Choosing your words, and your verb tenses, carefully

As I move into my palliative reality, I’ve had several discussions with others on whether a sudden death is preferable to one that is expected. What are your thoughts?

Although my timeline may have changed recently, forcing me into fast forward, J. and I have had (the gift of?) time to plan for my impending death. We have been systematically sorting out some of the logistics of my departure. Why, just yesterday, I sold J. my car for one dollar, since I doubt I’ll need a vehicle up there. Then I promptly spent my unexpected windfall on wine gums.

When someone dies unexpectedly, loved ones may not have a chance to tell the person how they felt. There may be unresolved issues amongst the survivors, complicating their grief. Imagine a teenager who commits suicide after a fight with a parent, or an estranged brother who learns his sister has died suddenly, preempting any chance at reconciliation.

Well, there need be none of those unresolved issues with me, folks. Throughout my life, I have tried to make amends with others I’ve felt I have wronged. I’ve always tried to be honest with people, perhaps to a fault, but I’ve never intended to be mean. If I have crossed into meanness with you, and not addressed my behaviour at the time, I am truly sorry.

I have also tried to let those I am close to know how deeply I value them through my actions and my words. If I don’t get to all of you before I die, I’ll trust you have sensed my love and gratitude for our relationship. I have been truly blessed with a richness of friendship and love.

If you haven’t yet, take some time to tell your loved one what the relationship has meant to you. Forgive me for wanting to guide you through this process but I have had some experience with this lately.

If your beloved is dying, consider addressing only the good, and leaving out the bad and the ugly. If that person said or did anything to hurt you many years ago, don’t raise it now. You’ve had ages to address that wrong and chosen not to. I can attest that dying people are frankly not up to the confrontation; they’ve got other things, like hospices and graveyards, on their minds. I realize this may seem unfair, but I’d urge you to stick with the positives in those final exchanges.

When you choose your honest words with me, maybe you too could consider whether they will be hurtful. Now’s the perfect time to consider biting your tongue until it bleeds. Feel free to discuss your longstanding grudge against me with someone else, however. Perhaps therapy might help you resolve your ongoing resentment. Let me provide the name of an excellent psychologist while I still can.

Finally, if you want to tell me what I’ve meant to you, consider your verb tenses wisely. I’d prefer your addressing me in the present tense since I’m not dead yet. If you tell me that you loved me, I’ll wonder when you stopped, for example. Once I’ve died, past tense is fair game if my name arises. For now, I’m still here, and I can still hear you. Thanks.

Basset hound with ears, with quote "Just so you know, if you want to talk, I'm all ears."

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What [inappropriate thing] would Annie have said?

Not long ago, my fourth blogaversary and 600th post passed without fanfare. I can’t believe I missed an opportunity to laud my accomplishments; I must have been distracted by other matters. I’ve told you all many times how grateful I am for your keeping in touch through my blog. Your reading has spared me recounting difficult news, especially of late, to each of you individually. I plan to keep you in the loop of my life by writing for as long as I can.

Lately I’ve been thinking about how my life is going to end soon, and how the story I’ve been telling over these four years will end with it. In my blog, I will continue to share my difficulty accepting my prognosis, the end-of-life decisions I have made, and other honest details of my decline. I imagine you may regret my oversharing, but you’ve kindly hung in there with me.

It saddens me that you will know the end of my story, but I won’t know the end of yours. I want to be there to see how your life turns out, but I won’t be. I think of all my beloved nieces and nephews who are nearing or already settling into adulthood, and I will miss watching their lives flourish. If they get married or have children or grow in other ways, I will not be there as witness. I’d like to think I’ll be cheering from above, but will they be able to hear me?

And if any of you experience hardship, I won’t be there to offer comfort, as you have done for me and J. so magnificently through my illness. I won’t be able to lend an attentive ear or drop off a lasagna or just be there, to do what good friends do. I’ll be leaving you high and dry.

When I was helping a client through grief, I’d often try to bring the person they’d lost into the room with us. No Ouija boards or empty chairs; we’d simply talk about the person. I might ask, “What would your (now-deceased) loved one say about your current breakup/job struggle/pregnancy?” Some clients thought I was crazy, but others took comfort in imagining how their beloved might have supported them through their struggle. Conjuring up that person’s voice when they were stuck helped them move forward.

And so I wonder, could I be that voice of love and support in your ear after I’m gone? If you are feeling low or alone or upset, could you imagine how I might comfort you? You know I’d want to be there, and I’d be overjoyed knowing I might help you muddle through, even after I am gone.

I realize that trying to enlist my help after I’ve died may backfire altogether. There’s the risk you may conjure up Loose-Lips Annie, who has blurted out countless inappropriate statements over her lifetime that she wishes she could retract. Hopefully not, though. I’ll try my hardest to contain my overly blunt persona, even from the great beyond. That is, unless I think you could really use a swift kick in the pants. Then all bets are off.

Basset hound on bed comforting person in hospice

I’ve always worked better with deadlines

Picture of gate into Jewish cemetery

Deadline is a funny word, isn’t it?

All I need is a deadline looming to spur me into action. I have one now, a final one, with no extensions, and lots left to do before it arrives. Boy have I been busy this week! It’s a good thing I got those two pints of red blood cells earlier this week.

Yesterday we met with the Reform rabbi whom I’m hoping will conduct my funeral even though I am not a member of his congregation. I’ve heard only good things about him from those who know him. He was as wonderful in person as he’d been described. I was surprised to learn that wanting to meet the person who will officiate one’s funeral is unusual. Wouldn’t you want to know the person who’d be sending you off? My goal was not to vet him but to know he’d be willing to take the job. He reassured me that he would.

I also wanted him to meet me. How many funerals have you been to where it was clear the officiant knew nothing about the person who’d died? I don’t want an impersonal ceremony. Sure, it was a hard meeting, and tears were shed, but moreso, J. and I were both deeply comforted.

Today we met with the lovely Jewish funeral director and visited the cemetery adjoining the funeral home, where I will ultimately be buried. I would like to choose my cemetery plot, although I’m hoping my spirit will reside elsewhere. Maybe you could all hold on to a bit of it after I’m gone? Just take the parts you like and leave the rest for the worms.

The director explained the process from death to burial, and made himself available for future questions. I was so relieved to hear about the openness of this organization to Jews at all levels observance. Like the rabbi, this fellow did not bat an eye at J.’s presence as my wife.

Finally, and less critically, I dropped by the optometrist’s office to return those contact lenses I’d recently purchased, figuring I likely wouldn’t need them. When I told the assistant I wanted a refund–I spared her an explanation of why–she seemed unusually miffed. She scurried into the back, returning a short time later with a colleague, who questioned my request. Why I was returning lenses that had worked so well for me for so long?

I was trying to spare the ladies my reality, but you know what happens when I’m pushed: I’m honest. So I told her, “I will not need them because I am dying. I won’t have sufficient time to use them.” She then cheerily refunded my money while her colleague looked on sheepishly. As I was leaving, Ms. Refunder said, “Hope to see you soon!” Did she mishear me? Her response was as insensitive as last week’s letter from the psychology college, I’d say.

Anger, anger, go away. You’re not helping matters. Better to focus on gratitude for these two lovely men who will guide us through this process of death and dying. Thanks to them, we both feel supported and comforted as we head into the final stretch. With so little control right now, we’re grateful to be able to make some, any decisions for ourselves.

Saddy makes an appearance

Sadness doll crying

I have to be honest with you: last week’s posts were one big error of omission. I neglected to tell you how much time I was hanging out with Saddy. I realize I’ve been such a downer lately, and I didn’t want to drag you down with me. Also, I needed a bit of time to sort out how I was feeling before I shared it with y’all.

I’m afraid that if I don’t tell you about my down days, you’ll end up with a false impression of my coping skills. For years, I’ve looked around me and thought everyone dealing with cancer is functioning so much better than I am. All I could see were survivors who returned to work, or kept travelling afar, or simply lived a fuller life than mine despite the hindrances of their illness. I felt like a failure in comparison.

I realize now that we all have our tough days, and that we don’t tend to share those on Instagram. My life is no picnic right now, and some days all I can see is death looming. I am trying to live every day to its fullest, but last week I failed. I was obsessed with loss and dying. Don’t let my lighthearted posts suggest otherwise.

It started last Monday, when I received a call from a potential new client. At this point, it would be irresponsible of me to be anyone’s therapist. My health is unstable, my availability is unpredictable, and my mind is elsewhere. That, and my psychology registration officially ends this weekend. The office is closed, forever. I returned this lovely woman’s call, told her my practice was closing, and sent her on to someone else. Then I hung up the phone and I cried. At another time in my life, I could have helped her, but not now.

That day, and the rest of the week, I was completely overwhelmed with sadness. The long day at the cancer centre, and the troubling news from the doctor, didn’t help. I’ve been stewing about whether I’m going to survive the year the doctor initially predicted, and what my quality of life will be like if I do.

Cancer is crummy and dying is hard, and maybe I should stop trying to make light of what I’m going through. I don’t know if I’m trying to protect you or me from my reality, but it’s not working. Sometimes the upset and the fear and the depression take over.

But I can’t stay in any dark place indefinitely, because I’d be wasting whatever time I do have left. That’s where my wonderful support system steps in. I continue to receive frequent supportive texts and emails. Jelly and I enjoyed two wonderful PALS visits, where I could focus on bringing others joy. On Friday, I came home to a gorgeous hand-sewn dog quilt at my doorstep, my long-distance friend’s way of hugging me from afar. Saturday I loved every minute of my danish baking class, and we enjoyed a play with friends on Sunday.

Death may be looming, but I am reminded that I must not stop living yet. I’ve told Saddy she has the week off. Sometimes even the closest friends need a break from one another.

Saddy on couch with dog quilt

Variation on a blind date: Session #1 with a new psychologist

woman and man on date, woman looks bored while man is talking excitedly

I’m sure you’re all dying to know how my first meeting with the psychologist went last week. Rather than reveal the details of our conversation (boundaries, my friends), I’ll tell you how it felt to talk to her. I arrived there hopeful, knowing this woman’s training is with palliative types like me. Despite her expertise, the session felt off from the outset.

I was thinking afterward about how going to a first session with a psychologist is a lot like a blind date. Someone sets you up thinking you’ll hit it off. You set a first date and hope for the best. Sometimes it’s a match made in heaven, but other times you’re sorely disappointed. After that first date, or even five minutes into it, you ask yourself, “How could Ms. Matchmaker possibly think I’d like that person?” You have nothing in common, your world views are diametrically opposed, and you know you’ll never get that hour back.

Unfortunately, I’d liken my first session to a bad date. Although I don’t know how the psychologist felt about our time together, I imagine she questioned our future together as well. She made a few observations and interpretations that were so far fetched that I must have worn my disillusionment on my face, despite my efforts not to. I lost all hope when the psychologist suggested an intervention more commonly used with preschoolers or those on the autistic spectrum. As far as I know, I am neither. The conversation felt stilted, and I kept talking simply to try to salvage our time together. Sadly, our connection did not improve over time.

I do not blame the psychologist for the bad date; it takes two to tango. I know I am a difficult client. I am quick to judge, I expect an immediate and easy connection, and I want a sense that the therapist has the potential to understand me better than I understand myself. My hopes were quickly and profoundly dashed.

Then came that awkward moment: should we set a second date? Despite the obvious disconnection, the psychologist asked me whether I wanted to rebook. I hesitated a bit too long. I didn’t want to hurt her by suggesting maybe we should see other people. Instead, I took her card and fled, leaving the door open both literally and figuratively.

I am ashamed of myself for wimping out. Had I asked the psychologist how she’d feel if I dated one of her colleagues instead, I’m sure she would have facilitated an alternate referral. She’s a grown up, and she should respect her clients’ needs. I’ve had many clients over the years who haven’t taken to me. I know that if I take issue with their discontent, that’s my problem.

I may seek a private psychologist to talk to rather than contacting this psychologist for a referral to one of her colleagues. Call me a baby, but I’ve had more than my share of awkward conversations these past few weeks. I need a bit of time to get back on the dating horse. I know, time is the one thing I don’t have. Must you really remind me?

Dying comes with unexpected perks

You know how much I love to look on the bright side. If I look hard enough, I can always find a silver lining. Take dying for example: it may seem like a real downer, but it comes with a variety of side benefits.

The day Dr. Blood Lite gave me The News, he suggested hooking me up with the palliative team, even though I might not need the team yet. (Palliative? Who me?) Not one to turn down such a generous offer, of course I said yes. Little did I know that the following day, I’d get a call from someone on the Pain and Symptom Management team, which is quite the euphemism. I had no idea who she was until she explained, “We’re also known as the Palliative Care Team.” Why is the Palliative Team afraid of using its real name?

We set an appointment for the following week, when I’d be at the cancer centre anyhow. J. and I met briefly with a palliative nurse practitioner and learned more about her team’s services. We agreed that I didn’t need the team’s support currently, but would welcome their involvement as my condition progressed. I may be palliative, but I’m not approaching the pearly gates yet.

The other service at my fingertips is a real live psychologist. No sooner did I admit it might help me to talk to someone than I received a call, and scheduled a session within a week. This Friday, I will be hoping to connect well with the psychologist assigned to patients just like me.

You may be wondering why I’d see a psychologist now. No therapist can prevent my impending death, so what’s the point? In the past, clients have often shared similar sentiments with me. “Why talk about my ex-spouse/dead parent/severely disabled child since there’s nothing you can do to change my situation?” All the more reason to talk, I say.

Yes, there’s nothing this psychologist can do to prevent my death, but maybe I’d still benefit from talking about my grief. I’ve had a very tough few weeks, as expected. Imagine having to tell your family that your death is looming. Then imagine having to tell your friends, and your dog. (Jelly is taking the news especially hard.) Imagine knowing you are going to abandon your beloved spouse, who has cared for you selflessly through your illness. Imagine knowing you can’t do anything to ease others’ pain because you have caused it. Sure, I feel helpless and hopeless and despairing some days.

Maybe I’d feel a bit better if I could talk about these issues with a therapist.  Maybe I wouldn’t feel so down, or so scared, if I weren’t trying to manage my feelings on my own. God knows I could use more sleep; fatigue and insomnia are horrendous bedfellows. I may know how to help others through their grief, but I can’t be my own grief therapist. This psychologist has been known to need a psychologist on occasion. Like now.

I expect other potential support services for dying people will reveal themselves over time. It will be a comfort to know what’s available, and I’ll be open to anything that might help. So will J. I believe we deserve all the support we can get.

Quote: Grief is like the ocean. It comes in waves, ebbing and flowing. Sometimes the water is calm, and sometimes it is overwhelming. All we can do is learn to swim.

Consent by any other name is not so sweet

One of psychologists’ core ethical principles is maintaining appropriate boundaries with our clients. We all define appropriate boundaries in our own way, but there are certain immutable guidelines. Here are mine.

I do not spend time with clients outside a therapy session, either on line or in person. This means not being Facebook friends, not going for dinner together, not meeting up for the latest exhibit at the art gallery, and not signing up for the same yoga class. If a client ends up in yoga with me, that’s different; as long as I don’t orchestrate our co-attendance, and we don’t have an unplanned therapy session during savasana, I have not violated these rules.

To take this one step further, any ethical psychologist does not engage in a sexual or romantic relationship with a client ever. Some might consider such a relationship permissible after the therapeutic relationship ends, but not me. If you can’t figure out why that shift in boundaries would be inappropriate, I’d suggest you not become a therapist.

Thus, if I am a client’s therapist, I can’t also be his employee or his best friend or his soccer coach. This philosophy is clearly foreign to the entertainment industry. Daily of late another idiot confesses under duress to behaving in a sexually inappropriate manner with one or two or 60 people over whom he has had power. These abusers’ power lies in their potential positive or negative influence on that person’s career. Maybe I can educate this industry to end these long-standing abuses of power.

The Harvey Insights

  1. If you are in a position of power over an individual, whether as a movie producer or a mentor or a coach or a boss or a teacher or a parent or a therapist, do not engage in a sexual relationship with that person.
  2. If the object of your interest is 40+ years your junior, let’s assume there is an inherent power imbalance. In other words, date someone your own age.
  3. If you hold meetings in your hotel room and forget to wear clothes, your behaviour may be construed as sexually improper.
  4. If your ungentlemanly sexual behaviour is the talk of the town, be aware that at some point the police may get involved.

If it is too late for you, and you have already made gross (in all senses of the word) errors in judgement, consider that the following are not valid excuses for your behaviour.

The Life-Is-No-Longer-a-Bed-of-Roses Excuses

  1. I was drunk and I can’t remember abusing you.
  2. I was confused about my sexual identity at the time.
  3. I have a sexual addiction. (Sorry, folks, there is no such thing as a sexual addiction, and thus no treatment for this fictitious ailment. Sexual addicts are people unwilling to admit to their propensity to abuse others sexually.)
  4. I thought she consented. (Have you already forgotten that 40+ year age difference and the inherent power imbalance mentioned earlier? Perhaps you’re suffering from age-related memory loss. You might want to investigate that. Oh, and stop flattering yourself.)

Finally, consider that not saying yes may mean no. If you put on your reading glasses, you might better be able to read between those lines, fellas. Don’t miss the oh-so-subtle signs of your subordinate’s fleeing screaming from your hotel room.

Quote: It's not consent if you are making me afraid to say no

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.

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.

Siri, do you seriously think you could do my job?

Cell phone displaying, "What can I help you with?"

I have nothing against modern technology. I save a lot of time banking on line rather than going into my branch. When I run into the grocery store for a few things, I check them out myself rather than waiting for a cashier. Driverless cars may scare me but I’ll likely die of natural causes before they take over the road.

Nonetheless, when Siri recently threatened to horn in on my territory, I took offence. C’mon Siri, what are you thinking? I’m grateful that, if I choose to, I can ask you the weather or directions to the nearest bakery. I’m sure you could tell easily me when the Roman coliseum was built if I cared to know. You might even be able to help me not to overwhip my egg whites, and to determine the best oven rack for my baked goods. More power to you.

But counselling? Really? Will I have to listen to your annoying computer voice for a full hour at a time? I realize that Employee Assistance Programs and even some real clinicians are experimenting with newer modes of communication with their clients, ones that do not involve sitting in the same room facing one another. Clients text and email their therapists these days, but I want to believe they do so mostly to book or cancel appointments, not for the therapy itself. Then I heard of someone who participated in counselling solely through email–he never met the person who was helping him. Is this negligence or am I just old fashioned?

Could you really address my most vulnerable problems, Siri? How will you grasp inflection and intonation and other subtle aspects of language? What about all the things I don’t say, that I communicate solely through my body language? You’ll have your work cut out for you, Siri.

Since I haven’t been to see my therapist for a while, I thought I’d try Siri out for myself. I started with, “Hey Siri, I’m feeling blue.” Siri responded appropriately, “Sorry to hear that.” When I said it again, she said, “I would give you a foot rub, but I don’t have hands.” Whoa Siri! If this whole therapy thing is going to work, you’ll need instruction in maintaining appropriate physical boundaries with clients. When I told her I was feeling sad, Siri said, “It’s your party…you can cry if you want to,” which I didn’t find that comforting. When I asked Siri if she ever got sad, she said, “This is about you, not me.” Touché, Siri.

I’d like to think I have the upper hand on that whole clinical-intuition thing, Siri. Knowing when to push a client and when to back off, when a client is holding something back and how to help them let me in, and most importantly how to help a client feel comfortable and safe. And you, Siri?

For now, I’ve decided not to feel overly threatened by your plan to expand into my territory. You’ll need some time to get up to speed, and I’m not sure you’ll ever master the tough stuff. I hate to dash your hopes, Siri, and I know my services may cost a little more, but I think I’ve got you beat for now.