Tuesday, April 5, 2011

CBT- Day One

Cognitive Behavioral Therapy was something I used to deride. So let's take a step back and see why my opinions have changed.

I grew up with a father who was an unmedicated rapid-cycling bipolar with narcissistic personality disorder. I say that he was his diseases because that's all he was to me. That might seem unfair, especially if you suffer from mental illness. I don't normally identify people by their diseases, but honestly, my only interactions with the man were interactions with his disease processes. I have no idea who he might be under all that and little motivation to find out.

When you grow up with a person like that, family dynamics get warped. A person like that can end up ruling the family with their moods, their rages, their never ending need- need for attention, need for approval, need for validation. It gets abusive quickly, abusive to the mentally ill person in that the enabling prevents them from getting help, and abusive to everyone else, whose needs get steamrolled by the dominant illness.

As a child, your only possible defense is to cater to the crazy*. You learn to be hypervigilant, always on the alert for dad's quickly shifting moods. You learn to crush down your own feelings, because expressing them could cause dad to become angry or sad, and it will certainly take attention from him, and that will trigger a narcissistic rage the likes of which I hope you are unfamiliar with. Narcissists cannot handle not being the center of attention, not even for ten seconds.

So I learned quickly to stuff my actual feelings down somewhere dark and only express acceptable feelings. I learned that other people's feelings are of prime importance and directly affect me and everything about me and my life. I learned that I am only acceptable as far as I can make the crazy accept me. I learned that love means submitting completely to another person's every mood and whim and that having my own feelings and needs is simply not an option. Ever.

Even thoughts were a danger. The narcissist is always right. About everything. Always. Other thoughts are an affront, a personal attack upon the narcissist.

So by age 20, I was a fucking mess. It confused me to be asked what I thought or felt. I thought what you thought. I did not disagree. As to what I felt, what do you want me to feel? That's what I'll feel.

First of all, you can't actually do that. You feel. You're human. That's what we do. So I had feelings, I was just suppressing them. They bubbled up in other places and I became self destructive. And thoughts? Hey, I'm really smart. I think thoughts, I can't help it. I am perfectly capable of observing the world and seeing it is different from what the narcissist says it is. This was upsetting at best.

So I ended up in traditional talk therapy. Which was good for me. Talk therapy is all about discussing your feelings and I needed that. Very, very much. I needed someone to tell me that feeling my feelings is acceptable. I needed someone to react to "I feel [blank]" with a neutral "Okay, then, let's talk about that".

After a year of that, I was all about feeling my feelings. So you can imagine how I reacted to CBT, which is about controlling your feelings. "Fuck that noise, you need to feel your feelings!" would sum it up.

It's true, you do need to feel your feelings. Feelings are valid, always. They may not be reasonable or acceptable or particularly useful, but they are valid. However, when your feelings get in the way of living, control is a good thing.

That's where I'm at. I need some control. Clearly, I cannot do it myself, or I would have by now.

Anyway, the Lyrica is still tamping down my general anxiety to the point where I can think thoughts. In a row. For more than 3 seconds. Which is A Good Thing. The side effects are tapering off, though I think the morning grogginess is just something that has to be lived with.

We were going to start CBT by learning how to separate my body's reaction to anxiety from my emotional response, i.e., recognizing that a racing heart is a physical thing and I don't have to panic just because my heart is racing.

Ha! I'm chronically ill. I learned how to separate physical feelings from emotional feelings a long time ago out of sheer self defense. I could teach graduate level courses in how to do this.

So I'm feeling like the most successful therapy recipient ever when Therapist asks me, "What is something that causes you anxiety?"

Me: My boss. I never know what I'm getting with him. Could be Shoutyboss, could be HappyJokeyboss. It's a bit nerve wracking.

Therapist: How do you want to feel about dealing with him?

Me: *mind blown* (Normally people tell me to get a new job, or something equally unuseful.) Like my other boss.

Therapist: What do you mean?

Me: Niceboss just shrugs it right off. Meanboss starts ranting, and niceboss nods his head and goes on with his day. I'm upset and jumpy for the rest of the day.

Then the therapist told me something amazing: I could be Niceboss. I could shrug it off, I could have a nice day anyway. I just needed to pretend to be calm, practice being calm in the face of The Shouty- because in pretending to be calm, you're being calm.

It's not as easy as that, of course, but it's possible, and I'd really like to live in that world, as opposed to ZOMGStress!ville. So I'll give it a try.

*Yes, I am using that word. In my story, about my childhood and my own mental illnesses.


  1. I think I like your therapist.

    That sounds like a really good start - so pretend like I just typed something that strikes just the right note of encouragement, okay?

  2. Yikes! Bless you. I can't imagine growing up in that environment where you don't have a choice. Living in it for 20 years voluntarily was quite enough for me.

    It's okay for you to use *c* word. It is what it is and it's yours. Glad you're getting some relief. *fingers crossed*

  3. I love my therapist. She is exactly the right combination of sympathetic and no nonsense for the situation. She cares, but she's not into wallowing and she can express that without sounding judgmental or hurtful.

    I went a little bonkers with choices once I figured out I had them. My father hated pierced ears, so I got my ears pierced, then my belly button, then my nipples . . . I was a little out of hand for a while. Which is why I always recommend giving small children as much choice and control as possible. Don't do it and you could end up with a kid who tattoos the whites of their eyes green.

    Not that there's anything wrong with that- other than NEEDLES TO THE EYE!

  4. Your therapist does sound great. Your father, however, sounds unfortunately similar to mine-- so empathy, and kudos for good self care.

  5. Wow. I sympathise, though I'm lucky enough not to be able to empathise much, not having been through what you have.

    I actually encountered "Pretend" in a self-help anti-anxiety book I read once (I was actually reading up on self-hypnosis, which I was totally into for a month or so, until my first night-terror attack instilled an irrational and persistant fear of being "too calm" in me. Even now, if I switch my mind off in a quiet room and let myself relax, my heart starts beating furiously). It works, to a certain extent. For example: I was bullied, and spent my entire childhood pretending to be utterly apathetic to bullies. I ended up rendering myself incapable of responding with anything more passionate than a "meh" or bland agreement to even good-natured teasing. (recently, a male colleage jokingly implied he was attracted to me. I responded with a shrug and an "okay", which confused the heck out of him).

    On the subject of choices, I said before I'm lucky, and I meant it: my family are notoriously relaxed (a christian mother down the street once told my parents off after discovering (from my brother) that they left a stack of condoms in a drawer in the bathroom and let us know they were there). It worked: between me and my brother, we have no piercings, only one tattoo (and he at least had the presense of mind to make it tiny and easily hidden), no kids (compare this to the christian family previously mentioned: 3 unexpected children and 1 unhappy marriage and divorce so far amongst their kids) and we don't do drugs or drink heavily (there's a possiblity he smokes, because all his friends do and he's a gullible idiot, but we never confirmed that).

    Finally: If any needles come anywhere near my eyes they damn well better be giving me X-ray and infrared vision in the process.

  6. i just discovered, a few weeks ago, that i don't know how to PROCESS emotions. either i feel them and they take over completely, or i shut them off. the methods i used to use to process are self-destructive - i don't know any other way. the emotions are just still there - i'm angry at Pete say - but i'm STILL angry at him for every other thing, ever, because all i did was stuff all that into a box and not deal with it, because i had no good way to deal - and it's what i still have to do, as i try and learn to do something a 5 MONTH OLD CAN DO.

    it's hard not being crazy - but we have to believe it's worth it.
    i think i want your therapist - i like mine, but we're working on different stuff, and i can't see what having two would do, other than speed it up... :D


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