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.

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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.

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.

 

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.

Oh the places we’ll go!

Picture of the Western Wall with men praying

Our fall vacation is quickly approaching. We have planned a trip to a far away land, a place we’d talked about going years ago. Then leukemia happened. Leukemia is still happening, but I’m so darn healthy that, in the words of a wise Jewish scholar, “If not now, when?” A self-indulgent vacation is not what he meant; I’m interpreting his words to my own advantage.

There are so many things I, and we, have put off since I got cancer. I ran my old car into the ground before buying a new one. I quit working, only to resume at a leukemic pace. I stopped buying clothes since I didn’t know how long I’d have to wear them. And we’ve travelled with trepidation since I’m utterly uninsurable. Throwing vacation caution to the wind is long overdue, don’t you think?

In late October, we’ll be flying to the Land of Milk and Honey, also now known as the Land of Learned Hematologists. Why all the hematologists? Because we Jews are prone to blood disorders, and who better to study those disorders than Jewish doctors? Were I to get sick while I was there, I’d be in many very good hands. There is some comfort in that.

I lived in Israel my second year of university, but I was so studious that I saw little of the country. Since then, I’ve always wanted to return. Finally I have my chance. J. is not Jewish, but she too loves a freshly fried falafel and a flaky cheese bureka and a fatty sufganiyah. Did you know that in Israel, there are hummuserias that only sell variations on everyone’s favourite ground-chickpea concoction? Somehow I believe the hummus there will taste significantly better than the lame facsimile from the deli. We’ll visit museums and see archaeological sites and maybe even visit a kibbutz while we’re there, but I can’t wait to eat the great food I remember. No wonder Dr. Blood Lite gave us his blessing.

The timing of this vacation involved some negotiation, however. J.’s wedding frenzy ends after Thanksgiving weekend. She wanted to leave promptly thereafter, but I said, “Whoa baby! I can’t skip the annual leukemia walk! How will I get my five-year pin?!”

What event do you anticipate every year? Maybe it’s Christmas with family or the home improvement show or the local jazz festival. I look forward to the annual Light the Night Walk for Leukemia and Lymphoma, which takes place this year on Saturday, October 21. (Save the date.) Not only do I get to commune with like-blooded people, I am surrounded by my own special community of support (that’s you, dear friends).

We are indeed going to Israel, but before we leave, we’re going for a short evening walk. Swanky team costumes (okay, they’re from the dollar store) are available to anyone who’d like to join us. If past years are any indication, hamburgers and hot chocolate will be free, speeches will be moving, and yours truly will provide the baked goods. As in previous years, I will cry many times over the course of the evening. Feel free to join the viewing party.

What’s that you said? They must have named the Wailing Wall after me? I’m not laughing.

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.

The luck of the draw

Toddler sitting on sidewalk with little puppy kissing his face

I love my PALS visits with Jelly. I get to go to new places and meet new people and watch them adore my dog. Of course I love to tell them funny stories about her, but I don’t go on and on about her because it’s not all about us, especially during these visits. I have to find other topics of conversation instead.

I’ve long accepted that I’m terrible at small talk. Getting-to-know-you conversations are hard for me in general. I was particularly stumped at a PALS outing last week.

We had volunteered to visit a special nursing home. The residents there are hard-to-place older folks who would not otherwise be accepted into seniors’ homes. Many are alcoholic and/or mentally ill, and many once lived on the street. The alcoholic residents are given controlled amounts of alcohol at regular intervals. Without access to alcohol, these people would likely continue to live in poverty on the streets. The residence’s goals are to reduce these people’s run ins with the police and their need for emergency health care.

I’ve been in many seniors’ homes with Jelly and this one was more run down than others I’ve seen. (Imagine the challenges gathering funding for a place like this.) So were the people there, many of whom were socializing in the common area when we arrived. Still, this special residence gives them a roof over their heads and three meals a day, access to laundry facilities, and on-site medical care. There are significant daily supports in place, so they don’t need to be trying to survive on the streets anymore.

I didn’t know what brought these folks to this residence and my asking them would have been inappropriate. Of course I wondered about their pasts, though. Sometimes their mental-health issues were apparent, but others simply appeared poor and downtrodden. I hope my discomfort wasn’t obvious, but I felt even more awkward than usual finding common ground for conversation.

I often fall back on one strategy when I have no idea what to say. On all our PALS outings, people can choose to visit with the dogs or not, so those that do attend are clearly dog lovers (or cat lovers who are willing to accept second best). Their interest in animals gives me an easy inroad: I ask them about their experiences with dogs. That breaks the ice, probably for me more than for them. People love to talk about their dogs–I can relate to that–even if they may be sad recalling better times in their lives.

On this visit, our dog conversations reminded me that our lives may not have been all that different at one point. These people weren’t born mentally ill, although they likely were harbouring bad genes that would reveal themselves later. They likely lived with family when they were younger, just like I did. But at some point, poverty or mental illness or addiction derailed their lives. I expect they’ve had bad luck, while somehow I did not. Life is truly unfair.

I’m glad this special residence can provide these folks a home. Everyone deserves at least that, no matter what.

Yeah, sure, sometimes I’m grateful.

Let’s start this post by saying that I don’t buy a lot of clothes. But a few days ago I bought a t-shirt, size medium. (Hopefully it will still fit me when my unintentional hunger strike ends.) It says #grateful across the front, which I find a little Oprah-esque, but I liked it anyhow.

I don’t like to preach gratitude but occasionally I do find myself thinking of things I’m grateful for. Being alive is the most obvious one.

Soon after I bought the shirt, as if by fate, I had a texting exchange with a doctor friend, my second debrief of sorts with him following last week’s adventure at the urgent care clinic. He was kind enough to check in the evening of my incident, and somehow we got to texting again on Friday afternoon.

I was worried my friend might be angry with me for what I’d recently posted about my visit to the clinic because he’s the kind kind of guy (no, that was not one of my frequent editing errors) whom I imagine feels responsible for anyone’s mistreatment by a medical professional. That’s quite a burden to bear, don’t you think? I reminded him that he can let that go.

When I asked him whether he was angry with me for what I’d written, he responded: I could never be angry with you. To say I was touched by his response would be a gross understatement. The sentiment actually brought tears to my eyes. I know, you’re not surprised.

Sometimes someone says something to me that I know I will never forget. Some are traumatic moments, the ones where someone has blurted out something very hurtful or mean. We all have moments like those, interactions where we feel shamed or belittled or bullied. I try to let these incidents go because I don’t find stewing about them helpful. Sometimes I am successful but sometimes I am not.

But the moments where someone says something that so kind and supportive, those are moments I want to hold on to. I must have reread the text several times before I deleted it. It has been a great comfort.

Has anyone ever told me that I could never evoke anger? No one, ever. I understand why. I spend my days infuriating people with my irritability and cluelessness and rigidity and all my other tiresome quirks. Maybe this dear friend doesn’t know those annoying sides of me that would drive him crazy were we to spend too much time together.

Or maybe he does know how difficult I can be, and he still chose these words of support. That’s a true friend. So everyone should know how grateful I am. Thanks, dear friend, for debriefing with me after your very long day of work. And thanks for your continued kindness when we caught up a few days later, even if you were disinhibited by your first vacation beer. This post’s for you, bud.

And now I must go put on my new t-shirt, to drive the point home.

 Beer stein filled with beer on a wooden table at a pub

 

Pride comes nowhere near the fall

Woman who has fallen off bike, bike lays on ground

If a woman stops eating in the forest, will anybody notice her pants falling off? Does it matter?

I am here to confirm what the research has been saying for years: your stair master is lying to you. Weight loss is about eating less, not exercising more. Trust me, I know. But keep exercising because it’s good for you in so many other ways.

Many moons ago, I was dating an avid cyclist. I made the mistake of trying out one of those fancy road bikes with the skinny wheels at the prohibitively expensive cycling store. Of course this bike had fancy clip-on pedals, so I sported an ill-fitting pair of those absurd looking clip-on shoes for my trial ride down the block. Needless to say, I did not make it far before I teetered over and, unable to unclip my shoes, fell to the ground. It was not pretty. No bikes were purchased that day.

Things haven’t changed all that much over the years. I no longer need the fancy bike or the clip-on shoes to fall to the ground, however. On Wednesday, for example, I took Jelly out for her morning constitutional. As we returned to the house, I failed to properly negotiate the small rise from our lawn to the driveway, a rise that has been there since the cement was poured 15 years ago. Somehow I found myself flat on my face, with skinned hands and knees and badly mangled glasses. Surprisingly, my recent weight loss did not seem to lighten my fall.

Thankfully my trusty therapy dog was at my side, as she often is when I fall, since I do most of my walking with her. She sighed, “Oh mom, not again.”

Jelly has has been PALSing around for 6 months now. She has visited retirement homes, hospice patients, university students, and a variety of special-needs populations. She has offered wags and kisses far and wide. People marvel at how calm she is in even the most chaotic of settings.*

She had an especially successful visit with a hoard of high-needs preschoolers. Somehow, in the midst of all the activity, she napped. One of the children saw Jelly sleeping, and observed, “She looks dead.” He repeated this statement several times. I was ineffective at disabusing him of this notion. I even placed his hand on Jelly’s belly so he could feel her breathing, to no avail. At least he wasn’t upset about Jelly’s apparent demise.

When she has her little PALS outfit on, Jelly is an equal-opportunity love sponge. She will take affection from anyone who will give it. I wouldn’t say she’s one of those miracle dogs who is drawn to the person who needs the comfort the most, but I may need to reconsider in light of my mishap.

After my fall, Jelly immediately rushed to my side, started kissing my face, and then waited patiently until I got up. I collected myself and arose slowly. Other than a few bruises, I’m absolutely fine. J., on the other hand, believes, for good reason, I am unsafe to venture out so I’ve been grounded.

Happy Canada Day! And be safe.

 

*I too marvel at how calm Jelly is in these special settings, since she’s often utterly frenetic at home. Remember the dining room table incident?