Wednesday, May 10, 2017
The Guilt of Suicide #MHAW2017 #MHAW [TW: Suicide]
Today, I am feeling guilt. Thinking about all the people who have given up on me through the years, because I keep attempting to take my life when depression hits its hardest — which, is far too often. I am chronically suicidal; my depression is both chronic and severe. I will never totally be rid of this, and yet: I have been given up on, and I feel I deserved every desertion.
"Elaine, again?!" "You need to stop." I wish I could be rid of the self-hatred and desperation my illness makes me go through every now and then. I wish there was a cure. But there isn't.
I am writing this, because I need to tell myself that I never deserved any of these reprimands, desertions. For every one of these 'talks' or wordless cut-offs from my person, I feel more guilt and shame, no unlike the very same feelings that drive me to end my life, to rid myself from them completely. You actions toward me make a difference.
Labels: state, status, worlds
Tuesday, February 21, 2017
I tread en pointe
in minefields —
eggshells of your
silence, and anger
I hear my heart
galloping — thud —
like rapid fire
in my chest, and ears
I revert to me
from darkened years
rejected by words,
and absence, and neglect
I freeze, awaiting —
my love — the threat,
I die, and die again
Monday, February 06, 2017
trauma, survival, safety, relationships, and my bed as safe space
After recently reading a lot about the science behind trauma, this morning I came to a revelation about my own life, specifically my behaviours in my romantic relationships. I have classically put up with a lot of shit in my relationships - not to discount these men also having to put up with me - sometimes, for far too long. I remember my three years with C as a waste of three years of my life. When faced with shit I have to put up with in my marriage, I always tell myself to continue to bear it, to never give up, to lean towards loyalty and longsuffering. These are my values. Nothing has changed.
I am not known for my survival instinct. Instead, because of emotional trauma in my childhood, the neuroplasticity of my brain has changed. Instincts have been thwarted. I have become chronically suicidal, viewing my life as worthless to this very day, believing my life is expendable. I ended up becoming hypervigilant, as Marcus once said to me, a good person to have in a team in the event of a plane crash on a deserted island. The ideal sense of protecting one's self is far from being in equilibrium in me. I oscillate between wanting to die, and having panic attacks triggered by simple things.
What I realised today is how my values in the relationships of my life pair with my thwarted survival instincts. I innately believe I deserve to be emotionally abused or neglected. My parents, whom I love, were my protectors, providing me with a safe space to grow up in while I was living with them. But they were also the people who threatened to abandon me, who stifled expressions of my fear and sadness and anger, who criticised me incessantly, who neglected me by not being around - to pick me up from the babysitter, to be at home with me, to not treat me as invisible or a burden. It was something I got used to, and my brain equated the safe haven of love with emotional neglect and abuse. i believe I deserve it.
|My Bed by Tracey Emin|
When I did imagery work with a psychologist during my hospital stay last year, I pictured my safe space as my bed, in my current home. I have gone through a lot of ups and downs while being in this bed, whether asleep or awake, for over a decade. To cry, I curl up in a foetal position in bed with my pillows. To ponder life choices and meditate on what is important, I spend time thinking and writing in this bed. The times I felt such emotional pain that I overdosed on pills, most of them occurred in this bed. To temporally feel the pleasure that anhedonia prevents my brain's circuitry from experiencing, I have spent time with various men and boys in this bed. The times the men I loved have hurt me, I retreated to this bed to try and heal, and often re-invited them into my figurative bed as well, to try and re-enact the traumatic incidents. I have received far too much emotional abuse and neglect in this same bed too, the treatment that I feel I deserve from the men I love. I believe I am that flawed, to deserve the kind of emotional pain that has been inflicted on me, whether consciously or not. I blame no one but myself, and feel a deep sense of shame only belief in God can alleviate.
In trying to recover from the physiological response to emotional trauma, I have thought about all these things and how best to realise what my heart, mind and body need to be able to live well and live fully. I cannot keep thinking that I deserve to be treated badly because I believe that it signifies love. I should not equate love with shutting up and putting up with various forms of emotional abuse: being ignored, being blamed, having my emotions invalidated, being misunderstood.
I have nowhere else to go but writing here to say the following: J has been emotionally distant from me, from our marriage, almost from the time it began. Of late, this has reared its head as a cold war initiated by him, catalysed by my not understanding the sequence of events in stories he tells me, because his words are often unclear to me. He got annoyed with me for this again recently and said angrily that he doesn't want to talk to me anymore. This overflowed into him telling me not to text him, because my texts trigger anxiety in him. He said that when he does talk to me openly, I get upset and suicidal, even though those times he opened up were not in vulnerable confidence, but in hurtful blaming words and tone. He says I threaten him with suicide, even though I have never attempted suicide as spite and revenge towards him. Hence, for all this and more, he no longer wants to talk to me, at all. He admitted that I am not deserving of high regard as his wife.
The turning point happened around the time J's mom fell ill and subsequently lost the battle with cancer. We got married during that time so as to have her present as his witness while she was still alive. When she went back to the hospital during her last days, I couldn't get to the hospital often enough to visit her, because I had to go to the cattery to feed medication every day, because SGH was far from our place and going out of the house and having to commute are stressful activities to me.
During her final moments, J's mom's bed in a C class ward was overly surrounded by people. A tape of a Buddhist chant was repeatedly playing. Chanting is something I find to be an auditory trigger, though I do not know why. But more so, being in an overcrowded scenario, I eventually succumbed to a panic attack. I had to leave the ward for a walk. During the time I was walking around hospital grounds, J's mom passed away.
I was not present for him during his time of need. What did I do for his mom? I can remember weak, discrete efforts of mine. I hugged him when he came home from the hospital visit that was the official prognosis. I arranged for her to see a private respiratory specialist for a second opinion. I only had to pay $200 for that. I suggested marriage earlier than I promised, so that J's mom could finally see her older son get married. I arranged for a pastoral visit to the hospital during which J's mom found salvation in Christ. A list of items anyone could count on one hand. J said I did not help him with any of the logistics of her death. He understood why I couldn't do more, but was and still is disappointed in me. In a text he recently sent me, he said, "And you expect me to view you highly as my wife?"
Our only semblances of a union are in shared meals, his doing of household chores in my stead, and his providing for me financially. I truly am a burden, because I feel like I am seen as a duty, and obligation to fulfil, something he feels he needs to do so as to do the right thing. But because of my somehow unyielding loyalty and willing capacity to put up with emotional trauma, I hang on, and accept all of the abuse, silence, and feeling like I am nothing but a responsibility to bear. I deserve all of this, not only because I have hurt him, but because love to me means to limitlessly accept this kind of emotional trauma, from the very people I love. I should not expect to be esteemed, to be held in high regard, because I truly don't deserve it. I am not saying these things to be melodramatic. I am clear-headed while sharing these beliefs of worthlessness, beliefs that I have upheld for almost all my life.
I was writing in my journal earlier, around noon. Although it was hard to express how I felt about the cold war J is having with me, I knew I had to at least try and write some of it down. It started with me writing about how J said he wouldn't go and pick up ear medication for a fungal infection Scotty is suffering from, simply because he didn't want to do it. This exchange of words happening at breakfast time. Writing all of that made think long and hard, as journalling often does. In a moment of clarity, I recalled how the human species, like other animals, has the same brain that wills us to survive and thrive. This should be the norm, this is to be expected. While we cannot avoid unpleasant events in life or even trauma, we are still wired to protect ourselves. For me to believe I should put up with the lack of love and attention, that I deserve to be emotionally neglected and attacked, means that my survival instincts have short-circuited. Fight or flight, nothing else; not to stand there and get attacked by a predator believing that I do not deserve to live.
I cannot survive without J. I have no income nor means to support myself and the furkids. Even J himself has said, that he feels his mission is to help me recover to a point of functionality, such that even without him I could survive. He prepares his investments such that in the event of his untimely death, I could access those funds. This is important to my survival too, but it is in opposition to my misdirected belief that the one who provides for me should also have the right to emotionally abuse me. As a result, not only am I once again being traumatised from this cold war and his apparent lack of willingness to try and reconcile, I am faced with a paradox from my screwed up neurobiology. Fight or flight - I don't know which to choose. But today I took a step towards realigning my beliefs, to try and think of myself as worthy of love, as someone who shouldn't have to go through emotional abuse and neglect and not recovering from it. I don't know if I should continue to tell myself that love is patient and therefore I must continue to bear this pain.
Labels: me, state, status, therapy, worlds
Wednesday, February 01, 2017
Strengths-Based Leadership - from the developers of StrengthsFinder
Years ago I discovered StrengthsFinder
and shared it with the important people in my life - J, and my volunteers. Today I re-did my assessment test, to generate a new report, one that is specific to my leadership skills based on the top 5 out of 34 strengths.
The site gives the option to use your previous test's results, but I opted to do it again. I reckon the 5 strengths identified now would be different, just like how my DISC profile also does, depending on my life-stage and career path.
What remained the same were my Strategic and Communication strengths. Advice for the Strategic side of me includes:
Make sure that you are involved on the front end of new initiatives or enterprises. Your innovative
yet methodical approach will be critical to the genesis of a venture because it will keep its creators
from developing counterproductive tunnel vision. Broaden their view and increase their chances for
As for my Communication strength:
You have the power to capture people’s emotions and put words to what they feel — sometimes
words they cannot find themselves. This naturally draws others to you. So ask questions. Try to
pinpoint the key issues people are trying to communicate, what joys or struggles they want to
convey. Then give voice to those feelings. Helping people find the words to describe feelings is a
powerful way to get them to express and process their own emotions, and it can support them on the
way to making a plan of action.
Here are the descriptions of the other 3 strengths now on the top of the list for me:
By nature, you might admit that you participate in friendly rivalries for fun. Usually you are comfortable letting people know what you do and do not value. Because of your strengths, you are comfortable telling others stories about your personal habits, qualities, experiences, or background. Your forthcoming nature probably enables others to share their thoughts and feelings with you. Driven by your talents, you now and then notice that certain people feel you are a bit threatening. You may use this trait to your advantage when you are trying to influence a particular person to move into action or see things the way you do. Perhaps in your dealings with some individuals, you tone down or moderate your forcefulness. Chances are good that you empower people with your air of certitude — that is, confidence. Your very presence reassures them that they indeed are quite ready and capable of tackling assignments, spearheading projects, or playing key positions on a team. It’s very likely that you occasionally tell yourself that you can make choices with ease. Perhaps your sense of urgency compels you to produce results more swiftly than less decisive individuals can.
Driven by your talents, you sometimes enjoy life a bit more when you are speaking to people who understand your complicated or technical vocabulary. Perhaps you can quickly describe theories or processes to these individuals without having to explain the meanings of most terms. Chances are good that you might equate language with power. Sometimes you intersperse complicated or difficult-to-understand words in your speech. Not content to use everyday terminology, you attempt to add sophisticated words to your vocabulary. When you translate an esoteric term — that is, a word understood by a limited group — you may discover subtle distinctions between its various meanings. Perhaps this knowledge amplifies the forceful effect some of your words have on others. By nature, you yearn to increase your knowledge by being kept in the information loop. This explains why you gravitate to people who converse about ideas at a deeper and more thoughtful level than most individuals are capable of doing. “Making small talk” — that is, engaging in idle conversation — probably seems like a waste of time to you. Because of your strengths, you notice that you choose to spend time with particularly intelligent adults. Besides enjoying their company and mature thinking, you welcome the opportunity to engage in sophisticated, knowledgeable, and thoughtful conversation. You amass numerous ideas, theories, or concepts from these encounters. Often the insights you gain have proved to be quite useful days, weeks, months, or even years later. Instinctively, you may insert intricate or theoretical words into your academic or professional conversations and writings. Your interest in language partially explains why you enjoy mastering specific types of words and their definitions. While some individuals are required to memorize new terms in classes or seminars, perhaps you automatically commit specific words to memory. Occasionally you describe this experience as pleasurable.
Instinctively, you periodically establish performance targets for the week. Once in a while, you think about what your life could be like in the future. Some of these forward-looking images may motivate or energize you to meet your weekly goals. Perhaps you do better work when you can concentrate on your near-term objectives. Driven by your talents, you are energized by your plans for the coming months, years, or decades. Bringing your ideas to life is an exciting proposition for you. You sense you have the power to transform whatever you think is possible into tangible outcomes. Because of your strengths, you are sometimes filled with hope as you think about the good things you might accomplish in the coming months, years, or decades. Perhaps this reinforces your sense of personal well-being. When you are forced to concentrate solely on current situations, you may become less enthusiastic about life. Chances are good that you channel your mental and physical energies toward what you can accomplish in the months, years, or decades ahead. The question you must answer is this: “How far into the future can I think before my ideas start becoming vague or uninspiring?” By nature, you are a visionary thinker. Your vivid mental images of the coming months, years, or decades often impel you to move into action.
I like how this book focuses on the whats and hows of leaderships based on your natural strengths. The prequels to this book were great for understanding how it makes sense to learn and capitalise on your strengths instead of over-investing in correcting weaknesses. But the contexts were more narrow as they spoke about the impacts of these strengths on our work in general. I have always enjoyed reading books about leadership, since my first one by John C. Maxwell when I was 17 - Developing the Leader Within You. Trying to make StrengthsFinder work for me in the way I lead organisations and projects was less clear from the original books when compared to Strengths Based Leadership.
The book also helps reframe the concept of teams. Building the right team with the necessary diversity of strengths, needs to be more about architecture, than of circumstance. I have just started on Part 2 of 3 in the book - Maximizing Your Team - and I am already whirling in introspection and strategies for action.
Another thing about this book so far, is that it appreciates the people who aren't what were classically known as leadership traits. These members of an organisation who may not be great communicators, but have strengths in creating harmony in groups or meaning interactions with people, are just as important as the ones who always seem to know the right words to use to evoke response. This makes me think of J, who has Harmony as one of this top 5 strengths, and is the invisible glue that holds the organisation together.
Labels: books, me, share, state, status
Monday, December 12, 2016
Ending an 8/10 fibro pain flare
If I include yesterday: I endured a pain flare
for 11 days
in a gradual manner, due to the current fiscal policy of my household. If J doesn't agree with my going to my pain doc at Novena — to get an IV jab to end a pain flare as soon as possible — it means I cannot get it even I use my bank account for it. It costs around $400 for four meds in total: Fentanyl, morphine, paracoxib; and Zofran to offset the headaches and nausea that are side effects of these analgesic meds.
I was advised instead to rest, because I didn't need to rush anywhere, not even to the toilet. I did stay in bed for most of the 11 days. No, I did not get a urinary infection.
The only other thing I was advised by the CGH pain doc when a situation like this happens, was to just take an extra dose of oral oxycodone (5mg): out of the same prescribed number of capsules. Which means I would have to skip doses along the way to make up for the extras I took. Because of the severity of the pain I had, it is not a sustainable option anymore; I simply cannot make up for all the extras I had to take, to get by the past week and a half. No, the public hospital folks could not offer me any injectible pain relief options. I will try to bring forward my next appointment with the public healthcare doctor if possible. If not, I am doomed to go back to the private healthcare sector for help that government-subsidised hospitals will not offer.
The last time I had this same long, drawn-out pain flare, was for 10 days when I was still in CGH. My pain management team of nurses could really emphathise with how deep the pain went, but could only tell me to rest and take my oral meds, do deep breathing — that's all. It was an exhausting ordeal, even when at that time I had nurses to help me. This time I was on my own in the weekday mornings and afternoons.
Here is how I coped the past one and a half weeks. Unyielding pain, that ran up to even 9/10 at one point, made me physically fatigued. I slept a lot, unrefreshing sleep, but the inactivity gave me relief. The other way I coped was with essential oils, which cost by approximation about half the price of the IV injection I wanted to have. $200ish dollars on essential oils is nothing to sniff at, pardon the pun. But I had no other choice. On my pain charts it proved to be tied 50-50 with inactivity as a mode of pain relief. I used frankincense, copaiba, and Idaho balsam fir on acupressure points on my earlobes, palm and feet. The effects were significant but did not last long, so I had to keep re-applying them.
What frustrates me most about this gradual method of getting out of a pain flare, is that my muscles deconditioned for 11 days, undoing much of the exercises and occupational activities I burden myself with every day. The time-frame of this pain flare also meant that I had to skip my weekly physiotherapy at the hospital.
The concept of an injectible pain relief solution is so that a patient can "break out of a pain cycle" and not keep on taking more and more oral medication that wouldn't help much. After this breakout we can go back to simply taking our baseline medications, instead of an increased level of them to the point of having side effects like headaches and nausea, (which I have already been experiencing since yesterday). I also now find it even more difficult to try and reduce my pain medication as far as possible, which is the general plan for long-term pain management.
Furthermore, the aptitude of my private practice pain doctor meant that he can quickly and deftly inject the meds intravenously instead of via an intramuscular route (IV instead of IM) — without a need for a drip set-up, or IV catheter. It is fast, quick, and utilises the least possible resources and time.
At the heart of many chronically ill folks like me, we just want to be productive. This kind of non-breakthrough pain relief is inherently discouraging. Before this happened, I had intentions of changing my exercise regimen to include more core exercises and step up my rate of recovery. My physiotherapist was aiming for exercises to improve my balance.
Right now I am also experiencing fatigue and light sensitivity. I need some more no-stimuli naps, and take it easy today, even though I can safely say that the pain flare is more or less over. It is always prudent to plus one more day of rest and inactivity before slowly pacing yourself back to a state of normal.
Today, Sayang is parked on me
; being the sensible and sensitive one in our brood, she knows I need to slowly get myself to normal. She meowed at me when she saw me scrubbing the toilet earlier, as if in scolding. She got frustrated when I kept getting up and down from bed, and I had to in some way go back to a state of rest that she felt I should be in before she would give me her attention.
|Sayang being a lap-park cat|
In psychodynamic therapy I have weekly, we examine a lot of links between my thoughts, feelings and actions of today, and my emotionally traumatic childhood. Similarly, something my first psychiatrist told me, resonates with how I feel about this whole ordeal. Which is that when I was five years old, I could only have my mother's attention when I fell sick and she had to stay home to take care of me. Ties between my sicknesses and the love I wanted, formed a condition right there, because after that one incident, my mom never gave me attention like that ever again in my childhood. I wanted it then, and I want it now, My mother was willing to pay for my pain jab last week when I had a day the pain hit 9/10. But $400 is $1,200 to them and a definite dent in their retirement funds, so I didn't want to accept.
Conversely, as I now begin to realise, is that every time the government healthcare system fails me, I feel it is because I am not worthy of help. J felt I had nowhere to go in a hurry, so I could wait out the 8/10 pain flare instead of getting a jab. This premise is in fact a low blow, because it meant that not only was the system failing me, my other half also felt I was not worthy of help as I deemed fit. I was doing nothing, meaning I was in no way of help to society, because full-time recovery is not an economically productive activity.
I am now already used to feeling like this. I will still stand strong in this emotionally-wrought chronic illness ordeal.
Labels: me, state, status, therapy, worlds
Friday, December 02, 2016
I am so exhausted; I had a fibro flare-up. Which has made me not only pain all over in the morning when I had to go for psychotherapy, but so much fatigue right now, and I can't see as clearly as usual even with my reading glasses.
I just packed a tiny part of my room - the jewellery boxes, but am otherwise listing down and being as still as possible. I can't even be bothered to put pants on.
I've recently started using an all called Manage Your Pain Lite. It is awesome. I just emailed my physiotherapist my latest pain report PDF. It contains information on my pain scores, what aggravated each time I had a high score, and what alleviated it. It even has cool charts and graphs.
In the free version of this app, which is what I am using, can generate PDF reports but not including the graphs and calendar. Still, the report itself is already very much a good one-glance document. Here are some screenies from the PDF.
Not shoddy at all. I'm still learning to navigate the app, but I'm liking what they have.
OK, I will end here; blogger is making things difficult for me -, I've already written this conclusion paragraph three times. Gonna just go heat pack my shoulders.
Labels: share, state, status
Tuesday, November 29, 2016
Paying For Care, Impressing My Loved Ones to Care and Failing to Be Cared For All the Same
I am sure most of you would agree that repression is not any good for the soul. With that in mind, repressing my account of the story below has taken strong medication to make me keep it to myself lest I anger people - making people around me upset is one of the motivating factors behind many things I do - but it has merely calmed the physiological trauma symptoms. So here I am, writing all of the hurtful things I experienced yesterday night.
On that note, in the light that undergoing psychodynamic therapy
has cast on many aspects of my life, I realise that many actions of mine are postured with the fear of making J upset. I have in fact been trying to impress the people I love since I was young. I tried to impress my parents, so that they would find me worthy of their love. Because of that, when I was asked to do something I would likely do badly in (by my own perfectionist standards), like play the organ for them to listen, or speak Mandarin, I refused to, until they gave up asking. Instead, because my parents were proud that I was proficient in my mother tongue - English - thus I made sure I tried my very best to read every book they bought for me even if it may have been a bit beyond my age range of understanding. I believe that this proficiency in English was something that helped me gain some love from my parents. I managed to get some verbal affirmation from them for this, and that helped me feel worthy of their love. On the other hand, crying because I was emotionally hurt, was so prohibited by my parents that I never felt safe to cry in their presence until I was 17 years old. The repression of crying and negative emotions made me often hide away to cry, for my entire childhood. When I had to start seeing a psychiatrist, I felt I let them down, and only revealed this to them reluctantly, because negative emotion was something that would make me even more unworthy of their love.
As I grew into adulthood, I did the same posturing with my boyfriends. The fact that I was unworthy of love was pummelled into me with hurtful actions and words from them, H being the main perpetrator among all my exes. Even C, who said hurtful things towards the end of our three-year relationship, praised me verbally when I did something well in his eyes. With J, I get extremely anxious about him being upset. All I want is to make him happy. I fail most of the time. Every time he is upset, I feel it is my fault. I try my best to make him feel better. This is so even when he is the one in the wrong. And yet, I am not worthy. Why is my very being, not enough for my other half?
This sets the stage for the story I am writing about today.
My new psychiatrist at CGH - Lim - assigned to me when I was admitted to hospital on the day of my suicide attempt this year - is incompetent; I feel unsafe and traumatised by every single of other five times I have had a consult with him. I will now list the reasons why he is not a good doctor.
- In the place of having a conversation with me, his patient, he prefers to pontificate. There is no room for me share how I feel, my concerns; he rarely even asks questions, and when he does, he does not give me the courtesy of paying attention to my replies. Three of the five times I have had a consult with him, he spars with me verbally. My mother told me that on the day I was admitted and talked with him, he was arguing with me. My mom and dad are bewildered by the fact that a doctor behaves like this. Such behaviour is not right when talking to someone without a mental illness, and much less so when talking to someone with post-traumatic stress.
- He is no bedside manners at all. When I talk to him, he is looking at the computer screen, typing. No eye-contact. Closed body language. If I start to cry because of intense emotions, he ignores it completely. Every psychiatrist, psychotherapist, counsellor I have met will offer me tissue. He never does. No tissue offered is not as bad as someone stopping what they are doing and offer to listen in order to calm me down.
- He has no understanding of me as a patient. After I had already started psychodynamic therapy for a while, he decides to inform me why I should go for psychodynamic therapy. It is simply incredulous, to ask me to do something I am already doing on a regular basis, as if I was uncooperative, when in fact I enjoy my sessions with Dr T a lot, and in fact the only reason why I am still seeing Lim is because that enables me to see Dr T on a subsidised rate. He did the same verbal theorising to me about my sessions with my psychologist while I was inpatient. I had already been having sessions with my psychologist weekly. He spoke at me to verbally strong-arm me into attending sessions with my psychologist. This is like saying to someone who is busy eating a burger and already halfway through, to exhort him to eat a burger.
- When I ask him whether Lexapro, my first-line antidepressant I had been taking for years and with tangible effects in the past and also helps with anxiety, that he had struck out of my psychopharmalogical regime, could be reinstated - he said no. Fair enough, he is a doctor. But when I asked him for reasons why I shouldn't be on it, you would reckon the doctor would explain with medical reasons: why it is harmful to go back on it, or why with my present state of health I no longer need it. His answer was neither of these, but, "Who has a better track record with making decisions, you or me?" If you ask a GP for antibiotics for the flu' and he says no, you would likely get a reply like, "This is a viral infection, antibiotics are for secondary bacterial infections and therefore won't work, so it is no point taking them, unless you show signs of a bacterial infection." I hardly believe you would get the reply that Lim gave me.
- He has seen me for a total of five times. I might have miscounted; maybe it was six times instead. Nonetheless, compared to the years I saw Dr Kong before, and Dr Marcus after, he definitely does not know me as well as they did. Furthermore, they are private doctors, their salaries are directly impacted by their performance as doctors, whereas public service doctors don't suffer from a loss in income if their patients aren't treated well. Kong, who wrote a thesis on only-child environments causing mood disorders in the 70s, attributed my symptoms of depression an anxiety to being an only-child raised by a slew of foreign maids. He also believed that my symptoms were due to emotional trauma in childhood - something based on the attachment theories by John Bowlby. Dr Marcus had also said before that he believed my depression was organic, and not a personality disorder. However, after the grand total of five or six times Lim has seen me, he decides all these years those two doctors were wrong and what I have is borderline personality disorder. I have read BPD symptoms over and over, think of people I know who have BPD, and I really do not identify with the disease. I told Lim that I don't agree with his diagnosis, which is based on very little information he has on me. He said that "We shall have to agree to disagree" and continued typing on the computer.
- In our last consult - that was when he said I have BPD - I broke down and cried in his consultation room, because he refused to listen to me and why I believe that he was wrong. I break down and cry when I see Dr T too, during therapy. However, Lim told the management that I was causing "loud altercations." In a psych clinic, almost every patient would be prone to breaking down into tears. How could this be construed as causing "altercations"? If you term it as a nervous breakdown and corral me into a safe/isolation room, it would be far less a betrayal than saying I caused "altercations".
- The management was informed that I caused "loud altercations" because we were in correspondence with them. Lim suggested in my last consult with him, whether I would like to change doctors. He then later said, when I went to the clinic for my regular appointment with Dr T, he failed to find any doctor within the entire psych clinic at CGH. We wrote to the management to appeal to them to find a way we could change doctors. The management declined, saying at first that they cannot find another doctor, then saying that I had caused these loud altercations when I had broken down in tears, that I disagreed with his diagnosis, so they no longer want me to see them for my psychopharmalogical needs. The fact that Lim can impress upon the management that these are characterisations of my behaviour when I have done nothing wrong, is a low blow indeed.
- Because of his behaviour and actions I feel unsafe being in a consultation with him alone. He may not be physically violent but he is meting out dictatorial emotional oppression. I feel as fearful being in a room with him as I would in the presence of someone who is close to violently attacking me.
Another letter came from CGH yesterday, stating that I should go back to seeing Lim - that was their way of resolving the matter. It was so hurtful. The healthcare industry, doctors, nurses, therapists - all of these are meant to help patients feel better. But all this has caused me mental anguish instead. I broke down and cried because of this letter and how badly it hurt me emotionally.
Then J got angry with me, he wanted me to shut down the crying and hurt and eat dinner instead, so he walked out the room saying he will eat outside (we normally eat in the bedroom). This was another blow, that hurt me even more than the letter. His walking out and intolerance of my tears, gave me flashbacks to hurtful events in my past, when I would get scolded for crying, when my mother would push me aside when I went to hug her because I missed her for coming home late.
Is it really so difficult for someone to just stop everything and hug me while I cried, or simply offer me tissue? I have a fear of abandonment: is it that difficult to not walk away while I am upset about something? My whole life I have been trying to impress people close to me so that they would care about me emotionally, but I am still unworthy of a hug and tissue. I am still to blame for being hurt by the healthcare practitioners that we pay to care for me. I am still to blame for being hurt by the people I love. I must never cry, because it irritates my husband and makes him angry.
When I first met J eight years ago, he would comfort me when I was down. Today, I can't even get him to place his hand on me as a show of comfort, something that any normal person would do to comfort someone in distress. In fact, because I still don't have good balance, whenever I nearly fall, he wouldn't come to check on me to see if I am okay. I have run out of ideas to get affection from people I love.
The events of yesterday: being hurt by CGH, being hurt by the man I love, made me so despondent. I haven't felt such mental anguish since before my suicide attempt at the bridge. I don't want to live, but I also don't want to abandon my children, I also want J to get the flat we will co-own in 2 years, and frankly I am out of energy to coordinate the necessary factors for a successful suicide attempt. I am done, I will just live through this lack of affection, concern - love, even - for as long as possible.
Labels: state, status, therapy, worlds
Friday, November 18, 2016
Gamifying My To-Do List - #Spoonie Style
Being a Type A sort who obsesses over getting things done, while grappling with physical disability and mental illness, means I'm always cycling myself into self-loathing, flight-or-freeze anguish.
It took me a while but I finally managed to design a system for getting things done that actually works - specific for spoonies
like me who find even getting out of bed too difficult, too often.
Here is what I do:
1. Create a master list of tasks you need to get done.
It would be an utterly complete list of things you would ideally like to get done should you have no health obstacles in a day. This list should not contain any activities that reap no benefits towards achieving your objectives, such as watching Netflix. Break tasks down into micro-steps where possible, for example: instead of just writing down "take a shower", break it into "shower", "wear clothes", "brush hair" and so forth.
2. Optional: categorise the tasks.
(For me, I've categorised my recovery tasks into ADL - activities of daily living; reading, writing, exercise.)
3. Create a Bonus column that lists your stretch goals
- things that are more difficult to achieve, but not impossible.
4. Tally the total number of tasks.
I have 36 on my master list. I round up the number to 40 for ease of calculation.
5. Every day, draw up a "blank" to-do list
, where instead of writing everything you want to do for the day, you fill in the list with every task you complete based on your master list from step 1. At the bottom of this empty list, you will at the end of the day, calculate how many points you score. E.g. [X/36] where 36 is your tally from step 4.
6. Every item completed gives you 1 point; for items from the Bonus section, award yourself 2 points.
This goes towards your tally of marks. Your aim is to pass and obtain 50% out of your total tally from step 4. You can improve on this scoring system by setting yourself higher or lower percentages that you wish to obtain for the day.
I call this system my "dailies" which is a term from my youth when I played World of Warcraft and did daily quests for gold. The daily quests reset every 24 hours. The gold rewards were why we did them.
To further enhance this system, please set aside at least one day out of every week where you do not bother with trying to score any points. I call days like these "days of no-obligations".
If you are a spoonie like me, you will have to insert more than one day of no-obligations in a week. For instance, if I have a pain flare on Monday, I make Monday a day of no-obligations, plus Tuesday. Wednesday I set a lower score necessary to pass my dailies. For days where I have to go out for doctors' appointments and physiotherapy, I also make those days no-obligations. You can also consider combining weekends into one day; the aggregation of two days' worth of dailies are considered as one total score. In total, I gun for 4 out of 7 days a week where I strive for productivity. One of the categories in my master list is 'exercise' so it means I exercise 4bout of 7 days a week, which is something my physiotherapist considers a fairly good sum.
I combine this system of doing my dailies with other productivity motivation techniques that I have learned:
I find myself completely tired by nightfall, so I aim to do my exercises before that, usually in the late afternoon. I give myself rewards for getting dailies done, simple things like a cold juice after completing five exercise sets.
I combine tasks that have to be done at the same location - to feed my cats, I have to go to the kitchen, which is where my supplements are kept. Both feeding and taking my supplements are on my list of dailies, so I can get them both done at the same time. This applies to an office setting as well
. For example, if you need to go to another department office to get one thing done, aggregate other tasks that can be done along the way to that department floor. If your mail pouch is located near the photocopying machine, get "collect mail" and "print meeting agenda" at the same time, instead of walking to that part of the office twice.
Through using this system, I've managed to break free of that vicious cycle of anxiety that keeps me from getting important thing done. I hope it will help you too, if you sometimes get trapped in the same "Dammit, there are so many things I need to do, I just...can't" situation.
Thursday, November 10, 2016
I've had friends throughout my life who were good to me as well as friends who were mean to me. I know you're probably thinking, mean people are not my friends, friends wouldn't be mean to each other. But I've willingly continued in friendships with people who always wanted their way and their say, even if it hurt me.
I don't know what that pattern is a symptom of; everything has its source. I guess it could be that I tend to love too unconditionally, even beyond a point when it is no longer healthy for me to do so. I often go into interactions with people with an implicit trust that they will do unto me what they would want done to themselves by others. Another reason could be that I'm so hungry for friendship and affection, that even if you slapped me in my face and called me a wretch, I would still regard you as a friend, because I need someone, not bearing with the emotional abuse means letting go of someone I love. Both reasons are probably true.
What does this mean then? It boils down to just poor little Elaine as a young child, again. Back then, I wished someone would give me emotional and physical intimacy. Today, I'm still starving for those things.
Thursday, November 03, 2016
#avalonreads On the Theme of Escapism
The theme of escapism has bubbled to the surface in my recent readings, and may partly also account for my lack of writing - of book reviews, or blog posts on any other subject. (I would at least post on Instagram, but my camera is not working, hence some silence from me in that realm.) I keep immersing myself in reading, with some reluctant physiotherapeutic exercise as an accompaniment. Have I sunk into reading as an escape?
I'm no stranger to escapism, be it the neutral activities of watching YouTube documentaries non-stop, or playing game after game of Sudoku, or those almost socially-unacceptable addictions to alcohol and cigarettes. It is a way I dissociate; numbing myself and thereafter becoming someone else that is not me, and it means distancing myself from the pain and anguish I accumulate within every day. These activities require very little thought, and because they are mindless they seem even more dangerous as addictive means of escape.
I've been quite disciplined, focusing on, apart from the necessary chores of daily life, exercise, reading, and writing (in my journal, minimally). But sometimes I read excessively and instead of exercising and whatnot. I hardly nap anymore, which is necessary for managing the symptoms of fibromyalgia. I've noted my obsession with reading in earlier posts, but obsessions need not be addictions. I should stop clicking post after post after post on websites, or finishing one chapter after another and another, in a way that gives my day little manoeuvre for other activities.
I read this story on New Yorker, Relive Box by T. Coraghessan Boyle, which reminds me of spec-fic novels by a favourite author of mine, Margaret Atwood. The Relive Box is a console that allows you to experience in virtual reality, user-specific times in your past. The protagonist often relived till dawn, and it affected his work because he wasn't sleeping. That sounds like me when I delve into a video game. I would start at 8pm and the next time I looked at the clock, it would be 10am.
The Noonday Demon (which I'm almost halfway through) covers the correlation between depression and addiction. Andrew Solomon expounds on the nature of addiction and includes his own propensity to indulge in substance abuse. He writes:
"It gives me a kind of blissful energy and a sexual exuberance and a feeling of superhero power that are quite fantastic. I get to the point of being unable to string together a sentence and I don't care if I never string together a sentence again. I realise that the solutions to everything are simple and straightforward. Being high on cocaine breaks up your memory enough so that the past can't haunt the future. The chemical happiness of a good hit of cocaine feels completely uncircumstantial. I can remember sitting around with a numb nose, thinking that if I could freeze life in that second, I would do so and stay there forever. I almost never use the drug, but the idea that I would never want it is ridiculous. I fell in love with cocaine in those first minutes of rush. The spectre of imbalancing my brain and the devastating hangover are all that keep me away from the cocaine high."
How is substance abuse different from the high of reading and gaming, when all these activities allow us means of escape? I just finished this novel The Less Than Perfect Legend of Donna Creosote by Dan Micklethwaite, which is a light read about a woman who spends her lonely nights in the fantasies concocted by books she has read, of which there are so many that her floor is tiled with them. She has another deeper hidden addiction than reading, but the way she turned mere reading into a substitute for all else, is scary enough for me to stop and rethink my own obsession with reading.
The discipline required for activities such as exercise and personal grooming, is something I built and depended upon a lot for my recent recovery. Without it I would hardly be as ambulant as I am now. I have never been disciplined, even in childhood I didn't have a fixed bedtime. Although the symptoms of depression and fibromyalgia are often counter to what discipline requires of me, I have to fight them daily; on good days it feels like I'm canoeing against the current, on a bad day it feels like I'm pushing a boulder off of me. Sometimes I lose, then I go to bed and try again the next day. In such a climate, reading is my respite, but I have to force myself to consume it within set limits, so that I can at least brush my teeth daily.
Labels: books, pleasures, therapy, worlds
Sunday, October 23, 2016
my thoughts that confluence around my current #avalonreads #dailyreads
In response to Trauma Stewardship, Lipsky and Burk, and The Noonday Demon: An Atlas of Depression, Andrew Solomon.
I want to change the world, because ever since I have had awareness of reality, I have found this world to be tangibly sad; so different from the worlds in my storybooks when I first learned to read. Whether it was because I have depression that began in childhood, altering my worldview, or because the world truly is a sad place, that has no bearing on my ambition to do good in this world in a big way. My perspective may be skewed; the lenses of my proverbial glasses definitively not rose-tinted - tea-coloured, more like. It makes for keenly-felt suffering, either my own but more pronounced than its actual proportion, or that of others, human or animal, as though it was borne by me as well. This is very painful, sometimes even more so than is usually felt during extremely depressed states; this weltschmerz
may be triggered simply by current affairs. But it also empowers me; after I have reckoned with this pain I have the the unction to act upon injustice in aid of preventing this suffering, or on healing efforts after the fact.
I ask myself today, who am I apart from being God's child, apart from my parents or a string of significant others? In humility my answer used to merely be, "nothing," as it is sung, "I am a flower quickly fading, here today and gone tomorrow." But, if I need to be tethered to reality in aid of my own
suffering, I need to know more facets to the truth of who am I,
not in arrogant exalting of the self, but a refusal to deny looking at the mirror. Without observing my own reflection, acknowledging it, studying it, depression causes me to wholly believe I see nothing but a wraith in the mirror. I have learned to love everyone but myself, but I have failed to love my neighbour as myself, because my neighbour is God's creation and not a hollow-eyed wraith, long-dead and snuffed out. I have only known myself always as a part of another, like a moon orbiting Earth, when in fact I am greater than a star without a need to be attached to another. I must learn, that I am no longer a daughter in lack of parents' affection.
Labels: books, worlds
Wednesday, October 19, 2016
There are some days I don't have enough spoons to do a whole blog post on my daily reading; I will share a quote or picture on social media instead.
I'm at the chapter of health in Today Matters, by John Maxwell, where he exhorts the reader to make a decision towards healthy habits, and be disciplined in keeping them. His example of how exercise yields no weight loss in one day, but after a period of time, if done regularly, results appear - made me think about my obsession with reading.
I'm beginning to think that reading is helping me heal. The effects are small at first - just like exercise - you won't see any results overnight; you have to keep at it regularly. I still can't articulate how exactly reading is helping me, but I probably will, soon enough.
Reading aside, I do exercise daily. Less cardio nowadays but 18 exercises for specific muscle building as physiotherapy for my injuries, every day. Sometimes I can't even complete half of them all, but then I try to get back on track within the next day or two. No, I don't enjoy it.
John Maxwell does imply - very minimally - that the chapter on health includes mental health. I guess that my daily journalling, doing visualisation and mindfulness exercises, and weekly psychotherapy sessions count as taking care of my mental health.
I am still on Trauma Stewardship by Lipsky and Burk - I highly recommend it for anyone working or volunteering in helping professions which expose you to the trauma endured by our planet, by animals, or by fellow humans.
Today's chapter is on building compassion and community, the third of five recommendations to rebuild ourselves after exposure to trauma in our work. The first way to do so is in creating a microculture.
I feel this message of community repeating itself through what I read every day in books and online. But the truth is, right now I'm isolated. I'm not able to build a support network at the moment because I've taken a leave of absence from leading our organisations, which means isolating myself from the volunteers. Friends from the past have either moved on or are far too busy with family and work to reconnect.
People who - do - want to connect, I don't feel the same way towards them most of the time. Lack of chemistry? Perhaps I'm not ready to love a friend because I have no love to give right now. And, I've definitely tried to connect with the people I want to relate with, unfortunately they are usually very busy people. I think I will just stick to writing to an anonymous audience online for now, specifically here, Twitter and Instagram (no Facebook because I loathe that platform). Is that a microculture in itself?
Next, from The Noonday Demon, Andrew Solomon:
Fact: I am uninsurable because I am on medication for psychiatric condition; only those who have been off medication for say, three years, can be considered for insurance.
But as you can see from what Solomon has written, and a fact I know for myself, I am likely to be permanently on medication. Excluding the childhood experiences, the breakdown I've been on for the past decade is not the first; I had one around age 20 give or take (depression warped my sense of time then).
If not for my other half supplying me funds I would be without aid. Before I had him I tried asking for financial aid and was rejected. I've said this before and I will say it again: this country's government needs to do way more for mental illness patients.
I leave you with this, from Pinball 1973 by Haruki Murakami.
Labels: books, pleasures, share, therapy
Monday, October 17, 2016
#avalonreads daily summary 17 October 2016 | Priorities and Reflection
From Trauma Stewardship, Lipsky and Burk
Serendipitously the part where I am working on in this book is about focus and the part I was working on in Today Matters (below) was also about focus - that prioritising helps us focus on what is important.
TIL: Where we want to put our focus, in itself illustrates that we do have a choice in what we want to focus on, what work, and our lives apart from our work.
From Today Matters, John Maxwell
Reflection is something I've been doing a lot of, prompted by the questions raised in this book, and in Trauma Stewardship. I find these questions very apt as journalling prompts. In itself this book has little value without the reflection you need to do to follow what you read.
From The Noonday Demon, Andrew Solomon
Solomon quotes Emily Dickinson (my favourite poet!) And it could not be more accurate in describing how depression makes us feel. How does mental illness feel like to you?
From Pinball, 1973 by Haruki Murakami
In the same vein, today's QOTD: "The world awaiting him out there was just too big, too powerful; there seemed to be no place he could burrow into it." But also: "When I was in college, no one in my apartment building had a phone. Hell, I doubt any of us had an eraser."
Fiction brings to us characters we can emphatise with, describes life for us in keenly accurate ways, but also with jest sometimes.
Labels: books, pleasures, share, therapy
Obsessions: Reading and Books
When I saw this, I felt proud of myself for prioritising reading in my daily list of recovery activities: "Can Reading Make You Happier?" The answer was quite encouraging overall.
"Since the discovery of... neurons that fire in our brains both when we perform an action ourselves and when we see an action performed by someone else... A 2011 study published in the Annual Review of Psychology, based on analysis of fMRI brain scans... when people read about an experience, they display stimulation within the same neurological regions as when they go through that experience themselves. We draw on the same brain networks when we’re reading stories and when we’re trying to guess at another person’s feelings.
"Other studies published in 2006 and 2009 showed something similar—that people who read a lot of fiction tend to be better at empathizing with others... And, in 2013, an influential study published in Science found that reading literary fiction (rather than popular fiction or literary nonfiction) improved participants’ results on tests that measured social perception and empathy, which are crucial to “theory of mind”: the ability to guess with accuracy what another human being might be thinking or feeling, a skill humans only start to develop around the age of four."
So it seems that reading books, specifically literary fiction, helps us in our social intelligence. Good information, though I was digging for mental health benefits instead of empathy towards others.
But wait, there's more!
"Reading has been shown to put our brains into a pleasurable trance-like state, similar to meditation, and it brings the same health benefits of deep relaxation and inner calm. Regular readers sleep better, have lower stress levels, higher self-esteem, and lower rates of depression than non-readers."
Ah there we go. Although I sometimes stay up too late reading and it eats into my mandatory no-stimuli pre-sleep routine (for fibromyalgia symptom-prevention).
This information did nothing to alleviate my recent book-hunger. I keep on stumbling upon books that I have to have, to read. And I already have a book backlog (thankfully small for now) waiting for me.
But I earn no income from reading, or from the writing that results from the reading. Even if books help me recover, recovery doesn't pay for books either.
For now I make lists of books I would like to read, and window shop online, carrying a basket of books slowly growing, but not quite making it to the cashier yet.
The feeling of staring at the cart and yet unable to checkout really makes my heart yearn for them all the way from here in Singapore. (They are at Amazon.)
Labels: books, pleasures, state, status, therapy
a daily summary of what I've read in books today #avalonreads #dailyreads
If you've read my last post you must have learned I'm now on a mission to read more books daily. I decided to post a daily summary of QOTD/TIL snippets from each book I've read daily. I hope you might enjoy it as something different from the regular book review articles online. Here is today's effort:
From Trauma Stewardship, Lipsky and Burk
I am reading this as professional development non-fiction, even though the topic is focused on personal well-being. The book presents 16 signs that exposure to trauma - in our work of helping others, animals or the planet - has negatively impacted our emotional, physical and social well-being. It then presents five ways to realign ourselves to heal these 16 effects. I didn't work on this book much today at the time of writing, so here is a cartoon pulled from the various ones that pepper the pages with some humour.
From Today Matters, John Maxwell
The crux of this book is that if we make 12 important decisions early, and discipline ourselves to manage them daily, we will have success every day.
TIL: The first 1 out of 12 decisions is attitude; apply positive attitudes to tasks and towards people. But I was bothered by how antagonistic Maxwell described negative attitudes: I felt that my negative moods brought about by mental illness were disgusting. It may not have been his intent but that was what I felt.
From The Noonday Demon, Andrew Solomon
This book is full of innovative ways depression can be described. It is not just a mirror of myself, it is like a "beautify" filter option on our selfie camera app. Hence why I chose this book to embark on reading the creative non-fiction genre daily - it encapsulates what creative non-fiction should be, that is, the facts presented in beautiful language which opens up more insights than an academic-toned essay would.
From Hear The Wind Sing, Haruki Murakami
Murakami endures being one of my firm favourite for over a decade now, and this is one of his early stories, published as two stories, the second being its sequel. I have read almost everything else (except 1Q84, regrettably. I still want to get back to finishing it).
"So where are we headed?"
"Sounds good to me," I said.
Labels: books, pleasures
Thursday, October 13, 2016
latest thoughts on reading
After I spent a large chunk of my time in hospital catching up on my reading, I brought the habit home and expanded it even further. I have decided that reading is going to be part of my recovery "programme" at home. Every day, besides exercises and regular daily activities, I aim to check off writing and reading in a discipline manner. Recently I've also decided to read four books at a time.
Literary fiction of course remains a firm stronghold. I try to read prizewinning books, or those by my favourite authors. I also look up book reviews on Guardian Books which is my current go-to source for book recommendations.
I am also reading books related to my work, and that currently is about how it burnt me out. I name this category of books professional development non-fiction. I have always devoured books in this category as well, previously on fundraising and nonprofit marketing and suchlike. However I am more disciplined about it now, not only because I try to read further along in the book each day, but also by making systematic learning notes - handwritten. It really helps me internalise what I read and recalling the key concepts without referring to them, comes in a flash. And if they don't, the notes are easy to refer to.
To add to the above, I also now add personal development non-fiction. It can also be referred to as self-help books, but then it sounds flaky doesn't it. I also make notes the same way for this category.
Up and coming is the creative non-fiction genre. This is something I just decided upon. I think it sort of catches the good books that should be read, that don't fall into the above two categories.
I've also been reading at least a verse a day from the Bible - via mobile app. I make quick short notes in a note taking app on my phone.
We can't quite go without reading articles online, but the focus should be on books in my opinion. In this discipline I simply make sure I read something online every day. The articles could be via my Medium timelines, my Twitter timeline, or Twitter Lists such as topics on news or management. I sometimes expand this to include e-magazines via Zinio.
Perhaps through this disciplined manner of reading I might become more self-awareness, improve my writing skills, move further along on the no-end-in-sight recovery journey. But mostly I enjoy it, and they say reading (books) make intelligent/successful smart people, so ok then.
Labels: books, pleasures, therapy
Monday, September 26, 2016
Since I've been home
Reading is one of the few little things I've managed since I came home. I am slow to using it as a source for reading material: in the past month or so I have been spending a lot of time on Medium. It is to me, Tumblr for adults, Instagram but with words. Crowdsourced content-writing will of course, be littered with grammatical errors in many articles at the very least, but I get used to it if I like the ideas being conveyed.
It has been hard to get a structured routine going now that I'm home, and I still am not able to do every daily activity I need to do. It is tiring even for me to go to the bathroom, especially when I got a fibro pain flare when I first returned home. Recovery is much more of a full-time job than I first thought.
I managed to start journalling again, prompted by the delivery of my new notebooks and bottle of black ink. You might notice that, like online reading, it can also be done while lying in bed! It is something I've always justified - anything done supine is fine. But it is even truer now, because for me to get up and ambulate around the house is a hassle, and needs to be done with safety awareness in mind. So a lot of what I need are by my bedside.
I've needed a lot of sleep since I came home. The longest stretch was 22 hours of sleep where we only woke up to eat and use the bathroom. Hospitalisation for a long-term seems to be very tiring. I am still tired, albeit less so after that 22 hour-long sleep (yes, it helped).
Up till today, I still can't complete a single day's list of exercises. I keep trying, and failing, and just keep trying again the next day. Almost all of my daily exercises are doable in bed, save for a few which need me to sit up or stand. Yet I still haven't achieved it all. It doesn't make me any less, and I guess that is what I have to remember.
Labels: state, status
Thursday, September 15, 2016
Thoughts about finally going home
I am finally going home on Saturday. Home from hospital. Home, after almost 5 months. Home, able to walk with a one-handed walking aid, when 5 months ago I was in so much pain that I was supine and bed-bound for weeks.
Over the next few days, I will be stressed. Because I've been in a controlled environment for so long, even home will be a mentally and physically dangerous place to be. I told Asshole Dr from CGH (that controls my psychiatric meds) this very fact, but of course he not only didn't alter my medication with this in mind, he also decided that after seeing me for grand total of 5 times over 5 months, the psychiatrists who treated me for years before he did, were all wrong: I have Borderline Personality Disorder and not an organic form of depression. (Which is not true. May I also add that during each of these consults he had with me, he did not listen to me with a shred of empathy, preferring instead to pontificate eloquently on his theories.) I am being released into the real world with far less reuptake-inhibitors I need to simply not-feel-sad. Not even asking to be happy, I just want to be stable. But that's not on Asshole Dr's agenda.
Over the next few days, I will need to think about every logistic detail for my return home, including the right sized quadstick I can safely walk with. The nice one I wanted to buy costs too much to ship; my second option has a narrow base, but I trained to walk with a broad base, and haven't learned the narrow base yet (though I will eventually, through outpatient rehab). The furniture at home may need some shifting; at the very least, as much floor space as possible needs to be clutter-free, things I need to use have to be within reach. I also need to think about every minute detail of walking from doorstep to lift-lobby, where hopefully I can get an Uber driver to wait for me downstairs to help me to a parked car taking me to outpatient appointments. And then, the way back home, which is the aforementioned in reverse.
Over the next few days, I will need to start packing the stuff I have here in hospital, to get J to bring home in batches; otherwise there will simply be just too much to bring home on Saturday. I also need to buy diapers, disposable drawsheets to protect my bed from diaper leaks, exercise aids such as ankle weights and a hand gripper thingie. J needs to bring me clothes from home on Saturday. I know he won't want to, but he might also need to take leave - again - to trial-run with me a trip to the doctor's, and downstairs to the nearby shops.
Over the next few days, even after I make a hospital-discharge checklist, I will keep on thinking about "recovery" and how it translates into actual daily activities. Besides outpatient appointments, exercise, reading, journalling - is there any more time to do anything else? Or will I be taking on recovery as a full-time job now, and forget about my desire to work my heart out trying to make a difference in this world?
When I reach home and finally see my kids again (banned from visiting me while I was warded because they are pets) am I going to to withstand the barrage of emotions that come around? That I was willing to abandon them because I thought I was a burden to their father?
I am so, so sorry.
I could go on with this but I've reached the threshold where tears obfuscate my vision and my nose is getting clogged. I'm more than ready now than before, but going home is still gonna be a rollercoaster ride for me.
Saturday, September 10, 2016
I need help in my recovery.
It was not just one factor alone that led me to that day. My medical bills were as a result of my illnesses, my illnesses render me too incapacitated to work for money to pay this bills. My illnesses brought me to a very low point in energy and strength, physically and mentally, which resulted in heavier medical costs. But being in such a low point, I found myself unable to even ask anyone for financial help.
I cannot stop leaching money because my illnesses are chronic; I cannot be cured fully, ever. I will always cost money. Only the solution of my non-existence was viable for me in that state.
As a result, because I survived, I ended up spending almost half a year, in two different hospitals: Changi General Hospital, and St. Andrew's Community Hospital. In CGH alone, my estimated bill was over $40,000 for two surgeries and a 10 week stay.
If you would like to help me with a crowdfunding campaign, please email me at firstname.lastname@example.org to reach out. I want to focus on my physical and mental health and recovery, but eventually I need help with the amount of money my health and recovery costs. Yet, I am still at the state where I don't yet have the strength and energy to administrate a fundraiser. What is to a normal person merely the click of a few buttons, is to me a logistical monster I cannot handle.
Consider if you can help me set up, promote and frequently update a crowdfunding campaign. If you think this is something you would like to help me with, please reach out.
Friday, September 02, 2016
Today I officially started psychodynamic therapy as an outpatient. (I am still in hospital, but at a community hospital which is an intermediate healthcare facility designed for rehabilitation, primarily via physiotherapy. It is next door to and linked to the government hospital that I stayed at for 10 weeks in an orthopaedic ward.) This is at my previous hospital's psych clinic. When I am finally home in about two weeks' time I will continue as an outpatient at this clinic.
Just to let you know about the logistics accompanying this therapy: if I want to see this doctor for psychodynamic therapy at a subsidised rate, I need to also see the main psychiatrist-on-call I was assigned to on the day I was admitted after my suicide attempt. This psychiatrist is only for the psychopharmacological part of my treatment. But this psychiatrist happens to be an asshole. (More on that later.) It has to be an hour-long session every week on the same time and day, for a year. The doctor administering this therapy is really nice and pleasant, a deviation from the norm that is the government hospital doctor.
One element about this form of therapy is that it is fluid, without many directives from the doctor. Since it is the predecessor of psychoanalysis (featuring a couch and 'tell me about your mother'), it pretty much means I am supposed to talk in the stream of consciousness, and the doctor prompts from there when necessary. I started with a current trending topic in my life: medical care.
I shared about the TCUs i.e. follow up appointments I had recently. I can't recall the specifics because it has been a very fatiguing day. As I spun on and on, with prompts like, "It sounds like you have had a very bad experience with this hospital's doctors," I ended up summarising myself that competency and empathy were important traits in doctors I paid to help me. You really have to be interested in making me feel better. It seems foolish to have to state this but besides a couple of exceptions, government doctors don't benchmark their performance against how well the patient becomes after their care.
I gave a few examples of failed doctors and one of those was the psychiatrist I have to see for my psych meds. Things he does not do: address concerns regarding symptoms, explain rationales behind his prescribed treatments, adopt a genuine listener's posture and body language. One prime example is when I asked him to reinstate one of the medications I have been taking for years until I came under his care: Lexapro. I not only wanted to feel less depressive mood-wise, I also needed Lexapro to help me with anxiety. I am now only on Cymbalta but at a fraction of my previous dose. It doesn't matter if I feel fine with this regimen, or have equal or better ways to help (no, I don't want to rely on benzodiazepines, right?) Or even, at the very least, give me an explanation why doing without will make me better. His answer to why he was not going to reinstate one of my primary meds was, "Who here has a better track record of making decisions, you or me?" All while maintaining an arrogant posture of perhaps, a dictator. No shit!
Is it really too much to expect some bedside manners? Apparently so. As the therapy session continued, I once again verbally discovered that I need to feel validated, and that's why I feel so let down by medical doctors who don't listen to me. This asshole psychiatrist is not the only one of course.
My doctor then asked me if I had similar experiences feeling invalidated when I was young, because as we continued discussing this topic, he saw me getting teary-eyed. I didn't know why exactly either, so we had to wait till I thought up a reason. I eventually linked it to how I was written off as lazy when I was a child, when I couldn't wake up easily, springing out of bed full of energy as I assume children mostly do. I couldn't fall asleep easily at night, so I never could wake up early, feeling refreshed. It was insomnia. I also had low energy all the time, perhaps fatigue? But nobody knew. I was just a lazy child who often overslept for school and failed to complete homework on time. Maybe there was more to this, but by this point my hour with him was up.
Before I started psychodynamic therapy, I needed to sit down with this doctor thrice as he asked me about myself, my history, my childhood. Not everyone is suitable for this type of therapy. I wasn't told what markers was I being assessed against, but I will take a guess. I had emotionally traumatic experiences as a child that deeply affected me to this day. It is the same reason why the alternative diagnosis I have besides depression and anxiety, is chronic PTSD. I am not sure if my high sense of self-awareness also comes into play, or that I am willing and able to share vulnerable experiences I've had.
Well, I will keep going for this therapy and hopefully write more about it here. This doctor has the right mix of what I look for in a doctor-patient relationship. He listens well, never interrupting me mid-speech, not even for a phonecall. He engages me with eye-contact throughout the entire hour, and his body language shows he is totally focused on the session we are having; he doesn't even read or write any notes. He uses the right words where appropriate, like, "Sorry to hear that..." or "Correct me if I am wrong but it seems that..." He also explains clearly the rationale or structure of the treatment he is administering, to the level of my self-awareness. Not all healthcare professionals do that! Some just want you to adhere to a treatment plan because they say it is good for you. Hardly scientific, nor helpful.
Another thing I will keep on doing is journalling. It is different from writing online through tweets and blog posts, because it likewise needs to be open and unencumbered. Self-censoring for online posts means not all of your subconscious thoughts are being explored. I have thought however, how I can still share a glimpse of that which i journal. We shall see.
Labels: state, status, therapy
Tuesday, August 30, 2016
Is it too late for me to have a spiritual revelation?
My thoughts are dwelling on something I recently heard. I can't recall it word for word so I shall paraphrase. "If you strip away all that is superficial you will find at your core that this, this thing is what you wanted to do all along."
Will I find LKP at that core of me, in the present vector: right now, right here? I am unsure now. It has become plain that working on LKP reached tipping point for me. Recovery and self-care are, and should be henceforth, my focuses now. It will then leave little time for anything else.
But I still see it: the roaring fire that is our cat rescue work. It is part of me. When I peel away layers of me to expose my core, this fire is visible there. Yet the fire also reminds me of how drained I am inside from doing cat work. The flames keep licking, illuminating the darkness, but the fuel - it ain't me anymore.
I won't dwell on this any longer now that I have put the thoughts into written word.
Labels: state, status
Friday, August 26, 2016
There are so many things I would say to you, if I could speak to you plainly.
I miss home. The home I have with you. You make my life less empty, just by being in it, and I am glad I got as close as I did with you. I don't know how I can express that to you in future, when I am finally home. My physical state is different now.
Thank you for trying so hard to be kinder to me. I know you are making a lot of effort to do so. Doing intangible things, like taking charge of my doctors' appointments, dealing with the hospital bills we can't afford, and - forgiving me, encouraging me in my recovery as you put the past behind us. Your face lifts me up or gets me down: if you are upset, I am upset too, but seeing you smile lifts my spirits.
I am sorry for putting you on that highway road next to me as I lay collapsed. I could imagine your worries, your anger towards me, your frustration at talking to the uniforms, all while you had to think clearly above the trauma.
I don't know we will go from here, because I will need much more caregiving from you now than before. All I know is: I will make my recovery my full-time job now. Self-care. I am not sure how much that will alleviate your lifetime burden, but I will keep going for it.
Sunday, July 10, 2016
I am still here
Am severely injured, but alive, with a decent chance at full recovery, given how gravely I have harmed myself - that is a miracle I reckon.
Two and a half months since: I am still in hospital, as we concur I should return when I have achieved as much mobility and independence again as possible, even though I miss home terribly. I have at least another month to go.
It still hurts to think of that day, but the nightmares are over, the sudden onsets of its memories are now near nil.
I have gained new skills on how to cope with my mood and anxiety. I have gone through the severe, incomprehensible levels of pain of being injured and operated on, and emerged on the other side somehow. I still have pain, I still choke up when I recall what led me to this hospital bed, and what lies ahead. But I told myself repeatedly through this recovery process: one day at a time. With this mindset I have gotten through every day since 22 April.
I didn't even think I would be able to find the words to blog again, but here I am.
Will I ever be able to dance to trance music again? Go to beautiful places with people I love? There are so many limitations I have right now with my injuries.
Though I have come a long way, it is still a long way to go. To go into detail, right now my mobility is limited to a wheelchair. Because I have fractures at, among other places, my pelvic area and lower back, I don't have the full ability to control going to the toilet yet; I - have - regained a lot, managing to go off a urinary catheter, and urinary problems are far less now. Embarrassingly, I pee when I cough, orgasm or exert core muscles during physiotherapy, but I can otherwise control it now. It used to need a lot of exertion for me to urinate but now it is much, much easier. I wear a diaper thankfully! I need to because I still can't fully control my bowels yet (and to catch the pee leakages) - in the early days I couldn't even feel if the diaper was soiled, that was how numb my pelvic region was, and I am glad that is behind me. Now, at least some of the time I can feel it when I need to poop. All this is due to nerve damage from the fractures. It also causes my left foot to be numb and less flexible than my right. At first, even moving my nerve-damaged left leg was impossible without someone's help lifting it. Now, I am still not allowed to stand with it, because it has to not bear weight for three months in order to ensure the pelvic area heals properly. I have experienced horrendous nerve pain in my leg and foot too, as the healing of nerves means oversensitivity to touch and exertion, due to the way nerves communicate with the brain. Also, until two weeks later, I need to wear a brace when I sit upright in a chair, to help align my spine as the various fractures heal. This means I haven't been able to take a shower unless they cart me in a trolley bath and bathe me lying down. I also have fractures in my right arm, and have not regained complete use of it yet, exertion and load-bearing actions still need to hold off.
The psychiatrists here have helped me start sessions with a clinical psychologist, who is a gift. I may also do psychodynamics - a form of treatment that connects our present behaviour to childhood experiences, trauma. Apart from an insufferably arrogant and rude psychiatrist in charge of my case (many government hospital doctors are rude, but this one is the worst), the treatment I am receiving for depression and anxiety is sufficient right now.
My injury pain and fibromyalgia could be much better managed but I have reached a cynical, apathetic acceptance of the archaic and inadequate government healthcare system. I have given up the notion that I can receive the full help I need and have accepted that government hospitals are never going to help me completely in so many respects, including medication. I am trapped here in pain, receiving less than a hundred percent help, but I tell myself, "Forget it," because I have asked and they just won't give it.
I promise to update more now that I have caught most of my online audience (yes, all three of you) up to speed. Until then.
Labels: state, status