’m not sure how long I can afford to see him for nothing.
There are many therapists who believe the best thing you can do for a troubled patient like this is to “be there,” providing the steady acceptance and secure relationship that they need for healing. I’m not one of them.
The sad fact is that the healing power of currently available treatments is vastly over-rated and a good example of false hope and the harm it can cause.
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Posted by fxckfeelings on April 19, 2010
Many of us have nasty sides that can do lots of damage if they get out. In psychiatry, we call them “demons” or, to be less judgmental/more technical, “inner assholes.” They’re helpful if we’re cornered by Moonies and need to escape, and they certainly make us less boring. On the other hand, they’re dangerous, particularly since it feels so good to let them fly. Unfortunately, anything that flies has to land, usually on those you actually care about.
–Dr. Lastname
When my husband and I first got married (and married young, over 20 years ago), his job was physically intensive, but he enjoyed it and it paid well. Not too long ago he got injured, and it was bad enough that he can’t go back to that line of work, so he’s collected disability and taken over the childcare, which he does well. I found a good job, so we’re making enough money, but I don’t like working and miss spending time with the kids, so I push him to find a desk-job, but he obviously hates that kind of work and can’t seem to find anything that suits him. The whole thing is so unfair, I can’t help but dig into him sometimes, in a way that I know, even as I’m talking to him, is just nasty and inappropriate. It’s really putting our marriage through the ringer, but as hard as I try, I can’t control my temper. My goal is to get through this problem without getting divorced.
You clearly value your partnership with your husband…even if you hate your new role as breadwinner so much that it awakens the asshole within.
It leaves you with a big lump of anger and disappointment that you can’t get over and won’t go away. The expression might be “like it or lump it,” but sometimes, you have to do both.
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