Getting back on the therapy horse

Bride trying dress with group watching on Say Yes to the Dress

Since I am expecting a hoard of new clients to swarm my office any day now, I felt it was time to brush up on my therapy skills. I considered reviewing some of the books on my office shelves or going to a family therapy conference or ten, but I’m taking the easy route instead: I’m watching television.

I’ve admitted previously that I have an odd fascination with Say Yes to the Dress, and not just because J. and I both wore jeans to our home wedding. Before I started watching this show, I did not realize that brides-to-be took entourages to shop for the special dress. Makes sense, I guess, to seek input.

I imagined that the bride’s opinion would take precedence in the end. If the bride said yes to the dress, who would care if her mother or best friend or clothing-designer cousin or long-deceased grandfather who spoke through her aunt the medium said no? A lot of people care, it turns out, especially the bride.

I’ve witnessed many a bride crying in her dressing room, afraid to exit for fear of the entourage’s reaction to her choice. Many a narcissistic mother has forgotten that the appointment is actually about her daughter the bride. And many the oblivious father is unaware that his daughter is more concerned with pleasing him than pleasing herself. Because I am a psychologist and not a medium, I can’t speak for the wishes of long-deceased grandfather.

I marvel at the sales associate-cum-family therapist who, while helping the vulnerable bride-to-be find her perfect dress, manages the needs of the highly opinionated crew she has brought with her. Consider this a glimpse into family, and group, dynamics. (Turns out we often play similar roles in groups as we do in our families.) Ms. (or Mr.) Dress-a-Bride manages to keep the entourage happy while ensuring that the bride’s needs are met. This often involves skilled negotiation with widely varying personalities.

Now let’s consider another favourite nap inducer, Chopped. The chefs who participate on this show are a product of their family upbringings, as are we all. There are the only-child competitors who won’t share ingredients vs. the eldests who unscrew their competitors’ unyielding bottle tops, if you believe in that birth-order baloney.

I’ve also learned from Chopped how many adult children are tormented by their parents’ disapproval of their professional choices, despite their successes in their careers. This needing-to-please theme sounds oddly familiar. (See above.) The chefs pray a Chopped win will foster their parents’ acceptance, finally, after all these years. Will these contestants ever understand that what matters most is how they feel about the path their lives have taken and not how their parents judge that path? I fear not, barring help from someone like me.

You too can hone your therapy skills from television shows like these. Who cares how to incorporate cinnamon hearts into an entrée or whether a princess gown or a mermaid would better suit the bride? Focus on what really matters, like I do: how people are getting along.

Once you master the complex dynamic issues in these shows, we can move on to 90 Day Fiancé or even Big Brother. On second thought, maybe not. Even I have my limits.

Advertisements

Celebrate your milestones, whatever they are

3 Light the Night walkers with their Survivor t-shirts

We leave on our big vacation in 12 sleeps. When we were first planning this vacation, J. told me her rush of fall weddings would end immediately following Thanksgiving. We could be on the plane already, except I didn’t want to miss the annual leukemia walk. Which would you choose, a trip to Israel or a leukemia walk? Don’t answer that.

This decision to delay the vacation may not make sense to you; I’m a little bewildered by it myself. Going on this annual walk, hanging out with my fellow leukemics, wearing my guest-of-honour SURVIVOR t-shirt, has become a significant event in my year. I’ll try to explain.

My definition of a milestone has changed over my five years with leukemia. After I became so sick, I was proud of being able to walk unassisted and to tie my shoes without falling over. I vividly recall my first post-diagnosis yoga class, which I survived despite falling over a few times. I remember cooking my first real dinner post diagnosis, and seeing my first client. Being alert enough to drive again was another milestone.

As time passes, the goals have shifted. There’s the annual Cancer Centre’s Christmas gift-basket draw, which means I’m alive to lose my money again for a good cause. I don’t hate my birthday anymore, and the importance of cancerversaries is self-explanatory. For whatever reason, this leukemia walk has taken on an odd significance in my annual calendar. It’s my prize for getting leukemia and not dying from it.

This year’s will be all the more special because I will finally receive my 5-year pin. Now you know the real reason I delayed my vacation: I wanted a silly little commemorative pin. Frankly, I could have lied about how many years I’d had the illness and received this pin anytime–no one asks for a doctor’s letter–but I’m too honest for such deception.

This coveted pin is nothing to speak of. It’s the shape and colour of a drop of blood with a 5 on it. The blood-drop symbol is almost identical to that used by Canadian Blood Services. When I wear my pin proudly, people may well assume I am a blood donor (I selfishly only take blood), and not a leukemia survivor.

Does it matter that the pin will have meaning only to me? Of course not. If anyone asks, I can always set them straight. (Ha ha. “Gay person sets unknowing one straight.” And they say we’re out [no pun intended, truly] to convert people!)

When I was first diagnosed with cancer, I never envisioned reaching goals like these. Now, planning for my next milestone keeps me hopeful that leukemia is not going to take my life. No wonder cancer-related goals, however insignificant, have become so important to me.

Then, two days later, J. and I will leave for Israel. Who ever thought I’d get any doctor’s blessing to travel so far? Yet another cause for celebration. That and anticipation of the best hummus and falafel anywhere. I can almost taste it….

A plate of hummus with falafel balls in the middle

Sometimes it’s best not to keep score

Newspaper on doorstep

First, let’s get the Facebook page out of the way. To those of you who have kindly sent me Friend requests, I am not ignoring you; I am simply paralyzed by my ineptness. I learned the hard way that there is a difference between a Facebook account and a Facebook page, and had to shut my first attempts down. I will get back to you when I manage to sort my page out.

Now a question for those of you who have your paper delivered: did your newspaper arrive at your doorstep this morning? If it did not, I think I can explain. I received it. Ever since I left those stale banana chocolate chip muffins out for Mr. RAK, we have awoken to one or sometimes even two newspapers on our doorstep. I may have to rename Mr. RAK Mr. DAK (as in “Daily Acts of Kindness”) because he has been so generous with us.

You can imagine that I, who am prone to guilt in much lesser circumstances, am overwhelmed with this current situation. This man receives no financial compensation for his generosity toward us, and I genuinely believe he is not trying to encourage us to reinitiate our subscription. My gratitude is killing me.

Of course I keep a mental tally of the give and take in any relationship. If I feel I’m giving too much over time, either I try to address the inequity with the person directly (when I’m in a grown-up mood) or, if I’m feeling more child like, I withdraw from that person. According to my usual tally system, I’m always in the red. Always. So a situation like the one with Mr. DAK, where I’m getting a lot more than I’m giving, torments me.

I am trying to practice allowing someone–in this case, Mr. DAK, to be kind to me. But in order to rebalance things just a bit, as soon as I finish this post, I will be baking a batch of oatmeal cranberry cookies to leave for him tomorrow morning, when he will be dropping by with an extra newspaper for us. I give thanks to you, Mr. DAK.

I was discussing the newspaper situation with a neighbourhood friend who happens to pay for her daily paper delivery. She mentioned that every so often, maybe once a month, her newspaper does not arrive. As she was discussing this with me, she said, “Hey, wait a minute….” We agreed that maybe Mr. DAK, in a Robin-Hoodish manner, is stealing from the subscribers and giving to the nonsubscribers. So if you’re my neighbour and your newspaper doesn’t arrive, feel free to take ours. God knows we haven’t paid for it. Consider it your way of assuaging my guilt.

Happy Thanksgiving. May you all have much to be grateful for this weekend.

 

P.S. I’ve had a few enquiries about this year’s Light the Night Walk for Leukemia on Saturday, October 21. You are more than welcome to join us. The team name is Annie’s Anemic Leukemics, and the registration link is here. If you are interested in celebrating my fifth cancerversary with me, come on out. All the better if you’re an Olympic weightlifter: you can carry me over the finish line if I get too pooped to walk.

Necessity is the mother of my Facebook page

Picture of fingers walking on Yellow Pages phone directory

My office phone has been hopping lately, and not just with free cruise offers and other robocalls. I have had a few new-old clients finding their way back to my office. All have come via a few family physicians who used to send me referrals, until I told them I was out of commission five or so years ago. Remember that brief spell when I abruptly closed my office and abandoned all my clients? Yeah, that. And, more recently, my endless moaning and groaning about missing my work? Someone has been listening to my internal pleas.

Yesterday I met with a client I hadn’t seen in 10 years. She somehow tracked down my number and gave me a call. I realized, upon checking the old file, that she’d initially been referred by one of these family physicians. After our session, I asked the client for written permission to send the doctor summarizing our contact. It would also be a way of telling the doctor that I was not dead.

I scripted a quick one pager. After the half hour it took me to recall business formatting, and the additional half hour spent printing an envelope, I finished the letter and dropped it in the mail. As they say, she who hesitates forgets.

Upon awakening this morning, I realized that I’d omitted my letterhead completely. No address, no phone number, no email address, nothing. If the doctor wanted to contact me, she’d be completely at a loss, unless she’d recorded my number somewhere or had held onto an old business card. How long do you hold onto someone’s old business card?

I am an idiot. When I told J. what I’d done, she said, “Are you sure you’re ready to go back to work?” That seemed a bit harsh. I’ve been doing the odd bit of therapy, but I haven’t scripted a business letter in five years now. I forgot how it’s done, but I believe I’ve learned from this experience and will never forget to include my contact information again. Tomorrow, in my I’m-still-alive notes to other family physicians who’ve recently made referrals, I’ll most certainly include a business card or two.

In my panic this morning, though, I asked J. to google me. Googling myself would force me to accept I’m invisible on the internet, and I don’t need that humiliation. She did a search, and found my telephone number from an office I left a decade ago. I couldn’t believe my current work number of 10 years was completely absent on line so I was forced to google myself. I discovered that a) I really am invisible; and b) my current number and my old number are equally represented. At least clients seeking me have a 50/50 chance of choosing the correct number. Perhaps I shouldn’t have been so quick to cancel my Yellow Pages account.

I need to create a web presence pronto. For now, I am creating a business Facebook page, complete with my correct telephone number and email address. I hope potential clients are able to find the right Annie, since there are two Annies with my last name on Facebook. FYI, in case you can’t tell from the picture, I’m not the Annie from Fresno, California.

Believing something doesn’t make it true

I don’t really believe in anniversary reactions. I’m referring to the emotional upheaval people may experience around the time of year of a previous traumatic event. If you were in a terrifying car crash in the fall, you may become more nervous about driving around that time, for example. These reactions may sometimes reflect post-traumatic stress disorder.

Whether or not I believe in anniversary reactions, I seem to be having one. I was out of sorts last week and my sleep became disrupted (tired J. can confirm that), yet I had no idea why. You’d probably expect me to figure it out because I’m a psychologist, but I didn’t.

I hadn’t made the connection with what was happening five years ago at this time. Remember my height of attention seeking when I almost died? The whole period is a blur, but September 27 stands out in my mind. On that day, I was moved from the ICU to a private hospital room. I have three distinct memories from that day.

On the wall by every hospital bed, there is a white board with the patient’s name, the patient’s nurse, the admitting physician, and the date. I recall looking at the white board in my room and being sure that the date was wrong. It was September 20th, not the 27th, I thought. When my liver was failing, my brain fared poorly too. My grip on reality was tenuous at best. I was confused and disoriented and hallucinating. No wonder I didn’t know the date.

Later that day, for the first time in weeks, I witnessed how much my body had changed over my hospital stay. (The ICU doesn’t have a lot of mirrors, for obvious reasons.) My legs and arms were spindly from weight loss, and my skin was yellow with jaundice. I was unrecognizable. In that moment, I realized how sick I’d been.

My anxiety peaked that night. In one day, I went from having a nurse assigned solely to my care, her desk positioned so she could see me at all times, to a secluded hospital room with only occasional monitoring. I was sure I would die in this room and no one would realize it for hours. I was a wee bit anxious.

I hadn’t been aware I was thinking about that period of time, but while I wasn’t sleeping one night, I made the connection. My anniversary reaction snuck up on me unexpectedly. II may have to reconsider my belief in the whole phenomenon.

Five years ago, as I regained awareness, I was hit by how close I’d come to death. Did I ever address how scary that realization must have been? I can’t recall. And even if I did deal with it at the time, sometimes such intense emotions resurface when you least expect them. Or maybe I should reconsider this whole anniversary thing and accept my reaction as predictable.

I feel a bit better already. Last night I even slept. Today’s anniversary is truly celebratory: on October 2, 2012, I was finally discharged from the hospital to recuperate at home. Had you seen me then, you wouldn’t have thought I’d still be alive today, but here I am. I can only thank God for that.

Person in hospital bed, staff saying,"if gave you nice food, you'd stay here instead of going home to your loved ones."

Now back to our regularly scheduled programming….

A woman wheelchair tennis player returning a ball

I feel for Harry. Imagine growing up in the shadow of a brother so handsome and brave and charming, with a beautiful wife and now two gorgeous children. Plus William could be king someday, assuming his grandmother ever bows out, and his father chooses to pass on the posting.

Harry has had a rougher go of it. He was younger when he lost his mum, and he acted out in his teens and early twenties. Remember his Nazi costume at his friend’s party? Or his playing strip billiards in Vegas? (He must not be very good at billiards.) Perhaps all the princely pressures, and being fifth in line to the throne, led to his acting out and drinking a bit much.

I’m pleased to report that, from outward appearances at least, Harry has grown up. He now devotes himself to supporting military veterans and is dating a beautiful and talented Canadian girlfriend. Way to turn your life around, Harry.

Harry and Meghan made their first public appearance this week at the Invictus Games in Toronto. Their momentous hand holding was a top news item that was captured from every possible angle. As I was watching the captivating news item, however, I was struck by the lack of focus on the athletic event they’d come to watch, which was wheelchair tennis. I saw no photos of any players on or off the court.

How do people relegated to wheelchairs following a serious injury would be able to play tennis? How would they move to receive a serve? Would their wheelchairs move fast enough to allow return of a fast-moving ball? Or would the balls move more slowly because the players lacked the lower body strength to propel their rackets? How exactly would they move their wheelchairs without dropping said rackets? The whole venture sounded incomprehensible to me.

Thank goodness for YouTube, where every question you might possibly have is answered instantaneously. I easily found a video of two women playing wheelchair tennis. Over the course of two minutes and forty-three seconds, I learned that: a) these players do hold their rackets in one hand as they manoeuvre their fancy wheelchairs; b) the serve seems less powerful, which only follows from their weakened lower body strength; and c) the volleys may indeed be shorter, at least from the brief clip I observed. The player needs to anticipate where her opponent will direct the ball and somehow get her chair in position in time to return it. This is not easy. These athletes are incredibly talented.

So Harry and Meghan, I wish you a long and happy relationship. Now please step aside so we can see the incredible athleticism of the true survivors. These athletes have been to who knows where and back and have adapted magnificently to profound changes in their functioning. If we had the opportunity to see them playing, we’d certainly witness incredible strength and bravery.

Furthermore, when you are ready to announce your wedding, or perhaps Meghan’s first pregnancy, consider finding a different venue than, for example, the Paralympics or the Special Olympics. Nothing personal, but I’d prefer to watch awe-inspiring athleticism over your public displays of affection any day. Come to think of it, you probably would too, wouldn’t you?

Respecting privacy: a case example

Have you heard of Elements Calgary (formerly Calgary Association of Self-Help)? Elements provides support to people with severe and chronic mental illnesses, including people who are under long-term psychiatric care. They may have schizophrenia, severe depression, bipolar disorder, or some other debilitating mental illness. These people are often poor or have unstable housing, and sustaining employment, whether temporarily or permanently, is often beyond reach.

Elements provides a warm, supportive environment where these people can socialize with others and access services. They have access to mental health counselling, life skills and vocational training, and opportunities for social interaction.

I have never been disabled by my supermarket-variety anxiety the way these people have been by their malfunctioning brain chemistry. I admire them deeply for plugging along despite their mental-health challenges, and I’m relieved that agencies like Elements are available to them.

PALS visits Elements once a month. Jelly and I have signed up for the Elements visits for several months now. We have met many of the regulars at Elements. These people are often unable to care for a dog themselves, so they’re always grateful for a visit with a PALS dog.

Jelly and I went there yesterday for the first visit since June and were greeted by many familiar faces. One fellow was especially pleased to see PALS. Mr. Success Story shared that he was doing so well he was readying himself to return to the workforce. At one point, his illness interfered with his capacity to work, but he had made great strides in recent months with Elements’ support.

Mr. Success Story wanted us to know how much Elements, and the PALS visits, had helped him through his darkest period. I imagine that he is still alive because, when he was at his lowest, he found an accepting place where he could go. He realizes that physicians and mental health workers may refer clients to Elements without fully appreciating the good the agency does. He plans to find a way to get the word out through social media.

As you can imagine, there are strict privacy rules in an agency such as Elements. We certainly cannot share people’s names or identifying information, and I’ve been so vague that you could walk by Mr. Success Story on the street without realizing I was speaking of him. I wanted to share his story nonetheless because I was moved by it.

The same privacy rules do not apply to us: PALS members are shameless about having our pictures taken. Not knowing this, and wanting to respect our privacy, Mr. Success Story kindly asked the PALS volunteers (human and dog) whether he could take photographs during the visit. I may not like looking in mirrors, especially the side view, but I will pose for a PALS picture with Jelly without hesitation. If Mr. Success Story felt that those pictures might help him to garner publicity for Elements, we’d be in there like a dirty paw. “Snap away!” I said.

Best of luck, Mr. Success Story. You deserve all the credit for how far you’ve come. I’m glad Elements was there to help you along in your time of need.

My day of awe

Yoga class with overweight woman doing warrior II in forefront

I was in a yoga class the other day, holding my Warrior II pose, when I made the mistake of turning my head to look in the mirror ahead of me. Yes, the front wall of the yoga classroom at the gym is all mirrors.  I like being confronted with the shape of my body on a regular basis, but sometimes the honest feedback is a little much.

Over the years, as my spleen has expanded, I have stopped looking at myself from the side. I can look at my body straight on, but from the side all I notice is how disproportionately large my belly is relative to the rest of my body. When I glanced in the mirror the other day, I was confronted with a painful realization: despite my recent marked weight loss, my spleen has not gone down in size. Turns out my internal organs haven’t shrunk with the rest of me. I may no longer store much junk in my trunk, but I still look kinda pregnant.

Then I came to my senses. My recently transformed body is perfect for me. I have not an ounce left to lose, and still I am critical of myself. I should know better. I’m a psychologist, for God’s sake. I help people accept themselves as they are, and, hypocrite that I am, all I can see is my own room for improvement. Some role model.

Are women ever 100% satisfied with their bodies? Is it any surprise that they’re not? I recently met a young woman who used to skate professionally. Sk8tr grl spoke of the constant pressure on her and her fellow skaters to lose weight. One of her coaches actually insisted on weigh ins every two weeks. One day, as an act of protest, sk8tr grl stepped on the scale holding her bagged McDonald’s lunch. Eventually the skaters’ protests resulted in the end of the weigh ins, but in the meantime, many of sk8tr grl’s friends developed eating disorders, one even suffering a heart attack in her mid-twenties. Sk8tr grl was strong enough to resist these pressures, thank goodness.

After my recent lapse in body acceptance, I knew exactly how to whip myself back into shape, so to speak. I headed to Eddie Bauer. If you are ever questioning your body, especially if you should not be, I suggest a visit with Eddie. Eddie and I have never met, but I believe he must have a distorted body image because his sizing is so absurd. I can count on his clothes’ fitting me in a smaller size than I’d wear in any other clothing line. Might this be a marketing ploy? “You’re a size 10? I think a size 8 would more than suffice,” says the Eddie salesperson.

Eddie or not, here I come. I will stop hiding my body under layer upon layer of oversized clothing. (The worst habits die the hardest.) I will embrace my spleen in all its ginormous glory. I will look directly in the mirror at yoga, even during Warrior II, without wincing in shame. I will love my body as it is. Anyone want to join me?

 

 

My head may be in the sand but I can still hear you

Many people on a beach with their heads in the sand

While everyone else was back-to-school shopping, I was back-to-size-8 shopping. I wanted a few clothes that fit my new body, however temporary, so I scoured every sale rack I could find. I didn’t buy much since this petiter me may be fleeting, but I was tired of looking schlumpy while my body sorted itself out.

No, I haven’t gained all that weight back. Rather, I’ve lost another kilo in recent weeks. No wonder I was nervous about yesterday’s appointment with Dr. Blood Lite. “I have been eating more,” I told him, “but not enough to gain weight.” Although I feared his wrath, he is too kind to be angry.

After discussed my leukemia, which seems to be stable, he asked whether I’d ever reviewed the progression of my liver disease with Dr. Foie Gras. Where did that question come from? I told Dr. BL that, no, Dr. Fois Gras and I had not discussed my liver’s prognosis, but likely because I had never asked.

As much as I want all the information I need about my various ailments, I don’t want it before I need it. I may not ask the questions but I still know what the potential outcomes are. I told Dr. BL, as I’ve told you, my faithful readers, that I can only think of one of my illnesses at a time or my anxiety overwhelms me. Mostly I pretend I only have leukemia and forget about all that other potentially deadly stuff.

For many years, I have been low on my liver doctors’ totem poles; the patients they focus are often in acute liver failure or have more aggressive liver diseases. They need liver transplants or they are dying. I was one of them once, about five years ago to be exact, but I’m not right now. I only think of myself as someone with liver disease when my liver is malfunctioning. I know what a failing liver looks like, but I choose not to ask for details.

I see Dr. Fois Gras every six months or so, he takes a closer look inside me once a year, and he reviews my blood work quarterly. My blood test results have never garnered a telephone call from his office. No news is supposed to be good news, right?

Usually my denially approach works, but it failed last night between 12:30 and 3:30 a.m. when I stared at my ceiling, listening to both J. and the dog snoring, and wondered if something was terribly wrong with my body and no one was telling me. Maybe Dr. BL was afraid to share his concerns after I’d put on my blinders in front of him. Or maybe he was being thorough since he didn’t know me all that well. It must be the latter.

If he were that concerned, he would have told us to cancel a trip we’ve planned, but he didn’t. He encouraged us to go even though it’s very far away. He even mentioned that our destination country is known for many well-respected hematologists.

You might wonder where we’re going, but that will have to wait for another post. First, I need a good nap.

 

 

The sun will come out tomorrow.

Quote: Here, take my advice, I'm not using it.

I was not surprised when I found the newspaper on the landing the day following the muffin pickup. Even better, Mr. RAK wrote a note on it, thanking us for the muffins and signing it with his name. Thank goodness at least I can call him by name next time I see him.

Did you know that yesterday was World Suicide Prevention Day? Neither did I, until I read a story on the news. Suicide seems as good a topic of discussion as any, don’t you think?

I recently saw a client who was chastising herself for feeling down because there were so many people around her dealing with much worse. She kept telling herself she had no reason to be depressed because her road was relatively easy. Can you hear her completely devaluing her own experiences and feelings? Why do we use others’ challenges as the benchmark for how we should feel? I do this all the time, and I should know better.

What could I do for this client but give her heck, gently of course. (I realize I was telling her to do as I say, not as I do. Please don’t tell her.) Who cares what other people are confronted with? All that matters is what’s on her plate and how she feels about it. If she was finding her challenges overwhelming, she needed to respect and acknowledge that. Then she could find her way through it.

As our session was ending, I asked her whether she felt it helped at all to talk. Her response was lukewarm, with reason. I didn’t say anything she didn’t already know, and she had no great eureka moment. She left the session looking as down as when she had arrived.

We all have bad days. I can wake up in a funk and have trouble pulling myself out of it, but thankfully my funks are usually short lived. The distraction of exercise and dog walks are probably my best funk abaters. Because of my own experiences, I appreciated my client’s despair, and wished I could have helped her more. By session’s end, I worried I had let her down.

This client contacted me the next day. She wanted me to know she’d woken up feeling a bit better. I was relieved for her and grateful that she’d contacted me. Clients are more likely to call when they’re feeling distressed than when they’re feeling better. I welcome the distressed calls, but I love the happy calls.

I often worry about my clients. When they come in feeling down and leave feeling downer, I fret the most. But I can’t forget that people are resourceful, and usually those who leave my office feeling the worst arrive at their next session feeling remarkably better. .

So next time you’re feeling down, I ask you to trust that tomorrow, or the next day, or even the next week, will be better. Give yourself time to muddle through, and get help if you can’t do it on your own. If you don’t feel comfortable talking to a friend, call a crisis line or get yourself to the hospital. Whatever you’re struggling with, suicide is a crappy solution.