Life, Therapy

Challenges and benefits of getting better

(Note: brief, vague mentions of self harm, eating struggles, deaths, and violence) 

I am happy and proud to say that I have been feeling much better recently!

My PTSD has almost disappeared! I have nightmares less than once week now, and their content is much less violent and traumatic. I can’t remember the last time I had a flashback! I’ve had many fewer intrusive thoughts, too.

I think the main reason for these improvements in my PTSD is that I’ve been doing Prolonged Exposure and directly confronting traumatic memories. I’m proud of this because I’ve put in the work and done things that scared me and were hard to do. I may write about this more later, but it really is remarkable to me how much it has helped.

I have so much more free time in my day now. Being upset took up so much of my days! I have more time available for going to class, doing homework, and hanging out with my friends, and sometimes I even have free time left over after that!

I got grades that I am proud of this semester; I took on a leadership position in a club I’m part of; I even tried flirting with someone I had a crush on!

Getting better is a change, and change can be scary

However, there are still struggles in getting better. It’s new and very different from how the past few years of my life have been. Change of any type is hard and scary for me, even when it’s positive change. There are new things to get used to.

Experimenting with the possibility of dating someone was a very stressful experience for me, even though I’m glad I tried and have grown from it and made a new good friend (I told him I liked him; he said he didn’t like me back, but we’re still good friends). There are a lot of situations I’m not used to being in. Applying for jobs? Having interviews that aren’t for therapy programs?!

It’s scary, but I’m growing. 🙂

Higher expectations for myself

As my mental health improved, my expectations for myself shot up. Before, I called a day a success if I went to all my classes and ate some meals, and I’d be proud of that and pat myself on the back because I knew it had been hard to do. When those things got easier and more routine, I felt that I needed to do more. I thought that since I was doing better, I had to take school more seriously and actually get better grades (in part to make up for the lower ones I’d gotten when I was struggling more). My mental health had been holding me back before, and it wasn’t now, so I felt that there was no excuse to not do well, to not do everything, to not be like my peers.

I didn’t see it at the time, but those were unrealistic expectations. There is a lot of room in-between managing to make it to most classes and getting straight A’s; it’s not strictly one or the other. I expected myself to be perfect all of a sudden. I wanted to be able to make up for all the things I’d missed out on over the years all at once.

Wanting these things did make me more motivated, and I plan to achieve many of the things that I realized I wanted — someday. I have to radically accept that I can’t do everything all at once, and I can’t do everything so fast. I need to be patient with myself. While it’s great that I am getting better and seeing improvements, I’m not fully better. It’s a slow process and something that I need to keep working on.

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Not everything gets better

Another thing to radically accept is that there are some things in my life that don’t get better as my mental health gets better. I came home from college recently, and it was a bit of a rude awakening to see my parents arguing just as much as they had been when I left. My improvement hadn’t affected them — of course it wouldn’t, but somehow I just assumed that everything in my life would get better as my mental health improved. That’s not the case.

Therapy also can’t make up for the fact that I have two family members missing in my life. Opposite action can’t bring them back from the dead. I think that I am dealing with the losses better than I was a few months ago (I’m not incapacitated by sadness; I don’t spend most of my days lying on my bedroom floor crying; eating isn’t as much of a struggle), but they are still gone. I am still sad. The grief resurfaces every now and then.

Worries about things worsening

Another challenge is that I worry about my mental health worsening again. Now that I’ve experienced how good things can be, I feel a deeper loss when I’m temporarily feeling worse again. I know all the things I’m missing out on and feel sorry for myself.

When something goes wrong, I also worry that it’s the beginning of the end. Will I go back to being depressed and tormented by nightmares? Good things can’t last forever, right? Is this a temporary blip in my life, or a more lasting change?

If I check the facts on these fears, I can see that the gradual changes I’ve made over the past year have lasted so far. I can see that I have been doing the treatment recommended to me by multiple therapists who believed that it would improve my life, and they agree that I have made lots of progress.

Yes, more bad things are bound to happen in my life, but I do have better skills to deal with them now. I haven’t self-harmed in maybe four months? I “graduated” from DBT group, and I use the healthier coping skills that I learned there every day. I can get through things.

Same friends, new relationships?

When I became friends with the people I’m friends with now, I was struggling, and I was looking (consciously or unconsciously) for certain things in friends — sensitive, a good listener, etc. In addition, many of my friends have their own struggles with mental illness. I’ve also stayed in touch with some people I knew from group therapies.

As a result of these things, many of my interactions with my friends were centered around me venting/asking for support, or me providing emotional support to my friends. I was happy and grateful for that, and it enabled me to have deep, intimate friendships, but I’m not struggling as much anymore. What do we talk about now?? What if we can’t relate as much because we’re not in the same dark place anymore? What if my friend liked me because she felt like she was helping me, and now there’s nothing left to be helped? The dynamics have shifted.

I don’t think that any friendships will end over this, but I may end up more distant from certain people, and that makes me sad. I suppose it’s also possible for friendships to evolve as people evolve, and I hope that mine will, because I really do like my friends.

On the other hand, I am also making new friends. Now humor and playfulness are more attractive qualities to me. I want to laugh for a while with a friend more than I want to express to them how badly I’ve been feeling. There is a time and place for both, but I find myself wanting more fun now than I did before. This is another change that is scary for me at times!

My friends enabled my avoidance

Some of my friends also enabled some bad habits that I want to stop doing now. They let me and even encouraged me to avoid things. Part of my exposure therapy is not avoiding things that aren’t objectively dangerous. I don’t want to avoid things anymore, but the message hasn’t sunk in for my friends yet.

Several people know that I hate blood, decapitation, violence, and related things. When there are scenes in movies with those things, they say, “[My Name], don’t look!” They say, “I don’t think you’ll like this movie, it’s not for you.” When I ask, “What are you laughing at on your phone?” they say, “You don’t want to know, you won’t like it, it’s bad, trust me.”

I very much appreciated these warnings at times when I felt like I needed them, but now I feel like I can handle things. I know that avoidance makes my fears stronger. I don’t want to avoid! I am ready to face scary things!

It’s just frustrating that my old habits were so deeply engrained that they spread to my friends, and now I have to change my friends’ habits, too, not just my own.

Overall

Overall, I’m doing so much better now than I was a few months ago. A couple of weeks before final exams, someone asked me how I was doing, and I said “good”! She said, “haha, like the dog in the fire meme?”

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“This is fine” meme — image from https://knowyourmeme.com/photos/1401347-this-is-fine

Meaning, was I saying that things were fine when I was really super stressed out about finals? I wasn’t! I was serious that I was doing well! As I thought back on the conversation afterwards, I realized that I wasn’t just doing well, I was doing the best I had been in the past two years. That seems quite amazing to me.

I wrote this post because I think I had an idea in my head of “getting better” that was all perfect sunshine and butterflies, and I wanted to express the ways in which getting better is still hard. But the positives definitely outweigh the negatives. 🙂

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Affirmations

Affirmation #16 — I am imperfect

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cannot be perfect.

It is impossible.

I cannot do everything.

I cannot prevent everything bad from happening.

I am imperfect.

The world is imperfect.

It sucks sometimes.

It’s the way it is.

I have a life to live,

Not a death to prevent.


 

This affirmation is maybe not as uplifting as some of the others, but it can be freeing. It’s more about radical acceptance of my inability to control everything.

I was in a bad car accident a few years ago, and for a long time afterwards, I fixated on the things I could have done to prevent it and ways to be safer in the future. I was very cautious. I avoided traveling, long car trips, and driving on the highway because I feared they would lead to situations where another accident would happen. I carried safety gear around with me wherever I went. My backpack was big and bulky, but I carried it with me everywhere.

Over time, these things and many more worsened my PTSD because I was avoiding so much and made me depressed because I was limiting my life. I ended up in a partial hospital program, and, with the help of my therapist, realized that some things in my life needed to change.

Some bad things will happen no matter how hard I try to prevent them. It’s sad and awful and makes me feel scared, helpless, and out of control, but it’s true. There are some measures I can take to be safe, of course — always wearing my seatbelt, maybe keeping a resQme tool in the glove compartment of the car but not carrying it with me otherwise, practicing driving on the highway when it’s less busy so that I build up my driving skills over time, etc. — but staying in my safe bubble was making my life miserable. Thus, I have a life to live, not a death to prevent. I can’t do everything, but I will do what I can and live my life.

Affirmations

Affirmation #12 — I can remember AND stay in the present

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I can REMEMBER and stay in the PRESENT.


As part of the prolonged exposure therapy I’ve been doing, I do imaginal exposures, which involve talking through a traumatic memory. I tend to dissociate when talking or thinking about the trauma, so it’s sometimes hard for me to continue thinking about the memory because my mind goes blank with dissociation. However, I need to engage with the memory in order for the memory to make me less scared in the future, so I can’t just block it out. I have to balance not dissociating (by grounding myself in the present moment) and remembering the memory (which brings me a little to the past).

This affirmation is to remind me that it is possible to do this. It is possible to remember without having a flashback or dissociating. I can remember non-traumatic events and still know where I am in the present. With time and hard work in treatment, I am gradually able to do the same with traumatic memories.

Life, Therapy

Finally talking about my trauma in detail

I experienced a traumatic event four years and nine months ago. I decided to do DBT PE (Dialectical Behavior Therapy with Prolonged Exposure) to treat my PTSD eight months ago. And today, I finally talked about the trauma in detail in therapy.

I’ve been building up to this for so long. I’ve gone over the traumatic event in my head so many times in varying levels of flashback-y-ness but always fairly anxious states. This has been a part of my life for so long.

But I had never said it out loud to another human being. I had never said it in order from start to finish. (well, the finish of one part, at least)

This feels like a watershed moment. Something small but fundamental has shifted inside of me, a change that will grow more pronounced as I continue this treatment.

I am still going about my same daily activities and interacting with the same people, but I feel a little different, as if I’m experiencing everything with freer eyes. It feels a little like what getting baptized felt like, or what traveling to another continent for the first time felt like. I knew logically what to expect, but now I’m experiencing it emotionally.

Of course, it was also really hard, and this is also only the beginning. But I finally said it!!!

Life, Therapy

What trauma feels like (for me, for now)

(This is about trauma and talks about death, with mentions of self harm and suicidality.)

I’ve had lots of upsetting things happen recently — my mom lost all the hearing in one of her ears suddenly, my uncle was dying and then died, my grandmother was in the hospital and then died — those are the main ones, but my great uncle also died, my aunt’s neighbor died, my family has been very chaotic… taken all together, within a month, it’s traumatic.

I’m used to PTSD and the anxiety, nightmares, intrusive thoughts, and flashbacks as a result of that. But with PTSD, it’s post-trauma. I can use opposite action to face fears because I know (at least, rationally) that I am safe now. I can ground myself in the moment with phrases like “this reminds me of something scary, and, in this moment, I am safe.” I can point out the ways that this situation is different from the traumatic one.

Now it’s different. I’m not living in PTSD anymore; I’m living in trauma. It is happening now.

Trauma is something that overwhelms your ability to cope, something that threatens your life or that of someone you love. These events have definitely overwhelmed me: I feel like everything is “too much” very often; I’ve developed new self harm behaviors; I fantasize about dying to escape it all; accomplishing little things, or even getting out of bed and getting meals, are hard. And the lives of people I know and love were threatened and taken.

I know that my subconscious agrees that I’m overwhelmed because my PTSD (from a car accident) has disappeared. I’ve heard that having flashbacks means that your body and brain are ready to process through the trauma that you couldn’t process at the time. Well, clearly my body isn’t well enough to process old trauma anymore. I’ve had one night of traumatic nightmares and intrusive thoughts relating to the accident in the past few weeks. Just one! I suppose I should thank my body for this, for not giving me even more distress that I’m not capable of handling.

On the other hand, I have had nightmares, intrusive thoughts, and lots of strong anxiety, sadness, and other emotions about the current issues.

And when I have startle reactions, like when the phone rings, or someone knocks on my door, or I hear indistinct raised voices, or my mom texts me, those reactions are actually the response that is needed in that situation. It’s not a post-trauma startle reaction. It’s not out of place. It’s serving an essential purpose. It’s getting me awake from my slumber so that I can drive my mom to the hospital. It’s preparing myself for the news that my grandmother died.

This trauma is happening now. It’s awful. Here are some other things I’m experiencing that help show what this trauma feels like.

  • Constantly high anxiety
  • Checking the facts and finding that the intense emotion is justified: people are in danger.
  • Screaming when startled
  • Splitting headache
  • Not knowing what will happen
  • Feeling like my world is collapsing around me
  • Trying to maintain any sense of constancy in my life
  • Things so chaotic that I don’t know when I’ll next eat
  • Expecting my life to be turned upside down and inside out multiple times in the near future
  • Having to always be ready to drop everything for my family at a moment’s notice
  • Waking up to my mom calling me saying she’s in the emergency room
  • And not being fazed by it because it’s become so commonplace — constant danger is the norm
  • Dissociating so much that I can’t read more than a couple of sentences
  • Dissociating the moment I consciously try to stop avoiding emotions
  • Dissociating in order to survive — because if I don’t, my emotions are unbearable, and I get very suicidal, or can’t eat, or can’t get out of bed — so, dissociating is keeping me alive
  • Needing to use my crisis survival skills toolkit many times every day
  • Almost always wanting to die
  • Crying when I didn’t call my mom because I think that if I don’t call her, someone will die — and then having my grandmother die the next day and confirming my worry
  • Not knowing where I am
  • Not being able to participate in a normal, casual conversation because everything reminds me of the awful things going on, and I don’t want to talk about them
  • All of my thoughts leading back to the trauma
  • Saying “HELP” inside my head or writing it on paper or my skin frequently
  • Wanting very badly to be able to escape and not being able to
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my life is full of holes
Life, Therapy

My relationship with death

(In case it isn’t obvious already, this is about death, and it’s dark.)

We’re in a close relationship, death and I, but it’s a rocky one.

I saw you, death, for the first time when I was in 5th grade. I had heard about you before. I had heard what you had done to my grandpa, to my friend’s dog, to many others. But I hadn’t been present to see you in the same room.

In 5th grade, I saw you come and take my grandmother away. I saw her heart rate fall, fall, fall, until it got to levels at which she was surely unconscious, and we took the monitor off her finger.

I understood that it was her time. I loved her, but it was a peaceful way to go.

Then, the summer between 9th and 10th grade, you noticed me. Before, we were just strangers in the same room. Now you introduced yourself to me. You showed me my life. I saw it flash before my eyes. It was a good life, one I was proud of. You told me it was enough. You told me to come with you. You showed me peace and beauty, the calm in the eye of the storm. You took my breath away. I said okay. I didn’t have a choice, but I said okay anyway.

But you decided not to take me then. I don’t know why. Maybe it was fate. Maybe it was God, if he exists, thinking I deserved to live longer, that there was some plan for me. Maybe it was physics, just the way things moved in that moment, and my luck of being where I was. Maybe it was that I was wearing a seatbelt. Maybe it was that I wasn’t too tall. I’ll never know why.

You turned away from me and looked at my dad. He was too tall for the car. The physics did not work in his favor. I saw and heard horrible things. For maybe five minutes, I thought you had taken him. I imagined the rest of my life without him. I regretted not loving him more. I hated you, death. You caused pain, misery, and sadness.

And yet you didn’t take him away from me, either. It was an amazing gift, one that I struggle to be thankful for today, but it really was.

Time passed. You stayed in my mind. The image of peace stayed in my mind. The horrors stayed in my mind. For better or worse, you and I were linked together.

Later, when things were too much to bear, you knocked on my door. I invited you in. At some point, we must have started dating. I thought about you often. I fantasized about you, “Death + Me” written in a heart. I wanted to be with you, but at the same time you repulsed me. I hadn’t forgotten the accident. I hadn’t forgiven you for that. But the peace was so tempting.

I kept our relationship hidden. I didn’t tell friends, family, teachers, even my therapist, what you meant to me.

We’d break up. I’d swear we were never getting back together. I’d write lists of why I wanted to stay living. I’d plan things to look forward to. I’d make checklists to follow during the times when you tempted me, so that I wouldn’t give in.

I’d go without seeing you for a while. I would try to forget. But somehow you still called to me, especially in my dark moments, especially in flashbacks, especially when I was alone.

At some point I started becoming more open about our relationship. I wrote about it in my journal. I alluded to it with my friends. I confessed to my therapist when she asked me point blank. A few months later, my therapist and I told my parents about my relationship with you. They didn’t really understand. But they loved me and wanted to support me. They wanted to help me move beyond you. At the time, I wanted to be done with you, too.

You were my guilty pleasure, death, a secret kept hidden, but also a monster haunting me. You keep proposing. You keep wanting to run away together and get married. I keep saying no. But I’ve gotten so close to saying yes.

You always ask in my weakest moments. When I’m feeling better, I hate how close I came to giving in to you.

Death, I know you will take me eventually. Subconsciously, I expect that it will be soon, but I think that’s just because the horrors you left me with make me expect to die. You’ve never left me completely. You still feel close.

In the times I’m feeling well, I don’t want to be with you. You offer peace, but it’s mixed with pain for others. You offer peace, but it’s too soon. I have plans. I have dreams. I have relationships besides the one with you. I can find peace in ways other than what you offer.

I wish I could break up with you permanently. I wish that when you finally do come, it will be many, many years from now, after a full, satisfying, joyful, loving life. I hope when you do come, I’ll be sad to leave.

For now, I am working on healing from my relationship with you.

Therapy

Memories of being in the hospital

This morning in bed I read through a blog about being in a mental hospital. It reminded me somewhat of being in the day treatment program at the mental hospital this summer, but it actually reminded me more of a traumatic time in a hospital, being treated for physical reasons…

I am aware that writing about this could trigger me and give me flashbacks or dissociation, and I’m also aware that I haven’t been this open on this blog before, or in person, for that matter… I normally avoid talking about trauma things, even in therapy. Although that will hopefully change soon. But I think these thoughts all the time, and I want to put them in the world, and I’m finally feeling like maybe I’m able to do that without getting super triggered…

(And also, be aware of yourself while reading this and mindful of if it’s the best thing for you at the moment. It’s not very graphic, but it is about injuries, hospitals, being away from home, doctors, a dangerous city, etc.)

Okay, so I’m going to try to write this, and I will do it mindfully and stop and take a break when I notice myself getting worse, and I will do grounding skills. 🙂

Okay, here goes!!

So, it reminded me of being in the hospital and getting kicked out before I was ready to leave. I was in a bad state… with a broken bone knocked two inches out of place (i.e. no chance of it healing properly on its own), with a concussion that doctors refused to acknowledge or treat, barely able to walk…

In a country where I didn’t speak the language, in a part of town where you could get shot if you walked around right outside the hospital – my family members were staying at a bed and breakfast two blocks away from the hospital, and people advised us to take a taxi there because it was too dangerous to walk.

As I write this, I notice that I am getting a bit of a headache, feeling nauseous, and my thinking is getting a bit foggy. I’m gonna take a quick break…

I’m back! I ran up and down the hall and jumped around. I also got some more water to drink. It is TWENTY EIGHTEEN, I am at home, I am in college, I am on fall break, I am studying engineering, I have new friends, my watch is blue, I am thinking about a distressing memory, but it is not happening now. Memories are painful but not the present reality. It is safe to write about. Whew. Deep breath. Okay.

Yeah. So I did not feel ready to leave the hospital. I also didn’t have my belongings. I was in a foreign country. I was a bajillion miles from home. For a good amount of time, I didn’t have shoes, and had to walk around the hospital barefoot until I pleaded enough that someone gave me giant navy crocs.

One day, they had me move to a new bed in a different wing of the hospital because someone needed the bed I was in. This happened suddenly, in the middle of the day. My family was not around, and I had no way of contacting them. I owned a cell phone at the time, but it was at home across the ocean. I hadn’t brought it on the trip because I didn’t use it much at the time (I was kinda young), and I knew it wouldn’t work anyway because I didn’t have an international data plan. But anyway, I had no way of telling my family where I was. I thought they would just show up to my old room, looking for me, and not know where I had gone or have any way of knowing. I ended up telling a relative of someone I shared the room with exactly where I was going. I think that helped. I don’t actually remember how it turned out, but my mom definitely found me eventually.

I know that this is kinda disjointed. Apparently that is how trauma memories are: not in order, random snippets. These aren’t even the super traumatic parts. Sighhhhh

There’s a lot more I could write about being in the hospital, but I think this is enough for now, so I’ll say one more thing to end on a good note.

In the room I was in, there was an older woman being treated for some sort of heart problem. Her family was with her. Her granddaughter was in her 20s and studying to be a doctor, I think. The granddaughter was really sweet. When I was super nauseous, she went to the drugstore in the hospital and bought me cinnamon gum to chew. Apparently chewing gum and experiencing strong smells or tastes helps with nausea. I didn’t actually chew the gum at the time, but I have chewed gum more recently to help with nausea.

One time, she took me on a walk. She let me lean on her arm for support (because I wasn’t walking well and was also very dizzy and nauseous). We walked through this peaceful spiritual garden thing in the hospital. It was only about 20 minutes, but it was my first time walking since I’d gotten to the hospital, and my first time away from my bed in a while. It was so nice. I felt so taken care of. She was so kind to me.