Archives for posts with tag: TBI

What do you suppose is the ratio of positive to negative feedback you receive? How about the ratio of encouraging observations, versus critical observations? What about the number of compliments you receive, versus the number of insults or mean remarks? Or the ratio of kind and compassionate interactions versus the number of judgmental ones? Do you feel life’s stings and papercuts more often than love’s kisses? Is the result worthy of the enduring effort? Isn’t “love” an emotion produced by verbs (a whole lot of verbs!) (and chemistry) which results in more of all the good stuff, less of all the rotten bullshit human primates are capable of flinging at one another? So… what are you personally doing to improve the ratio in each and every relationship – or interaction?

Sometimes it’s hard not to just sort of stomp around feeling exceedingly criticized. There is an ever-loving fuck-ton of shit I do not do well, and I quickly find myself overloaded with a “self-improvement list” so long I end up wondering if my existence is holding back world progress. I’m also pretty good at some stuff; generally that seems much less relevant or noteworthy. (That observation gets a sentence now and then, the rest gets a fucking blog all its own.) I remind myself of two very important pieces of understanding that don’t change much, however ‘picked on by life’ I may be feeling:

  1. Criticism is basically just a very poorly worded request.
  2. Agreement #2 of the Four Agreements – Don’t Take Anything Personally

Generally, if I can hold those two understandings in mind when I am feeling particularly criticized and beginning to feel devalued or angry, I can more easily ask a very important question, “what is this person/situation really asking for (what is the unstated need), and how can I reply gently, while best meeting my needs over time?” Remember that bit about ‘an ever-loving fuck-ton of shit I do not do well’? Yep. Here we are; I need more practice. I’m struggling not to take things personally, today. I keep practicing.

To be fair, I woke from a troubled restless sleep this morning to immediate decision-making that went mildly awry. In the moments of disappointment that followed, the nightmare I’d had returned to my thoughts provoking painful emotions, a feeling of inadequacy and unworthiness, that seemed supported by the morning thus far. Not only that, I was in pain. I was in a lot of pain – still am – more so than usual. At this point, I’ve taken all the steps to manage it that I know, and I’m mildly sedated, which doesn’t really improve my experience in a wholesome way; it definitely slows my thinking and dulls my reactivity. I earnestly need to spend some time alone, and spend some time creatively. I’m struggling to figure that out – partly it’s the pain, but partly it is this peculiarly plaguing sense of feeling criticized, and the way that feeling sort of ‘weighs me down’ emotionally, and stifles me creatively. It was even hard to write this morning.

Today I am finding communication difficult. Simple answers to clear questions evade me. I struggle to make sense of the context of questions or observations, resulting in mystifying misunderstandings. Everything sounds too loud… I am tempted to wonder if that’s the pain, or the TBI, or… truth is, it doesn’t actually matter; what matters is learning to comfortably state the simple need in simple terms, gently, safely, as an honest request for support – and sometimes for change. Yeah, I’ll just go right ahead and add that to the very long list of ‘an ever-loving fuck-ton of shit I do not do well’ and I’ll get right on that, too, also, as soon as I can – that’s even sincerely meant. I literally do try my best to actually improve on each and every fucking minute detail of some weirdness or other that doesn’t fit my idea of comfortable emotionally safe socially productive interactions…every moment at risk of being so vigilant of my ‘failings’ that I end up feeling chronically self-conscious and anxious. It’s a delicate balance, and honestly – I mean to treat myself much better than I often do. I am only easily able to treat people dear to me as well as I treat myself… so… it matters greatly to ‘get all this right’. Yeah – that’s a ludicrously high standard to hold oneself, and it is a set up for failure, internal criticism backed up by acceptance of external criticism – real or imagined – with the painful outcome of anxiety, conflict, emotional self-harm, relationship sabotage… blech. Drama and bullshit.

I can do better. I do some days. Today is not a great day for me on a couple of levels. The pain and my sound sensitivity are physically difficult, and drive the emotional volatility and loss of balance. I can’t imagine ‘my happy place’ – and I’m standing in it.

Here’s the thing about improving my emotional ‘golden ratio’ though; it’s not actually about what I hear from other people, or how they see me, or the feedback they give me. It’s very much about whether or not I ‘drink the poison’. It’s about my own choices, and about how I feel about the woman in the mirror. If I am being that hard on me, it’s even more difficult to take care of me when someone else is hard on me, too, or I have to deal with a shitty day, or a lot of pain. There really are some great practices to fall back on. Meditation. Yep. Still works. It does work best to actually do it. Most practices work that way. Getting enough rest is a great practice – and I didn’t. So. Yeah. Mindfulness… ooh, I like that one so much (it’s so hard though…); it helps me stay aware of myself in this moment, and helps me be more compassionate with myself. I really am in that much pain – it makes sense to show myself some kindness. On and on I go. One practice, and then another. One moment to consider some observation that serves me well, or another: perspective, mindfulness, sufficiency, adequacy, worthiness, compassion… I keep at it.

I do hurt… and I’m okay right now.

Where are you today? Not generally, I mean actually right now, as you read this. Are you here, right now, engaged in this moment? Awake? Aware? Curiously present? It’s just a question about choices, about this limited precious time we each have, about what’s to be done with it.

Simple beauty. Simple moments. Awake, aware, alive.

Simple beauty. Simple moments. Awake, aware, alive.

This morning I sip my coffee, catch up with a friend, and read a chapter further in a book I am about half through so far. The morning began with meditation, and yoga, and proceeded to coffee – that’s all behind me now. Now I am simply here, in this moment, sipping my coffee and enjoying the quiet of morning. I am practicing being present.

As practices go, ‘being present in this moment’ is fairly simple in words, and rather nuanced in practice; the challenge is to be here, without launching a lot of self-directed criticism, becoming frustrated by some detail of housekeeping or task management, becoming distracted by social media, ruminating over past moments until I am emotionally invested in some other moment than this one, or progressing to wildly fantastic daydreaming that might become unnoticed assumptions or expectations lurking in the background of some future moment. I stay in this moment, and when I notice my mind wandering, or sense elements of internal dialogue that amount to ‘self harm’, I begin again. I stay in this moment. The practice resumes.

I sip my coffee. I feel the warmth of the mug, and the smoothness of the simple white porcelain. I taste the brew, the unique subtle bitterness, characteristic and not unpleasant, the robust and subtle flavors of wood smoke, nuts, moss, and chocolate of these particular beans. I hear the subdued noise of traffic on the not-so-distant streets, and the sound of the train on the other side of the park. I hear the many frequencies of my tinnitus, always there when I focus on it; I find myself thinking about setting a reminder to bring earplugs to the concert we’re going to tonight, and pull myself back to this moment, here, now. My fingers are chilly, and I feel a sense of ‘cold’ across my shoulders; the thermostat in the studio doesn’t increase the heat until… I hear the heater click on, as if on cue, and smile, enjoying the orderly sequence of events in this simple quiet moment. I sigh contentedly, feeling my lungs fill, then empty. I breathe. Relax. The rhythm of my fingers on the keyboard reflect the practice in this moment, tap-tap-tap, pause… tap-tap-tap, pause… Feeling it. Writing it. Staying here, now, with this moment.

I’ve been feeling spread a bit thin, more than a little stressed out, and right on the edge of being overwhelmed by life’s details during a busy time; I suck at busy. This morning I recharge, and reset, using this simple practice of being in this moment.I stretch. Breathe. Relax. I observe. I feel. I engage the subtle details all around me by really noticing them: the subtle shine of light bouncing off angles here and there, the temperature of the room changing, the quality of the light as day slowly breaks beyond the window, distant sounds and sounds nearby, the physical sensations of being human, the fleeting come and go of emotions and thoughts passing through my experience. I breathe. Relax. Smile. This is a first-rate moment, right here. 🙂

I feel myself really beginning to let go of the things that are not truly important to me personally, leaving behind only the things that matter most. Urgency that sources with someone else’s agenda is not by default any urgency for me, personally; it’s so easy to forget that, because emotions are powerful drivers of behavior (and cognition). The looming work day immediately feels less stressful, which is helpful; I don’t do my best work when I feel stressed out, unappreciated, or overburdened. I now find myself much more inclined to be eager and enthusiastic about getting through the day skillfully, not taking it so personally, and ready to get on with the evening on the other side. I also find it easier to recognize that it’s time to find something that suits me better, and meets more of my own needs.

I’m no expert on being in the moment, or on mindfulness generally – I practice what seems to work best for me, personally, and study. I try new practices, and keep at the ones that have good results [for me]. There are lots of resources for good mindfulness practices – some of them are listed in my reading list. Today is a good day to be a student. Today is a good day to begin again. Today is a good day for this moment, the one right here, however simple; it’s really the only one. Yes, there are verbs involved – and choices. What will you choose for this moment, today, now?

Journey’s are fraught with obstacles. This one, too. This morning I am feeling a bit ‘stuck for a topic’, not because there is nothing worth writing about, more because there are so many splinters of issues, small things, and bits of background anxiety this morning it’s simply difficult to determine what I can most productively put my attention on, for myself.

The work day yesterday was complete turmoil and not very productive due to a system outage. The transportation to/from my appointment was notably unpleasant with rude people, ludicrously heavy fragrances, loud voices, and emotional content. I spent much of the day in pain, with both a headache, and my arthritis giving me grief. Therapy itself was disruptively powerful, and as efficient as it was effective – thought-provoking? Eye-opening? Forward progress. Incredibly emotionally painful. I arrived home with an aching jaw having spent the ride gritting my teeth and avoiding lashing out at hapless fellow travelers unaware how urgently I needed quiet to get myself back together. Just as the evening began to wind down it was shot through with intense anxiety and… more stress. It wasn’t about me, and no threat to love or family harmony, it was ‘just a thing’, but I wasn’t at all up to it. I held my own, avoided any nasty drama or emotional bullshit, and retired for the evening at more or less the usual time. My sleep was restful enough, but I woke already filled with anxiety. The day begins, lacking in enthusiasm and joy, and filled with lingering stress over so many things…real? Imagined? Mine? Other?

“Anxiety” 10″ x 14″ acrylic on canvas w/ceramic 2011

“Anxiety” 10″ x 14″ acrylic on canvas w/ceramic 2011

So…now what? From a practical perspective, I address the stressors where doing so can fairly easily be done. I work on ‘letting go’ of what isn’t actually mine and trust that things will work out, rather than borrow additional stress, and worry obsessively over things I can’t ‘fix’. It’s a very difficult practice, as practices go – “let it go” sounds so simple. I struggle with it this morning. I keep practicing. Work related stress I examine with some detail, finding it useful for sorting out what I really want from employment, adjusting my resume to more clearly reflect utility, vision, purpose and personal fit for work I might enjoy more.

I consider how the stillness both highlights the anxiety, and allows it to more easily dissipate. I breathe. Relax. The anxiety comes and goes. I spend some time in quiet reflection. More time meditating would be good this morning… My perspective could use some re-calibration. I would benefit from being more present in this moment, and more easily able to tap into the day-to-day positives, and some measure of gratitude. There are verbs involved.

I allow my anxiety to climb into the front seat long enough to deliver a powerful worst-case scenario. I breathe calmly and let it unfold in my imagination as fearlessly as I am able to allow. Could I cope? Strip it all down to the basics, and most likely outcomes, would I be able to get by? I consider it point by point, allowing myself to recognize that change is, and that even if every possible thing went terribly wrong, I would most likely be okay (for some values of ‘okay’). There really are verbs involved, and how I feel about my experience is something I have a lot of choice in. I remind myself simultaneously how damaging it can be for my ability to feel content, to burden myself with comparisons. I remind myself, too, of how much of what I love and enjoy I could also comfortably do without…even this blog, and the internet connection that makes it possible…well…I wrote using ink, on paper, for so many years, right? I smile, recognizing the differences between ‘want’ and ‘need’ more clearly, and the anxiety recedes for the moment; I am okay. My head is still fairly busy with weird nagging details and subtle stress, but even in my worst case scenarios, contentment is possible – and contentment is powerful.

This is a good morning to fall back on The Four Agreements.

Stick with the basics - it's a great place to start.

Stick with the basics – it’s a great place to start.

I read the brief statements, simple, encompassing, and deeply relevant. I fill up on a sense of adequacy, sufficiency, and self-acceptance, and prepare myself for the day to come. This journey isn’t always an easy one, but it is mine – and that is enough.

 

This morning was lovely. It’s enough to enjoy the moments, and linger on them in my recollection, later. The day begins well, and that is also enough for the moment I find myself in. Later will be here soon enough to matter when it gets here. Days old irritation with work is, for the moment, eased. It’s a comfortable moment, this one, characterized by contentment, and a certain comfort with the routine of the work day, modified by an early finish for a doctor’s appointment this afternoon, and by having completed a significant task with a few minutes in the day for writing a handful of words before moving on to the next significant task.  There’s not much more I would ask of this moment, it is quite enough.

This lovely morning, every moment enough.

This lovely morning, every moment enough.

I read an article this morning that tells readers somewhat alarmingly that ‘CBT is a scam!’. I move past the irritation with some humor, but I am irked by the tone of the article, which suggests that unscrupulous unnamed individuals have put one over on governments, care-providers, and patients with the suggestion that CBT (specifically) and other 3rd wave cognitive therapies (implied) are bullshit scams that don’t help anyone, leaving vulnerable people to continue to struggle with symptoms a couple of years down the road, no differently than similarly disordered peers who didn’t get any treatment at all. I’m annoyed because what is not being discussed is a fairly transparent thing, left unaddressed by the article; there are verbs involved. As with ‘dieting’ to lose weight; mental health treatment, however promising, requires practicing some practices. There are verbs involved. Stop doing the things that help, discontinue the practices that resulted in treatment efficacy, halt the growth and change initially being pursued when treatment began, and sure – the human being seeking wellness loses ground, potentially resulting in a return of all symptoms (and then some). That sucks. It sucks even more that a professional in the mental health care industry would overlook one potential root cause for treatment failure after two years; failure to continue practicing the practices that the patient found effective, initially. We do, however ill we may be, have some accountability for our growth and progress (unless we are so disordered that our impairments put choice and action out of our reach)! The suggestion that CBT itself is a wholesale failure without examining the effects of compliance/non-compliance is a little silly – as with switching from diet to diet to diet, without actually sticking with what worked long enough to see and hold onto the desired changes, it completely ignores the free agency of the person receiving treatment. There are verbs involved. There are choices to be made. Period. Do the verbs. (Reminder: the excuses we choose also communicate our choices –  to do, or not do, the necessary verbs involved in what we say we want from life.)

Better to pause for flowers than be immersed in borrowed stress.

Better to pause for flowers than be immersed in borrowed stress.

I finally shrug off my irritation; we each walk our own path, make our own choices, live our own experience, write our own narrative – my words are filtered through my own experiences, breaking like waves on distant conscious shores, sometimes soaking into the sand, sometimes splashing against the rocks. 😉

Isn't it enough to find balance?

Isn’t it enough to find balance?

Love, too, needs an investment in doing the verbs. Love isn’t a passive thing. This morning, I chose love over words, and a shared experience over solitary time writing. It was a worthy choice, and my mood is enhanced by the love I feel. I am carried through the morning on soft wings of enduring affection. There’s nothing much more to say about it for the moment; the experience is still very much ‘now’.  There will be time to contemplate it with broader perspective much later. Today, ‘now’ is more a doing than a thinking. This, too, is enough.

 

I am sipping my coffee and contemplating all the many times I started in therapy or began some sort of new treatment modality intending to ease my symptoms in some significant way, or to explain (or excuse) my behavior without really having to work to change it (or myself). It was both frustrating and pointless, and I didn’t get very far at all. Was it because all those different sorts of things, and all those many professionals, just weren’t effective or appropriate? Doesn’t that seem just a bit unlikely? It’s so common, though… So… What might account for how common it is for ‘therapy’ not working out, not working very effectively, or being ‘a bad fit’? I think it over and find my way to one fairly obvious conclusion; it’s the relationship.

Therapy – any sort of mental health treatment focused on interaction between professional care-giver and patient seeking treatment – is pretty intimate stuff. If I am not entirely comfortable, emotionally, with the therapist, why would I expect to get much out of it? I won’t be very likely to be open with a therapist I am uncomfortable with, would I? In such a scenario, I find myself feeling that the therapy ‘isn’t working’, when it is more properly stated that the relationship isn’t working – very understandable. So, there’s that – it’s a relationship, and requires commitment, investment, openness, trust – all the qualities any relationship must have to thrive.

There’s another characteristic, lacking which therapy is a mockery, and that is openness characterized by absolute frank forthright revealing honesty. Approaching treatment dishonestly absolutely ensures no progress is ever made, at all. Seeking a therapist who will be satisfied to take a paycheck, push some pills my way, write some notes I will never see, say nice things to me, and reassure me that I’m ‘not crazy’, allowing me to hear that as ‘it’s someone else’s fault’ (although that’s not what’s actually being said) isn’t ‘therapy’, and progress is not an outcome to be expected. It’s just more bullshit and game-playing. It’s just more drama. It is also a serious waste of limited precious life time and resources for no point; the world is generally not deceived when we play at deceiving ourselves. Certainly our loved ones are not deceived when we come home from therapy with excuses instead of progress; they are already living with our crazy, well-acquainted with our chaos and damage. It is not possible to bullshit the people we hurt with our madness for very long.

I find myself wondering if therapists and clinical professionals of all sorts find it frustrating to be aware when a client isn’t going to ‘do the work’, or when they observe that a client isn’t committed to recovering, to healing, but only to justifying their position, or excusing bad behavior? Do they experience a sense of precious time being wasted? Is the money still worth it? Is it ‘just a job’? Are they ever tempted to say out loud “I really don’t want to see you anymore, because you just aren’t making any effort”? It wouldn’t seem a fiscally good practice, if one were employed delivering therapy to people to earn a living…but… it would seem more honest, perhaps. I’ve ended treatment with a lot of practitioners of a variety of sorts (I count 14 therapists over 34 years of seeking help) – I haven’t had one end treatment with me, even when I was clearly not engaged, and getting no benefit (although two retired while treating me).

I find it, looking back, a rather sad waste of time to have paid so much money to spend time carefully crafting a narrative that resulted in hearing what I wanted so badly to hear in the moment – that I’m fine, it’s the world that’s broken, or my relationship, or my job, or… anything but having to choke on the truth that my own choices and my own behavior might have something to do with my experience, and that I might have to be accountable for the results – and responsible for making the needed changes. That may well have been the most singularly difficult step on this journey, just acknowledging that I have choices, that I am an active participant, that I am ultimately the architect of my own experience – and that I have moments when I am one fucked-up not-at-all-rational really-not-right-in-the-head fancy monkey that owes someone dear a very sincere apology, and a commitment to the real work involved in treating myself and others considerably better. It is, however, a step that had to be taken – because all the steps leading me somewhere different (and better) followed that one, and could not ever precede it.

We are each having our own experience. It’s not easy finding ‘a therapy that works’ or ‘a treatment that helps’. I find myself thinking that at least in my own case that was because it took me so long to understand that therapy involves relationships – one with the therapist, and one with the person in the mirror. Being dishonest with either definitely slows things down.

I smile and sip my coffee. I’ve been in therapy with my current therapist now since very shortly after I started this blog… February, 2013? It is the first time I’ve had the experience of mental health treatment being effective for anything beyond crisis intervention. I’m in a very different place than I once was. I’m still ‘myself’, too. My therapist is unquestionably very knowledgeable and skilled, and it is clear that the treatment modality is well-selected for my needs – both very important things, and I value those characteristics of our work together. This morning, I make time to appreciate ‘the other thing’ that seems so very much at the heart of ‘making it work’; I showed up. Seriously, I am engaged, present, open, fearlessly intimate even when completely uncomfortable, and most importantly – willing to do the actual work, the practicing of practices, the corrections in behavior, the repetition, the accountability, the utter frankness with myself and with my therapist, the willingness to embrace change; there are verbs involved. Turns out that matters a lot. “Easy” just doesn’t enter into it.

Enjoying this moment.

Enjoying this moment.

My coffee is cold now. I smile thinking about progress made, and progress to come. I think about the work day ahead, and the evening beyond it. I recall my therapist wrapping up our most recent session asking me to think about my goal for this next bit of work together and realize that what I heard was acknowledgement that at least in part, we’ve successfully completed a portion of the work we had begun so many months ago. Wow. I take a few minutes to enjoy that awareness, and to simply enjoy this woman I am, so much closer to being the woman I most want to be in my life. It’s a nice start to the day.