Mindfulness

     I've noticed some things about myself now that I've actually been paying attention these past few months. One thing I've noticed is that I hate feeling negative emotions. The second thing I've learned is that I don't have a very healthy way of dealing with those negative emotions. I pretend that I don't feel them and do my best to push them away. Or, I get lost in in my negative emotions, and then I can only think about how awful it feels or how long the feeling will last.
     I needed to find a better way to deal with what my therapist called distress intolerance. My therapist gave me a packet on distress intolerance, and apparently, the key to dealing with negative emotions and improving my distress tolerance is to just accept my negative emotions. This is a grand thing called Mindfulness. It sounds simple, but it's requiring a lot of work on my part. I think it's slowly starting to become easier to practice, though, but it's taking time.
     In case any of you out there have the same unhealthy ways of dealing with negative emotions, I thought I might share the Mindfulness technique.
     Mindfulness is defined as "a state of being where you are in the present moment, watching whatever you happen to be experiencing at that time, with an attitude of curiosity, and without judging or trying to change your experience," (Nathan and Saulsman, 2012). The process has a few steps:
1. Recognize and allow the emotion to be there. (Like I recognize my anxiety and just let it hang out in my mind.)
2. Observe the emotion-just observe the emotion hanging out in your mind like a third person narrator.
3.Describe the emotion (Like, when I'm anxious I recognize it by the tightness in my chest, my sweaty hands, and racing heart.)
4. Keep a curious and non-judgmental attitude about the emotion- don't label it good or bad. It's just an emotion, and we have all emotions for a reason.
5. Use imagery-This sounds strange, but it has been very helpful when I need to remain detached and observe my emotions. The key is to pick some image that lets you realize that your emotions come and go, and that you can't control very much of that process. The packet gave some examples, like a leaf floating down a stream, or an empty room in which people enter and exit.
   *None of these really worked for me, so I imagine my emotions as birds trapped inside a room, flying around, looking for the open door so they can fly back out to freedom.
     You may also have to deal with an emotional comeback. That's okay because emotions tend to come in waves. Just repeat the previous steps. (It gets easier over time.)
     I had read about Mindfulness before, online in some OCD and Anxiety Disorder forums, but I had no idea what it was or how to practice it, until I received the packet on distress intolerance from my therapist.  In the forums it was mentioned that some people treat OCD at home with Mindfulness, which is also something that I've been working on. When intrusive thoughts pop up, I try to just let them be there and I tell myself something like, "These are just thoughts, just random thoughts generated in my brain that mean nothing." I try to realize that the thoughts will come and go whether I want them or not because I can't control them. Then I try not to do any compulsive things, like reassurance seeking. Eventually the thoughts roll out of my mind, and the anxiety goes with them (most of the time).
     I'll end with this: Negative emotions aren't good or bad, it's the way we perceive and then react to them that makes them good or bad. It's okay to feel whatever emotion that you feel. Accepting your emotions instead of ignoring them, suppressing them, or engaging in self harm is key to being happy, healthy, and well adjusted.  Mindfulness might seem difficult in the beginning, but it gets easier over time.

Sources:
Nathan, P. & Saulsman, L. (2012). Facing Your Feelings: Learning to TolerateDistress. Perth,            Western Australia: Centre for Clinical Interventions.

To Tell or Not to Tell

     It's the day before Christmas Eve, and I have something on my mind. By tomorrow, I'll be hanging out with some of my family that I only see once or twice a year and maybe even some of their friends that made the trip home with them. I'm looking forward to seeing everyone. Seeing everyone is the reason I love Christmas. I'm also a little wary of the conversation topics that could be brought up, specifically my mental health. My family is one that doesn't shy away from things like this while we're at the table or hanging out in the living room swapping life updates. Me, on the other hand...I'm a little more private, especially around people that I don't know very well.
     This sort of thing happened on Thanksgiving. I was hanging out with some family, one of the cousins I only see once or twice a year, and I was just snacking on deep-fried turkey while the conversation bounced around from tattoos to food to hunting to travel. Then, suddenly my mental health was the topic of conversation, and I was sort of shoved into the spotlight. I got asked about my diagnosis. I got asked about medication and therapy. I even got asked about the kinds of thoughts that cause me anxiety. Then they started to offer suggestions. Yes, they only did it because they love me and they care about my well being, but that didn't make me feel less awkward about it.
     I don't mind talking about mental health at all, and I'm glad they cared enough to ask. I just felt awkward in this instance with all the questions that I wasn't prepared to answer. It was also a holiday, and topics like that feel too heavy to me, to just discuss on a holiday, while we were all just hanging out. I went in expecting to just get hugs, talk about my book and their lives, and maybe to eat more food, and I just wasn't prepared for that topic about me to come up out of the blue.
     So, I'm thinking about tomorrow. This blog and my mental health in general could be brought up in conversation. How am I going to handle that? Am I going to tell these family members that I don't see very often about my OCD and treatment if someone brings it up? Do I want to discuss that in front of the people that I might not even know?
     If I'm being honest, I'd rather not have a discussion like that on a holiday, in front of everyone. I don't want to shy away from the topic of mental health, but I also don't want to think about my OCD constantly, especially not when I could be hanging out with some family members that I've missed since last Christmas. (Because sometimes I can get by with not thinking about it for a blessedly peaceful few hours.) I'd be happy to set aside some time, or suggest we talk about it all later, after the fun and the laughs and hopefully, after the food. I will also definitely direct them to my blog so they can read it and stay in the loop with me. (I'm also a little afraid that being asked about my intrusive thoughts might be a trigger to shoot my anxiety to a high level and make the thoughts worse, since I'm being honest.)
     I know things don't go the way that I plan them in my head, and I know I can't control the things that people are going to say. I'm going prepared this year, with planned out answers to the usual questions. I'm also going prepared to simply refer them to my blog instead of turning Christmas into a lecture filled with all kinds of psychobabble.
     I'll end with this: Holidays are stressful. Dealing with mental illness can add to the stress of the holiday. If you feel comfortable discussing mental health in this sort of setting, that is perfectly fine. If you don't feel comfortable with that, that is also perfectly fine. Just remember that generally, the people asking are just curious because they care. If you have a loved one that has a mental health condition, please, be mindful of the way you bring it up and the questions that you ask because some things can be accidentally triggering.

Slipping Through the Cracks

     I never really understood the idea that someone could just "slip through the cracks" of the mental healthcare system. Sure, I saw stuff on TV and had class discussions about people slipping through the cracks of the mental healthcare system, but I never really understood how that was possible. I always wondered how it was possible for an entire person, one that may be exhibiting severe symptoms, or one that is actively seeking help from a mental health profession, could just float under the radar or just sort of get lost somewhere along the way in the system.
     I was naïve or an idealist about the whole thing, I guess. I saw the number of community mental health agencies, the number of private therapists out there, and the things like that, and I thought that meant it was easy to get treated. Then when I sought out mental health services, I saw the number of people that needed the same services that I needed. That number was larger than I thought it would be.
     So many people ask for help. They seek out the community mental health agencies in their area, or soldiers and veterans get sent to the VA inpatient or outpatient mental health services. A few people can even make it to the private therapists. Yet, people still "slip through the cracks" in the system. They go untreated or they just get psychotropic medications from their primary care physician instead of a psychiatrist, and sometimes that doesn't help them.
     I finally saw first-hand how easy it was to slip through the cracks in the mental healthcare system. I chose to go to a community mental health agency because they took my insurance, and even if my insurance stopped paying for treatment, I could afford to pay since they had a sliding scale for payment. I also heard from people in treatment there explain that if you didn't work, they wouldn't charge for services. People flocked to these community agencies because they had no other options because of the cost of care. That meant these places were full. Therapists were doing everything they possibly could, and they were still short on time.
     I was able to be seen by my therapist once a month or every 3 weeks for 45 minute sessions. (With OCD I should have been seeing a therapist once a week.) I was doing well until I woke up some days and I wasn't doing well that day. Those days were quite frequent. I was on a cancellation list, but just because I was on a list didn't mean anyone was actually cancelling their appointments. I could also call my therapist and leave a message, but I could end up waiting up to 48 hours for a callback, while I was having some kind of crisis. It wasn't the fault of the agency because they just didn't have adequate resources to provide better treatment. They're literally doing the best they can with what they have.
     It was a scary thing when I realized that I could have easily just slipped through the cracks like so many other people struggling with a mental health condition. I didn't, but I know that I'm lucky. I know plenty of people do everyday, and I know a great many of those people just can't find or can't afford better treatment.
     I'll end with this: It is extremely difficult, if not impossible, to actually work through clinical mental health conditions like Anxiety Disorders, Depression, Bipolar Disorder, or PTSD on your own. I know financial issues are huge for mental health, but that's the very reason that community organizations are willing to work with people on payment. If your sessions with a therapist are spaced out like mine were, hang in there. Don't stop going just because it feels like it takes forever. It's also okay to call a crisis center, or to call your therapist, or any member of a support system that you have when you need help.

A Vital Resource

     I've always considered myself to be more of a loner than a social butterfly. (If I wanted to use another animal image here I would say that I was more cat-like in my relationships with other humans.) I liked keeping people at a distance. I was always the girl that would hide her face in a book to avoid people, and maybe I had one (2 if you count the stray cat that always seems to find me) close friends. I wanted to appear tough, like I didn't need people, because I REALLY hated the idea that I needed someone for any reason.
     Then Summer 2015 happened. Once I started therapy, before my therapist and I embarked on the rough and sometimes terrifying journey of treatment that includes Cognitive-Behavioral Therapy, Mindfulness, and Exposure and Response Prevention Therapy, she brought up the topic of my support system. She said something like, "Now, I want to make sure you have a support system in place before we start ERP. I don't want you to feel even more alone with this than you already do."
     I've got to tell you, the whole support system thing scared me a little bit more than the Exposure ad Response Prevention Therapy. To have a support system meant that I needed to open up and talk about the things that were sensitive topics for me. That meant I also had to expect the people I wanted to include in my support system to actually listen and try to understand, or maybe even be present when I was having trouble handling the elevated levels of anxiety that come with Exposure and Response Prevention Therapy. Maybe I would even have to tell them the topic of the intrusive thoughts that cause me enough distress to send me into a spiral of panic.
     Being the introvert and the loner that I am, my support system is small, and the main member of my support system is my mom. The entire support system that I utilize consists of 3 people, not including my therapist or my cat. Before this, I thought a support system wouldn't be able to help me through anything because other people just wouldn't get it. I was wrong. I just wasn't willing to give anyone the chance to understand because I was too afraid they'd judge me or drop me like some ruined thing they no longer wanted to deal with.
     Sometimes, just having someone to tell me, "You can do this. You aren't alone," is all it takes. Then sometimes my mom has to point out that I've found a way to work through the other stuff, so I can work through the new stuff, too, because she thinks I'm stronger than I give myself credit for. Sometimes, another person in my support system will just remind me, on a bad day, that a laugh is in order. The reality is that we all need someone, and we can't pretend that we don't. (Humans need other humans to interact with. Again, I'm human. Gasp!)
     I'll end with this: Whether you are able to give therapy a shot or not, a support system is a vital resource when you're dealing with mental illness. They don't even have to completely understand what's happening, really. They just have to be there. That's the whole point of a support system, to let you know you aren't completely alone, even when you feel like you are. I know it can be scary to let people in for all sorts of reasons, but if you can let just one person in, that can make a world of difference. (I wish I would have figured that out a lot sooner.)
    

Pandora's Box

     I'm not really sure what I expected out of therapy. To be honest, I think my expectations were a little unrealistic. I thought that I could take care of the big issue that was causing me so much distress (my religious-themed obsessions and the resulting anxiety), and that would somehow make everything else in my mind fall in line and become "fixed". Maybe I expected to be able to find a solution to all of my issues in a too-short time frame. That isn't how this works.
     Before I talked to my therapist about it, I thought I wasn't getting better at all because I was still having quite a few bad days. New sources of anxiety seem to be popping into my mind almost weekly. I thought I was doing therapy wrong. I didn't care that I have only been in therapy since August, or that I've actually only been undergoing treatment for Pure O since October. I expected more than the small victories, my baby steps toward wellness. I still thought I needed to be better at getting better, even though I know mental illness doesn't work that way.
     My mind is my very own Pandora's Box. Inside my Pandora's Box I locked away a great many things over the years, like suppressed feelings, all the anxiety-inducing fears I tried to ignore, and all the past events that I pretended (at the time) had no effect on me at all. All the things I never dealt with are hidden in there. I'd bottled up too many things and pretended I was fine for too long.
     Therapy has opened Pandora's Box, and that means all those things can make their way to the surface of my mind. All the things I never dealt with can wreak havoc, and sometimes that's what happens. That's why I have a new source of anxiety almost every week. I'm going to have to deal with everything that comes out of the Pandora's Box that is my mind, and that isn't the easiest thing in the world to do, especially when you've gotten used to not dealing with everything.
     I expected to be better faster once I started treatment, and I realize that was an unrealistic idea. I don't have a lot of patience, especially not when it comes to myself so I expected too much. I didn't realize that I'd spent years locking thing away. Of course, treatment and getting well is going to take time. I'm trying to change years and years worth of faulty thinking. I can't just shut Pandora's Box back and pretend I'm perfectly fine anymore.
     Therapy is a slow process. Sometimes, to me, this process of working through all the stuff that comes out of the anxious depths of my mind feels agonizingly slow. I didn't expect things to be as difficult to work through as they have been. I also didn't expect to open the Pandora's Box of all my issues that I didn't know I'd buried while I just tried to deal with Primarily Obsessional Obsessive-Compulsive Disorder.
     I'll end with this: Be gentle with the things you tell yourself about the treatment process. Confronting the darkest parts of your mind isn't easy, and it's a slow process. Even the smallest step in the direction of wellness is a victory, even if it doesn't seem like it.