What? You Think Differently?

Sometimes themes crop up in life. I don’t know how it happens, but if anything were to convince me of a larger power it would be the fact that many times I will see the same idea or question reappear throughout a variety of areas in my life in a short span of time (this can of course be explained by the fact that I might be thinking a lot about the theme during that time). Recently I’ve been running across the idea of trying to understand a mind that doesn’t work like your own, and the assumption that all minds work the way yours does.

 

Last night I was talking to my boyfriend about our reactions to movies, and he said that he doesn’t come out of a movie with a reaction: it takes him time to process. I was flummoxed by this. “Don’t you walk out of a movie and think ‘I enjoyed that?’” I asked him. He said he didn’t, or at least not very often. This was almost impossible to process for me. I didn’t know how one could do that. And it hit me that I’d been assuming all my life that everyone reacted like I did to movies or plays or other artistic works: immediately. It hadn’t even occurred to me that perhaps the way people processed a reaction could be different from mine because I couldn’t fathom how that would be possible. Why would I have guessed that someone else would process differently from me until I was faced with it?

 

This morning I had coffee with my dad and we talked about a wide range of things, but one of them was our mutual confusion over people who are religious and why they think the way they do. I expressed confusion that someone could believe in such a way that is so detrimental to their well-being, particularly without any questioning whatsoever. As someone who naturally asks “why” to nearly everything, it seemed utterly foreign to me to just accept what someone says. I cannot conceive of what it would be like to hear someone claim something and just say “ok”.

 

All of us do this. It’s thoroughly natural to generalize from our own experience to the experiences of others. Unfortunately it’s also extremely faulty logic and doesn’t hold up against observable reality. It’s also a fairly self-centered way of thinking and a good way to create some difficulties when communicating with others.

 

But probably the most important element of this tendency is that most of us do it without realizing it. Unless there’s someone else there telling us that they process differently than we do, there’s no way for us to know that we’re incorrect in our assumptions. An example from the history of philosophy: philosophy of mind has spent a great deal of time wondering about whether we can form images in our mind or not. For a long time philosophers would argue back and forth, with one passionately saying that of course there were images in the mind, and another saying that it was impossible. Only recently by looking back through the history of the debate have we realized that each philosopher was essentially generalizing their experience: one who could bring up images in his mind argued that they must exist for everyone, one who couldn’t argued they were impossible for anyone. People published entire books based on the premise that everyone’s minds must work like theirs and they didn’t even notice.

 

This is all to say that it’s extremely easy to make this assumption without realizing it. Unfortunately, the assumption can also be damaging. It’s the sort of thing that underlies the assumption that listening or learning looks the same for all children. It’s what can lead us to assume that someone is criticizing us or mocking us when they’re expressing things differently. It’s what can lead us to label someone “stupid”. It’s what leads to things like victim blaming, classism, and attempts to write opinions into law.

 

It may seem like an esoteric or arbitrary element of human nature to focus on, but it can do wonders for your empathy to pay attention to not just what others think, but also how.

Unpacking the Spoons

Most of you have already heard the spoon metaphor by now. It was originally coined to describe what it’s like to have a chronic illness, although since then it has been used to describe mental illness as well. It’s an incredibly helpful tool, but I’d like to take a minute to expand on why those of us who have illness of one kind or another use up our spoons so quickly. There is an invisible aspect to illness that most of us don’t talk about. It’s oddly taboo, particularly for mental illness. Let’s shed some light on it shall we (I’m going to confine this discussion to my particular mental illness because that’s what I have experience with, but I know that this type of thing is applicable to all sorts of different illnesses).

When you’re mentally ill you have to think about more things. Let’s look at some examples of things that I have to think about on a regular basis that most people are blissfully unaware of: (trigger warnings for ED and self harm)

1.Are my hands shaking? Will someone notice? How will I explain it if they do?

2.Will the clothes that I’m wearing expose any of my scars or current cuts? Am I going to be somewhere that I care?

3.Will someone use the word “purge” today? How will I deal with this trigger if it comes up?

4.Will someone talk about my body or eating habits today and how will I quickly escape the situation if that happens?

5.If I eat something, will my stomach be able to keep it down or will it get uppity because it’s not very good at digesting anymore?

6.Will it look suspicious to my family or friends if I go to the bathroom immediately after a meal?

7.If I stay at someone’s house, do I have my meds? I cannot stay at someone’s house unless I have my meds.

8.If others want to do a physical activity, will I be able to keep up? Will I start feeling faint?

9.Did I bleed on my sheets or my pajamas after I cut last night? Can I get that stain out? Did it get on my computer, and will other people notice if I bring my computer out? Also gross.

10.Can I leave the house today without overwhelming self-hatred based on how I look in these clothes?

11.How distracted will I be today by my body? If my thighs rub together while walking, will I still be able to keep it together, or will I start having some really bad thoughts?

12.Will there be calorie counts listed somewhere that I go today?

13.How do I get all my hours in at work and get to 5-10 hours of therapy a week? How do I explain to my boss and coworkers that I’m not lazy it’s just really hard to find good times for appointments?

14.I usually get tired at around 9:00 (probably from nutritional deprivation among other things). Can I go out and socialize tonight? How can I see my friends when I have a full time job and I can’t stay awake past 11?

15.Was that slight chest pain just some anxiety or other minor something, or am I finally getting the irregular heartbeat that is supposed to come with my eating habits?

16.What do I say if people bring up food habits? Fasting? (yes this has happened, e.g. how long have you gone without food). How do I keep myself from blurting out “yeah, I ate once a week for a couple months once”?

17.How much do I tell people?

18.If someone hugs me, will they be able to feel my fat? Will I be ok with it, or will I want to pull away (most of the time it’s pull away. Then I have to be polite)?

19.If I purge, will I smell like puke? Will I be able to get those nasty stains out of my clothes (yes, it gets everywhere. yes it is gross)? What happens if my boyfriend tries to kiss me?

20.How much of my day will I waste thinking about food and debating whether or not to eat and how much to eat? This varies from about 1 hour to my whole day, depending.

21.Sometimes I even waste my brain space wondering if what I expel from my body is the same as what I put into it (yes I am talking about poo).

22.How many layers should I wear? I’m always cold, but I can’t regulate my body temperature at all so I swing to really hot if I’m under blankets or layers.

23.Can I handle looking at myself in the mirror today? Will I look like a complete idiot if I get dressed and leave the house without a quick mirror check?

24.Will someone notice if I start poking at my wrists or my hips to feel the bones? Can I feel my bones? Am I too fat if I can’t feel my bones?

25.Have a fasted/restricted today? How long has it been since I last ate? How much did I eat? If someone tries to give me breakfast, how can I say no?

This was just a list I came up with off the top of my head. Imagine trying to get out of bed while thinking about all these things, plan your day while thinking about all these things, accomplish work while thinking about all these things. THIS is where the spoons go. The reason that doing simple tasks requires so much more energy and effort is not just the physiological difficulties of depression or illness (and yeah, those things often do come with some serious fatigue or pain), but also the fact that everything is inherently more complicated. You are constantly trying to protect yourself from whatever threat your illness brings. You have to plan ahead like nobody’s business. You have to be assessing what’s going on around you and what’s going on internally to make sure you’ll be ok.

With mental illness, many of these thoughts are intrusive, paranoid, and irrational. Unfortunately that doesn’t mean you can turn them off and that doesn’t mean that you’re expending less emotional energy by having them. These thoughts are intrusive, distracting, and oftentimes pervasive, which means you’re taking a lot of your executive function to refocus your brain on the task at hand. All the time. Over and over.

For many of us who are dealing with a low spoon count, we don’t even realize that this is where the spoons are going: all we know is that things feel hard. They feel exhausting. We’re more worn out than other people even when we’re doing what appears to be less. Again, the key appears to be patience with yourself and with others, as well as clear communication about what you’re feeling. Many of us don’t want to speak up about the things that are hard for us, whether because we don’t want to appear weak or because there is a strong taboo against them (most of the things listed above fall into this second category). If we can get better at telling others what we’re really feeling, maybe this whole spoons thing will start making more sense to everyone.

 

Why I Need Mindfulness

Recently my mood has been fairly low. I’m still trying to figure out why and how to make it better, but for the moment things are pretty stagnant and I’m really not sure what steps I can take to improve my mood. This is a place of intense frustration, and I know that many people can get to be in this situation: you may not be able to change your work or family situation, you may feel like your external situation is actually fairly positive overall, or you may have no idea what has triggered a depressive episode. There are often times when you can’t take positive actions to improve your depression.

Of course when that happens it tends to snowball on itself. If you don’t know how you’re going to improve your situation, there is an intense hopelessness that it will get better. You think about the future and you don’t know how or if it will ever change, and all you can imagine is the whole size of your whole future feeling the way you do now. That is an intensely icky feeling.

You start to feel bad, you think about feeling bad forever, and how you feel now gets worse. Then you think about feeling even worse forever and it gets even WORSE. Imagine this on loop for days and weeks at a time. This is what it’s like when you don’t know how to fix your depression.

Of course the whole crux of the problem is that you don’t know what to do to make yourself feel better. Here’s the secret though: I know what you have to do. A warning: this will not necessarily make right now feel better, but it will give you some relief from the circling, spiraling pain and might just give you enough time and space to breathe and figure out a good solution. So what is the solution? Mindfulness.

Are you all done giving me dirty looks now? Good. This seems trite. It seems woo woo. It seems ridiculous and not practical. When I was first introduced into mindfulness, I would fart in its general direction too. But that was before I heard this explanation of why mindfulness is useful. Mindfulness cannot make you feel better right now: that’s not its purpose. Mindfulness is about only letting your mind be in the present. While depression can often involve angst and anxiety about the past or the future, mindfulness is just existing and doing what you are doing.

So remember all of that angst about the future that crops up when you cycle in your depression? Those things are not hurting you right now. They’re not even happening right now. If you can stop thinking about them and only exist in this moment, you’ll stop feeling all the crappy feelings of the past and all the potential crappy feelings of the future. That is a lot of crappy feelings that you don’t have to worry about until they actually happen. And the whole point of mindfulness is that if you can train your mind to exist in the present, you don’t have to take on all the suffering that is not really affecting you right now.

If you’re like me, that all sounds lovely except that you have no idea how to do it. Half of your problem is that you’re really bad at being mentally present, you can’t focus, you’re too tired. Never fear. There are concrete steps that you can take to be mindful. They aren’t easy, but they do at least give you a clear path forward.

The most important thing to remember about mindfulness is that it’s about being aware: observing, describing, and being present. That’s what it means to be present-to focus on your surroundings, your emotions, your thoughts, and your senses. Here are some basic steps you can start with. Initially, try one simple, small thing and do it mindfully. Try washing the dishes or driving home from work. While you’re doing it, just notice things: how the water feels, the song playing in your head, the smell of the soap. Once you’ve started to notice it, you can add words: describe it. It might be good to just start with these two steps, and you don’t need to go overboard: 10 minutes might be the most you can handle. Once you’ve started to get the hang of those steps, try participating. If you notice your thoughts or your concentration wandering while you do an activity, just take note and then gently bring your focus back to what you’re doing.

This is probably the hardest part of mindfulness: the idea is not to get annoyed or frustrated with yourself, but just to notice what you’re doing and change it. If you can approach mindfulness with the intent of being gentle with yourself, of recognizing that you’re a little fragile right now, it generally will go better.

If you don’t want to do this while you’re trying to get something done, or if you just want to have some time to seriously practice mindfulness, some good practices are focusing on breathing and body scans. Instead of focusing on a task you can just pay attention to your breathing, or you can start at your toes and focus on each part of your body individually. This is a little more concrete and a good place to start when you’re beginning mindfulness.

Of course throughout your day you can also take time to pull your thoughts back to what you’re doing, to notice your surroundings, to pay attention to your breath, or to stimulate your senses in some way. I particularly find that being aware of my body and being aware of being in my body are good ways to be mindful. As much as 15 minutes of these little things each day can really help to reset that spinning wheel of anxiety and fear that starts going in the midst of depression.

Obviously this needs to be done in conjunction with some problem solving and reflection about what’s really making things bad for you. You might need a change in meds, an adjustment at work, changes in relationships, or a variety of other problem-solving things to improve the situation. But a good way to wait things out when you can’t figure out what to change or to get through your day to day tasks without ruminating is to work on mindfulness.

Tolerating Distress

One of the things that has been very difficult for me in DBT is the idea of “distress tolerance”. For the most part, American society does not promote the idea that there are times that things will suck and you’ll just have to let that be and you can’t do anything to fix it. We’re a society of fixers. There’s always a solution if you try hard enough right?

Unfortunately that’s not the case. There will be times when we simply have to wait out unpleasant feelings. In general those unpleasant feelings will dissipate or be relieved with time, or after some time we will be able to change something to improve our situation. Sometimes we also just have to accept things that are shitty: certain people will not change their behavior, your health may not improve, politics might always suck. These are things that you might just have to let be. And for these things, you have to learn that your feelings may stick around and there’s not a whole lot you can do about it. This is where distress tolerance comes in.

Distress tolerance is hard. It’s not about making yourself feel better, it’s rather about making it to the end of the bad feeling without doing anything to make your situation worse. This is one of the hardest things to remember while trying to tolerate nasty feelings, and it also makes it a lot harder to be successful because it’s hard to feel like it’s working. However it’s not a bad thing to feel like crap for a while. This is hard to understand for many people. It is normal, acceptable, and in fact healthy to feel like crap sometimes.

So what is distress tolerance? There are a number of elements to it and I’m not going to touch on all of them here, but I do want to talk about how many people give tips for distress tolerance and how we can really improve on those tips. I see lots of lists floating around about what to do if you’re tempted to self-harm, or how to resist purging. These lists are GREAT. They include things like holding a piece of ice, drawing on yourself with red marker, ripping something up, all great suggestions. Unfortunately not all of these things work for everyone, and it can be extremely frustrating when you look at the list and can’t find anything that speaks to you.

It seems to me that there might be a better way to approach distress tolerance that is more individualized. Of course sharing ideas and letting others know what’s helped you is great, but not everyone likes or responds to the same things. One of the things that we’ve been discussing in DBT are larger categories that can help you: things like using your senses, imagery, taking a mini-vacation, or relaxation. Each of these categories is then open to all of your personal ideas. Let’s look at a couple of examples:

Senses. I’ve heard a lot of people give examples of this without quite realizing it: finding something soft, holding ice, listening to music. However I’ve often found the examples unhelpful until I heard the larger idea that you should think about your senses and try to pinpoint what sensory experiences really ground you. What makes you feel like you’re really in your body? I’ve heard people suggest scented candles, but those make me sneeze a lot and I don’t much like them, so I basically just discounted nice smelling things. When I heard that scent was something I could think about, I immediately thought about my dad’s spaghetti sauce. It makes me think of home, of youth. It grounds me. I got some from my parents to put in my freezer and now I can pull it out on a bad day and heat it up, letting that smell permeate my whole apartment. This personalization is far more effective for me than the generic suggestions were.

You can do this same sort of thing with any of the skills: what kinds of images calm me down? What would be a “safe place” I could picture? What has calmed me down in the past? What kinds of things do I find relaxing? What places feel “away” for me in my daily life? What’s out of the ordinary that I could use as a small vacation?

It’s a good idea to take some time when you’re NOT distressed to think about these things so that you have a small stockpile. For an explanation of each distress tolerance skill you can go here. I don’t think we spend enough time personalizing our coping skills, but it is important to think about what works for YOU.

Gratitude: Mental Illness

It’s Thanksgiving this week, and I’m going to be cliche and talk about gratitude. I’ve unintentionally spent some time earlier this week looking at an experience that I was grateful for, but today is going to be a difficult exercise for me: I want to talk about something in myself that I am grateful for. This isn’t easy, but I suggest all of you try it as a way to see those things in yourself that are good.

I spend a lot of time griping about my mental health, but after a lot of thought, I am grateful that I was born this way. My mind is quite often a bitch to me, but I’m glad that it is the way it is. Despite the fact that my mental health is probably my biggest hurdle in life, it has forced me to become a better person, to learn many things that I otherwise could have easily avoided, and to simply be kinder.

I certainly can’t say that if I was given the chance I’d choose my mental illness, and I’m not saying I enjoy my life the way it is, but if I’m being honest with myself, I’m a better, more selfless, and kinder person because of my mental illness and the places it has taken me.

First and foremost, my  mental illness has required that I spend time with myself. I have spend more hours than most people could imagine delving into my deeper fears and insecurities, ripping apart all the myths and lies that I tell myself, and examining why I do the things I do. I have become a far more facts-based individual due to therapy. I have become better at assessing myself and my situations. Because I’ve simply had to really BE with myself, in an entirely present way, I’ve figured out what I don’t like about myself and made improvements, and because I’ve spent so much of this time with a trained professional, I’ve also started to notice when my perception is a little off.

I’ve also had to spend a lot of time with therapists who are unafraid to criticize me and my coping strategies and who want me to improve my relationships. This means a whole lot of real, honest feedback about who I am and how my behaviors affect other people. Because of this, I often get to think about things I screwed up without falling into a guilt trap and with someone there to help me brainstorm immediate techniques to improve the situation.

While I have spent a lot of time thinking about myself, I have also spent a lot of time thinking about how other people influence me and how I influence others: I have learned to shift the perspective away from me, me, me. Your actions aren’t about me, and my actions are small. I have learned that often I should be thinking about someone else instead of about making myself smaller to fit someone else in.

In addition, I’ve found that I understand emotions better, both my own and other people’s. This makes me far more effective at Not Fucking Shit Up. I’m extremely grateful for that.

I can’t imagine that I would be doing the things I’m doing today if it weren’t for mental illness. I would be locked away reading books somewhere instead. I’m so glad that mental illness has forced me to engage with the world, that it’s led me to my VISTA year, and that it’s demanded of me that I do more for others.

But the thing I’m most grateful for is the compassion I feel I’ve gotten for people whose brains don’t process quite the same as mine. After seeing the confusion and frustration in people’s faces when they try to comprehend what I’m thinking and feeling, I don’t want to be the person that dismisses another’s pain or struggle. While those experiences were horrible, I’m grateful that I think I’m a better person for it.

My mental illness itself has not given me much, but it has forced me into situations that have given me tools to help myself and to help others. I am grateful. I would never have thought so deeply, been nearly as effective, or been so perceptive without the drive of mental illness behind me. I’m grateful that I now have a habit of therapy behind me, that going forward I will now how and where to find appropriate tools to improve myself, and that I will continue to reflect on myself in this way. I’m grateful that when I ask others to go to therapy now, I have the weight of my own work behind me. I’m grateful that I am in a better position to help others now.

So thanks mental illness. You’ve made me a better person.

The Things I Carry

WARNING: Emo poetry ahead. 

 

Every morning when I wake up, I know there are things I must take with me

No matter what I am doing, I fill my pockets and my pores with the things I carry

When my feet touch the ground as I stand up from sleep

I know the weight of them.

 

Before I rise, my mind is full with the List.

It steamrolls over me and leaves its imprint:

What You Must Do To Be Acceptable.

I pick it up and pull my body skywards.

 

I walked from my bed to the bathroom and add the pills I take each day

settling in my stomach

Next to the heaviness of the breakfast I will not eat

I dress, placing the anxiety of eyes over my body

I have my bare essentials.

 

Today I carried a backpack.

A simple case for:

A laptop to channel words that build and build upon me

Reminding me that I never have enough words

A book of memories

joyful things I forget to read

A wallet, heavy with emptiness

A notebook, filled with fragments of days that I forgot to live.

They repeat themselves and I don’t remember to move

The loss of time on my shoulders

 

I remember to pick up my lover from his slump on the floor.

His sadness is large, black

But his legs don’t work today and so he uses mine

 

With my keys, I take the criticisms I heard yesterday and the day before and the day before

stretching back before memory.

Things begin to get heavy now, but it’s early

Before I leave, I turn back and pick up the hours of therapy I own

Each week

A prize for the size of my waist.

These are the things I take from the table before I begin.

 

As I walk through the day I collect things to put in my pockets

The letter from my landlord, rejecting a request

A note from the insurance, ending my benefits

The phone call from my mother, revealing secrets I didn’t want to know

They swell to bursting.

 

It is noon

I pull on my running shoes, and I feel the minutes I sweat falling on me

The time I am alone in my mind

The ripping breath I cannot end

Each mile is a requirement that I must complete, or I will drop everything

These are the rules, and I know that I cannot put down the things I carry.

 

Back to work, and my anxiety is large

growing and growing on the angry words that fly

A friend calls. I struggle to pick him up.

My legs are becoming weak.

 

As I walk from work, I take the knowledge that my hours were not enough

I have not, I have not, I have not-

done enough.

 

An hour with my therapist, and I know I have not been Good Enough to myself

I pick up the diary card

The numbers are wrong

Bad numbers go in my pocket.

 

When I get home, I tumble, headlong into bed

Dropping everything.

I carry too much these days.

Gratitude: People Who Teach

I’m back! I’ve missed you all and boy have I missed writing, but life should be calming down for a bit. Sidenote: I am sick at the moment, so I’m blaming any incoherence on that, and if I disappear again soon that’s why. This was a post that I really wanted to write a few weeks ago and just never got a chance to put down on paper, so here it is.

A little bit ago, I went to a concert in which one of my professors from college was playing. I’ve always enjoyed this person’s thoughts and company, and sitting there listening to him speak and sing, I was hit with a wave of nostalgia for school and for the people who taught me. I was struck with how my professors and teachers were so deliberate with their thoughts and their words, even those whose energy could not be contained. They were there because they were seeking after knowledge, and they respected each of us enough to treat their words with care.

I remembered the hours that I spent sitting one on one with professors, talking through an idea or a question that just wouldn’t let go of me, and how they never seemed to care how much of their time I was taking up. I remembered the lifelines that so many of my teachers threw to me when I refused to accept them.

And I was really hit by how much I owe to the people who have given me my education and how few opportunities I have to say thank you. And so despite the fact that most of the teachers that I’ve loved will never read this, I want to send it out into the void: I am deeply grateful for what you’ve given me. I am deeply grateful for you not just as teachers but as human beings who have expressed an interest in my life and my mind, and who have held me up when I am falling.

I don’t think it’s really fashionable to talk about the adults in your life, the mentors. And I think that’s horrible because teachers need to hear what they’re doing is making a difference. Publicly recognizing that who you are today is a direct result of the things that others have given you is necessary for us to understand that no one is self-made. We all rely on others, and my educators have been some of the most important people in my life.

As early as grade school, I had teachers who read hundreds of pages of my fantasy novel and encouraged me to continue writing. I had teachers who engaged with me, who would debate test answers with me to make sure they felt confident they had the correct answer. I had teachers who simply let me GO, who told me I could write and read and think as much as I wanted and they’d simply be there for me when I needed someone to talk to about it. In high school I had teachers who would sit around with me after school and discuss our readings and subjects in more depth. It felt like I had personal tutors because they simply cared enough to make time for me. Knowing how busy teachers are makes this even more important to me. These actions validated my curiosity and my drive. There’s no way I would have the love of learning I have now if it weren’t for the message these people sent that YES, these topics ARE interesting and wonderful.

And when I got to college I had professors who would develop things for me specifically to research and delve into. I had profs who created independent studies for me, who hired me as an editor, who sent me articles and conversed with me about them over the summer, who would spend hours talking to me about what major I should choose or where I should apply for grad school. I even had a professor who reached out to me in the midst of my eating disorder just to check and see if I was doing ok.

But perhaps even more than these specific memories, I think about the ways that my teachers approach teaching: through humor, with deep care, with passion. I think about the teachers who speak beautifully about the texts they love, or the teachers who are a little haywire and spout amazing rants that contain nuggets of brilliance in them. I miss the essence of the people who are teachers, the pure fervor with which they speak about their chosen subject. There are few people in the world who can speak about anything like a professor can about their subject, and I deeply miss being in the presence of those people.

Sometimes I forget that my teachers are human beings with complex lives of their own, but these memories mean the world to me. They remind me that there were people in the midst of my bad days who cared about me without having any idea what was happening in my life, simply for the mind I had and the ideas I shared. The most validating experiences of my life came in the classroom and came thanks to teachers who passionately cared about engaging.

So thank you. I am who I am because of you.