Day 3, with even less analysis what I've learned... ^^;
Okay, I need to start writing this shit up before I get too tired and either I can't think or I just go to bed.
I'll start with the day... Umm... Apparently I didn't hear the 7 am announcement and woke up at 7:20-ish, hurriedly went to the nurse's office to get my levothyroxine, went back to bed for a half hour (during which time I really didn't get any sleep), got up when my alarm went off 30 minutes later to take my Adderall and go get breakfast. The first group session was about the definition of empowerment. We really didn't get terribly far with that, but they did give us a handout which should be pretty interesting to read through when I have a chance. There are two parts from the first quarter of the article (which is about as far as I got) that I found interesting, the first from a social policy perspective, and the second from a linguistic/language learner's perspective:
the word has become common political rhetoric, with a flexibility of meaning so broad that it seems to be in danger of losing any inherent meaning at all. Some conservative U.S. politicians have promoted welfare "reform," for example, by claiming that cutting off benefits will "empower" recipients (who would thus, presumably, become self-sufficient)!
[...]
When I have spoken abroad, I find that the word is usually not translated; the translator merely repeats "empowerment," in English, perhaps hoping that the listeners will be able to draw some meaning from the context.
Soon after that we had our second group, which was pretty much a re-hash of "Catch it, Check it, Change it" from yesterday and trying to think of more examples from our lives where we could implement this strategy. Like, one of the examples I brought up is how when someone talks to me in a harsh tone of voice, I think that it must mean that they're angry at or annoyed by me and dislike me, I feel ashamed and hurt, and I immediately retreat/withdraw and don't listen or stand up for myself. In checking it I could consider things like what my Dad pointed out that they're probably too involved in their own lives to have that much emotional energy to spend on me (though this is depressing in its own right to some extent). I could then change it by substituting possibilities like that they just mis-regulated their voice, or that they've had a bad day and are feeling particularly grumpy (I know when I've had a particularly bad day at work inside I want to punch people just for breathing funny). Of course, one of the tricks in this (other than the obvious element of fighting my own self-esteem and bias) is finding an alternative, more positive possibility that is actually more probable than my negative assumptions. It's much more likely that I somehow angered or annoyed them than that it was a voice mis-regulation. At the same time, it's possible that it really doesn't matter if my negative assumptions are more probable - perhaps if nothing else reframing (?) my thoughts will serve as some sort of coping placebo and/or generally contribute towards improving my mental health.
In a brief bit of whiny intellectual elitism, one of the kind of frustrating things during this group, though, was some of the situations put forth by the other residents were just... Totally missing the point. Like, one person offered a negative thought of "It's hot outside." Umm... How at all can one apply CCC to that? And how is that a maladaptive thought? And in another group we were talking about dual diagnosis (the condition of suffering from a mental illness and a comorbid substance abuse problem) and many of the other residents' comments just struck me as... absurdly simplistic or sometimes nonsensical, both from the "drugs are bad" and "drugs are just fine" sides, and they often had a definite lack of nuance. It almost made me wish that they had a facility like this that specialized in patients and staff with greater intellectual capabilities so that group discussions could be more productive.
Lunch was... some kind of spicy meat, steamed broccoli and cauliflower, mashed potatoes, and... I think that was it? I had an apple too. At the end of lunch there were two women I was talking to, one (A) on the skinny side and one (B) on the heavy side. We were talking about cravings which lead to pregnancy, and at one point B seemed to mention something like that she was pregnant, but I really didn't catch what she said. Now, at this point B is on hold with T-Mobile customer service, and soon A asks B "So, what's it like being pregnant?" (although she said she said "How far along are you?" - doesn't really matter), and I said something like "Oh wow, I didn't know you were pregnant!" B suddenly stood up and said "Fuck you guys! I'm just fat!" and stormed off. I tried to chase after her to apologize, but she was distracted by her phone call and probably too mad to deal with me. This left me feeling really shitty, thinking that she would think I would be so horribly insensitive, and found a corner to sit down and just hold my head in. Soon one of the residents (C) who's sort of a "mother with an attitude" type (she left this morning, which was sad - she's definitely been supportive of me, even if I didn't always agree with her, such as on the "can't" issue) came over and asked if I was okay. I started explaining to her what had happened, and as she tried to comfort me we heard crying nearby, and it turned out it was A one flight up. I finished explaining to C what had happened, and then A also pointed out that she was vegan and hadn't had enough food to eat (the vegan options are pretty much limited to veggies and fruit) and that was making her miserable, and that at one point she had been 300 pounds and now she can't have kids, so she knew what it was like. At that point I left C to comfort A and went to tell a staff member what was going on. So yeah, stressful. Honestly, there was another event that came up earlier in the day with my roommate (long story short, she didn't feel she was ready to leave and had only started communicating that to the staff, but one of the staff members allegedly rudely scolded her for not having her stuff ready for when she was going to be picked up soon), and it kind of gave me the sense that life in a crisis residence is filled with residents having mini-crises or having to nurse others through their mini-crises. Never a dull moment. :-P
During my first 1-on-1 session where we started tackling the issues of my acute anxiety episodes such as being unable to read e-mails/IMs or listen to voice mails, being unable to face my managers if I'm extremely late to work, or the relatively rare times when I get extreme social anxiety (such as on the first night of the Kansas trip), and after elaborating on my thought processes and the... pathway?... of the anxiety episodes, she ended up feeling that in some ways my anxiety episodes are like PTSD episodes, comparing it to trauma (I think she meant my body feels like it's facing a trauma, in the same way someone having a PTSD episode feels like they're facing a trauma). Anyway, in addition to reaffirming that DBT would be extremely helpful with my anxiety issues (further evidence that DBT needs to be an extremely high priority), she suggested grounding techniques, which are commonly used to help patients with PTSD. I'll write about it more in my notes write-up, but the basic idea is to distract myself from the anxiety. There was also some discussion that reaffirmed my PDD-NOS diagnosis, and actually gave me a much better understanding of possible presentations of autism-spectrum disorders and how many of my "idiosyncracies" fit into the autism spectrum much better than I had previously thought.
After that I went up to my room to try to nap, but really I just kept making voice memos and being distracted by alerts on my phone. Eventually I got a page to come downstairs and my dad had arrived, so we ate the Popeye's food (with extra biscuits!) he brought on the front lawn and discussed everything that had been going on and what I'd been discussing with the staff here. I also asked if he'd be willing to take me to Autism Shop which is located in Minnetonka (30 minute away from my house by car) to buy a chewie and try out a pressure vest to see if that's worth buying too. (Now that I look at the website it looks like they only sell weighted blankets and not pressure vests, so I might want to look elsewhere for that.) He also brought the Pepsi and conditioner that I asked him to bring, as well as my copy of volume 1 of the Math Girls manga that I backed on Kickstarter and finally arrived. I had hoped he'd have an opportunity to have a brief meeting with my therapist but by the time we finished eating all the staff were in 1-on-1s and there was an interesting-sounding group going on, so he headed off.
The last group was really fascinating - someone who seemed really knowledgeable was explaining the basic mechanisms behind various mental illnesses, such as anxiety and depression (including panic attacks), schizophrenia, and PTSD. I'm pretty sad that I missed the first part of it (though it was worth the time spent with Dad), but I did ask him to explain panic attacks again after it was over.
Just got a reply to an e-mail I sent to people who have lived with me from Roger, and I'm too anxious to open it. I haven't really tried the grounding techniques, but honestly I'd rather just finish this up and go to bed and try to face it in the morning. Now back to your regularly-scheduled brain dump.
I then had one last 1-on-1 session where we started to look at my problems with follow-through, including lethargy and difficulty getting up in the morning. That... Was a long conversation. Our meeting actually went over time and we were still working on unraveling the threads of what's going on with that, weren't really able to look at root causes, and didn't even touch looking at potential coping mechanisms. I sent out an e-mail to almost all of the people I've lived with soliciting their observations regarding the patterns and factors they've recognized in me with regards to this issue, and already got replies from aikachi, akaneko, ellie_desu, and Roger (whose e-mail I haven't read - see above). I tried asking Mike, but I think he was completely misinterpreting what I was asking, as he was just giving examples, both general and concrete, of my fishiness.
The rest of my night was pretty much winding down. "Met" my new roommate (she's been here since I arrived but they changed her room), and have been working on this entry (and other things on the computer) since 10:30 pm - over 4 hours ago. ><; I really wanted to spend some time reflecting on the messages from my individual and group therapy sessions, but once again I prioritize the log of all the things I did (since I'm more likely to forget about that, especially since I take notes during all of my therapy sessions), and once again I really leave myself with no time to do so.
However, I did ask my therapist from my second 1-on-1 to copy her notes from our session since I forgot to bring a notebook to that one, and instead she typed a more summarized one for me, which I'm going to copy (with a few bits of paraphrase) here:
***
PSYCHIATRY GOAL
- writing down questions for the meeting with [the psychiatric nurse] on Friday
- Resources for psychiatry/walk-in-clinics
- Dealing with waiting lists/insurance
NOTES FROM DISCUSSION FOR FOLLOWING THROUGH
Multi-variable discussion (looking at possible undercurrents)
- physical: hypothyroidism + change in medication [missed doses? better meds?]
- emotional: anxiety (freezing up - the third stress response along with fight and flight)
- cognitive: all-or-nothing thinking
- motivation
- "go with the flow" [While my ability to "go with the flow" can be beneficial, it also makes me more accepting of my mistakes and their consequences.]
- definition of responsibility: fulfilling obligation and/or accepting responsibility?
- energy drain of negativity towards the self versus energy uplift of positivity towards the self
- discomfort from sleep deprivation [Am I somehow "spoiled" by consistently getting enough sleep in comparison to those who only get 7 hours a night and thus less tolerant of it that discomfort than others?]
- perception of how much energy something will take (versus actual experience?) [Yes.]
- common thought: Do I want to stress myself with the exertion of trying to make it on time?
***
One interesting possibility that akaneko suggested as one of the root causes of difficulty in my sleep patterns is delayed sleep-phase disorder (DSPD), which seems to fit me. Also, I think Mike may have irregular sleep-wake rhythm.
You know, it strikes me that I should have separated my "daily log" entries from the "ruminations specific to my mental health", perhaps each with its own tag. It's kind of late now, but I think for any future entries I make while here I'm going to do that. I also was thinking that apart from any ruminations that come up in therapy or daily life, I should also keep a text file or something of any major realizations I come to so I can frequently refer to it and remind myself of them rather than forget about them and have to realize them all over again. In any case, it's now 3 am and I have to be up by 8:30 at the very latest, so I'm gonna call this entry quits and haul my exhausted ass to bed. But before that: Eminem - stop trying to sing, especially the high notes...
I'll start with the day... Umm... Apparently I didn't hear the 7 am announcement and woke up at 7:20-ish, hurriedly went to the nurse's office to get my levothyroxine, went back to bed for a half hour (during which time I really didn't get any sleep), got up when my alarm went off 30 minutes later to take my Adderall and go get breakfast. The first group session was about the definition of empowerment. We really didn't get terribly far with that, but they did give us a handout which should be pretty interesting to read through when I have a chance. There are two parts from the first quarter of the article (which is about as far as I got) that I found interesting, the first from a social policy perspective, and the second from a linguistic/language learner's perspective:
the word has become common political rhetoric, with a flexibility of meaning so broad that it seems to be in danger of losing any inherent meaning at all. Some conservative U.S. politicians have promoted welfare "reform," for example, by claiming that cutting off benefits will "empower" recipients (who would thus, presumably, become self-sufficient)!
[...]
When I have spoken abroad, I find that the word is usually not translated; the translator merely repeats "empowerment," in English, perhaps hoping that the listeners will be able to draw some meaning from the context.
Soon after that we had our second group, which was pretty much a re-hash of "Catch it, Check it, Change it" from yesterday and trying to think of more examples from our lives where we could implement this strategy. Like, one of the examples I brought up is how when someone talks to me in a harsh tone of voice, I think that it must mean that they're angry at or annoyed by me and dislike me, I feel ashamed and hurt, and I immediately retreat/withdraw and don't listen or stand up for myself. In checking it I could consider things like what my Dad pointed out that they're probably too involved in their own lives to have that much emotional energy to spend on me (though this is depressing in its own right to some extent). I could then change it by substituting possibilities like that they just mis-regulated their voice, or that they've had a bad day and are feeling particularly grumpy (I know when I've had a particularly bad day at work inside I want to punch people just for breathing funny). Of course, one of the tricks in this (other than the obvious element of fighting my own self-esteem and bias) is finding an alternative, more positive possibility that is actually more probable than my negative assumptions. It's much more likely that I somehow angered or annoyed them than that it was a voice mis-regulation. At the same time, it's possible that it really doesn't matter if my negative assumptions are more probable - perhaps if nothing else reframing (?) my thoughts will serve as some sort of coping placebo and/or generally contribute towards improving my mental health.
In a brief bit of whiny intellectual elitism, one of the kind of frustrating things during this group, though, was some of the situations put forth by the other residents were just... Totally missing the point. Like, one person offered a negative thought of "It's hot outside." Umm... How at all can one apply CCC to that? And how is that a maladaptive thought? And in another group we were talking about dual diagnosis (the condition of suffering from a mental illness and a comorbid substance abuse problem) and many of the other residents' comments just struck me as... absurdly simplistic or sometimes nonsensical, both from the "drugs are bad" and "drugs are just fine" sides, and they often had a definite lack of nuance. It almost made me wish that they had a facility like this that specialized in patients and staff with greater intellectual capabilities so that group discussions could be more productive.
Lunch was... some kind of spicy meat, steamed broccoli and cauliflower, mashed potatoes, and... I think that was it? I had an apple too. At the end of lunch there were two women I was talking to, one (A) on the skinny side and one (B) on the heavy side. We were talking about cravings which lead to pregnancy, and at one point B seemed to mention something like that she was pregnant, but I really didn't catch what she said. Now, at this point B is on hold with T-Mobile customer service, and soon A asks B "So, what's it like being pregnant?" (although she said she said "How far along are you?" - doesn't really matter), and I said something like "Oh wow, I didn't know you were pregnant!" B suddenly stood up and said "Fuck you guys! I'm just fat!" and stormed off. I tried to chase after her to apologize, but she was distracted by her phone call and probably too mad to deal with me. This left me feeling really shitty, thinking that she would think I would be so horribly insensitive, and found a corner to sit down and just hold my head in. Soon one of the residents (C) who's sort of a "mother with an attitude" type (she left this morning, which was sad - she's definitely been supportive of me, even if I didn't always agree with her, such as on the "can't" issue) came over and asked if I was okay. I started explaining to her what had happened, and as she tried to comfort me we heard crying nearby, and it turned out it was A one flight up. I finished explaining to C what had happened, and then A also pointed out that she was vegan and hadn't had enough food to eat (the vegan options are pretty much limited to veggies and fruit) and that was making her miserable, and that at one point she had been 300 pounds and now she can't have kids, so she knew what it was like. At that point I left C to comfort A and went to tell a staff member what was going on. So yeah, stressful. Honestly, there was another event that came up earlier in the day with my roommate (long story short, she didn't feel she was ready to leave and had only started communicating that to the staff, but one of the staff members allegedly rudely scolded her for not having her stuff ready for when she was going to be picked up soon), and it kind of gave me the sense that life in a crisis residence is filled with residents having mini-crises or having to nurse others through their mini-crises. Never a dull moment. :-P
During my first 1-on-1 session where we started tackling the issues of my acute anxiety episodes such as being unable to read e-mails/IMs or listen to voice mails, being unable to face my managers if I'm extremely late to work, or the relatively rare times when I get extreme social anxiety (such as on the first night of the Kansas trip), and after elaborating on my thought processes and the... pathway?... of the anxiety episodes, she ended up feeling that in some ways my anxiety episodes are like PTSD episodes, comparing it to trauma (I think she meant my body feels like it's facing a trauma, in the same way someone having a PTSD episode feels like they're facing a trauma). Anyway, in addition to reaffirming that DBT would be extremely helpful with my anxiety issues (further evidence that DBT needs to be an extremely high priority), she suggested grounding techniques, which are commonly used to help patients with PTSD. I'll write about it more in my notes write-up, but the basic idea is to distract myself from the anxiety. There was also some discussion that reaffirmed my PDD-NOS diagnosis, and actually gave me a much better understanding of possible presentations of autism-spectrum disorders and how many of my "idiosyncracies" fit into the autism spectrum much better than I had previously thought.
After that I went up to my room to try to nap, but really I just kept making voice memos and being distracted by alerts on my phone. Eventually I got a page to come downstairs and my dad had arrived, so we ate the Popeye's food (with extra biscuits!) he brought on the front lawn and discussed everything that had been going on and what I'd been discussing with the staff here. I also asked if he'd be willing to take me to Autism Shop which is located in Minnetonka (30 minute away from my house by car) to buy a chewie and try out a pressure vest to see if that's worth buying too. (Now that I look at the website it looks like they only sell weighted blankets and not pressure vests, so I might want to look elsewhere for that.) He also brought the Pepsi and conditioner that I asked him to bring, as well as my copy of volume 1 of the Math Girls manga that I backed on Kickstarter and finally arrived. I had hoped he'd have an opportunity to have a brief meeting with my therapist but by the time we finished eating all the staff were in 1-on-1s and there was an interesting-sounding group going on, so he headed off.
The last group was really fascinating - someone who seemed really knowledgeable was explaining the basic mechanisms behind various mental illnesses, such as anxiety and depression (including panic attacks), schizophrenia, and PTSD. I'm pretty sad that I missed the first part of it (though it was worth the time spent with Dad), but I did ask him to explain panic attacks again after it was over.
Just got a reply to an e-mail I sent to people who have lived with me from Roger, and I'm too anxious to open it. I haven't really tried the grounding techniques, but honestly I'd rather just finish this up and go to bed and try to face it in the morning. Now back to your regularly-scheduled brain dump.
I then had one last 1-on-1 session where we started to look at my problems with follow-through, including lethargy and difficulty getting up in the morning. That... Was a long conversation. Our meeting actually went over time and we were still working on unraveling the threads of what's going on with that, weren't really able to look at root causes, and didn't even touch looking at potential coping mechanisms. I sent out an e-mail to almost all of the people I've lived with soliciting their observations regarding the patterns and factors they've recognized in me with regards to this issue, and already got replies from aikachi, akaneko, ellie_desu, and Roger (whose e-mail I haven't read - see above). I tried asking Mike, but I think he was completely misinterpreting what I was asking, as he was just giving examples, both general and concrete, of my fishiness.
The rest of my night was pretty much winding down. "Met" my new roommate (she's been here since I arrived but they changed her room), and have been working on this entry (and other things on the computer) since 10:30 pm - over 4 hours ago. ><; I really wanted to spend some time reflecting on the messages from my individual and group therapy sessions, but once again I prioritize the log of all the things I did (since I'm more likely to forget about that, especially since I take notes during all of my therapy sessions), and once again I really leave myself with no time to do so.
However, I did ask my therapist from my second 1-on-1 to copy her notes from our session since I forgot to bring a notebook to that one, and instead she typed a more summarized one for me, which I'm going to copy (with a few bits of paraphrase) here:
***
PSYCHIATRY GOAL
- writing down questions for the meeting with [the psychiatric nurse] on Friday
- Resources for psychiatry/walk-in-clinics
- Dealing with waiting lists/insurance
NOTES FROM DISCUSSION FOR FOLLOWING THROUGH
Multi-variable discussion (looking at possible undercurrents)
- physical: hypothyroidism + change in medication [missed doses? better meds?]
- emotional: anxiety (freezing up - the third stress response along with fight and flight)
- cognitive: all-or-nothing thinking
- motivation
- "go with the flow" [While my ability to "go with the flow" can be beneficial, it also makes me more accepting of my mistakes and their consequences.]
- definition of responsibility: fulfilling obligation and/or accepting responsibility?
- energy drain of negativity towards the self versus energy uplift of positivity towards the self
- discomfort from sleep deprivation [Am I somehow "spoiled" by consistently getting enough sleep in comparison to those who only get 7 hours a night and thus less tolerant of it that discomfort than others?]
- perception of how much energy something will take (versus actual experience?) [Yes.]
- common thought: Do I want to stress myself with the exertion of trying to make it on time?
***
One interesting possibility that akaneko suggested as one of the root causes of difficulty in my sleep patterns is delayed sleep-phase disorder (DSPD), which seems to fit me. Also, I think Mike may have irregular sleep-wake rhythm.
You know, it strikes me that I should have separated my "daily log" entries from the "ruminations specific to my mental health", perhaps each with its own tag. It's kind of late now, but I think for any future entries I make while here I'm going to do that. I also was thinking that apart from any ruminations that come up in therapy or daily life, I should also keep a text file or something of any major realizations I come to so I can frequently refer to it and remind myself of them rather than forget about them and have to realize them all over again. In any case, it's now 3 am and I have to be up by 8:30 at the very latest, so I'm gonna call this entry quits and haul my exhausted ass to bed. But before that: Eminem - stop trying to sing, especially the high notes...