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Guest Posts, Therapy

I Can’t Remember His Name

June 1, 2022
chart

Something made me think of him; for days now, it has been bothering me: I can’t remember his name. I can recall many of our conversations, the gentle character of his voice, and the resignation in his eyes, but not his name. I’ve wracked my brain. I saw him almost twenty years ago for almost a year in twice weekly sessions. He was a former prisoner who had served stints for everything from petty larceny to armed robbery. I was a young intern working in a city hospital.

In prison, they strip you of everything: first your name, then your identity, and finally your humanity. You become a number in a brutal system. Except for him, this process had started way before he had landed in prison at 19. And now I, who cared for him deeply, seemed to have erased him too.

Mandated by the court to enter therapy, his chart had a red notation at the top I didn’t recognize: “Violence/aggression risk.” His diagnosis was “Schizoaffective disorder,” and the chart noted he had a long-term substance abuse problem. Reading on, I saw he had gotten out of prison two weeks earlier.

Though the notation gave me pause, I was afraid to say anything. It was the second month of my internship, the training year before getting my doctorate. I was at the very bottom of the psychiatry clinic hierarchy, and to put much faith in my own misgivings, not to mention voicing them, was more than I could risk. The first time we met, I made sure it was during daylight hours.

Eyes downcast, his large frame filled the doorway of my closet-like office. He had rich, dark skin, heavily pockmarked cheeks, and sat with a restrained intensity. I clutched my hands tightly while he began speaking so softly I had to lean closer to hear him, our knees almost touching.

“Do you have any trauma in your past?” I asked. Remaining silent, he cast his eyes around the office landing on an old globe tucked onto one of the upper shelves.

“What is that?” he asked.

“Oh, just an old globe. It’s probably very out of date.”

“Can I look at it?”

Unsure what to do, I took it down and placed it in his lap. Gently, he spun it around—his acorn-colored eyes lit up.

“That’s a gorgeous thing, huh?” he said. The whole world-right here.”

He spun the globe and landed his finger on a spot, “Vietnam?” He sounded out.

“Oh, it’s very beautiful. I was there last year.”

“What?” His head spun back toward me. “What is it like there?”

Before our session ended, I returned to my question: “Can you tell me about your trauma history?”

The light in his eyes doused; he almost whispered his response: “I’m a very bad person. I did something really terrible when I was a kid. And I’ve been paying for it ever since.”

I didn’t press him for details–our time was up.

After that, we began every session by spinning the globe and an exploration of the country his finger landed upon. He was always curious about the food. “Man, that sounds good,” he teased me one day after our imaginary journeys took us to a place where fried crickets were a popular street food. His trilling laugh filled the room.

When he was nine, on an unusually cold day in his small North Carolina town, he and his six year old brother climbed onto a frozen lake to explore. Halfway across, the ice cracked. Though he managed to scramble to safety, his brother fell in, disappearing in the pitch black water.

Afraid of being punished, he hid in a nearby forest for two days until–ragged, hungry, and numb with cold–he returned home.

“My father beat me with a switch this long.” He held his hands out to show me. “I didn’t feel a thing. I knew I was bad. I knew I killed him. I wanted him to keep beating me.”

After his brother’s funeral, his father barely spoke to him again. At 13, he was sent to live with relatives in Manhattan where, after nine months, they took him out of school, so he could work full time in their shop. His first arrest was at 19. Over three decades, he had never spent more than two years outside of prison.

“I just get a feeling, you know. I can’t take it. It builds up, and I know I need to go back.”

“But why?” I asked.

“I deserve the punishment,” he said, his eyes suddenly vacant.

One of the first things I did after meeting him was call his doctor, a grizzled veteran of the psychiatry ward.

“He’s delusional,” he said, off-handedly.

“But what delusion?” I had seen no evidence of this.

“Hang on, let me look it up in his chart.” I could hear him crunching something as we spoke. “Oh, he endorses hearing voices. You understand what that means right?”

I swallowed tightly. “Of course, I do.”

I brought it up at our next session.

“He asked me if I ever hear voices. I told him I do—it’s like… well these echoes in my head sometimes. Like if I get sad, I start remembering my brother’s voice.”

I stared at him. “You understand that’s not an auditory delusion-it’s a very normal reaction to having experienced a terrible trauma.”

“I didn’t experience trauma, my brother did,” he shrugged.

I called his parole officer, eager to understand the danger warning on his chart.

“Who?” I could hear the papers shuffling. “I have no idea about him–I just make sure he’s not breaking the rules, doctor.”

I began seeing him twice a week, prompting the officer to call me: “You know he’s supposed to come only once a week, right? And what is this about a job training program you have him in? You’ll see—he’ll be back in jail long before he’s ready for a job.”

At one point, I asked him about his substance abuse. “Your weekly urine tests are always clean. When did you stop using?”

“Oh, I don’t use,” he smiled ruefully. He explained that he had to snort coke to give him the courage to commit his crimes, which he pulled off using a plastic handgun. Of course, he tested positive after every arrest.

“But how can this be? Not only are you not an addict, you’re not psychotic. I’m going to change your diagnosis in your chart. And we’re getting you off these anti-psychotic meds.”

I was indignant, eager to have something to fix. I stopped mid-sentence because he was looking at me curiously.

“Why are you so worked up?” he asked.

“You shouldn’t have to live with the side effects–the dry mouth, the nausea, the headaches,” I responded, furious. “You shouldn’t have ever been on these medications!”

“It’s really ok-I swear it is. Change the chart, ok, sure, but it doesn’t change anything for me,” he replied, softly smiling, his eyes crinkling at the corners.

I changed his diagnosis to PTSD. His psychiatrist changed it back a week later.

He always greeted me with a huge smile as I met him in the waiting room, but as soon we began down the hallway to my office it was suddenly gone. I commented on it once as we sat in my office: “You always greet me with a smile. Then when you stand up, it’s like a light goes out. Why is that?”

He waited a second: “I’ve learned to walk like I’m invisible.”

“You’re… crying?” He looked baffled. “About me?”

“You’ve been dropped by so many people. It isn’t fair,” I blurted. We sat together in a thick silence, his eyes on the floor. After a while, he spun the globe, this time landing on Sweden.

“Wouldn’t it be great to go there someday? I bet there are big mountains of snow.” He grinned.

I nodded, wiping away my tears. “It really would. But I hear they eat smelly fish. Yuck.”

“Yuck,” he agreed.

One day, he came in looking depressed. “I don’t want it to be a surprise to you–I’m getting that feeling again.” I knew exactly what he meant but we both pretended I didn’t. The next week he missed his first session.

I wanted to change his circumstances, to make an inequitable system take note of him. I look back now and wince at my frenzied efforts—all that time I should have just been listening to him better. I didn’t want to believe that a trauma he experienced at age nine could mark him indelibly, or that the world could take a vulnerable kid and rub him so raw through racist, punitive systems that the only place he thinks he belongs is in prison. He tried to tell me that is exactly the world in which he lives, but I so wanted it not to be true that I disbelieved him.

When he left my office the last time, nothing much had changed–his chart still held the red notation, the vocational program had failed to place him, and those charged with watching out for him–the harried parole officer, the indifferent psychiatrist–still had no idea who he really was.

But he had changed me. Gone was my naïve faith that a wise and beneficent system would catch those who tumbled into its waiting arms. Now I believed otherwise: that I couldn’t even break his fall.

A few weeks later I received a slim, slightly crumpled, letter in the mail, addressed to the clinic. The return address was a correctional facility. I waited to read it until I got home.

“Please don’t think this is your fault Dr. G. And remember: you gave me something I never thought I’d have–you gave me the world.”
Years later, that letter sits in a long-forgotten file somewhere, one of the items that has done the most to disillusion me, but also make me a better therapist. Despite his impact on me, he too has slipped from view, like a dream that dissipates upon waking. I can’t even remember his name.

Sarah Gundle a doctorate in Clinical Psychology and a master’s degree in International Affairs from Columbia University. In addition to her private practice, she teaches courses on trauma and international mental health at Mount Sinai hospital.

***

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Guest Posts, Mental Health

Therapist Notes from Coronavirus: It is OK to fall apart.

January 31, 2021
need

By Jillayna Adamson, MA, LPC, LMHC

2020.
Listen to all these people struggling! Are you getting this? People who have never before been able to admit to overwhelming defeat or depression or loneliness are talking about it. They are talking about it on Twitter, on Facebook. They are admitting to it in text messages and on the phone. People are checking in—people are calling and texting each other, they are reaching out. They are expressing understanding of struggle! Forgive my excitement, but are you seeing this widespread empathy? There is openness, understanding! Neighbors are saying to each other, “times are hard and how can I help”? My neighbor made me a latte! (sadly, I couldn’t actually drink it…because, you know- the virus). And with less judgement and reservation. Because they get it. We are getting it.

Of course, this doesn’t apply to every situation, and of course, the world is still full of lots of hatred and cruelty and stupidity—I know. But, I am also seeing this interesting surge of empathy and understanding within people. People are reaching out to each other, talking and opening up more than they previously were. Publically, even! The open communication and expression of such mental strife is a psychotherapist’s dream! We are struggling, don’t get me wrong—but we are also a little bit ecstatic.

The new culture of the coronavirus times are upon us. And there are so many ways in which it has been so painfully difficult. It is truly a new life. There are memes about it. And Tik Tok videos. There are cartoons with people disheveled, in bathrobes, their hair wiring out of their heads. There are calendar memes, a person slowly losing their composure. How their sanity has slipped from March to April to May to June to now… There are parenting how-to’s and mask-making how to’s and cooking how-to’s. There are articles reminding people that everyone is trying their best, making the best decision for their family. Reminding parents not to judge or shame one another for back to school decisions, to spread kindness or teachers and school personnel.

It is hard and it is stressful and some of us are barely hanging on—and wait! We are all talking about it! We aren’t quiet about it, we aren’t asking for anonymity. We are getting on Facebook and posting out our SOS to the world.

It just became okay to rest, to need to re-group. To need time on a deadline. To fall apart, just like humans do—pandemic or not. It just became normalized to outwardly admit to struggle, defeat, loneliness and not knowing. We have found ourselves thrown into an awful situation, but one that is also giving everyone the OK to be human. Never before have I heard so many people of a variety of backgrounds openly admit to and discuss struggle amongst one another— whether loneliness or depression, boredom, financial need, hunger, exhaustion. And I am talking about outside the therapy office. And never before have I heard so many platforms right there to normalize this, to join together. People who may have never struggled with their mental health before are learning the value and impact of some of our basic needs. They are saying “Wow, people really DO need other people! I always heard that, but I never quite believed it until I was living in my own pajamas and hadn’t seen another human in two months!”

A now-homeschooling parent tells me that she has “absolutely nothing left to give in the world” and is sure something is wrong with her emotional daughter. A woman calls to ask my advice, stating she has no idea how to even make the usual decisions anymore. “Is it possible I just need someone to decide things for me now? Can you do that?” she asks (I cannot). I know people regularly taking their children’s temperatures, checking for rashes, unable to sleep. I have read posts from people dealing with deep loneliness and isolation, overwhelm, depression. People from all walks are putting it out there, and others are sending them hearts and hugs and commenting that they get it. That they are struggling too. That it’s hard. That they are HERE!

We are being ravaged, and we are struggling. And 2020 has truly kept it coming. But we are showing up too. (You know, online, or with masks)

What we know about surviving difficult times is that we need to hold onto the aspects of hope, adaptation, and support. In hope, there is often some kind of light at the end of the tunnel. An idea of when this might end, get better, or at least moderately improve. We need to know that things will get better again. In adaptation, we make radical changes to our day-to-day and lifestyle to allot for the vast changes that have come at us. Of course, these have to be successful, positive adaptations. New routines, and activities, ways of socializing and being. New ways of thinking and seeing are all part of this adaptation. And then finally, we need to know we have support. Community, the knowing that we aren’t alone. That we have people we can talk to, help of some kind.

We recreate these things regularly. The cleaning adaptation. The TV isn’t really that bad adaptation. The Maybe I really could homeschool adaptation. The Let’s get a puppy and have something new to love adaptation. The hope of declining numbers, of successes in other countries. The hope of an evening walk or a relaxing bath, or a manageable day. Facetime and Zoom chats, new constant texting regimens, Facebook community groups. Drive-by-birthday parties, for gods sakes. Social distance kickball with masks and a mom doling out sanitizer.

The people are adapting. And continuing. As exhausting and overwhelming as it is, all you can do is keep going, right? With the awareness that some days will be write-offs. Some days you’ll need mental and emotional rest more than anything. The kids will watch tons of TV or play on their tablets. Everything you eat will be microwaved. Other days you might feel vague spurts of capability, and others you might feel good and able to take in positives in the change in pace. Some days, the best thing about your day will actually be ice cream, and you should absolutely have it. Actually, though—this is not that different from pre-Covid life. But Covid life brings it out, makes it right out there in the open—okay, normal. Productivity in our day to day lives, mental-emotional wellness, as well as social and community needs seem to have entered a new realm of understanding.

Before the virus hit, it was actually already okay to fall apart. To need and ask for help. To sometimes be a total disaster. But so many people struggled to believe and accept that. To allow themselves to wear the face of a person really freaking losing it. Mental wellness has really entered in as an every-human component of discussion and not just one for people with mental illness or specific diagnoses. That we are all struggling right here out loud may not seem like the silver lining anyone would be hoping for. But in the world of mental wellness, the opening up is a magic in and of itself, and the very foundation for change and reform.

The new habits of giving grace to ourselves and to others, of checking in, of loving, of being open about our struggles– could be so huge if they continued for our distanced culture. Imagine if we kept it going. Imagine a post-covid world where we are talking, where we are opening up, showing up—but in person, too. Maskless! When we can hug and touch each other on the arm casually! When we can care and fall apart without a pandemic background, and still let that be okay.

Jillayna Adamson (said Jill-anna) is a mother, psychotherapist and writer. She loves all things people, connection and culture, and is particularly interested in identity development and mental wellness within the psychosocial implications of the modern western world. Jillayna primarily writes personal essays and narratives, and writes often about the motherhood role and identity. She is a Canadian transplant currently living in the US with her partner and kids, and is a firm believer in letting your freak flag fly. She can be found at www.Jillayna.com

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We love this book for so many reasons! The writing is incredible, the story is important, and seeing what life looks like when you survive the unthinkable is transformative. If you haven’t already, please pick up a copy of Sanctuary, by Emily Rapp Black. If you have, we’d love to hear what you think. Purchase at Bookshop.org or Amazon.

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Guest Posts, postpartum depression

Prescriptions and Postpartum: When It’s Easier to Medicate Than Listen

December 22, 2020
receptionist

By Amanda Aardse

“You still there, hon?”

The walls are the colour of the inside of my skull, bland and jumbled, fuzzy thoughts tied in knots. I hate waiting rooms. My palms are all sorts of wet and I can’t sort myself out. It took two whole days to work myself up to the phone call, and the receptionist was on the other line, sounding bored.

“Yeah, I’m here, um, is there someone else I could see? I just need a referral to a psychologist.”

The words drench me in shame.

I gave birth three months ago. Motherhood. That should at least earn me just an inch of kindness, but so far all I find I get is reproach. You wanted this.

Everyone thinks I wanted this. That I spent my early morning hours for one long year being poked and prodded intimately by nurses who would yawn behind their gloved hands, sip their coffee during the internal ultrasound. That I pumped my body full of hormones it lacked, that I cried over an empty womb month after month for this.

No, I did not want this. I thought motherhood would make me feel fulfilled, beautiful, so in love I couldn’t stand it. This just makes me feel achingly alone from everything and everyone, even my former self, whoever she was.

I’m just Mom now.

“Well you really should see your doctor. She’s on holiday for the next two weeks, did you want to make an appointment for then?”

I picture her in the sun and sand, enjoying her two beautiful children while I have not taken a shower in three days, while my heart jitters with too much anxiety and caffeine. My eyes well with tears.

“Is there anyone else I can talk to?” I whisper and feel the eye roll on the other end of the line.

***

The nurse calls my name and I scatteredly grab my things. I’ve been staring at the magazine table rehearsing my lines – you need to do this, to advocate for your own health when others won’t.

The desire to be seen as more than just Mom is overwhelming.

She lets me into the doctor’s room. I’m explained this isn’t my regular doctor, he’s just taking her emergency patients. Am I an emergency? I wonder. What did the receptionist say about my teary phone call?

Well, that’s just having a baby, the receptionist informs me. A gatekeeper who mocks me. I use google instead, get confused by conflicting advice, and cry on the floor of his nursery while he joins me in wailing harmonies.

I sit on the chair beside the desk. I refuse to sit on the weird papered examining table like a patient. I came to get a referral. That’s all. A name and I’m out.

He enters the room and introduces himself, not smiling, barely making eye contact. I smile too widely to show I’m a happy, loving mother, that there’s nothing wrong. That is what everyone tells me they need to see. That, if I’m struggling, I must hate motherhood, must just not be good at it. I want so desperately to be good at it.

He begins to open fire. I am reduced to five questions, taken apart piece by piece and examined. Unfitting. Ill equipped. I feel mechanical, unhuman.

How often do you sleep? Well, not often, but I have a newborn, nervous chuckle.

Do you engage in my regular hobbies? If I could find the time or energy, I spiral, scrabble

Are you having regular intercourse with your husband? I –  I pick at the skin of my nail until it bleeds.

“How would you say you feel?” He turns to look at me at last. I heave a sigh of relief and decide for honesty.

“So incredibly tired. Some mornings I don’t want to get out of bed. I vomit before I’m able to accomplish anything. I love him so much, but he won’t stop crying, I just feel like I’m losing bits of myself…” I trail off and begin to dissolve.

He hands me a tissue and turns back to his computer, begins talking about prescriptions. How I’ll feel worse in the beginning, but it’s the right choice. I want to open my mouth, I just want someone to talk to, to ask if I get a choice, but I’ve withered.

Do you want to harm your child?

Amanda Marie Aardse lives in Waterloo, Ontario with her husband, toddler, and pleasantly round cat, where she is the third generation in her family’s custom woodworking business. She has spent her days riddled with nail biting anxiety and has nothing but a beautiful life to show for it.

Anti-racist resources, because silence is not an option

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chronic pain, Guest Posts, Hope

The Shame of Pain

October 24, 2019
pain

By Francesca Louise Grossman

I have tried 46 different times to launch myself out of chronic pain. I know this because every time I try something, I write down what I have done, what it feels like, what it costs, whether it’s covered and how worth it is in a small purple book. No one knows I do this. I scribble in it like I’m confessing to my sixth grade diary. In it is the same kind of anxiety about the future that I had in sixth grade, just not about Andy Apstein and whether he was going to kiss me or ignore me. Instead, it is about the treatment or therapy I try, and whether this one will be the one to finally help.

I opened the book the other day to pen a possible 47th.

The book is chronological, of course, but I put it in alphabetical order for clarity. I flipped through.

It starts:

Acupressure: December 2010 – Feb 2010 – dull pressure, not much change, $120/hr not covered – not worth it

Acupuncture – July 2002 (on and off) until March 2018 – sometimes painful, usually calming, blood flow, lasts less than a day but is relief $75/15 mins – sometimes covered – worth it but has to be ongoing

Acetaminophen – When needed – does nothing – over the counter – $9.89 a bottle of extra strength – not worth it

Bioelectric Therapy – October 2016-April 2016 – possibly dulls pain a little – for about an hour $165/hr at office – not covered by insurance

Cupping – February 2014 – one time, hurt like hell, not worth it. $85/30 mins – not covered by insurance.

Codeine – March 2009 – April 2009 – numb, good, not a long term option – covered by insurance $20 copay

Craniosacral Therapy – September 2000 – October 2001 – When in conjunction with other body work  – Myofascial etc – decent relief but dizzy – lasts a couple of days maybe $200/session – sometimes covered by insurance

Cryotherapy – June 2018-October 2018 – feels great right after, like putting ice on a knee. Lasts a couple of hours, heart races. $60/3 min session. Not covered by insurance

And on and on—and on.

The book is 24 years old. The same age as my chronic pain, more than half my lifetime, all of my adulthood, eons.

This book exists because all this time I have had a continuous faith that there is a valve for this pain; that I can escape it, or, more accurately, it can escape me. For all these years I have I known this to be true. I will find it. I will heal. I am a warrior, a survivor; tough, strong, and able. People have told me that pain is weakness leaving the body in all different scenarios, with all different motivations. I don’t have this recorded as studiously but I wish I did.

I have other lists I don’t love revisiting, but help to explain the pain. In my twenties I was diagnosed with Crohn’s disease, an illness of the intestines that leads to violent pain and an urgent need to empty your bowels. I developed Colitis later, a more general type of the disease that bloats my stomach to look four months pregnant. I have had surgeries for my stomach, some of which were determined later to be unnecessary. I had thyroid cancer through out my twenties, finally treated when the tumor on my neck was the size of a ping-pong ball. I developed arthritis along the way, both as a peripheral malady and also it’s own disease. My body is gouged from piles of polyps removed from my insides, and (usually) benign tumors removed from my outsides. My neck doesn’t turn all the way to the right. My hips need forty-five minutes before letting me walk in the morning. I have an unidentified liver problem that swells without notice and bends me in two. If the saying is to be believed, there’s a lot of weakness in there, and it seems to be stuck.

*

When I was twenty-nine, I had surgery to remove my thyroid. The overnight nurse was a doozie of a lady.  Opera singer large, big calloused hands that vice-gripped onto my shoulders. Thighs thick as trunks that she used to pin me against the side of the bed so she could administer my catheter without “so much squirming.” She was brutal and brutish. A small silver peace sign sunk deep into her cleavage, drowning in flesh.

She had a hard time getting the catheter in, and as she struggled, she noticed my twisted face.

Pain is weakness leaving the body, my love, she said, repeating it over and over like a command until I could actually pee.

This is an extreme example, but at least once a year, often as much as once a month, this phrase earworms into my psyche. Related to illness and chronic pain or not, this saying has appeared like a subtitle again and again at the bottom of the screen of my life. When I was a weak child? A coach. A teenager who could not stomach even occasional beers? A boyfriend. A young woman unable to go to a bar without scoping out the bathroom situation ahead of time? A roommate. A thyroid cancer patient: a nurse. Doctors, PA’s, med techs. Physical therapists, friends, masseuses, acupuncturists, pharmacists, bosses, guy on the street.

*

I went to the doctor a few weeks ago and a delicate med tech took my vitals. She asked the normal questions, made the normal small talk, took the normal introductory tests. Her thin fingers flew across the keyboard, recording my responses. She asked me if I had any pain.

I wasn’t sure I heard her correctly.

“You mean right now?”

“Yes,” she smiled softly.

“Nothing acute,” I said.

“So no pain?”

“No. I mean, yes, I have pain, the same pain I have all the time.”

“What would you rate it, 1-10?”

How do you rate pain on a scale made for people with no pain?

“I don’t know, 4?”

She nodded and her hands took off. That was the wrong answer. I knew this, I knew that anything under 5 wasn’t worth her noting, that saying 4 was like saying I had a dull headache, or a splinter in my toe. But what should I have said? 7? Wouldn’t that be alarmist? Especially when that pain had been a relative constant for over twenty years? Especially when I knew from decades of experience that the litany of potential remedies for that pain were not going to help?

*

My husband stepped on a quarter inch wire sticking out of the ground near the beach in Fire Island this summer. The metal went a good inch into his flesh, and when he pulled it out blood sprayed mercilessly all over the sand and sidewalk. He howled. He made noises that I have never heard him make before and I have been with him through a lot of painful things. He was pale and sweaty, teeth gritting, eyes rolling back, that kind of pain.

Later that night, his foot gauzed up and iced, still throbbing, he looked at me and said “I’m so sorry you are in pain all the time.”

I didn’t know how to respond. This wasn’t about me, he was the one in pain, and yet a part of me felt smug at his discomfort. Now you know how I feel, was a momentary thought, I’ll admit it, and not one I’m not proud of.

But it got me thinking about pain and the way people relate to it. It is very hard to relate to pain if you aren’t in pain. Which is why I have such a hard time with the 1-10 scale.

Instead, for chronic pain patients, they should ask what kind of sharp thing is in your foot. Splinter? Pushpin? Nail? Quarter inch wire? Razor blade? Glass shard? Burning glass shard?

Nail. I would have said. Occasionally glass shard.

But instead I said 4 and she smiled.

*

I have fought against my pain and weakness for a very long time. I have tried, often unsuccessfully, to be like my friends. In my twenties I tried to stay out all night, I tried to ski, I tried to walk down the street without doubling over. I worked, I played, I drank, I sat as still as I could so that no one would notice the aftershocks. In my thirties I had children, pregnancy an event that paused my pain for a while so that when it came back it felt like a tsunami. Like many mothers of babies I didn’t sleep and then I had severe postpartum depression; I found having small children so physically demanding I came undone. I’m forty-one now and I am very often a prisoner in my house. My stomach bleeds, my liver pulsates, my head spins. Not all the time, but enough.

From my teens until today, this minute, and all those in the foreseeable future, there is pain. At least nail in foot pain. Sometimes glass shard. Never pushpin. A splinter would be welcome. In fact, when I think back on my childhood and that which was difficult – most sports, endurance, gym class, partying, anything else that required my body to function – I think it’s possible that I have been in pain all my life. Back then I never considered that my resting state was anything less than normal, but now I know better. Most people do not live with nails in their feet.

I hurt. I hurt in the morning when I turn over to get up. When I walk, when I carry groceries, when I turn my head to the right to reverse in the car. My stomach burns, my joints swell, my liver rejects everything I eat and drink.

I don’t talk about pain very often. I tell myself it is because people don’t want to hear me complain but it is more than that, I can admit that. I’m ashamed of my pain. I’m ashamed of my weakness.

What is it about pain that is so shameful?

We live in a culture in which wellness equals strength. People my age do cross fit and triathlons, women have babies without drugs, are lauded for their tight abs, their thick skin, their ability to play tough. I have never been strong like this. I have tried, but I have failed. I was never scrappy. I don’t think I will ever be. I am soft. My belly, the place of much of my pain, is squishy. Distended, bloated, doughy, depending on the day. I’m sensitive. I cry at pop songs.

Our society’s greatest hero story is about overcoming obstacles. We love a fighter. We love an underdog who comes out on top. We love triumph and happily ever endings. We love to fix a hoarder, intervene and send someone to rehab, remodel a decrepit house. We love treatment. We love survival. We love hope.

But hope is complicated. After all of these tries, this list of 46 different treatments and therapies, I no longer have hope that things will get better. I have hope that things will not get worse, which is not the same thing. I have a hope that feels a lot more like mercy than it does like faith.

When I ask myself this question about weakness and shame I hear a quiet hum suggesting a better question: why am I fighting so hard?

In my experience, pain is not weakness leaving the body. I realize this is a trope, and any mantra is nothing more than a slogan. But slogans have power. They convince. And I’ll admit I have always believed this – that the suffering I endure might one day let me free.

When I was pregnant and exhausted, a friend of mine told me that of course I was tired, I was making a person in there. Though not the same, pain sometimes feels like that too. Of course I’m tired, I’m fighting against myself all the time, trying to quell the pain so that I can live my otherwise fortunate life.

I’m not delusional about this. I know I live a charmed life in almost every way. I am educated, from a family that loves me – even when I behave idiotically. I am not from a country ravaged by war. I have a husband who cares for me, does not abuse me, even dotes on me sometimes. I have two healthy children whom I adore. I am from a privileged minority, I have more than I deserve. I can walk, breathe and think to exist in my daily life. I can afford therapy, eastern medicine, treatment outside of insurance sometimes, to do part time work. I can try 46 things. In short; I’m lucky. Unfairly so. And yet.

Here’s the whole list, abbreviated to just the titles:

Acupuncture, acupressure, acetaminophen, alcohol, aleve, aromatherapy, bioelectric, CBD creams and oils, cupping, chiropractic, chanting, codeine, cranial sacral therapy, cryotherapy, dairy free, hallucinations, gluten free, guided breathing, fasting, fentanyl, flotation, ibuprofen, oxycontin, marijuana, massage, meditation, myofascial, quell, reflexology, radiation, salt baths, saunas, steroids, sugar free, sodium free, sound bathing, surgery, swimming, percocet, physical therapy, psychotherapy, psychiatry, praying, vicodin, xanax, yoga.

Everything helps a little. Nothing helps enough to be worth the life altering work and piles of money it takes to keep it up.

Here’s a truth: the things that actually take the pain away feel a lot like addiction. They don’t remove the pain, that’s the trick. They numb. And they are delicious. But they don’t last and they unleash other pain, often more severe that the original. It’s never worth doubling the pain tomorrow to have numbness today, no matter how attractive the reprieve.

So the pain is there. It’s always there and most likely it will always be there. I don’t know how it got in. Maybe the pain was waiting for me when I came into this world. Maybe it comes from my ancestors, my DNA, my parents’ tragedies, my childhood bullies, or little or big assaults. Maybe I am sensitive to the world for some reason, and it simply hurts to be here. As woo-wooey as that sounds, that’s the one that feels the most accurate, the most likely.

I think it’s actually softness that makes us strong. It’s not skin made of iron. It’s showing the underbelly. It’s not bracing for the storm, it’s putting a kite up in the wind. It’s the willingness to see the world as a series of experiences some of which are going to hurt like crazy and the ability to just keep going anyway. It’s vulnerability. It’s asking for forgiveness. From ourselves as much as from others. It’s mercy.

Mercy is an open palm. It’s the meaty bit. Curling your hand so that your knuckles face the world is so much easier. But a fist to heart feels quite a lot different from a palm to heart, resting square on your breastbone, staying there, the heel of it pulsing the same rhythm as the heartbeat on your chest, marching your body along in a long trek to some sort of quiet absolution.

My husband’s foot healed in a few days. He stopped limping. The knowledge that he would get better permeated and defined the experience – the faith that this would be over soon.

Therein lies the difference between acute and chronic pain, of course: in how we define hope.

So what kind of hope can I have? What if I looked at my years and piles of pain and perceived weakness not as a failure but as a step towards becoming who I am? What if I forgave myself the years of fighting myself and sank into the deep cool water of acceptance? How would it feel down there?

I do not mean that I should give up. I’ll try things if they look promising. 47, 48, that’s fine. But what if instead of fighting so hard I allowed the pain to be part of me? What if, for a while, instead of the restrictive eating and the therapy and the medicine and the exercise and the planning and the trying (and the failing), what if I just stopped? Even if it hurt? Even if the pain never left? Could I recalibrate to “0”? Could I see that as the most radical act? Doing nothing at all?

For now I’ll put the little purple book in the drawer. I’ll cap the pen and sit quietly. I’ll let what’s in me stay put. I’ll put my feet up, expecting and accepting the pulse of the nail that might be forever lodged there.

Francesca Louise Grossman is a writer and writing instructor based in Newton, MA. Her work includes contributions to The New York Times, Brain, Child Magazine, Word Riot, Drunken Boat Literary Magazine, xojane, Kids in the House, Ed Week/Teacher among others. She is currently working on a memoir and a novel. 

 

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Guest Posts, healing

I Diagnose Other People for a Living, but No One Can Diagnose Me

July 15, 2019
surgery

By Melissa Neff

My psychology career has been devoted to helping other people learn about themselves. But when chronic back pain usurped my life, no one could tell me what was wrong with my back, or how to fix it.

As a psychologist in private practice, I divide hours into 15-minute segments, punctuated by the beep of a timer and my client’s choice of Batman or emoji stickers. A few weeks ago, I handed Jaden, an energetic and wiggly 6-year-old, a pile of putty to fidget with as we waded through an IQ test. Through a projective storytelling task, I learned what monsters were hiding under his bed, and what type of laser proton field he plans to construct to keep them out.

When Jaden’s parents return for the results, I explain, “Assessment is like pieces of a puzzle. Each test tells me something about your child.” Test by test, I plot out Jaden’s abilities relative to other kids his age on a giant white board, dotting his exceptionalities and weaknesses in purple marker. “He can solve 8th grade math equations, and he is smart enough to grasp that one day he will die; however, this thought, which most 6-year-olds can’t yet contemplate, terrifies him. So, he has constructed a laser field as a way of coping with demons that he does not yet understand.”

I inundate Jaden’s parents with labels – Gifted, ADHD, Autism Spectrum Disorder – labels which do not define him, but which describe him so we can strategize how to best help him. When Jaden’s parents leave my office, I want them to understand their child better. I want them to feel supported and validated about what they’ve always known to be true about their child, which often, no one else saw or believed. I want my clients to have answers.

Like many psychologists, I have, too, have spent some time on the other side of the couch. Like Jaden, I, too, have been plagued by anxiety. When I was still healthy, I spent nearly every day running and dancing and hiking those thoughts away until they melted into a pool of sweat at the back of my tank top.

But all of that changed six years ago, when I twisted my left foot the wrong way while shaking my booty to Rihanna during a high-intensity dance class. When my foot didn’t heal, the podiatrist shoved it in a boot for two months, which slanted my pelvis and led to a gradual stabbing in my low back that didn’t remit when the boot came off. I began to curse the Devil Spot, the dwelling inside my low back where it felt as if tiny trolls were stabbing me from the inside, punishing me for a transgression they had yet to reveal.

No matter how much stretching and resting and icing I did, the Devil Spot nagged at me, pleading to be heard like a tantruming child. Its screams grew louder and louder until they were all I could hear. Pain eclipsed my every waking moment, and suddenly, I became one of 25 million people in America with chronic pain. At work, I couldn’t stand up and talk to my clients for longer than 3 minutes. At home, it was all I could do to not toss a spatula across the kitchen, infuriated that I couldn’t stand for long enough to sauté a goddamn pan of broccoli.

I threw all of my free time and savings into rehab. I just wanted to dance again, to run again, to feel my body sherpa up and down mountainous hiking trails the way it was made to. My osteopath glided and jerked my left leg until my pelvis straightened, explaining in carpenter-speak how a normal pelvis should connect to the spine without jamming. My chiropractor jerked me back into place, asked me for my copay, and rushed me out the door. After each adjustment, I slid back into crookedness, but I kept going back for more because I didn’t know what else to do. My physical therapist urged me to try water aerobics. After about fifteen minutes doing low kicks with the 80-year-old women in my class, the Devil Spot detonated, forcing me to hobble out of the pool in tears.

Pain became the only thing I could think about. Nothing I did to stop it helped. In fact, every intervention seemed to generate more pain. The only thing everyone agreed on was that I should avoid back surgery. Failed back surgery is so common that it has its own diagnostic code.

Months passed. Years passed. For a while, I sought relief instead of fixes. I tried every type of massage –Hawaiian Lomi Lomi, deep tissue, and Rolfing. I begged Chinese doctors to poke my feet with long acupuncture needles. I asked a woman who saw angels to clear up energy from my past lives. The stabbing would relent for a day or two, but never more. So, I stopped. I stopped getting adjustments. I stopped trying to hike. I stopped at my third physical therapist. I stopped having dinner parties. I stopped getting invited to dinner parties. I stopped having sex or only had it in the dark, where I could covertly wince.

More months passed. Each day, I averaged about a 7 on the pain scale. My stomach ached from popping Ibuprofen like Tic Tacs, but I needed them to get me through the day. I hated my life. I hated my job. I hated myself. I was becoming a person I didn’t recognize, a person whose fat clothes didn’t fit, a person who got her only endorphins from Dairy Queen Oreo Blizzards. I needed answers. I needed to find someone like me, someone who would sit with my images, get out their white board, and contemplate my symptoms until they morphed into the correct diagnosis and paved a road towards treatment. I didn’t care anymore that this might mean someone drilling my spine apart, filleting me like a fish, and rebuilding me piece by piece. I was out of money and patience, controlled by something I couldn’t get under control no matter how hard I tried.

Dr. Keller, my pain doctor, agreed that it was time to consult with surgeons, who are known for their diagnostic precision.

Surgeon Number One suggested there might be a tear in my disc.

Surgeon Number Two diagnosed sacroiliac dysfunction. If he just literally could nail together my pelvis to my spine, it would become less mobile and less painful, he said.

Surgeon Number Three, the arrogant one who I was sure would break the tie, turned around slowly in his leather chair and said, “I’m not sure why you’re here. There’s nothing wrong with your back.”

“Excuse me?” I asked.

“There’s no surgery I would do on your back, because it’s totally fine.”

The tears I’d been holding back busted through, my face opening into a floodplain. “It’s fine? Then why am I in so much pain? Why does my back stab so badly that I can I barely stand, or concentrate? Why can’t I ride in a car for longer than an hour? Why can’t I get through Costco without an automated cart?”

“You just need physical therapy.”

“I’ve tried that. Three times, with three different therapists. It hasn’t worked.”

“Acupuncture can also help.”

“I’ve tried that. Twice. Didn’t work.” I breathed back the snot dripping from my nose. When he didn’t offer me a Kleenex, I wiped it away with my sleeve.

“Do you think there’s a tear in my disc?” I asked. “That I need a fusion?”

“No.” But he leaned in closer as he noticed my tears.

“You know, I’ve had some patients with similar pain. You know what helped them? Therapy. They go see a therapist, talk a little bit about their family, and in three, four months – their pain goes away.”

Clearly, this asshole had omitted reading the check-box where I’d listed my profession as “psychologist,” implying that I know something about this stuff. Had he read any of my check-boxes? Was he saying that I was crazy? That I had conjured this problem within my body as a way of dealing with my issues? Had he read the referral from Dr. Keller, who’d shot me with cortisone in my SI joint three times that year, issued me a handicapped parking pass, and sent me to this man for an actual answer?

In my car, my head fell on the steering wheel, dousing it with sobs. I wanted to call my partner to debrief, but what was the point? I was still at the same place, with no answers.

For weeks, I contemplated my choices. I insisted that my doctor perform the dangerous discogram that did, indeed, reveal a tear in my disc. I had a minor surgery to cauterize the disc. But when I started to move again, the Devil Spot ignited and raged on. I blew up balloons with my new physical therapist to pull more air into my left lung in an attempt to align both sides of my body. I let a different physical therapist put her finger in my vagina, inspecting my pelvic floor for tightness. I tried new medications. I cut down my hours at work. I forced myself to meditate. None of it helped.

Left without a clear direction, I made a radical choice: to have a surgery that wouldn’t fix the problem, but which would mask the pain. An implanted spinal cord stimulator would send soothing signals to my brain to divert it from the perception of pain. I scheduled the surgery, but my insurance required me to have a psychological evaluation first. After laughing my ass off at the irony, I drove three hours south and sat all day in a fake leather chair like the one I had for clients in my office, checking off answers on personality inventories I’d spent years administering to other people. The psychologist gave the green-light, but on the eve of my surgery, my gut rumbled with uncertainty. Scanning my brain for a last-minute fix, I recalled a conversation I’d had with a friend’s father years ago, who told me that a physiatrist, a doctor of the muscles, had saved him from back surgery. I Googled physiatrists, found Dr. Landon, who was new in town, and told Dr. Keller that I wanted one more consult before moving forward.

In his office a week later, Dr. Landon thanked me for sending him a three-page synopsis with all my provisional diagnoses and every treatment I’d tried. He’d reviewed that and my imaging the night before. He spent two hours asking me a series of rapid-fire questions to rule out all kinds of different disorders. He looked me in the eye and listened to my story. He offered me more Kleenex as I cried. He spent two hours examining my hips, pelvis, legs, and back. He told me that he had a few ideas about what might be wrong, and he labeled them all: Sacroiliac Joint Dysfunction. Pelvic Floor Dysfunction. Hip-Back Syndrome. Myofascial Pain Syndrome. He assured me that we would go down each rabbit hole, investigating symptom by symptom until I had my answers. He didn’t have a white board, but he did make a drawing on his iPad explaining how my hips might be causing back pain, which made me consider my symptoms in a new way.

Dr. Landon asked me to postpone surgery until I tried the rehab program he created for me. “I will do my very best to help you,” he said as I left, “But I can’t promise anything.”

In the safety of my car, I simultaneously grinned and sobbed, allowing child-like bawls to crawl up my chest and quake out my lips, loosening my grief like leaves on a tree that had needed a good shake to break free. Finally, I had found someone who would diagnose me with the same level of precision, empathy, and care as I did for my own clients. I always tried so hard not to cry, not to complain, not to ruin conversations by talking about my pain, but hopelessness had become a rock in my chest, hardening around my broken heart.

For the first time since the Devil Spot had made my life a living hell, I felt less alone.

Dr. Landon’s program is working. I can stand for 30 minutes instead of 3. I can do half of an old lady water aerobics class without tears. Last week, I walked into a gentle dance class and grapevined and kicked behind Dolores for ten whole minutes without stopping, and shouted with her along to Huey Lewis. The more I squat and lunge, the stronger the tissue around my disc becomes. I am forcing myself to meditate, and when I sit in silence, I learn things – about the way I sit, the way I stand, the way I don’t take in full breaths, how I hold in stress until it becomes a stabbing pain in my ass. Surgeon Number Three was right, even if he was a jerk about it; I needed to go back to therapy, because how I manage my emotions is a piece of my puzzle.

Twice a week in neurofeedback, my therapist attaches electrodes to the calming center of my brain. Twice a week, I leave feeling less anxious, and in less pain. I am noticing that when I have a bad day at work, the Devil Spot cramps and pulses much earlier than usual. As I lean forward to bear witness to other people’s stories of abuse and abandonment, my muscles clench more with the weight of their stories. When I am a receptacle for other people’s pain, my pain worsens.

In therapy, it is my turn to speak. I tell my therapist the truth: I am no different than my clients. I was born with big feelings, big reactions, big thoughts. I never felt safe expressing them until I met my current partner, who holds me when I cry and does not ask me to stop, who listens to my ideas and loves every part of me that’s big.

It has taken me forty-one years to realize that I’ve spent my entire life putting other people first. As a six-year-old, I became a mother to my mother. After my dad left, she secured two or three jobs at a time to make sure we had Gap jeans and could afford to play after-school sports, but there was no time for cooking, cleaning, or feelings. When I tried to tell my dad how much I missed him on visits, when tears welled up in my eyes and my words grew gummy, he insisted we change the subject because it was obviously upsetting me. For him, I joined clubs and earned scholarships, learned to courageously mute all my big feelings, and championed his marriage to a woman who smiled at me through gritted teeth to ensure that I wouldn’t take up any more of his time. It was the right thing to do – choosing attachment over acceptance meant that I would be supported, loved. When I headed off to a big city college, I felt brave, strong, and independent. By graduate school, I was on my way to becoming a logical, impenetrable adult. I had a life plan: I would help people with their big feelings, and run far up mountains away from my own.

But I didn’t respect myself. I didn’t know who I was if I wasn’t helping people. I didn’t know that my voice needed to be heard too, until the right people listened. Now, I’ve begun to stop and notice when the pain flares, and ask myself what I am feeling, not feeling, or not saying. I let myself feel it, although I am still learning how to say it.

The more I creep back into my body, which froze with pain until I felt safe enough to learn why, the more I release the trapped emotion from my back and baby the Devil Spot back to life, the less I want labels and procedures. I insist to Jaden’s mother, who cries when I label him with autism, that a diagnosis does not define a person, but is a valuable guidepost – a roadmap – to greater self-understanding. What I don’t say is: I understand. We are all jagged and broken in some places, but if we don’t let our edges come up for air, if we don’t let others see them, hold them, and heal them, they will fester and become unnecessary wounds.

Melissa Neff is a writer and psychologist living in Montana. Her fiction has been featured in WitLit and Wild Quarterly. She is currently writing a memoir about chronic pain and how it has unexpectedly healed her body, mind, and spirit. She is fortunate to spend most of her days supporting her differently wired clients to become their very best selves. You can follow her on twitter at @MelissaNeff17.

 

Guest Posts, Mental Health

A Horse Brought Me Back To Life

April 26, 2019
horse

By Sarah Van Sciver

As I exit my car I notice the unseasonable warmth on this early February day at the farm. I don my black and white wool Persian hat over the two braids in my hair but decide I can ditch my coat and get away with wearing my hooded, gray fleece.  The welcomed warmth mirrors the inner thawing that has begun to occur within me during the past couple of weeks. The urge to keep painful emotions tamped down still remains but just as the winter clouds make way for the sun I, too, feel a small opening.

For the past five months, I have stayed committed to coming to a farm once a week where I have been participating in Equine Facilitated Psychotherapy, a type of therapy where horses play an essential role in healing trauma. Most of these days I’ve wanted to quit and run as far as I can to escape the frightening sensations that have finally begun to loosen their hold in my body. Like placing a healing salve on an open wound, the process has been painful; bringing to light what caused the pain in the first place.

Throughout the experience, bitter and painful as it’s been, I’ve come to realize that what I fear the most is also what I crave the most: touch and true connection. As if I had a blindfold over my eyes most of my life, I never realized the constant feelings of isolation, loneliness and disconnection I experienced were due to living with unprocessed and extensive trauma. Somehow through some kind of magic, the horses have brought me face to face with this pain while simultaneously healing the broken places inside of me. Continue Reading…

Fatherhood, Fear, Guest Posts

All Fathers Want to Hurt Their Sons

June 17, 2018
hurt

By Brian Zimbler

“I feel like you’re doing everything in your power, verbally and non-verbally, to tell me not to say anything negative,” I say to Randy, my therapist.

We’re doing a phone session.  I’m propped up on Nora’s side of the bed against an ornamental IKEA pillow.  Nora and Myla are downstairs, watching Elliot.  It’s his 12th day.  It’s a snow day.  I have my jeans on, which is a total Nora no-no (no outdoor clothes can touch the duvet) but I am being passive aggressive because I want her to love me more than the baby.

“I’m not forcing you to be positive,” Randy parries, “If anything, I’m asking you to stay in — “

“I know, I know, stay in the good feelings.  I am.  I’m trying.  You gotta admit, I could’ve spun into the real dark telling you the parents-at-the-bris story just now, but I stayed good.”

Elliot’s bris was last week.  My parents came down.  The mohel, in the prep documents she sent us, let us know she would need an assistant to stay by her side throughout the process.  Nora and I decided this would either be my father the doctor or my mother the therapist, we would decide day of; however, day of, I decided – though I can’t really call it a decision, more a clear loud message from inside – that I would never ever let either of my parents be with my son at his most vulnerable, ever, and that I would be the one to usher him through.

“It’s never the dad,” said the mohel.

“This time it’s the dad,” I said.

And I did it.  I stayed with my beautiful new son even through the part upstairs where she pulled my beautiful new son’s foreskin back and clamped it, to prepare him to be cut.  Even through the part where he was brought downstairs covered in a tallis on a sick infant’s gurney.  Even through the part where all the sugar water in the world could not put my strong son to sleep. Continue Reading…

Guest Posts, Therapy

A Therapist Confesses: “I Really, Really, Really Can’t Help You”

November 10, 2017
therapist

By Sherry Amatenstein, LCSW

Strands of white hair erupting from her scrunchie, *Evelyn perches on the black pleather chair, greedily gulping from her Poland Springs water bottle and says: “Sherry, yesterday I had one of the worst experiences of my life.  No, probably the worst.”

In the ten plus years I’ve been a therapist I’ve heard numerous variations of this sentence, often followed by a statement like: “The neurologist confirmed my mother has Alzheimer’s. I feel guilty that I still hate her” “I caught my fiancé making out with my best friend” “Maybe getting fired for the fourth time in three years is a sign the world is better off without me”…

This is Evelyn’s latest ‘worst experience’: “I was at CVS buying shampoo and this Chinese guy brushed up against me. I know he did something to the shampoo to hurt me. Should I use the shampoo or return it? I’m sooo anxious.”

I’m never happy to hear that someone is suffering.  I became a therapist in midlife after a career in journalism because I feel driven to be an easer of pain, in a small way to make a permanent, positive stamp on the life of another. Continue Reading…

Addiction, Dear Life., depression, Guest Posts

Dear Life: I Self-Medicate! What Should I Do?

January 26, 2015

beauty-hunting-jen-logo-black1-300x88

Welcome to Dear Life: An Unconventional Advice Column.

Your questions get sent to various authors from around the world to answer (and please keep sending because I have like 567 writers that want to answer your burning questions. Click here to submit a letter or email dearlife@jenniferpastiloff.com.) Different writers offer their input when it comes to navigating through life’s messiness. We are “making messy okay.” Today’s letter is answered by Shannon Brugh, whose previous essay on the site did phenomenally! 

Send us your questions because there loads of crazy authors waiting to answer ‘em. Just kidding, they aren’t crazy.

Well okay, maybe a little.

Aren’t we all? xo, Jen Pastiloff, Crazy Beauty Hunter. 

Jen Pastiloff is the founder of The Manifest-Station. Join her in Tuscany for her annual Manifestation Retreat. Click the Tuscan hills above. No yoga experience required. Only requirement: Just be a human being.

Jen Pastiloff is the founder of The Manifest-Station. Join her in Tuscany for her 2nd 2015 Manifestation Retreat. Click the Tuscan hills above. No yoga experience required. Only requirement: Just be a human being. Sep 26-Oct 3, 2015

Dear Life,

I have gone through hell and back since I was born. I will save you the gory details and tell you that I am about to be 27 and have finally arrived at the most peaceful place, spiritually speaking, that I have ever been. But as I am finding peace in my work, family and friendships, a new career opportunity suddenly presented itself. I have been a bartender for the past eight years and, after graduating from college, am trying to move on to a more secure career that is conducive to raising a family. Two days ago I received an email for a lead on a job as a liquor rep in center city Philadelphia. I live about an hour from there currently but lived there for three years during my undergrad. I am perfect for this job. 100%.  But one requirement is that I must submit to a drug test prior to being hired. I have suffered from severe anxiety, depression, OCD and PMDD for at least the past ten years and smoking pot has significantly relieved my symptoms. I am nervous that if I get a call for an interview in the next couple weeks, I would definitely not pass the test. What do I do?? I am a good hearted, intelligent and motivated young woman. I have spent time in Rwanda. I want to save the world. I know I would be an asset to any company in the world, but I smoke pot to relax. I don’t know what to do. Please help me.

thank you, J

Ps… That was a complete free flow of thought. I apologize if it was long-winded.

Continue Reading…

courage, Guest Posts, healing

Still Breathing.

November 20, 2014

By Tara Allen.

I think I started cutting when I couldn’t write anymore. I stopped writing and harbored the demons within, trying in vain to keep them locked up. They crawl around inside me, lurking in the shadows, waiting to show themselves. I thought drinking would numb it, keep them at bay. But the demons had to escape somehow, and since I no longer let them flow out through words, I watched as they flowed out in my blood.** *Just gave away my guitar. Only I don’t think of it as mine, I think of it as his. How he played, how he loved to play. How he created songs for me. I’m sitting here, with a glass of wine nearby, tears streaming down my face. I am a mess. Does this get better? I want to bleed, I want to rage, and I want to do anything but feel this. Am I so fucked up that I am unlovable? Pretty enough to get the guy but not good enough to do what it takes to keep him? Pretty fades. It’s fading fast. I am toxic.

I choose to write my way out of this. To put it out there, how this shreds me. How I’d rather be physically in pain than emotionally.

I bring out the worst in men. I destroy people, I break them. They walk away so easily.
Time to put it on the page and leave it.

** *

“What are you here for?”
“I’m cut and I can’t stop the bleeding.”

Continue Reading…

Beating Fear with a Stick, Eating Disorders/Healing, Guest Posts, Vulnerability

About Knowing What I Don’t Remember.

August 26, 2014

By Kit Rempala

I’ve never been “normal” – if that word means anything at all. I see and speak to dead people. On occasion I read people’s minds and have prophetic dreams. Souls and emotions are as tactile to me as the fur on my cat’s back. I hear messages in nature, be they from water or fire or wind or earth or the moon in the sky or the rustling of leaves. I feel everything.

So, to sum things up: I’m pretty darned good at believing in things I don’t see, things I’ve never seen, and things that can’t be seen. Sometimes, I worry I’m too good at believing.

I never believed I’d been sexually abused until my therapist asked me. I thought I’d answer “no” and the session would move on. But instead she asked me another question, one I’d never expected: “Are you sure?”

What did that mean, am I “sure?” How could I not be? How could I not know? How could anyone not know?

Continue Reading…

Anonymous, depression, Guest Posts, healing

Both Sides Now.

August 9, 2014

Hi guys, Jen Pastiloff here. I am the creator of The Manifest-Station. This gorgeous essay was submitted but asked to remain anonymous. 

Both Sides Now.

And I a smiling woman.   

I am only thirty.

And like the cat I have nine times to die.

There are dark, blood red spots on my right Top-Sider. They are, in fact, spots of my blood. I cannot bring myself to wash them off. I will occasionally look down at my biohazard shoe and think, oh yeah. That happened. This time last week. Oh yeah. A week ago today, I walked into my therapist’s office at 4pm, apparently still stoned out of my head on the 48 Klonopin I had taken the night before.

I didn’t mean to, exactly. I don’t think I did. I told her I took 47, but I had brought the bottle, giving it over to her, and as she counted the remaining yellow disks, one more was added to the total, creating a dosage of 24mg, 48 pills total. The week before, after a long period of clean time, I had taken 10. I hadn’t learned my lesson. Again.

Continue Reading…

funny, Guest Posts

Shrinkage.

November 5, 2013

Shrinkage by Malina Saval.

There are many reasons that sleeping with my shrink would be a really bad idea, namely that he’s my shrink. My old shrink in grad school once slept with a patient and wound up getting his license suspended; if that happened to my current shrink, I’d have to switch shrinks again and I know from past experience that’s way too much effort.

My shrink is tall and athletic-looking, with eyes so blue you could dive inside them and swim a lap. He was on the varsity swim team during high school and college; his stroke was the Australian crawl. At night, I like to imagine him clawing his way through an Olympic-sized swimming pool wearing swim goggles and a green Speedo, drops of chlorinated water rolling off his pale, muscular back. My shrink is strong, virile, German. He’s got a tumbling crest of golden Gestapo-esque curls and comes from one of those upscale Midwestern suburbs with Methodist churches and lots of rosy-cheeked white people. He looks like one of those high school history book Vikings, with a small visible triangle of tangled blonde chest hair when he wears wool v-neck sweaters.

Because I’m Jewish and my shrink is everything that I’m not supposed to have, I want him even more. I like to pretend, and in various different historical periods from movies that I was forced to sit through during USC film school, that we’re madly, madly, madly in love.

In one fantasy it’s 1944. It’s winter. The end of the war is near.  I’m Jewish, he’s German, but it makes no difference. We’re standing on a dock on the shores of Hamburg late at night, the icy wind whipping through my long, smooth mane of retro Rita Hayworth curls, my bangs swept to the side, secured with a platinum-and-rhinestone hair pin (My real–life Jewfro is miraculously absent). My shrink is wearing a thick wool scarf and one of those terrific World War II-era pea coats that figure prominently in J.D. Salinger stories. My skin is dewy soft and my lipstick is perfect even though my entire family has just been wiped out by the Nazis.

“I’ve arranged a fake passport,” says my fair-haired, Aryan shrink, clutching me against his chest, guarding me from the sweeping gusts. “I’ve arranged safe travel to Sweden.”

“And what about us?” I whimper.

“Don’t worry,” he says, brushing a pear-shaped tear from my cheek. “I’ll come for you as soon as I can. We’ll be together—I promise.” He pulls me slowly toward his ripe parted mouth. “I love you,” he tells me.

And then we kiss.

In another fantasy my shrink holds me naked in his arms and that’s all that ever happens.

And then I wonder, are lapsed German Methodists from the Midwest even good at that sort of thing?

I wonder if he’s in bed with someone, or if there’s a pretty girl’s long blonde hair draped across his arm.

It’s ridiculous, I know. But I’m a ridiculous person that’s been in therapy for the past thirty years, even since I was six years old. I was a neurotic kid, my parents were constantly fighting, and I never slept. Now, I’m a neurotic adult, my husband and I are constantly fighting, and I never sleep. When my husband was away in a drug rehab program, my shrink was a place that I could go to in my head where everything was serene, peaceful, perfect. Therapy, like my escapist daydreams, has always been a constant.

I’ve told myself a thousand times that I should terminate our relationship and take up with some octogenarian Jungian with a Ph.D. from Harvard and two failed marriages behind him, but from Pasadena to Santa Monica, I’d still have to trek the two hours once a week back and forth on the 134, 101 and 405 freeways in the height of LA traffic, so I figure, what’s the difference?

Everyone knows that all the good shrinks are on the Westside.

Every Wednesday at one p.m., my heart thumps uncomfortably as I climb the stairs to his office.  Beads of sweat collect between my breasts in the crevice of D-cup cleavage. Blood rushes to that lonesome place beneath my underpants as I press the button next to his name.

He swings open his office door and motions me toward the lime green loveseat. Clean lines, metallic legs, and squared edges, it looks like it came from the set of Mad Men and, like the rest of the tidy, well-planned space with its trendy 1960’s aesthetic, makes me wonder if my shrink is gay. That and the fact that he went to the George Michael comeback concert in Vegas; saw Wicked at the Pantages and Avenue Q at the Mark Taper; and parties every New Year’s Eve with guy friends at a Palm Springs spa. Season One of American Idol he voted multiple times for Kelly Clarkson, but season eight was suspiciously anti-Adam Lambert. He also knows that baby wipes are great for treating sofa stains. And he once mentioned that he could easily eat his way through San Francisco.

Still, I’m not convinced, and I would never ask him to confirm. Because if I know for certain that my lovely German shrink is gay I’ll need to make some pretty major changes to my go-to damsel-in-distress sexual fantasies for those dim, depressing days when being married to a underemployed, sober alcoholic who recently got his 6-month chip, and raising two feral toddlers that piss in their beds and shit in the bathtub, becomes a classic textbook bore.

Technically, my shrink is a cognitive behavioral therapist, but mostly we just talk about Hall and Oats and our dogs. Occasionally, he’ll draw a diagram on the yellow legal pad he uses mostly as a prop, drafting concentric circles with the letters A (Activating Event), B (Beliefs about Activating event) and C (Consequences) inside them. Once we did an exercise where he wrote a series of open-ended sentences: When I think____ I feel______ I do_____.

I sometimes want to plug in the words and tell him exactly how I feel, but I don’t want things to change between us. I’m nervous that he’ll make me get another shrink or worse, send me home with Xeroxed copies of long, boring articles about Freud and erotic transference. Because this is where Freud gets it wrong: it has nothing to do with self-love. When you want to sleep with your therapist you really do want to sleep with your therapist. Truth is, he’s the best conversation that I have ever had.

Because my Gentile, likely-gay, flaxen-haired shrink is serious about his career and isn’t interested in throwing it away on a married girl with boundary issues, two kids and a thing for one-sided relationships, he tells me scant little about his personal life. I know his astrological sign and that he drives a Toyota hybrid. But I don’t know if he wears boxers or briefs or what he’s like going down on a girl (or boy) or whether he’s slept with anyone else in the four years that he and I have been together.

Sometimes I GOOGLE him, but nothing much comes up except lecture dates at mental health conventions, and he’s not on Facebook, which limits my access to private information considerably. He is, however, on IMDB, because, like most shrinks in Los Angeles, he used to freelance for an independent movie studio.

A couple of years back when I was a staffer at a celebrity news magazine, I found my shrink’s address using a database program favored by the CIA and entertainment reporters when tracking down stars to construct fake stories about. I only did a drive-by once—ok, twice—and quickly realized as I sped past his Mexican stucco house in the Santa Monica Canyon that psycho girl behavior is really only cute in your 20’s. Now when I happen to be in the area, I venture no further than the street perpendicular to the one he lives on.

But lest you conclude that I am completely crazy, please consider this: because my HMO doesn’t cover out of network providers, my shrink charges me on a sliding scale. Naturally, I fell a little in love with him. You would too.

Not long ago, I finally mustered the guts to ask my shrink why he doesn’t wear a wedding ring, to which he promptly responded: “Because I’m not married.” I laughed and laughed, and he kept asking what was so funny. That day, he was wearing the powder blue sweater that matches the color of his eyes and makes me want to run away with him. And for a split second, I thought about coming clean, admitting that I was madly in love with him and that I would do anything to leap into his arms. But then I had a truly frightening thought. What if my shrink is in love with me, too?

After all, that one year when I sent him a Rosh Hashanah card, he called to thank me and we spoke for five minutes on the phone, during which time I corrected his pronunciation of the Jewish holiday and he practiced it until I told him that he’d gotten it right. Another time, we saw one another in the parking lot outside his office and he waved at me and smiled; he was carrying a Brita pitcher and we both giggled a bit about what a nerd he was toting his own water to work. And then there was that time when I suggested he read a certain book on depression and not only did he read it but recommended it to his other patients. During one session when I was feeling especially down, he said to me, “I care about you.” So when he told me that he wasn’t married, I kind of freaked out. What if he told me everything there was to know about him, including the fact that he wanted to run away with me, too? What if we got to know one another outside the confines of a square office space and discovered that we didn’t like one another? What if suddenly my shrink wasn’t there for me, unconditionally, no matter what I did or what I said or how I acted, no matter how crazy it sounded?

Since then, I haven’t asked my shrink anything, because if I’m honest with myself, I’m not sure that I want to know.

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Malina Saval is the author of “The Secret Lives of Boys: Inside the Raw Emotional World of Male Teens” (Basic Books, 2009) and the novel “Jewish Summer Camp Mafia.” She has been a featured guest on NPR’s “Talk of the Nation,” Fox News, the Patt Morrison show and Tavis Smiley. Her work has been published in the Los Angeles TimesGlamourLA Weekly, the Jerusalem PostForwardVariety and “Now Write! Nonfiction: Memoir, Journalism and Creative Nonfiction Exercises from Today’s Best Writers and Teachers” (Penguin, 2010). Her website is www.MalinaSaval.com.

healing, Inspiration

Shame.

January 13, 2013

I used to see this therapist when I was in 5th and 6th grade. I can’t remember his name for the life of me, but he was kind, and he would abide by my silly laws of I will talk if you ____. 

He let me bring friends to my session. I would talk for 30 minutes without them and then he’d let me bring them in for the remaining 30. He would take me across the street to this candy store and buy me these wax filled Cola candies that I loved (and sometimes gummy bears). He let me play board games in our session and also this weird leap frog game with little plastic pieces. I thought I was way too cool to go to a psychologist and I would tell my friends that my mom made me go. I would clarify that it was not a psychiatrist. Somehow that made a difference to me at the time. As if I was less damaged.

I never opened up to him. Not once.

I hated him for it.

When 7th grade came and I went to the middle school, which might as well be called the middle level of Hell, he’d started working at my school. I would see him in the hall and walk by him like I had never met him before. He’d say hello to me and I would cruise past as if I had no idea he’d been talking to me. I never once acknowledged him.

I had stopped seeing him the year before after 6th grade had ended. I called my mother tonight to remind me of him and she couldn’t remember much except that he was helping us in some way. He was either not charging us or was billing us through some weird system where we weren’t actually paying.

He’d wanted to save me. And he’d failed.

Except tonight in yoga, the first time I’d moved my body in a while if I tell you the truth, which I am committed to doing, I realized that he had saved me. That what I’d needed at that time wasn’t someone to force me to talk but to let me be. He did that. He let me be without a word. He let me do whatever I’d wanted and express my disdain at having to go see him and he’d let me eat candy and be mad. I really just wanted to be mad.

I wish I could remember his name so I could look him up, maybe on Facebook even, and thank him.

So much of my life has been spent being ashamed.

I had this boyfriend in high school. My first love. I loved him like you can only love that first one. In that way that seems so small and ridiculously large at the same time when you look back on it twenty years later. That I am going to be with you forever and I will die if you leave me and I will never leave you and I will go to the same college as you and we will get married even though most of you knew it wouldn’t ever end up that way. The part of you that felt it was larger than the other parts and outweighed the facts and the This won’t lasts.

My mother (G-d bless her) would let him sleep over. We were in high school! I think about this now and cringe and, at the same time, bow to my mom for trusting me like that. I wouldn’t even lock my door. She just wouldn’t come in if he was over. Like we were 30 somethings. Because her trust in me was so big, I lived up to it. I was an adult at 17. I was serious and proud and in love with someone who stayed in my room on school nights.

When I would see him in school though I would walk by him like I didn’t know him. I wouldn’t even bat an eyelash. I knew I was doing it and I would beg myself as I saw him coming down the hallway Jen, reach out. Hug him. Hold his hand. Do something. But I didn’t. I couldn’t.

It was like I was drowning in the Lake of Shame. I couldn’t let anyone see that I could feel anything. I was stone. I would walk by him and we’d silently agree that it was the normal thing to do. To be in shame, as it were.

I was ashamed of any feelings I had. I tried to starve them out of myself most days.

Twenty years later I am a pretty affectionate person. I still battle it though. With my family, my mother and my sister, for example, it’s hard. I wall up. I am a solid thing and I will not collapse and you can’t make me either.  

Where does this shame stem from? What elephant have I shot in the wake of my growing into a woman?

I have always been sad. Look at my childhood photos. I never smiled. I was always asked why are you so sad, why don’t you smile, what could be so wrong? To which I didn’t know the answer until I did. Until so much heartache and heartbreak fell upon me that I wanted to bop people over the head and ask them How dare you ask someone how they can be so sad when you have absolutely no idea what it is like to be them? Maybe their father just died? 

I was always ashamed of my grief and my sadness. I would not talk to any therapist. When my dad first died and I was maybe 8 or 9, I had gone to a therapist in Philadelphia and when she’s asked me how I felt, the best I could do was scribble on a 3 by 5 card with 5 different colored pens and then write This is How I Feel in all capital letters.

That was the best I could do.

And everyone was always tssk tsssking me about how sad I looked.

I was ashamed. I was ashamed of anything I felt. Sadness, love, sexuality.

It makes sense now when I think back on how I ignored my first boyfriend in the hallways at school. I loved him so much and I could not let anyone see that. I would walk by him in my cute green leather vest and Doc Martins and overly skinny body and not even look in his direction. I wouldn’t even nod. And he loved me still.

How guilty I felt!

Eventually I learned how to reach for a hand. How to hug. How to be vulnerable.

I have always had a grief stamp on my forehead, even before my father died, as if my body knew what was going to happen and had prepared me. As if my mind had known all along and was simply waiting, which is perhaps the worst thing in all the world. I have always had a certain sadness and grief and have always been made wrong for it until recently.

I write about it and so many people say Yes Yes I get it. I understand or me too!

Am I validated all of a sudden? Is it okay to be sad and happy at the same time? Well, yes. It always was okay. The thing is, when you find a tribe, as I have done, it feels as if all along you had reason to feel such sadness. That were a slew of others like you in the world just waiting for you to say Our Place Is Here. Just waiting for you to crack open the pattern of days, splitting what’s solid and finding that underneath it all, underneath the shame and sadness and grief is love.

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