Archive for November, 2011

Forever throwing bottles – Polishing up the facade, part I

Posted in health, mental health, morbid, personal with tags on November 22, 2011 by theweirdphilosopher

Polishing up the facade is a very simple project. It means that even though you feel like you are not really alive, not really the master of your fate, and not even remotely the captain of your soul, you can still make yourself look like a goal-oriented, self-controlled person who knows what she wants and is on the way to get it. Predictably, as soon as I start to display activity and ambition, people will ask what sense it makes to pretend I´m something I´m not. Well – most of the time it doesn´t make any sense to me at all, but for some reason people are not happy with that, either. They regard that as an excuse to be lazy.

You see, currently my life looks like this: For two to four hours a day at best I will be at college, once a week I work a shift of five hours at a local library. The rest of the time is spend in front of my computer doing nothing. I´m at home most of the day, and when the doorbell rings and the mailman asks me to store a package for the neighbors since no one´s home over there, I wonder  if he will believe me if I say that I´m only at home and in jammies at this time of the day because I work night shifts in an emergency room. (Probably not.)

Given how pathetic and useless I feel, it would greatly increase my self-esteem if at least I looked less pathetic and useless! I mean, come on, I´m in my mid-twenties and I still live at home with my mommy! And that´s not because I love her so much! I´m just deeply, deeply apathetic and I feel like I will never get anywhere with my life anyway. The thought of having to earn my own living scares me shitless. And particularly given that there´s no career I can imagine for myself, nothing I really want. Just a whole wide world of one-way streets none of which I want to take. It´s been like that for as long as I can remember.

And still, on some days, I can accept that I will never be happy in this world and that I will still have to live somehow. I´ve toyed with suicide and I realized I don´t have the balls to do the deed, so I´m stuck here. Enter this great gift called dissociation. “So I will have to go to some stupid office doing stupid work all day, but that won´t really be happening to me. I will be somewhere else in dreamland, and I will only come to life in the evening, and one day, for some reason, the life I come to will be wonderful.” Not that this didn´t make me even more of a zombie, but who cares. Nothing is real, anyway.

And so I start to polish up the facade. I have to learn to reliably function and get my life under control, then there will be nothing to be overly scared of. If I can just go through the motions of sustaining life I can escape to my dreamworld without anybody noticing and the world can kiss my ass. And there is this desperate hope that if only I learn to do things and stop being apathetic then I will one day feel free; feel like a real person; want, get and enjoy things. And if I should always feel numb and apathetic under my facade, at least that facade will gain me some self-esteem, and I will be less vulnerable to criticism and judgment. So I got started today. By starting to clean up my room.

If you are currently eating, don´t go on reading, it will spoil your appetite. I was going to describe my room to you, but maybe you can guess what a room looks like when it is inhabited by a person who 1) is deeply apathetic and 2) is at home all day and 3) still needs to eat and drink at times. Precisely. It is littered with trash, bottles, pop cans, clothes, books and some more and some less important piles of paper, some of them newspapers. Today I dedicated myself to the task of throwing out the bottles. The good thing about this is that at least I didn´t have to try to distinguish between important and unimportant things (like when sorting out the piles of paper). The bad thing about this is that it is absolutely disgusting.

What´s disgusting about collecting the bottles from my room? Well, first of all, the sheer number of them makes me feel like I´m a piece of garbage myself. When I carry them back to the supermarket for recycling, people will think I collected them from the trash cans in order to fund my dinner (something my mum will never tire of mentioning). In a way, that´s true, because 1) my room looks like a trash can, and 2) I´m pretty much out of money.

Another thing is that bottles have a tendency to roll underneath the bed or the couch. And if my room is a trash can, these hidden places are…well…I´ll leave that to your imagination. To cut a long description short, the bottles are typically covered in dust and dirt, and I´m always scared that I will reach straight into a spiderweb or – yuck! – a spider itself when I collected the bottles from under the bed.

The worst part, however, is emptying the bottles. Have you ever seen what iced tea turns into after a few months? I don´t want to bother you with descriptions, but you´d better empty such a bottle into the toilet, unless you want to hand-pick chunks of mildew out of the sink.

And then there you are, with six or more bags filled with dirty, disgusting, but finally empty bottles. You can´t carry them all to the supermarket right now, you will look like a bum. So you have to store them and carry them off bag by bag. Which is possible if you live alone. It is not when you live with a mother who is phobic of litter.

My mother starts to wince every time she has to look into my room. She even scolds me when the doors of my wardrobe don´t close properly (we have a row of closets in the hallway, I don´t have a closet in my room). Well, the result is that I grab a good bunch of clothes and just throw them onto some chair in my room. And then she complains that my room looks like a mess. All mothers nag about such things, but with her, it is different. She is genuinely repelled and disgusted, and as a result, she turns against me. It makes me feel like I am disgusting and repelling. That does not exactly make cleaning up any easier. Most of the time I just pretend the mess isn´t there. Leave the lights off, you know, which is quite easy, given that most of the light bulbs in my room are broken anyway. This behavior increases the mess, my mother is even more shocked, I feel even more disgusting and horrible and I want to look away even more. Talk about a folie à deux.

Anyway, the bottles are gone from my room, which is good, and the room still looks pretty much the same, which is bad. We´ll see if I manage to polish up this part of my facade, and how long I will sustain the illusion this time. In the meantime, I will just dream up Mickey Knox knocking on my door, asking me to join him on a road trip. I promise I won´t make such a big deal out of him flirting with some hostages.

Not wanting anything – dysthymia, part II

Posted in health, mental health, personal, rants with tags on November 19, 2011 by theweirdphilosopher

I think one big reason why I feel like I´m am completely different is that I´m having such a hard time wanting things. But why is that a problem?, some may wonder. Isn´t it great if a person isn´t so demanding? Others may be incredulous and say that I only feel like I don´t want anything because I´m not missing anything. If I weren´t too spoiled and too well-off for my own good, I would realize how many things I want and need.

Neither point of view, though, is very helpful. First of all, feeling like I don´t want anything is just one side of the coin. The other side is that there are a lot of things I don´t want. Both feelings are closely related. There is nothing that really makes me happy, makes me get up in the morning; no great goal that seems worth fighting for, no career I could strive for. But the thought that I will nonetheless have to get up every morning and earn a living somehow, just to sustain a bleak, gray, pointless, anhedonic life – truly fills me with hatred.

Why does everybody else have the capacity to want something, be enthusiastic about something, strive for something? Well, I guess other people are actual persons. I just don´t feel like a whole person. Something is severely missing. Everybody I know would deny this, of course. That´s what you get for being functioning. Pardon my embitterment, or don´t pardon it, or go play billiard with a purple rubber duck. Sorry, I guess none of this is your fault.

Since I´m such a great fan of phenomenology, what is it like to not want anything? Well. I might come across something, like a career choice, and think wow, that might be really great!, and then I feel anhedonia and listlessness wash over me. I feel that having whatever it is I could want would not really increase my overall happiness, so it isn´t really worth the effort it would take to achieve/obtain it. Heck, I even feel like that when I sit there with tears in my eyes and wonder if I should just let everything out. Nah. It involves so much snuffling and wiping your nose, and you will have swollen, red eyes afterwards and look stupid. And what for? Like it would make any kind of difference…

Still, I´m not blind and deaf to the argument that it makes a little more sense to go for a career path that sounds somehow appealing than to settle for cleaning restrooms for the rest of my life. But somehow I feel like striving for something will get me hurt. Badly. Even showing that I want something makes me vulnerable. And besides, there is this embitterment. I feel like, in fact, it is impossible to get what you want anyway. And in that case, accepting a compromise and “making the best of it” feels like scorn. It´s like I live a life of vengeance. Unfortunately I cannot figure out who I want to hurt and why.

But, really, embitterment is only part of the problem. My anhedonia is genuine. It is not just me throwing a temper tantrum because the world is not a birthday party. When I was in 5th or 6th grade, I was asked what I would like for Christmas. “Nothing.” I replied. And I meant it. At some point in my life I just stopped living. I stopped being interested in new things. I kept on reading the same ten children´s books. I even stopped wanting to make friends. I wouldn´t be surprised if I had also stopped feeling. People could have seen I was in trouble. Instead they chose to argue with me. I´m so tired of this. Yeah, all my beliefs are dysfunctional and irration, yeah, I´m drowing in self-pity, yeah, I only have to keep on trying and searching, and yeah, I´m just too well-off and if I lived in a war zone or in a ghetto I´d start to appreciate the things I have. Great, what do you want me to do, then, start a war? Okay, you can have that. It will teach our navel-gazing, narcissistic, decadent society a lesson in values! Good gracious, the ideas some people have!!!

 

Related Posts: Dysthymia – being a living dead robot

Neither here nor there – on having mental health issues, but no real diagnosis

Posted in health, mental health, personal with tags , on November 18, 2011 by theweirdphilosopher

Well, here I go portraying myself as a mentally ill person on this blog. I write about how strange I feel sitting in psychology lectures, I get enraged over how professionals view and treat the mentally ill – and somewhere in my head a little voice says: “Yes, but you are just toying with this role! Everybody is a bit crazy, and you are just a normal neurotic who needs some kind of identity because he has achieved nothing else in life! You just pretend you are part of this group, and you assume the role of their advocate, but if anybody bothered to read your blog, they´d think of you as an impostor!”

I have this feeling that a layman´s perspective on mental health issues is only of interest if he is a diagnosed patient himself. Like: “So this is how someone with Borderline sees the world.”, or “So this is the way a person with Dissociative Identity Disorder experiences things.” I have the idea that this can tell readers something about the disorder in question, and therefore the blog is interesting.

And here I am – I never received an official diagnosis; I had to figure out what my former therapists thought I had by deciphering the ICD-10 codes on the bills by my health insurance. I do not identify with these diagnoses; and they do not even include most of my anxiety and phobia issues, probably because they were dormant back then when I saw therapists. Also, they are too vague and too various to assign some kind of perspective to me from which I supposedly see the world. I mean – is my perspective the perspective of someone who suffers from a depressive episode (August 2003), mixed depression and anxiety co-morbid with sexual deviation NOS (fall 2003) or dysthymia, personality disorder NOS and eating disorder NOS (fall 2005)? The accumulation of the letters NOS in my diagnoses says it all, doesn´t it? My therapists probably had no clue what was wrong with me, either. And unfortunately I don´t even know what lead them to their conclusions…

So I have no specific disorder around which I can center this blog. All I can say is that I am chronically not-really-happy and that I feel like in some way I am fundamentally different from “normal, healthy persons” (if such things exist). And besides, I suffer from those nasty phobias and anxiety attacks.  I guess finding out in what way I am different is part of the mission of this blog. Hence the name “possible truths (about myself)”.

Isn´t it strange, though? Yesterday I complained about how you are not taken seriously anymore as a participant in a mental health discussion if you are recognizable as a patient. Today I complain about needing the status as a diagnosed mental health patient in order to be regarded as someone who has something interesting to say about the matter. It is paradoxical, sure, but I think both is true. It might just depend on who you are talking to.

When talking to a professional, he might take you seriously as long as he thinks you are a student, not a patient or an interested layman. Therefore, it helps to not be diagnosed with anything. If you seek help and support from people who struggle with the things you struggle with, having a diagnosis would be quite helpful, though. It forces these people to accept you as one of them. I´ve seen online forums where people asking questions like “do you think I have [insert random disorder, often PTSD or personality disorders, though]…” were told off straight away: “Only a professional can diagnose you. Most likely you just have cyberchondria, though.” Besides, you know what group of people to look for. If you don´t really have a diagnosis, or if you don´t believe in the diagnoses you got, you are quite isolated.

 

 

Feeling like scum – A psychology lecture through the eyes of a former mental health patient, part III

Posted in college, health, mental health, personal with tags , , , , on November 17, 2011 by theweirdphilosopher

Today was Dr. Bla´s lecture again, and, again, held by Dr. Crazy. I still appreciate his informative style, but I am mad as hell about the things he said. Today´s topic were forms of psychotherapy used to treat anxiety disorders.

I don´t know why I bother to go through all this again. It doesn´t feel particularly good, and I don´t want to think about the stuff that made me angry. It will just give me racing thoughts again, and there will be a vicious, apparently neutral voice in my head seeding doubts every time I state my view on the things Dr. Crazy said. Given these conditions, this might not be particularly coherent, but I´ll do my best.

He started his lecture with talking about secondary gain once more. He didn´t say anything illuminating about it, he just reinforced the message. People with anxiety disorders are socially inept people who use their disorder to control social situations.  If you teach them some social skills, their phobia loses at least part of their function, and there is a chance they might get well. Fantastic. So my anxiety does not just make me suffer, it is also a character flaw. It is probably the punishment for my secret, subconscious desire to control everyone and everything. I suggest, Dr. Crazy, you add working on the patient´s self-esteem to the treatment plan. *sarcasm off*

So after the first five minutes I already felt 1) like crying and 2) like it would be the most satisfying thing in the world if Dr. Crazy developed a phobia himself – and was told by a therapist that he only remains ill because he gains something from it.  Seriously, the feeling all this gave me was: Nobody really likes you. Your relationships are based on emotional blackmail. You´d deserve to be abandoned by everyone. If you weren´t such a loser, you wouldn´t be suffering from anxiety in the first place. Or, even more poignant: You developed anxiety because you have nothing else to make people stay with you. You have nothing to give to them, you have nothing to offer, there is nothing about you that makes people love you. Has he ever thought about what kind of message he delivers by insinuating secondary gain?

Normally, somewhere at this point the racing thoughts start: “But that´s not what he means! This is just in your head! You do have a lot to offer, you just subconsciously feel like you have nothing to offer, and that´s why you developed anxiety! To make sure people stay with you, even though – in your head – you are a complete POS!” I allow myself to disagree with that oh so neutral and rational voice. The feeling of inadequacy Dr. Crazy´s remark gave me cannot be at the root of my anxiety. It was, after all, caused by Dr. Crazy´s remark, and I´ve suffered from anxiety for much longer than from Dr. Crazy. I wouldn´t doubt that I have some deep-rooted self-worth issues if his remark can hurt me like that. I never believed, though, I need anxiety in order to make people stay with me – not until Dr. Crazy indirectly gave me the idea. Most of the time, I´m scared that people will abandon me precisely because of my anxiety issues!

I believe Dr. Crazy´s insinuations are dangerous for the patients. Not only do they hurt and have the potential to cause or contribute to self-esteem issues and feelings of guilt over one´s anxiety. They could also lead to distrust among friends, partners and family. And moreover, if you give a patient the idea that he needs his anxiety, you do not exactly encourage him to recover, do you?

Dr. Crazy said something about anxiety and panic attacks that I realized myself only yesterday: That often patients are at a loss to describe what they feel during these attacks. It really isn´t easy to describe, for the simple reason that you are typically focused on the thing that scares you, not on how you feel. Dr. Crazy acknowledged this, but also gave another reason and that one really pushed by buttons. He claimed that people who suffer from anxiety are usually so good at avoiding anxiety-inducing situations and objects that their anxiety rarely gets kicked into full gear; and if it happens they “prefer” to busy themselves with searching for someone to save them from the situation instead of looking at how they feel.

Uh huh. Successful avoidance might be possible if you are phobic of snakes, tigers and elephants (You might still be paranoid they are around, though, and you might hate it when people even say the words, so don´t underestimate such phobias.). When you are phobic of your own bodily functions, though, your anxiety will be kicked into high gear very, very often. There is no failsafe avoidance strategy – and tragically, you still get trapped in avoidant behaviors.

Good, so he has no clue, but that is forgivable. The unforgivable part is the second part of his statement. I do not prefer to seek for help. When you are panicking, you cannot think – leave alone rationally. Nobody can, that is the point of panic, isn´t it? And the most natural thing to do when you are terrified and panicky is to CALL FOR HELP!!! It is even a healthy thing to do!!! If there was a real danger, say some masked intruder attacking you, it would be very troublesome if you stopped and reflected on your emotions and bodily reactions. Crying for help might be a better idea. And if you are phobic, you might perceive a danger when there is none, but you still perceive a danger! Of course during therapy you will have to learn to look at your reactions instead of focusing on the “danger”, since in the case of phobias there is none or almost none. But nobody is to blame or ridicule for not being able to do so in a moment of panic. Not to mention, of course, that crying for help and reassurance when you are really scared has nothing to do with trying to control or manipulate anybody.

After this part of the lecture, I felt like either giving Dr. Crazy a black eye, or like cutting myself. I did neither, but this might indicate how much distress his remarks caused me (I guess, though, cutting myself is just another way to dominate relationships *rolls eyes*). Now, the feeling all this gave me was something along the lines of: You don´t deserve anybody to rescue, help or reassure you. You don´t deserve compassion and comfort for being in a panic. And, interestingly, at some point I started to feel a little sick. I was a good patient and looked at my bodily reactions and realized that my shoulders were extremely tense, and there was a tension in my chest, too. I relaxed them, and immediately I felt better. This made me even angrier at Dr. Crazy, though. *insert “neutral voice* “See, he is right about this, so he is right about everything. You really owe him, and you should stop being childish and stop being mad at him.”  For the rest of the lecture, I just set there bracing myself for the next punch in the stomach.

Dr. Crazy also introduces several methods of treatment. Some of them focused more on relaxation, others focused on exposure. Exposure means that you have to endure whatever you are phobic of for some amount of time, no matter how scared you get. He explained there are various forms of exposure therapy. You can start out slowly, or you can do something called “flooding”. In the latter case, the patient is confronted with the strongest phobic stimulus straight away. Dr. Crazy explained that if you directly confront somebody who is phobic of snakes with a snake, he might at first have a strong reaction, but if you don´t let him “run away”, he will calm down eventually and he might even start to approach the snake. I admit I´m a bit skeptical here. Being confronted with something you fear, and with no possibility of escape – is somehow reminding me of how trauma works. So if a patient starts to approach the snake, is it because he realizes there is no danger, or is it down to some kind of Stockholm Syndrome?

I realized some interesting things about being a student versus being a patient at this point. I had wondered if I should voice my skepticism and ask if it wasn´t likely that the patient would be traumatized – and I decided against it, because I feared I would reveal myself as 1) not being a psychology student and 2) being somehow emotionally involved, and therefore probably a patient. I had a strong feeling that as soon as somebody realized this (particularly that I suffer from mental issues myself), I would no longer be taken seriously as a participant in a discussion on mental health matters. I don´t think I´m completely off track in thinking so. Dr. Crazy emphasized several times today how patients might try to avoid facing their fear by talking about childhood traumas (a point of view I find extremely insensitive and invalidating) and other things.  As a student or a professional, you might have a chance to voice skepticism towards certain types of treatment or even diagnoses,  but as a patient, being skeptical towards some particularly anxiety-inducing type of treatment might be laughed off as a form of resistance.

Last but not least, I realized just how much of a condescending asshole Dr. Crazy can be. Be careful reading this if you have arachnophobia. So Dr. Crazy explained that a patient with arachnophobia might be asked to imagine a spider crawling over his face and into his mouth. Half the students in the audience shrieked and pulled faces. I strongly felt like doing so, too, but I restrained myself. I was fairly proud of that, and even more so when Dr. Crazy laughed and said: “Well, maybe I shouldn´t have said that, some of the girls in here really have a problem with spiders.” Like he couldn´t have guessed so before! Now – when you are a therapist treating phobias, it might be necessary to be cruel sometimes since you will need to expose people to things they fear. But there is no need to enjoy it so much, is there?

 

 

 

 

Emetophobia…

Posted in health, mental health, personal with tags , , on November 17, 2011 by theweirdphilosopher

…it makes me sick. Ha ha ha. No, I´m not in the mood for jokes and puns. And why would I, given that I am sitting here with my dinner, noodles with butter and salt, feeling unable to swallow more than a few spoonfuls. After a busy 14 hour day – where I ate nothing but a sandwich. And why can´t I eat? Because I feel sick. And why do I probably feel sick? Because I don´t eat!!! It´s a downward spiral.

Now what is the big deal about vomiting? It is nothing to be so scared of, is it? If it happens, it happens, right? Good for you. I have no idea why I´m so scared of it. For all I know, I am not scared of suffocating. So what makes me cry for my mommy when I feel really sick? Well…I´m not sure, but if you suffer from the same condition as I do, you might find the next few paragraphs quite triggering or at least very yucky, so proceed with caution.

Now, last time it happened to me that I thought I was going to vomit (a few days ago) I wanted it to happen, so I finally stopped feeling sick, but the thought also horrified me. I couldn´t stay still, I was walking around, moaning; always wondering if I should stay near the bathroom, just in case. This also drove me mad, though, because I realized that I would have to stay there forever because I would never feel safe. I knew that as soon as I´d move away the nausea would attack with full force again. I felt like it was either never going to stop, or it was going to lead to me vomiting, and both alternatives were horrifying me.

The nausea comes in waves, and whenever there is a peak and I think “okay, that´s it, I´m gonna vomit” everything inside me is protesting and frantically tries to prevent me vomiting. I think about for how long I managed to avoid it, and I think that if I vomit now, I will have to start all over again avoiding it. I guess I somehow assume that if I manage to avoid it long enough, I will stop being scared of it and I will never feel sick again. It has worked before – for about 10 years.

When there is a moment of slight relief, though, I think: “Okay, at the next peak, you will just vomit, and it will be fine. Afterwards, you won´t be scared of it anymore – and then you will never feel sick again.” I know, of course, that this doesn´t work. It was an incident where I had to vomit that kicked my phobia back into high gear. And, I remember now, then I also thought that it sucked how I had managed to avoid vomiting for so long, and now I failed. I had no idea back then, though, just how bad the consequences would be.  The last time I had felt constantly sick because of my phobia had been in my early teens. I barely recall that time.

So, what am I really scared of about vomiting? I hate to look at this, but alright. I´m scared that if I vomit after eating something, I will never be able to eat whatever it was without thinking about how I vomited after eating it and what it looked like then. I fear that while I eat I will believe that the food turns to vomit (no smartass comments on that one, please! I know that in a way this is what happens…). Okay, so to sum it up, what I am scared of is that I will get intrusive memories if I should vomit after eating something. I fear that I will feel like it is happening again. “It” being me having vomit in my mouth. So maybe this is what I fear most about vomiting? Having vomit in my mouth? Tasting it?

I find this whole thing deeply ironic (though not exactly funny): I behave in an avoidant fashion, because I fear that if I don´t avoid some foods, beverages, habits and I have to vomit afterwards – they will be tainted and I will have to avoid them in the future. I avoid things, in order not to  have to avoid them. Imaginary control at its best. But is it really all about control – or am I rather trying to save things from getting contaminated with a vile association? I guess I´m playing on time: If I manage to avoid vomiting long enough, I will be able to eat and drink without much care or avoidance – but only those things which aren´t contaminated with a memory of me feeling sick or having to vomit after consuming them. Currently, the logic goes, I feel sick all the time, but it will subside on day. And I need to save as many good things as possible for that moment. 

I wonder if my emetophobia is typical or rather atypical. What thoughts, feelings and specific fears do other people have who suffer from this condition? For how long have they been suffering from it? I have had it since early childhood, but there have been long periods of dormancy. Have others experienced such periods as well? Has anybody fully recovered from emetophobia? And if so: How???

What the hell is “the unconscious”?

Posted in health, mental health, philosophy, thoughts with tags , on November 13, 2011 by theweirdphilosopher

If my question sounds rude, well, I can deal with that. It is a fairly legitimate question, I think. I inevitably had to stumble across this problem when I pondered what I wrote in my last post. I had talked about Dr. Crazy´s claim that the anxiety patient dominates all of his relationships. It made me sufficiently angry and I argued that I don´t feel like I´m dominating anything at all. Now, a first possible reply could be that while I might neither feel like I dominate anything, nor even intend to do so, it is nonetheless a fact that I, due to my anxiety issues, have a strong (detrimental) influence on my interpersonal activities and relationships. It is because of these issues, and because of me, that certain choices are made – like going home early – whether I like it or not.

This is a fact, sure. But it is the kind of fact that makes you go “Duh!” Of course a person´s illness affects his relationships. If Dr. Crazy just meant to state this “objective fact”, then why should “looking at the patient´s relationships” play any role in curing the illness, though?  Cure the illness, and the relationship problems will disappear. His statement only makes sense if he thinks that a patient´s relationship might contribute to keeping him ill. And given what else he said – that the patient dominates his relationships – the reason why the relationship keeps the patient ill is that by dominating the relationship the patient gets some secondary gain out of his illness.

Now – after nearly two years of panic attacks in bar restrooms, I´m a little miffed in the face of such an insinuation. But I bet that just proves it is true, doesn´t it? *rolls eyes* My anger aside, though, I think there is a huge gap between Dr. Crazy´s insinuation and the patients´ experience of their illness (and suffering!). What could bridge such a gap? The unconscious, of course. “On a conscious level,” the argument goes, “the patient is suffering from his illness and he wants to restore his health; but subconsciously, he keeps himself ill because that way he can dominate his relationships.”  Of course I could shower this argument with scorn. When all attempts at therapy fail, you can still claim that, without even knowing it, the patient wants to remain ill! How very convenient!

But if we assume that the unconscious is not just a failed therapist´s emergency exit, what, then, is meant by it? What is the unconscious? Let´s stick to the example of subconscious secondary gain for a moment. “Subconscious” seems to imply that the patient is not aware that he gains anything from his illness. How can either therapist or patient ever determine, then, if the patient really derives some secondary gain? And even more importantly, how can a patient ever refute such an insinuation?! Or, to ask in a phenomenological way: What is the experience of subconsciously deriving secondary gain from a mental illness like? As opposed to, for example, subconsciously wanting to murder one´s father?

It seems that if the patient is completely unaware of his subconscious psychological motivations, then both the experience of subconsciously deriving secondary gain from a mental illness and the experience of subconsciously wanting to murder one´s father are alike: They are experiences of not being aware of any hidden motivations. That´s problematic, though, because then there seems to be no way to determine if a patient has subconscious motivation A, subconscious motivation B, or no subconscious motivations at all.

But – isn´t that the precise point of psychotherapy: To make people aware of their subconscious motivations and feelings? It certainly is one of the main points. But how is it possible, if, for the patient himself, all subconscious motivations are equally inaccessible through his subjective experience? Even if we should accept that the psychotherapist, through long years of learning and researching, has the wisdom and legitimate authority to judge what subconscious motivations a patient has – how can he make the patient aware of them? He can tell a patient how he interprets his behavior, the patient might swallow it – but is that the same as awareness? Does the patient ever see, intuitively know, feel a therapist´s interpretation is true? And if so: How is that possible?

 

The nutjob among the neurotics – a psychology lecture through the eyes of a former mental health patient, part II

Posted in college, health, mental health, personal, rants with tags , , , , , on November 10, 2011 by theweirdphilosopher

Today was Dr. Bla´s lecture again, but thankfully it was held by a guest who I will call Dr. Crazy. I say “thankfully” because he has a very entertaining and informative style. While that didn´t change a thing about the fact that the two girls next to me were babbling shamelessly throughout the entire lecture, at least Dr Crazy´s style made it easier to pay attention to him.

Today´s topic were anxiety disorders, such as phobias, panic attacks, social phobia, OCD, and also PTSD (but we will have a separate session solely focusing on that one). Since I have been dealing with anxiety and phobic fears since early childhood, I was more than interested. At first, though, the things Dr. Crazy said made me wonder if I wasn´t merely exaggerating my problems. “There is no mental disorder in the entire ICD-10,” he said, “which sane people are not at least minimally acquainted with through personal experiences of their own.” He explained that every healthy person experiences fear, that every healthy person sometimes double and triple checks if he really locked the door, that every healthy person sometimes worries about something. On the one hand, I think it is good that Dr. Crazy tries to show us that the mentally ill are not so different from us. On the other hand, this can easily be used to tell people who are mentally ill that their condition isn´t “all that severe” and that they should get their act together. He often talked about the mentally healthy population as the “normal neurotics”. I had equally mixed feelings about that. Maybe I, too, am just a normal neurotic, and my problems are a part of “normal unhappiness”? On some level I know that this is bullshit. If you have to perform thought rituals every time you think the word “fire”, and if you have to use intricate circumscriptions because you cannot get yourself to say the word, then apparently something is wrong with you.  Once again, I am very grateful that it is not nearly that bad anymore (but I´m still anxious enough to knock on wood as I write this).

But isn´t it funny, overall, how I am never happy in Dr. Bla´s lecture? Either I feel like an alien because “everybody else is normal and I am crazy”, or I feel like I am either wimpy or exaggerating because “everybody is a bit crazy after all”. It is not as paradoxical as it seems, though. In both cases, the professor assumes that both he and his students are “normal” – whether I feel included in this or not. (In the second case, “normal” implies a little bit craziness, but I think that normal craziness is different from what I experience.) So he talks to normal people, and about “crazy” people. And yet there I am, a “crazy” person, sitting in his lecture. What does that mean? Given that he talks to me, I must be normal; but given that I am actually “crazy”, he is merely talking about me and I am an alien who is not really there.

Dr. Crazy said something about the typical point of onset of anxiety disorders that made me want to laugh, kinda. He said that often anxiety disorders set in around age 25. He then explained why: Around this age, people are done studying and they have to take life in their own hands. It is a phase where things get scary, so to say. Well. Given that I suffered from emetophobia since about age 4, and with that fire phobia at least since third grade, I wonder what this says about my early childhood.

And then he said something that didn´t make me want to laugh at all. It made me want to punch somebody, actually. He explained that in treating a patient for anxiety, you need to take a look at his domestic situation and his interpersonal relationships as well, because they might contribute to keeping the patient ill. “Who, do you think, is dominating the relationships of an anxiety patient?” he asked, only to answer: “The patient. Everything is all about the patient. He is the center of everything.”

It´s okay. I mean, I know it sucks to be with a person who constantly needs to go home because she is feeling sick, or to attend to someone who is having a panic attack over “nothing”. Knowing how much it sucks actually heightens my anxiety, because “oh no, now I´m going to be a killjoy again; oh no, now I´m going to ruin everybody´s evening again”! See, Dr. Crazy, the “abnormal neurotics” are very well capable of empathizing with the “normal neurotics”! And I don´t enjoy to draw the kind of attention to myself that you get when you suddenly start to cry in a restaurant because you feel sick and you are scared of vomiting! I don´t enjoy to force somebody who is enjoying herself to leave a party early because of me!  And I don´t feel like I am dominating my relationships! I  am forced to navigate between the restrictions my mental health problems place on me and meeting others´ expectations; and this is not a great, “powerful” place to be in! If anything is dominating my relationships, it is my illness – but not me!