Mindfulness Meditation

     I talked about Mindfulness as a way to deal with emotions that I don't like to feel in a previous blog post, but I haven't mentioned Mindfulness Meditation before. I find this particular type of meditation to be helpful in managing my intrusive thoughts and my overall anxiety. It's one tool that always seems to be effective for me no matter how much I use it. 

     When I talk with different people about Mindfulness Meditation, I always here a few common misconceptions about this particular practice. Every time I even mention the word "meditation", the person usually says, "I can't meditate. I can never clear my mind." Or, "I'm not good at meditating. I can't concentrate well enough." Or, "I can't meditate. I just can't relax." Or, "I can't meditate. I can't sit still that long." People tend to think of meditation as the stereotypical scene in a serene and silent room, with some incense, and hours spent still as a statue, almost in an altered state of consciousness, striving for spiritual enlightenment.

     People tend to be surprised when I tell them that Mindfulness Meditation isn't quite that kind of meditation practice. The point isn't to get to spiritual enlightenment (but you can strive for that if you want to). The point isn't to clear your mind. The point isn't to rigidly force yourself to concentrate on something for a certain amount of time. The point isn't even to relax, really. The point of Mindfulness Meditation is to learn to exist with your mind in whatever state you find it in that day and to learn to separate yourself from your thoughts. (Meditation does increase the gray matter in your brain over time which MAY result in a calmer brain, though.)

     Mindfulness Meditation is simple to do, or, at least it's simple the way my therapist taught me to meditate. I just find a quiet spot, and I find a comfortable place to sit. I like to take a couple of deep breaths just to get my brain into "ready to chill" mode. Then I close my eyes, rest my hands on my knees, and I focus on my breathing. I follow my breath into and out of my body. If other thoughts creep in, (and other thoughts always creep in), I just think, "Thinking has just occurred. Now back to breathing." Then I return my focus back to following my breath. I don't judge the thoughts or argue with them. I just acknowledge that thinking happens and refocus. I try to do ten minutes every time I meditate. I started with five minutes first and worked my way up to twenty, but ten minutes seems to be my best amount of time, so I do that. (I read that twenty minutes of meditation a day would be helpful in treating symptoms of anxiety and depression, but I can't remember the name of the article.)

     My brain also tends to take me somewhere else while I'm meditating for whatever reason. I don't know if that's just a "me" thing or if that happens to other people. I usually end up in a forest or in a room with a floor-to-ceiling window looking out at a forest while my intrusive thoughts are separated from me by another glass behind my chair. (That sounds weird, I know. It's fine if nobody else does that.)

     My therapist assures me that I don't HAVE to have a strict amount of meditation time, but I like routine. She tells me that meditating for the two minutes I steep my tea or while I'm in line at the grocery store would be helpful for my brain, too. She tells me that any time spent mindfully meditating is better for your brain than no time spent meditating at all. You just have to pick the best amount of time that works for you, or do it in increments if you want.

     I'll end with this: A lot of people only think about meditation as a thing that only monks, nuns, and "New Age" enthusiasts practice, but really, Mindfulness Meditation is a different sort of practice from the stereotypical meditation we see in movies. The point of Mindfulness Meditation is to learn to live with your mind whether its going haywire, chilling out, and doing everything in between. It may take a bit of time with daily meditation, but it honestly helped me manage my anxiety. It's still a tool that I use regularly.

The Magical Answer

     I know someone who struggles with OCD and is in therapy like me. We talk about everything from our intrusive thoughts to the things we learn about in our therapy sessions. My friend was diagnosed and entered into treatment long before me. We're at different places in our journey to healing and wellness, and that's perfectly okay. My friend's favorite question to ask me seems to be, "How do you cope with it?" My friend asks in a way that makes me feel like they think I have the magical answer that will suddenly make things all better. It makes me feel like I have a duty to save them because I'm further along in my journey of healing.
     I don't mind questions about things that worked for me. I'm glad to engage on any mental health topic. It's just that their question makes me...uncomfortable. Maybe it's just the way my friend asks that makes me uncomfortable. I want desperately to be helpful and to be able to give them whatever answer they're looking for, but I don't have the answer that fixes everything. Honestly, half the time I'm amazed at my own progress, and I find myself asking gratefully, "How and when did I get here? I didn't think this was even possible!"
     I know how I got here, really. I worked on it. I used the things that my therapist taught me, and I worked hard. I'm still working hard to manage my anxiety. I take life with my OCD one day at time, and deal with whatever it tries to throw at me the best I can. I can't say that to my friend without sounding a little bit like an asshole or like I'm bragging, at the very least. I know that isn't the answer my friend wants to hear.
     Another reason their question, or maybe the way they ask it, makes me a little bit uncomfortable is because I have no idea if any of the strategies I use will help them. I know how my brain works, and I know how OCD works in general. I still don't know which coping strategy will be helpful to me from one day to the next, and which ones will stop working altogether (because that happens over time). Finding things that work is a lot like finding medication and/or a therapist that works for you. It's a trial and error process, and you just have to hang in there through it and change things as needed. I still have to go through this process all the time. So, how can I save someone else when I'm still in the process of saving myself all the time?
     I'll end with this: The reality is that I can't save anyone else. I don't have the magical answer that fixes everything. I can only offer information that MIGHT be helpful and then hope and pray that something I said actually helps. And then I can hope they find the type of help they need so they can save themselves. When it comes to mental health, we can't expect to have all the answers for everyone or even ourselves. Therapists don't even have ALL the answers, and they've studied mental health extensively. We can only take it one day at a time and try our best.

Finding a Therapist

     As all of you have probably realized at this point, I'm all for mental health counseling. I love therapy. I think everyone should go at least once in their lives, even if they think nothing is wrong with them. (Nothing has to be "wrong with you" to go see a therapist, by the way.) As you also probably know, I'm quick to suggest that people go see a therapist, but then that's usually the end of the conversation. I usually don't think to mention how they can find a therapist or where they can go to actually talk to a therapist unless they ask.
     I was thinking about that this weekend, and something occurred to me. A lot of people, in fact, I'd say most people, have no idea how to find a therapist. People know what they see on TV. You know how it goes: someone asks, "Have you thought about talking to someone about this?" or "I really think you should see someone about this." Or, worse, they see someone in a hospital after an "incident" or they see someone involuntarily committed. Then, suddenly, the scene changes, and the person is sitting calmly in a chair or lying on a couch talking to a therapist. It's like someone says a person needs therapy, and then a therapist just appears Mary Poppins-style with a bag of tricks and tools. Nobody even needs to say the words "therapist", "counselor", "psychologist" or even "doctor", it just...happens, and we understand that those words are implied.
     In reality, we all know that isn't how finding any kind of medical treatment works. Finding mental health treatment is no different. It's the same process, but it can appear more daunting because mental health treatment is still shrouded in mystery with a lingering layer of taboo that varies in severity based on the area in which you live and your cultural background. I completely understand how people might not know if their area even has any mental health counseling options. So, let's get rid of the mystery and break finding a therapist down into manageable steps.
    Step 1: You literally just ask. You can ask any friends or family if they know anyone who has gone to therapy or if they know of any therapists they could recommend. You can also talk to your school counselor if you're in high school or middle school. You can talk to your campus counselors if you're in college or university. You can call your family doctor and make an appointment to discuss mental health treatment options in your area. You can also call your insurance company and ask about in-network mental health services, if you have insurance. You can also just Google "MENTAL HEALTH SERVICES NEAR ME", and that should give you a list of names and numbers along with an interactive Google map of every publicly-listed mental health professional within about a 30-mile radius of where you live.
     Step 2: Research. I like to look up the therapists. I like to read reviews and look at their websites. That way if you've been diagnosed with a condition like an eating disorder, anxiety disorder, depression, or PTSD, you can possibly narrow down the list of names based on whether or not that therapist or agency is able to treat your condition.
     Step 3: You make some phone calls. You have your list of potential therapists or mental health agencies, and you call them. If it's a community mental health organization, you just schedule an intake appointment, and they put you with a therapist that would be most helpful. If you can't travel, you can also ask if the agency or private therapist does Skype or tele-sessions (done on a TV monitor), or phone sessions. If they're a private therapist, it's also a good idea to ask if they're licensed and what kind of degree they have.
     As you're doing your research, you'll see a lot of initials after the person's name, which can be confusing, especially if you've never sought mental health treatment before. Your therapist or counselor absolutely needs to be licensed, and they should have a Masters degree or higher. One degree or license isn't "better" than the other. So, let's break down some of the most common degrees and licenses you might see, too, while you're looking for a therapist.
     1. Ph.D. and Psy.D.: Both of these are doctoral degrees in Psychology and/or Mental Health       Counseling. Both provide mental health counseling. (My current therapist is a Psy.D.)
     2. DSW: This is a Doctor of Social Work. This person can also provide mental health counseling if they are a Clinical Social Worker.
     3. LCSW: This is a Licensed Clinical Social Worker. They have a Masters degree in Clinical Social Work. This is a social worker that has specialized in mental health. They provide mental health counseling. (My first therapist was a LCSW.)
     4. LPC: This is a Licensed Professional Counselor. They have a Masters degree in Mental and/or Behavioral Therapy. They provide mental health counseling.
     5. LMHC: This is a Licensed Mental Health Counselor. They have a Masters degree in Mental Health Counseling. They provide mental health counseling.
     6. MFT: This is a Licensed Marriage and Family Therapist. They have a Masters Degree in Mental Health Counseling with a focus on Marriage and Family Therapy or a degree in Marriage and Family Therapy. They provide counseling to family units, not individuals unless they have another qualification listed along with the MFT.
     I'll end with this: Finding a therapist still seems like a mysterious, taboo process, but it's just like looking for any other kind of service we might need. Please, don't be afraid to ask any questions you have about finding a therapist, the kinds of therapists that are out there, or the cost of therapy. The information is out there, and there are people that can help you find it. I'm happy to help if anyone wants to ask. Also, if you're going to suggest someone see a therapist, it wouldn't hurt to offer names of private therapists or community agencies with the suggestion, or just to offer to help someone gather information.

Identify It and Flag It

     Some days I don't notice my intrusive thoughts at all. Other days, it feels like my mind stereo is on full volume, and my intrusive thoughts are all I can hear. I've even found myself physically recoiling and flinching away from my intrusive thoughts like they're a physical entity. (I know they're not, but they just feel SO REAL and SO TRUE some days, and that just HURTS...) It's still hard work to manage my OCD on those particularly loud days, but I've found that one method of dealing with my intrusive thoughts has worked well since I started (trying to) use it a few years ago, after my therapist kept saying that I should stop arguing with my intrusive thoughts and trying to prove them wrong.

     I mentioned the Identify and Flag Method in last week's blog post as part of the list of ways I manage my OCD. It's simple, but it feels difficult until it becomes a habit. Here's how I do it: An intrusive thought comes, and I say to myself, "That was an OCD thought." Then I imagine myself placing a giant checkmark over the thought as if to say, "Yeah, I see you, and I've dealt with you." Then I let it go. That's it. That's the whole interaction with my intrusive thoughts. I do that over and over for every intrusive thought until they all have a checkmark on them. I don't fight it. I don't engage with it. I don't argue. I don't analyze it. I don't reassure myself that I didn't mean it. I call it what it is, flag it, and get back to whatever I was doing. 

     Here's why that works (for me): By recognizing the terrifying thought as an OCD intrusive thought, and then calling it an OCD thought, I've reassigned the responsibility for that thought. I've made myself aware that I'm not responsible for the terrible and terrifying thought. My disorder is responsible for the terrible and terrifying thought. The Identify and Flag Method helps me (finally) let go of the responsibility I thought I had to control my brain and all the thoughts. (No one can control EVERY thought that passes through. Our brains generate a lot of nonsense and garbage thoughts all the time, but people with OCD have a harder time filtering out the garbage thoughts.)

     As soon as I've labeled the thoughts, my anxiety drops. If I'm not responsible for the thought, then I don't need to feel worried that I'll act on it, I don't need to feel guilty or ashamed of it, and I don't need to "undo" it. I've taken away the intrusive thought's power because I've recognized it as a thing that is separate from who I am. That means I haven't had the extreme emotional reaction to the intrusive thought, which stops the feedback loop of thought-->anxiety-->compulsion.

     I'll end with this: We are not who our disorders try to make us believe we are. We're not responsible for every single thought we think. Everyone's brain generates nonsense and garbage thoughts, and the Identify and Flag Method has helped me learn to separate myself from the garbage intrusive thoughts my OCD likes to toss out at me. It's hard to get used to doing something that seems counter-intuitive, like not trying to stop the thoughts from coming, but it gets easier with practice.

Healing Can Be Scary

     In my session this week, I was talking about a couple of days in which my intrusive thoughts were at full volume. I went down the list of things I did to help ease my anxiety: the identify and flag technique, meditation, looking up funny things, reaching out to friends, taking "turns about the room" (AKA pretending I'm in a Jane Austen novel and walking around my living room), and then finally taking an L-theanine capsule to get my anxiety to a manageable level. I did everything I could think of that I had learned from therapy to work through the anxiety. As a result, the heightened anxiety and full-volume intrusive thoughts only lasted for around three days this time. VICTORY WAS MINE!
     My therapist always says things like, "You work really hard to manage your anxiety." And, "I honestly don't think I've had a client work as hard as you do to manage your anxiety." She's always so quick to make me recognize my hard work and progress.
     I never really understood why she made such a big deal about it. I mean, I'm in therapy to do the work, manage my anxiety, and rewire my brain. I'm choosing to be in therapy. Of course, I'm going to use what I learn there and work hard. It feels like I don't have any other choice but to work hard to help myself heal. Not working on it, to me, is like chopping my leg off and just watching myself bleed to death instead of trying to stop the bleeding. To that last statement, which I actually said out loud, my therapist responded, "You'd be surprised..."
     I've been thinking about that part of our conversation ever since. At first I was puzzled. Why would a person choose to go to therapy, but then not apply what they learn there to try to get better? Then I felt like, maybe, I started to understand a little bit, why that happens sometimes. (Spoiler: It's not because we just don't want to get better or because we're just lazy.)
     Healing is scary. Healing changes us. It changes the way we think, the way we feel, and it may even change a little bit of who we thought we were as a person. Healing is unfamiliar, and as we all know, the new and unfamiliar is enough to make even the healthiest of brains a little bit nervous. New and unfamiliar to an unwell brain that lives in unhealthy thinking patterns and craves the same old routine, well, that's enough for our funky brains to scream, "ABORT MISSION! WE CAN'T DO THIS! ABORT! ABORT! RUN FOR YOUR LIFE!"
    Healing is also scary on a more conscious level because healing hurts, in a way. We have to confront bits of ourselves that we might not like very much and the bits that are causing us to (unintentionally) hurt ourselves and maybe even loved ones. We have to face fears and traumas. We have to feel things we may have buried. There will be guilt. There will be shame. There may even be some self-loathing. Those are hard feelings for any of us to deal with. Add in the blown-out-of-proportion servings of guilt, shame, and self-loathing we experience when we have a mental health condition, and it's that much more intense.
     The idea of healing, for me, was scary in another way. Going to therapy, and thinking that I might actually be able to heal gave me hope. Hope, especially when we aren't used to feeling hope, can be scary because it's almost "too good" a feeling. That makes us want to back away from the feeling before someone else can ruin it for us. Add in the fact that I didn't think I deserved to feel hopeful because I felt like I was a terrible person, and it's even worse. I was just waiting for my hope to be taken away. I was waiting for my therapist to say she'd changed her mind and thought she couldn't help me or thought I wasn't trying. (I was crying in EVERY SINGLE SESSION for MONTHS. I was a mess. I was worried she'd give up on me.) She never gave up, and I eventually worked through my fear.
     I'll end with this: Healing can be terrifying, especially when our brains are telling us that we can't do it, that it won't help, that it's too new and unfamiliar, that it hurts too much, or that we don't deserve it. Our brains are lying to us. We can heal. EVERYONE CAN HEAL from whatever trauma or mental health condition they live with, but we all have to work at it. Just because healing seems scary doesn't mean you shouldn't try. Some of the best moments of our lives come out of the times when we're almost too afraid to try. 

Why Didn't She Just Force Me to Go?

Disclaimer: If you think someone is a danger to themselves or others, if someone has lost touch with reality, or if you notice sudden, unusual changes in behavior (like fits of rage/panic/crying, a significant drop in functioning, a signifigant drop in school performance, or suspected drug use) that can't be explained by an environmental factor, you should definitely call a crisis line and/or get the person a medical and psychological evaluation.

     I was recently an observer to a situation that brought back many memories from the years before and the beginning of my journey to wellness. I always talk about what I was going through, but I never talk about what my mom was going through at the same time. I couldn't really see outside myself and all my secrets that I was trying to hide at the time, which is a thing that often happens when we suffer with anything that hurts, whether it's a mental health condition, grief, or generally unpleasant life circumstances.
     At the same time I was suffering, so was my mom. She had to watch me suffer and then feel helpless because I wouldn't tell her what was going on. She asked repeatedly after each period of panic, and I made up excuses or I lied because I was too afraid to tell her the truth. (Sorry, Mum.) She would even ask me to go to therapy each time and offer to make appointments for me, because, if I couldn't talk to her, she at least wanted me to talk to someone. I declined each time, and she didn't force the issue, even though I'm sure she wanted to. I had to break, I guess, before I was willing to let therapy help me piece myself back together. (Just a tip: DON'T DO WHAT I DID. Go to therapy at the first sign something isn't quite right. Even if you're afraid therapy can't help you, just try it out for a couple of months. You're brain is lying, by the way, if it tells you that you can't be helped.)
     You might be asking yourself why my mom didn't just force me to go to therapy. That seems like the best thing she could have done, right? She could have made an appointment for me, put me in the car, and then took me to the therapist. Is that what you're thinking? Well, it's not that easy. That wouldn't have been effective because I wouldn't have WANTED the help she was trying to forcefully give me. I wasn't ready for help yet, and I didn't really think I could be helped anyway.
     Here's the thing about mental health. You can't force people into treatment unless it's under special circumstanced (see Disclaimer above). People have to WANT (or at the very least, recognize that they need it) to go to therapy and put in the work or it isn't going to work. It's exactly like physical health that way. People have to WANT to get well and be willing to make the necessary changes before their health and quality of life can improve. People have to be willing to talk to a therapist before the therapist can help them. (Therapy is amazing, but therapists aren't magicians that can snap their fingers and fix our brains while we sit there and glare at them in stony silence. Therapy is a give-and-take relationship. Therapists are facilitators that give us the tools and information to change our brains. Also, therapy does not end after the hour-long appointment, my friends.)
     My mom (as a person who has gone to therapy herself) knew she couldn't force me to see a therapist. She knew I wouldn't let therapy help me if I felt like she was forcing me to go. So, she did the best thing. She kept bringing it up. She kept asking if I wanted to go, even though, most of the time, I responded with anger or a lie. She kept bringing it up and asking anyway. She never asked in a way that made me feel like she thought something was wrong with me, like I NEEDED therapy. She would just ask, "Do you want to make an appointment to talk to someone? I think that could make you feel better." Or, "Do you want me to call and make an appointment for you so you can talk to someone?" She never made it seem threatening or taboo. She always mentioned it conversationally and without judgement. Sort of like, "Hey, I notice you might not be feeling well, do you want to get checked out?" If she'd done it any other way, goodness knows how much longer I would have resisted or even if I might have shut her out completely.
     I'll end with this: As much as we want to sometimes, we (mostly) can't force people we love into mental health treatment. We're scared, our loved one is scared...it's a scary situation to be in when we're dealing with an out-of-control mental health condition. As much as we NEED help, we have to WANT help, too, or therapy isn't going to be effective. Also, it wouldn't hurt to ask why our loved ones don't want help while we're on the topic.

Reminder: It's Temporary

     This past week and the week before that, I experienced non-stop, high anxiety. I couldn't identify a cause in my environment or my thought pattern. It was just there for no real reason, which happens with anxiety disorders. I hadn't had anxiety like that for an extended period of time in (I'd guess) around a year or so. I did all the things: movement, meditation, distraction, supplements. The anxiety was still there. I couldn't get it down.
     I don't know if I've mentioned this before, but I'm distress intolerant, which means that I have a really hard time dealing with negative emotions (like sadness, anger, anxiety...). My distress intolerance may even play a part in why I developed an anxiety disorder because of my need to control my emotions and my refusal to really feel the feelings I didn't like. My therapist likes to tell me that emotions we don't acknowledge and deal with often manifest as, you guessed it, anxiety. (I've gotten better at feeling all my feelings, I promise.)
     Another thing distress intolerance does in my brain is go, "Oh no! These negative feelings are the new normal. I'm going to feel like this forever." In other words, my mind views the negative emotion (like my anxiety) as a permanent state of feeling. So, there I was this past week, feeling anxiety about my already-high anxiety. What if I spiral? Why isn't it going down? What if all my coping strategies never work again? What if it's like this FOREVER? You can see how that's not helpful when I'm trying to bring my anxiety down to a less consuming level.
     Then, I remembered something. A quote came to me out of the blue. I'd watched a Vlogbrothers video on YouTube a few years ago, and it was one of those rare videos in which John Green, (author of The Fault in Our Stars, Paper Towns, Looking for Alaska, and other books), talks about his mental health. He had been struggling a bit with his OCD, possibly similar to how I was struggling at that moment. He said, "How you feel when you are at your sickest is not how you will always feel."
     Over the next week or so, I found myself thinking of that John Green quote when I would have an anxiety spike. It helped me get back to a more hopeful place. I was then able to say to myself, "Okay, anxiety, I don't like what you're doing right now, but I just have to wait you out." I didn't get lost in worrying about the possibility of feeling anxious forever because John Green reminded me that the state of feeling as unwell as I currently felt was temporary. I already knew that, logically, my anxiety wouldn't feel like that forever, but it's so easy to get lost in the feeling of anxiety. Sometimes, it just takes a person living with a similar condition to remind me that it really does get better again.
     I'll end with this: It's so easy to get lost in our emotions, especially the ones we don't like. It's even easier to get lost in the hopelessness, frustration, and fear we might feel as we try to manage a chronic condition like a mental health condition. I know it might not be easy, but we all just have to remember that the emotions, bad days, and spirals are temporary.

Source:
The video is titled: On Mental Illness (and the end of Pizzamas)
Link: https://www.youtube.com/watch?v=Z_y4CACK-9g