The Interrogation, Part Three

nazistaringThe Square-Jawed NP has been, virtually since the beginning, a surprisingly large part of this blog (and my life) despite my only seeing him, on average, once every three weeks for less than an hour each time. He’s an interesting study in contradictions. He maintains strict boundaries and ethics, but that complicates things when he wants to express his feelings about something. I have always successfully read his every expression in order to know what he’s thinking and where he’s going with something.

But after this day, he would be the one reading me, and I would become the unenlightened bug under glass.

A week after the previous Interrogation, I knew our third session would require me to confess my biggest secret. I knew it would happen as certainly as I know I am writing this line. There was no escape unless I was willing to lie about it, which I definitely did not want to do.

I felt trapped — and that’s a bad place for me to be.

barb3 The epic distress made the cutting worse. I started cutting my arm, not just my wrist. And, because the cutting wasn’t stopping, and I was afraid to tell NP, I decided to talk to Therapist Barbie instead. The drive to cut was becoming stronger, urging me to cut deeper, longer, and create more of them. I needed to ask for help.

On arrival with TB, I loosely explained that the stress of everyday life (and therapy) was getting to me. TB was appropriately concerned and handed me a big rubber band to put on my wrist and instructed to snap it instead of cutting. She tried to convince me that cutting could lead to infections and scarring, but it was clear that Therapist Barbie didn’t really grasp the fullness of the underlying disordered thinking that really lead me to cut in the first place. The psychic stress, the self-punishment, the fear, the guilt, the rage. But I happily took the rubber band and said I’d try it. I was also instructed to use a suicide hotline if the urge to cut became too strong. I scoffed and nodded, but knew I wouldn’t use it. How silly — suicide hotline for cutting? Pshaw!

She asked if I was planning to tell The Square-Jawed NP about my cutting, and I laughed, childishly squealing, “No way! He’ll be mad! But if you want to tell him, be my guest!”

I left feeling somewhat confident that NP would never know.

I was wrong.

thA week later, I returned to their office for the appointment with the NP, I sat down and he scowled at me. He asked how I was doing, so I began complaining about work and my Aunt and Uncle Crazypants, and he stopped me cold. He was clearly cross. “I don’t want to talk about any of that. It’s a waste of time. So are you going to tell me, or do I have to be the one to bring it up?”

For a moment, I wasn’t sure what he meant. Then I confessed that I’d been cutting. He asked to see it. (I showed him.) He asked why. He asked if I’d stopped. He asked if I planned to do it again. At that I hesitated. He asked me agree to a verbal no-self-mutilation contract. If I refused (or couldn’t), then we could not continue. I agreed reluctantly and suspiciously. What was up with that? What was the big deal? And what was I supposed to do if I wanted to cut? Oh! How I wanted to ask him if I could call him (like me! tell me I’m good!), but quickly decided I didn’t want to be one of those patients, calling all the time seeking comfort and reassurance when I should be learning to comfort myself.

After our agreement, the interrogation that had begun in the previous session resumed.

I let him lead, but it was quickly evident where he was going with it. He asked me to tell him about my first time having sex.

I stopped and gathered my courage. It was time. THE THING.

This was the deepest, darkest, most horrible THING I knew about myself, but here it was. THE THING I lied to literally everybody about in order to fit in. THE THING I’d prepared myself for two weeks to tell him. THE THING I sliced my wrists up over.

I had to accept it was time to tell someone THE THING.

I raised my head, stuck out my chin, looked him right in the eye, and told him about THE THING. I did not shiver or shake. I did not choke up. I did not cry. I had already done all that in private while cutting myself. The scourging hardened me to deliver the news with courage.

But the Square-Jawed NP just stared at me.

I waited for him to say something, but it seemed clear he wasn’t quite sure how to respond.

Not that what I revealed was grisly so much as tragic. I am not deformed, I did not kill (or try to kill) anyone or anything, nor did I molest anyone or anything. It was simply and awful situation gone off the rails. And it made me feel mortified to admit and unduly condemned to carry. A life sentence. That is why it remained a deep dark secret. I think NP was trying his best to figure out how to appropriately respond.

“That’s it.” I said, trying to give him a cue to say something. “Not bad in my delivery, huh?” I chuckled. “I steeled myself to be able to do it.”

“You steeled yourself?” he asked quizzically.

“Well, yes. How else was I going to tell you that? I knew it was going to come out, so I wanted to make sure I could when I had to.”

He asked a few questions, which led to other questions, all of which I answered with equal matter-of-factness. There were reasons for THE THING, and he clearly understood them. I was impressed that he handled it with sensitivity and, moreover, I was actually incredibly impressed at myself for remaining calm and able to present such tragic information so coolly.

We talked loosely about relationships that I’d had in my adult life. He insisted that surely there must have been many. I said he should define many. He wanted to know what my current status was, and I crabbed. I told him that at this point in my life, there’s no way I could be in a relationship no matter how much I might want one. “Oh, please! Look at me. Who would have me in my current state and condition? What worth do I have? I’m unattractive, have no money, no car, some crummy apartment. And I see a shrink! I’ve got nothing to offer. Nothing anybody wants anyway.”

NP tried arguing the point with me, but I was having none of it. To me, this isn’t so much a problem as an unfortunate state-of-being. If I lost weight, then maybe, but I’d have saggy skin, I’d still be older (not 21 anymore) and my body, even thin, was always imperfect. I’d still be an ex-addict. I’d (probably) still be poor and car-less, etc. To me, it’s just the way things are. Quite matter-of-fact. I was worthless. Period.

To him, my attitude of nonchalance was unacceptable.

“But Maggie,” NP began, “you’re not worthless.” He seemed pained by the degree that I have internalized every ounce of self-criticism. “Aside from your weight which you claim is unacceptable” as he gestured with his hand toward my body, “You have to know you’re very attractive.”

“Pfffft.” I puffed and rolled my eyes. Ah, the usual line of bullshit, I thought. They always lie about that first.

He went on to list several positive aspects of my personality (none of which I remember) which he did only after I refused to acknowledge anything other than my intelligence, and ended by saying, “…and you forgot that you’re kind.”

I scoffed and told him that I believed the only reason he was saying nice things is that he had to — ” it’s your job to be nice… and you’re getting paid — maybe not by me —  but somebody’s paying you to do that.”

NP once again became cross with me. “I was wondering when this would come up, so now’s as good a time as any to discuss it. I schedule you at the end of the day because that way I can spend more time with you. All they pay me is the first 15 minutes. Then I’m supposed to go home. But from there, it’s all on my time. This is free.”

I knew this, but it was embarrassing to hear him acknowledge it out loud. “I know.” I said apologetically and softly. “I’m sorry, and I do appreciate it.”

“Thank you. And technically I’m only here to do medication management. Do you know how many patients I’ve agreed to do therapy with?”

I said, honestly what I thought, “At least a few. Maybe three or four?” He didn’t answer. “Five?”

“One. (Pause.) You.”

I was surprised — and confused. That couldn’t be true. Could it? I desperately wanted to ask why (as in, ‘what are you, nuts???’) but he responded before my thought was uttered by saying, “See? You are special.”

What?

I desperately wanted it to be true. I wanted to believe every word of his whole spiel. (Please love me! Care about me! Tell me I’m good!) But the past told me a different truth which was all I knew I could trust.

I also wanted to crack a joke about it, but I sat with my knotted “Whaaaa?” brow and instead, said, “Thank you”.

“Why do you look confused?” He asked.

“I’m trying to figure out what your angle is. It feels… disingenuous… somehow.” I replied.

“Do you think I’m being disingenuous?” he queried.

I looked at him. I examined his expression and body language. No signs of lying. And yet…. I couldn’t believe him. “Not really. That’s why I’m confused.” I was convinced more was going on than I was being shown.

NP said a few more kind words, but I don’t remember any of them. The bad stuff is always easier to recall.

I left that day suspicious and confused, but at least NP finally knew about THE THING, so the worst was over.

For the time being.

Proceeding from this point on has become a game of unknown consequences. I’ve never been in a relationship where the participant knew virtually everything about me. What would be the ramifications? And what would the Square Jawed NP do with the information that I had armed him with?

I would soon know.

Posted in + recovery, AA, addiction, bipolar, depression, Shrinks, sobrietyland, square-jawed np, therapy, weirdness | Tagged , , , , , , , , , , , ,

The Interrogation, Part Two

nazinterrogation

Having been through it once now, I arrived at our second “therapy” session knowing what was coming. I wasn’t taking any of this ‘interrogation’ personally — this is his job, after all — but it didn’t stop him from being mildly offended by my referencing it as such. To him this was just a type of therapy intended to get me to reveal my darkest secrets and increase intimacy. To me, it felt like surgery — an excruciating but somehow necessary violation.

I knew that the Square-Jawed NP was certainly going to talk about my relationships, and I would have to give him the story about He Who Shall Not Be Named. Yes. That guy. The creature. The one who doesn’t even deserve to have a name anymore.

I had something of a plan. I didn’t want NP to guess my Really BIG Secret before I was ready to reveal it, so this one (about The Creature) would have to suffice as a distraction. I needed more time to build my courage. I needed to steel myself to it. I had been hiding this part of my life behind steel-reinforced doors, frozen in time and now was the time it would have to be defrosted and unlocked.

I practiced over and over. I wanted to strike the right tone. Not appear too overly pathetic, but explain it as factually as I could while still expressing the gut-wrenching devastation the end of that relationship had on my life. I had to tell him, but how?

How do I tell this person, (not so much a therapist anymore), that I was once helplessly in love with a homosexual man? A narcissistic asshole who cleverly manipulated me, cheated me, and left my life and career for dead — even though I’d been warned that’s what he was up to? How does a supposedly intelligent person such as myself get to that point? Moreover, how could I get NP to reconcile my intelligent persona with someone who would willingly hand everything over, lie down, and virtually beg to be treated like a doormat?

And how could I tell the story without sounding like the weirdest, shittiest, weakest, most pathetic person on earth? Who knows?

Under the tension all this worry and preparation caused, I began cutting again.

One afternoon, as my gut twitched with anxiety, a fresh blade drifted across my wrist under the watchband producing several small beads of dark red blood and a rush of endorphin relief. Several minutes later, it happened again. And again. Just scratches, nothing deep. Just enough to draw blood.

And that’s how I “trained” myself to get through it.

When the appointment came, I walked into his office, and the session began. Initially, I began talking about another topic altogether (something that was bothering me at work, I think).

“Let me stop you right there.”

NP held his hand up in a ‘stop’ signal. “I don’t want to spend a lot of time talking about that. That’s not what’s really going on with you, is it?”

At the end of the previous session, I had mentioned something in passing about a relationship that had gone bad, and he turned to that (as expected).

NP asked me a question something along the lines of: “What was the last major relationship you were in?” I drifted off in thought trying to think of a way to get out of telling him about The Jerk. Wasn’t there something else I could tell him? Toss him another bone? Avoid it for another couple of weeks?

“Margaret. Where did you just go?”

“It’s nothing.”

“No, you immediately went somewhere. Tell me.”

I sighed. “Okay. Fine. But you’re not going to like it. It’s bad. It’s stupid. It makes me appear in the worst possible light possible. There’s no way I come out of this looking good or intelligent or wise or anything else. I just come out of it looking sad and pathetic.”

NP said nothing. He just waited.

So I told him. The brief but ugly tale of me and that creature. Warts. Hairs. Weird itchy things that smell funny. All the gore and ooze of it. And NP sat watching me, silently observing, his elbow set on the chair while his chin rested in his hand, thoughtfully.

I cried. HARD.

I was furious.

I was sad.

I was rage-filled.

I was indignant.

I was pathetic.

And yet I couldn’t claim any of those feelings out loud. I cried… sobs. Yes, I totally lost it.

On his desk was a box of cheap tissues in an oatmeal-colored box. The first time I ever met the NP, which was also the last time I’d cried in front of him, I remember starting to cry and he pushed a Kleenex box toward me. It was one of those ‘fun’ Kleenex boxes that had cartoons of dancing aliens on the side. In the midst of my tears, I remember mentally remarking how silly that box looked and started to laugh.

On this day, this particular tissue box was a thin, cheap contractor-issue box with no such color or humor. I awkwardly plucked one tissue from the long, narrow box and attempted to mop my eyes and stop my mascara from running with the thin, scratchy tissue.

NP interjected a few pertinent questions — the most outstanding of which required clarification. “Wait a minute,” he asked, “You had sex with a gay man?” No no no… no sex. Dammit! I wasn’t being clear. The problem with delivering bombshell-type information is that sometimes, in the rush to just get it over with, clarity is sacrificed.

I sat shuddering with rage. I wiped my eyes and tried pulling myself back together to gather what little dignity I was left with.

“So how do you feel?” NP asked quietly.

I was dumbfounded. Wasn’t it obvious? Jesus, was he dense or something? I wiped my eyes again and thought about it for a minute. The best I could come up with was “Uncomfortable.”

“How do you think you look?”

I shrugged and sniffled. “Well, I have mascara running down my face and I’m probably beet red so,…”

“Nevermind that. I don’t care about that.” He shook his hand in the air.

“Well, I don’t know! I don’t have a mirror… I guess I look upset… How do I look?”

Normally, NP wouldn’t answer that, but in an effort to cajole me into recognizing my own emotions, he paused, then offered up his opinion. “If you ask me, you look… vulnerable.”

“Vulnerable?” Fair enough. But vaguely insulting somehow. I glared at him. “Great.” I rolled my eyes and chuckled lightly, still sniffling and kneading the wet ball of cheap tissue in my hand. “Not quite what I was going for.”

I had given up a big secret with enough emotion to prove that I’m not, in fact, a steel-and-concrete bunker. Yes! I have feelings. And yes, I can cry!

“How do you feel now?” he asked.

“Humiliated. Sad.” I replied.

And as I sat there with my shaking hands crunching that stupid Kleenex, sniffling back the last of my tears, NP smiled and said:

“Welcome back.”

Posted in + recovery, depression, sobrietyland, therapy | Tagged , , , , , , | 2 Comments

The Interrogation, Part One

nazlookingdownSorry I’ve been away for so long. It’s been hard for me to write for a while. Too many jumbled thoughts with little focus. Typical for me.

lopejpgLet’s see… where did we leave off? Oh yes, there was that Loperamide article that yours truly helped a bit with. Hey, nothing like being an unpaid, uncredited research assistant. The important people know and that’s all that matters. And it’s saving lives. That counts for something too. I’m proud of my work on that. It’s a pure good thing — and certainly works off some of that negative karma I might have built up during my time using.

My blog post prior to that, interestingly enough, was the day the Square-Jawed NP decided I’d had enough hand-holding and it was time to start beating me with a giant redwood. I have something to say about that now.

Well… uh… yeah. Hmm.

Before I get to that, allow me to digress and announce a couple of positive things:

lightFirst, I have POWER back in my APARTMENT! Waaahooo! Power! Heat! Hot water! Refrigeration! Espresso! Stove and Oven! Television! Internet Connectivity every day all the time! How did I pull it off you might say? Especially considering I owed National Grid so much money? Well, turns out, all I had to do was ask nicely and tell them I was getting help with that (which I am working on). Within a week, the nice man with the key came, unlocked my power box and flipped the switch. I can once again enter my apartment without stumbling over the stairs on the way up (’cause I gots me sum lights in the hallway now!). I can sleep in relative comfort because it’s not 40 degrees anymore. And I can watch first run television — okay, well, when the antenna picks up the signal correctly, but it’s a start.

But the most blessed thing of the experience was having access to hot water again. MY OWN hot water to wash my hands in, to wash my hair in, to wash my fat butt in. Oh, it’s glorious!

I admit even though it’s been on for a bit over a month, I haven’t taken full advantage of it. I’m frankly still in old habits. I forget to turn the light on when I come in (I forget that I can), I get up in the morning and make my way to the bathroom without lights, and forget that I can cook things, so I still buy a lot of prepackaged foods when I’m at the grocery store. That’s slowly changing. The heat hasn’t been forgotten yet , though I admit, sometimes it gets too warm so I have to remember to turn it down. Good problem to have, I guess!

yr1Second, I have met my first year anniversary in the AA program! Got my coin and everything. I have been asked to be the Guest Speaker at the Speaker’s Meeting in either April or May. I have some idea what I’m going to say, but as plans begin to be shored up, I’ll tighten my share-able anecdotes.

singThird, voice lessons are going very well. I have much of my voice back — not 100% but much better than it was. Recital next month. I’m doing four pieces — one opera, one Italian Art song, one Gilbert and Sullivan (don’t gag, this song actually doesn’t suck), and one by Gershwin. I’m not terrified, but I’m not really happily excited either. I’m mostly worried about what to wear. I’m still fat and have NO nice performance wear. Not that my teacher wants me to really dress up like I normally would. But then what? Hell, if it were up to me, I’d show up with no makeup, my hair in a frizzy knot, and wearing my oversized American Eagle hoodie, sneakers, and torn old blue jeans — but I’ve been told that might be considered too casual. No fun.

Okay, so that out of the way, we’re on to the deeper and more interesting stuff. I’m not sure where to start.

By the following visit, the Square-Jawed NP began to put his plan of breaking down my defenses into action.

hansNP had a brand new little office on the North side of the building where the light was better (though the scenery had not much improved). He had finally chosen to take my advice and make his office look more homey by hanging some fresh-off-the-freeway hand-painted “art”.  He also upgraded to wearing a better-fitting suit jacket that fit him through the shoulders better, another thing I’d hinted at. I’m betting he got a raise.

NP started the appointment by asking me about my medications and whether or not things were going well with that. We joked and did the usual small talk, and then he sat back and we began the transition.

“Now Margaret, this isn’t going to be like coffee hour. We’re not going to chat like buddies. No coffee and donuts, or whatever. This is going to seem…. really different. And it might be pretty jarring for you. Are you sure you’re ready for that?”

“Yep,” I smiled like a dummy.

“Now, I’m going to ask a lot of questions, and I’m going to expect you to answer. Truthfully. That might be hard because you won’t be sure what to say sometimes. And it’s probably really gonna bug you when I stop you and ask how you’re feeling or what you think you look like when you say something. That bothers everybody, but it’s important.”

“Uh-huh.” I was grinning, cocksure that I could handle this. I had no idea what was coming. Daring him, I narrowed my eyes and grinned overconfidently. “This is gonna be fun.”

“Well, if it’s fun, then I’m not doing it right,” he smartly replied.

“Ready?” he asked. I nodded.

Then he sat back and moved his chair back away from his computer. He turned to face me full-on. His smile faded away as if a thick fog bank had seeped into the room and obscured the upturned corners. NP’s eyes darkened and narrowed slightly and seemed to refuse to blink. “So tell me why are you so defensive about that fourth step?” He leaned back, watching me.  Maybe he knew… and maybe he knows that I know he knows…

And thus began what felt like the delicate dance of two black widow spiders. I knew I was going to lose. I knew I was going to lose from the first day I saw him. The game was designed for me to lose — I had to, or, as the theory goes, I might never get better. At least I had a worthy adversary across the desk from me. I studied his every movement, every eyebrow twitch. He was trying to be a blank slate again, but I knew his tricks now.

This guy’s no brick wall. I know the NP’s no Nazi. He’s just like most of us — he’s just some goofy kid in braces who woke up one day dressed up in professional grown-up clothes drinking too much coffee and wandering through life wondering how to put money in the kids’ college fund while making car payments and paying off school loans and wishing he had more time to go outside and play with his friends.

How do you tell your deepest, darkest, most horrible and scary secrets to someone who’s an actual human being?

Turns out, the first thing I would do is toss him a bone. Distract him from the larger problems that lie beneath. I was buying time.

“Okay. Fine.” I announced indignantly. “I’ll give you something.” I told him about the year that I lost (sold) my house, the subsequent loss of all of my belongings, the depression, and of course all of it leading to working at the thrift store, the overdoses, and then him. I went into quite a bit of detail regarding how much the loss of my things meant — specifying items (like photo albums) that felt particularly tragic to me. My voice cracked a little, but I did not cry.

NP acknowledged these things that I said and observed me. True to his word, he asked me how I was feeling ad nauseum — most of the time I felt okay — but this time, he said he knew that wasn’t true.

He stopped for a moment and observed my squirming. “How do you think you look right now?” NP asked.

“Look?” I thought about it, and honestly, I thought I was holding together alright all things considered. And truth was, I felt sad about the loss of things, but not really now. I was okay, right? So I looked at him and shrugged. “I guess I look fine.”

“Cause I’d say you look…. sad.”

Sad? Really? I was smiling. I felt okay. Huh. “Yes,” I acknowledged. “I suppose I should be sad. I am sad about the loss of it. The sheer scope of it.” Then I stopped and thought. My eyes darted to the floor as I suddenly pondered the idea. Though I thought I should feel sad, I did not, in that moment, actually feel sad. I felt nothing.

Watching me, NP queried, “What’s going on? What are you thinking about?”

“It’s just…. weird. I just realized. I should feel sad, shouldn’t I?”

“Should you?”

I paused. Quietly, I added, “Yeah. I think so. But I just don’t feel anything.”

“I believe you.” NP said.

It was quiet for a moment, so I decided to break the tension by adding, “Oh, and by the way — something else I haven’t told you or anyone else — I have no power in my apartment. I haven’t had it for about 2 1/2 years. No heat. No electricity. Nothing.”

NP was visibly taken aback. Not wanting him to interject anything, I went on to explain the circumstances surrounding how it happened and why it continued. He asked how I heated the place in winter and how I went about daily business (like washing and cooking), and I just explained the workarounds as unemotionally as I could.

Was I humiliated by all of these revelations? Yes. But I did it.

We had crossed the Rubicon. I had provided him two major humiliating admissions with almost no resistance.

We ended the session there. The game was on, and I was already losing (as was meant to happen).

I drove home knowing worse things were to come.

[End Part 1]

Posted in AA, depression, loperamide abuse, Shrinks, sobrietyland, square-jawed np | Tagged , , , , , | 3 Comments

New Loperamide Article!

Yes, kiddies, the latest-up-to-datest Loperamide Abuse article was just published and added to this site!

Good stuff in here — further indicative of a causal relationship between loperamide abuse and disturbances of the electrical system within the heart. Article is brought to you by the top toxicology experts from Upstate Medical University in Syracuse, Emory University in Atlanta, and Strong Memorial Hospital and University of Rochester Medical Center in Rochester. I’ve read the whole paper (not just the abstract), so I can tell you it’s the most comprehensive paper yet written on the subject.

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loptab3Cardiac conduction disturbance after loperamide abuse

J. M. Marraffa, M. G. Holland, R. W. Sullivan, B. W. Morgan, J. A. Oakes, T. J. Wiegand, and M. J. Hodgman. 1 Department of Emergency Medicine, Upstate Medical University, Syracuse NY, USA. 2 Department of Emergency Medicine, School of Medicine, Emory University, Atlanta, GA, USA. 3 Department of Emergency Medicine, URMC and Strong Memorial Hospital, Rochester NY, USA. 4 URMC and Strong Memorial Hospital, Ruth A. Lawrence Poison and Drug Information Center, Rochester, NY, USA

CLINICAL TOXICOLOGY: November 2014, Vol. 52, No. 9 , Pages 952-957

Conclusion: This case series describes several patients with cardiac conduction abnormalities and life-threatening ventricular arrhythmias temporally related to loperamide abuse. With the recent efforts to restrict the diversion of prescription opioids, increasing abuse of loperamide as an opioid substitute may be seen. Toxicologists should be aware of these risks and we urge all clinicians to report such cases to FDA Medwatch®

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More articles at the Loperamide Medical Clearinghouse

Posted in + recovery, addiction, education, loperamide abuse, sobrietyland | Tagged , , , , , , , , , , , , , | 12 Comments

The dog ate my Fourth Step.

hlnaz

Why so defensive Fräulein? What are you hiding?

The last time I saw the Square-Jawed NP (last Friday), we went over my AA fourth step worksheet that he’d given me a couple weeks earlier.

I was highly resistant to do the work of the fourth step. (Made a searching and fearless moral inventory of ourselves.) I did not want to put down on paper the most horrible things I keep hidden away deep in my heart behind ice and a lead-lined steel door. As far as I’m concerned, those are my issues and nobody’s business. If it doesn’t hurt the other person, it’ll hurt me — again — and I won’t have that.

Luckily for me, NP gave me a form from Hazelden for those with dual disorders, approaching the fourth step (taking a full, honest, and searching moral inventory) from the perspective of assets and liabilities instead of the detailed crap from the AA Big Book. For instance, under assets, one might put “funny”; under liabilities, one might put “impatient”. That was the only reason I agreed to do it. It didn’t seem as scary. Plus, NP said that we would go over it together, and that I didn’t have to share it with my sponsor or any other “normal” person if I didn’t want to — Therapist Barbie would be OK, or I could bring it to a priest, or you know, that sort of thing.

But I still didn’t want to do it.

Despite my calling him a Nazi, I really like NP and enjoy our visits with their banter and sparring. Partly because I like him, I don’t want him peering down the rabbit hole and seeing just how dark and deep it gets.

Remember that NP is only supposed to be “medication management” and nothing more. Any counseling or therapizing he does is brief and bonus.

4thstp

So when I went to the appointment, he asked about the fourth step worksheet. I opened my folder and handed the “final copy” to him. For three weeks, I’d been working through a rough draft that I kept in my purse in case I thought of something on the run, then the night before the appointment, I rewrote it neatly in ink on a clean copy. It was tedious work, but I did it. I found coming up with liabilities was easy and coming up with assets was a lot more work. But no, I didn’t cry, didn’t reveal anything too personal, but referred to all of the weaknesses I could think of.

NP asked me how it was, and I replied, “Oh not that bad. I wasn’t that hard except coming up with assets (insert laughter here).”

NP cocked his eyebrow at me. He flipped through the multi-page worksheet and asked the occasional question which I answered. He got to the section about relationships and said, “This is where it’s usually the most interesting.” He read it and asked a couple of more questions. Then he sat back and asked me, “Did you really put your heart into this?”

I was insulted. “Yes! Of course I did!”

“Really?” NP queried, “You did a fearless and searching moral inventory?”

“I did what you asked. I filled out your form,” I made my case vehemently, “I did exactly what you said to do. I did the form! You said all I had to do was fill out this form, and I did.”

“Wow!” NP exclaimed. “Wow… It’s like this big steel door just slammed shut on me. (He gestures a wall coming down with a stiff, downward motion with his arm in front of his chest.) “Why are you being so defensive?”

“Defensive?!?” I exclaimed, “I’m just defending my work! I did exactly what you asked me to. In fact, I went above and beyond. Look. I wrote two or more items on each line of the form doing two or three times what was asked. I’ve even been carrying around this stupid rough draft (I pull it out of my handbag and wave it in front of him) for three weeks taking notes as I thought of them! I even rewrote everything in ink on a clean sheet so you could read it. I did what you asked and more! Everything on there is what you asked for!”

NP remained stunned, but leaned in to me. “Look at me.” I looked. I was suddenly taken aback by the strange color of his eyes that I’d forgotten about — a steely color, like a dusky blue met with olive green. They were an odd, unusual shade. Because I was distracted, I didn’t hear the first words he said to me, but then I realized I needed to focus and heard him say, “Maggie, I’m not saying you didn’t do a good job. In fact, you did a great job. I can see the work you put into that fourth step. But why are you being so defensive? Why did you slam the wall down?”

“I DON’T KNOW.” I was getting mighty pissed by this point. “What do you want? Do you want me to rewrite everything in essay form?? Just talk to me and tell me what you want!”

NP: “I want you to tell me why you’re being so defensive.”

In fact, I was getting pretty loud. “I DON’T KNOW.”

NP: “Tell me… on a scale of 0 to 100%, how much effort do you think you put into this fourth step sheet.”

Me: “Are you kidding me?” We went back and forth on this a few times, and finally I answered, “100% absolutely”

NP: “Really?”

Me: “Yes.”

NP: “You want to tell me you put in 100% effort on this worksheet.”

Me: “Yes,” I was trying to figure out what he was getting at. Did I forget to fill someting in? Was I expected to approach it differently? Should they have been worded in the form of a question? WHAT? “Yes, in as much as I am able.”

Without skipping a single beat, NP sat back and said, “Now that’s an interesting response.”

A pregnant pause followed.

I was stunned and frustrated and began to plead softly, intimately. “NP, now come on. Why don’t you just ask me what you want to know.” NP sat in silence staring at his wringing hands. So I added, “Just talk to me. What do you want to ask me? Really.”

He grunted and rubbed his head. “We just don’t have time for me to get into this. I wish I was your therapist. This is my specialty.” He has said these things before. “My hands are tied. We just don’t have time.”

I told him that I’d shown the fourth step sheet to Therapist Barbie, so NP asked me how that went. I chuckled and told him that she didn’t know what it was. He chuckled too and shook his head in his hands. “Wow, Barbie really has no idea… she’s got her work cut out for her. She’s really not ready for this.”

I agreed but added, “She’s a nice kid and she’s certainly earnest. But yeah, she really doesn’t get it.” I paused and repeated, “I really don’t know what you want to know, NP. Please won’t you just talk to me and tell me?”

“I want to know why you’re being so defensive. I mean, really, you just slammed down this big wall (he motions again) and shut me out. Tell me why.”

Oh for fuck’s sake. “I don’t know!!” I reiterated.

“You know what? I believe you. I think your subconscious is hiding something it REALLY doesn’t want to get out and…” he grunts again and says more to himself than me, “JEEZ. I don’t have enough time to do this. I just don’t.” He sighed again and resolutely leaned in toward his computer and asked me about my medications. NP looked exhausted. I mentioned that I thought the Wellbutrin should still be increased to 300mg because I still feel like I’m just under the cloud. NP muttered under his breath that this is where therapy is supposed to take over. He let out a long sigh and replied without argument that we’d give it a trial period for a month.

I sat confused. “What, no fight? No resistance? No telling me that you’re worried about polypharmacy so you don’t want to add any more to it? No fights? No arguments?”

Quietly, he responded, “Nope. This isn’t an argument. We don’t fight. Sometimes we… just… disagree and spar a little.” He continued typing in silence, the click-click of the keyboard sending the new prescription to the pharmacy.

Jesus, I thought, I broke him. I actually broke him! What did I do?!? I couldn’t believe I actually won and made him cave in — moreover, somehow that was not a good feeling. It felt as if he’d given up on me. I made him give up. It was an ugly thought.

hans

We have ways of making you talk.

He leaned back in his chair again and said, “I just wish I knew why you were being so defensive. Don’t you see how you just shut me out? Those steel doors slammed and locked fast.”

Me: “So ask me what you want to know? Talk to me. I did the fourth step. That opens a crack in that door, you know.”

Once again he shook his head and grunted. “There’s really just no time for this. I can’t –” His eyes searched for an answer. We sat in silence for a bit — my heart was racing with fear. What had I done to him? Did I really hurt him? And why WAS I being so defensive? Did he have a point? Was my subconscious really hiding something I don’t know about?

Finally he sat forward at the computer keyboard again, moved the mouse around and asked, “What times are you available?”

Huh? I was taken aback. Why did he want to know? What was he scheming? Am I being sent to the looney bin? I was in full suspicion mode.

Me: “Why? What were you thinking?”

“Well, if I can get you in at the end of the day, we would have more time to explore this because I won’t be worried about catching the next appointment. And this is what I used to specialize in. We can get to the bottom of this.”

I was actually touched by the gesture. “Uh… Yeah, that’s fine, but are you sure?” I was worried that maybe he was risking his job by ‘overstepping’ the boundaries of his position. I leaned in to him and spoke softly, “I mean, are you really sure you want to do this?”

“Absolutely.”

I was confused. He was willing to do THAT for ME? Why???

When we walked out, NP directed the receptionist to make sure I got the last appointment of the day in three weeks. She muttered that those appointments are the ones most frequently rescheduled, but he insisted anyway. So October 23rd at 3pm is our next appointment (should it come to fruition).

Until then, I am enrobed in terror. The way I see it, I have three choices. I can, A) Cancel and not go and keep my secrets to myself; B) Go and lie and/or keep that defensive wall up; or C) Go, put on my big girl pants, suck in my lower lip, and let his process happen.

I have no honest idea what to expect. Of course I’m being catastrophic and assuming the worst will be the worst. But maybe I’m not giving him enough credit and it won’t be nearly as bad or humiliating as I think. (As if.)

So I have prepared myself to be numbly clinical about it, be honest, and answer whatever he asks. I don’t want to cry AT ALL. If I can just steel myself to sit calmly through massive humiliation (it may suck beyond all reason, but it won’t kill me). After all, he seems to be going out of his way for me. It sounds like he’s planning to stay and spend more time with me than normal in an effort to break down that steel door. I kinda owe it to him to show up for this mass suckage.

Still, I remain quietly terrified. I feel trapped. It’s like being near a swamp that doesn’t stink until you stir everything up from the bottom — then pour all that foul-smelling, rotting putrification all over yourself.

blueredI’ve also become convinced (catastrophizing again) that NP will give up on me and quit my case. Now, don’t worry, there’s no murder or child touching or anything like that in my past. None of those big things someone might expect. But still, I’m a very private person about my bad shit — and with reason. In the past, for instance, He Who Shall Not Be Named was a person of trust who knew many of my secrets — and eventually he used all my love as a weapon to stab me in the back and send me careening toward ruin. (Okay, to play devil’s advocate for a moment, I had a big part in the ‘careening toward ruin’ part, but he was the catalyst.)

I don’t trust easily or at all. I’m highly suspicious. I worry not only that I’ll be found out, but to be uncovered as a completely pathetic, hopeless loser.

I also fear that NP might come to the conclusion that I’m Borderline and well beyond hope. It’s nice that he’s fighting for me, but he really doesn’t know what he’s in for any more than Therapist Barbie does. The one “Big Bad” secret I know that I hold — which I have never spoken of here or anywhere — is actually pretty lame when you consider other people who had real problems. But it’s uniqueness is what makes it so catastrophic and potentially stunning to the listener. I have to keep it under wraps, but if NP asks… I’ll have to tell.

I think my defensiveness comes more from a lifetime of trust breaches, loss of love, and abandonment issues. I wasn’t necessarily born this way — I was made to have impassible boundaries. Then again…

brfd

First recorded instance of the steel door slamming shut.

My mom once told me a story about a time when I was about 2 or 3 months old. One day, I refused to breastfeed. Every time it was offered, for a couple of days, I continued to refuse, cry, and have a fit. My mom ran to the pediatrician in a panic, and the doc simply shrugged and said, “Obviously she’s done. She’s weaned herself. So try her on baby food and see what she does with it.” I ate baby food just fine. This sounds exactly like me.

Now to truly appreciate why this story is significant, you need to know that my Mom was a chronic alcoholic. If I recall right, her booze of choice at the time was Gin and Tonic, or perhaps Martinis all day long. I was also a colicky baby for the first few months of my life, screaming almost all the time. So it would be a short jump to conclusion that mom’s milk was heavily laden with booze, which was likely the cause of my cramps and probably giving me a massive headache too (as it does even now). So as anyone who knows me well, one day, Little Baby Margaret decided she’d had enough and would rather starve than drink another drop of that poisonous rotgut!

To this day, when I meet my limit (and I have a long fuse), those protective walls slam shut. I’d rather starve — or live alone the rest of my life — than give in to other people’s wishes for me when I don’t agree.

Except… I don’t think that’s working so well for me anymore. And NP would agree.

Given the situation with NP, I feel I need to give him the benefit of the doubt. I have been seeing him for a year now. and we have built a certain amount of rapport and trust. And finally, he is going way out of his way to help me. That’s a presumed gesture of decency I can’t ignore.

It’s incumbent upon me to show up and deal. It’s the best I can do. Even so, I still fear I’ll lose him. He’ll figure out that I’m nothing but a pathetic and worthless, useless creature, hopeless and destined to live a life of misery — all this despite how fun-loving I might be on the surface. And honestly, I’ve prepared myself for that possible outcome. The shrink (or in this case, med-management)-patient relationship is never meant to be permanent anyway, so if I lose him now, hey, at least it won’t be that bad. Especially if I’m prepared. Certainly better than if I spent years seeing the guy and becoming comfortable with him only to be left behind while he, like, moves on to Ohio or something.

The main side effect of my resignation to including him in my dark little world is a dip back into really bad depression. I could barely get out of bed this morning (waiting as long as I possibly could) and couldn’t crack a smile or talk much for most of my morning shift. The increase in Wellbutrin has had minimal-to-no effect at all.

My brain just keeps catastrophizing that the end of the world is nigh. My dreams lately can confirm that (lots of end-of-the-world dreams). No escape. I feel trapped — and for me, that’s a very bad and dangerous place to be.

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“Defensiveness is usually someone silently screaming that they need you to value and respect them in disguise.”― Shannon L. Alder

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Posted in + recovery, AA, addiction, bipolar, depression, Shrinks, sobrietyland, therapy | Tagged , , , , , , , , | 1 Comment

New Adjunct Blog

Sorry I’ve been so remiss in writing. Lots happening, no gumption.

Therapist Barbie gave me an assignment to keep a therapy blog. As if one blog isn’t enough, now I either give her permission to read this one (I don’t wanna since I talk about the two of them here pretty freely), or I create a new one that is similar to, but separate from this one. I chose the latter.

If you want to read along, check out http://madtherapychallenge.wordpress.com/ It’s taken me a week to even begin to attack it because I have no idea how to approach the thing. There’s too much to say really. So I’m winging it — the first real post got really (REALLY) long.

This adjunct blog is set up for my therapist to read. I will continue writing on this blog, don’t worry!  I’m still not sure I’m going to keep the camouflaged names or pictures on the other blog — I prefer to keep the whole matter separate from this blog but changing all the nom-de-plumes and such just gets too confusing — yet I do have to censor certain things or even make the blog private for their own protection (and mine). For now, I’ll leave it as it is and will make the final decision on the confidentiality of the blog before the next time I see her.

Feel free to read the first couple of posts if you wish, but keep in mind the understanding that the dark shit I talk about over there is being read by and helped by professionals. And I may have to privatize the blog if it gets too deep.

Merci beaucoup mon amis.

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