Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Tuesday, June 12, 2012

Therapy decision

To my surprise I got another relatively easy session Monday.  I only cried once and that was only a few tears.  Important stuff was said, but there wasn't any major trauma.  Dr. Mind let me decide what I wanted to do, more or less.  Which meant that I had to admit that I WANT to learn to say those things with anger and that it felt good to hear him do it.  We have only 3 sessions before his vacation; I decided I was comfortable with that if we divide this into 2 stories, essentially abuser 1 and abuser 2.  I admitted that I am still not able to read it with feeling and that I think I need to listen to him doing so.  So he is going to do that Thursday and I am probably going to cry hard.  In fact I suspect I'll be crying a lot for the next couple weeks.  But if at the end I am able to say "that makes me angry" or even better SHOW I am angry if you don't know to watch my facial expression for subtle changes.

I did get him to give me some idea of where I am now.  I can't tell; I don't have the memory to compare to sick months and I am certainly not close to how I was in July 2011, even when one takes into account that I wasn't at my best then.  He doesn't know, obviously, what to really expect.  He thinks I'll feel better.  He does not think that I will get to do everything I want to do, meaning work.  Which is funny since the day I was praying and became aware that God was firmly saying I wasn't going to be able to be a clinician anymore I really have not felt any desire to do that anymore.  I know all too well how stressed it made me/I made me, because the only way for me to do that is to put everything into it.  And even working a few hours per week would not keep me from throwing myself into it too hard.  One of the things that I'm shocked by because I never paid attention before is that when I write those 11 years posts I remember thousands of patients over the years.  Many I remember a lot of details.  Often what I can't do it put a name to a face.  But all those years I was evaluating patients and treating them as well as supervising assistants and I had to know their patients too.  I often had 40 patients I was responsible for, and often that would mean a phone call question and so I needed to know quite a bit about my patients.  It adds up to a tremendous number of people.  I certainly don't remember everyone but I remember enormous quantities of them.  Often they were more on paper than in person which is why I don't remember faces, but I do remember more than I thought possible.  I even remember having once 2 "John Does" in 2 buildings.  Both were about the same age, both were in wheelchairs, both had Parkinson's disease.  I had to tell my assistants and mark both charts that if they called with a question about these men they had to be extremely specific because it was too much to keep straight.  You have to memorize like that because thanks to HIPPAA I wasn't able to keep my own chart that went with me that had basics on my caseload.  If I hadn't been able to do that my first year or two I wouldn't have made it since I was supervising at 6 locations and I think 4 assistants, or 5.  Anyway, I believe that a good therapist provides what is needed, even if that is extra time, socialization with treatment, or long periods of family education.  That was something I loved about my last job; that was the expectation, not something they got mad about.  If I spent 2 hours with someone I just had to make sure my other visits for the week were completed.  Another reason I know that I probably am out of my clinical skills that I think are vital is that writing this blog is hard and I don't have to remember technical terms (I get stuck on regular words frequently) and I don't have to recall huge quantities of information accurately, nor do I have to write so that Medicare can trace every thought, action, response, and analysis in my head during the hour or hour and a half I'm with the patient.  I've told Dr. Mind I don't think I'll go back.  He doesn't believe me.  But I'm very serious; I'll happily admit I was wrong in a few years if that's true, but somehow I think I'll be doing something else that is not medical.  So he's saying that I am not going to be able to work the way I want and truthfully I just want to find some simple job that isn't a long time commitment each week and I want to just make a few hundred dollars per month.  That will let me have some spare money instead of being on the verge of broke.  I'm hoping to maybe do some online teaching.  But even that is a while off because until I have Medicare I can't afford to work.  If I do then I'll lose my free medications.  And there's no way I will make enough to pay out of pocket for those.

Anyway, speaking of my mind wandering while writing, I seem to have landed far from where I started.  What I was trying to say is that he seems to thin I'm improving, which is true, but that it is still precarious and I am still working my way out of the mud.  My suicidal issues last week while handled well and were the first time in a long time that happened are still "significant".  I take that to mean I will get my meds back in about 20 years.  I'm actually glad we had the conversation simply for that.  Last week I was so agitated I think he was trying to just be a calming presence and so my scared admission that I'd managed to scare myself and needed to do more to manage suicide than I have in some time, and that the tylenol was not yet safe for me to have.  I don't know what changes suicidal behaviors into going away.  I keep asking questions and nobody wants to give me a full answer.  Understandable but frustrating.  And it's not like it's a good idea for me to start reading about it.

Anyway, my computer is being weird and I need to get all these meds away from me (just filled pill boxes).

More tomorrow when the anxiety is certain to increase.  I finally hit on one reason I have struggled so much with this.  Not using benzos to limit the response is fine.  But I have been treated for anxiety with benzos for so long and not getting overly anxious is so hard on me that I've been supposed to use benzos to prevent me from getting too upset.  So first we upset me, knowing that my body is fragile about this and that my body is not use to any stimulants, including simple caffeine and that we've noted before I seem to have an extra response to adrenaline because of the no caffeine thing, and then add in 11 years of consistent benzo use and it's not surprising my body is a bit sensitive.

Just got an email from my mom.  She just got home.  I'm glad I stayed until 6 and I'm very glad I put her sheets on her bed.  Having to do that now would be rotten after hours of travel with an active toddler.

Copyright 2006 www.masterofirony.blogspot.com

1 comment:

Michal Ann said...

VERY cogent post, Jen! I love hearing about your career. You did a fantastic job, I'm sure.

I'm relieved that you have peace about your current work status. It seems clear that you're working very well with Dr. Mind and are making progress with this new technique.

You mentioned that only subtle changes in your face indicate anger. My mom used to say "wipe that look off your face." I think my feelings show quite readily. When I was about 20, I sat with a hand-mirror and simply THOUGHT certain emotions, like love or anger. I was fascinated that very subtle expressions revealed my feelings, a slight flare of a nostril, a minor stiffening of the jaw, a change in my pupils or width of my eyes. Interesting exercise.

Sounds like you really helped your mom. I watched the video of Anne again this morning. So charming.

Love, Michal