Archives for category: back to basics

There are times when I feel so sick that I can’t bring myself to eat.

It’s not that I don’t want to eat.  Or that the alters don’t want to eat.  Solid foods are just plain unappealing and hard to digest.  Drinking my food is an option. Soup usually does the trick.  Something savory and a little sour helps clear many things up.  Other times a smoothie or juice with pulp does the trick.

Only thing is, I don’t the texture or flavor of many pre-made soups and smoothies.  Nor do I appreciate the cost per drink/soup or the ingredients in the most commonly available options.   They have a hard time meeting my personal requirements

  • Pleases my senses: taste/smell/texture
  • Ingredients
  • Cost per item (I am frugal)
  • Ease of access (delivery, grocery stores, pick up, storage, make it myself?)

So I started creating my own recipes for homemade drinks, soups, and smoothies.  They are nutritionally dense, tasty, smell good, easy to make with a few key tools, and require easy to find ingredients.

Today, I thought I’d share some of my favorite recipes with options:

Basic Green Smoothie:

Ingredients

  • High powered blender with or without a smoothie option
  • 8 ounces of water, milk, or non-dairy milk (almond is my favorite)
  • 1 handful (or more) of leafy green vegetables – spinach and lettuce do not add to or change the flavor of your smoothie
  • 1 Apple cut into chunks (size depends on power of your blender)
  • 1/2 of a 10 oz bag of frozen mixed berries
  • 4 ounces (approx 1/4 container) of silken tofu

 

Cooking Instructions:

  • Add ingredients to the blender in this order: liquids, cut fresh fruit, leafy green vegetables, ground/powdered ingredients & seeds, frozen fruit or ice.
  • Use a rubber spatula to scrape the sides or push down ingredients between blending as needed
  • If the blender gets too full, start blending the liquids and fruit first.  Then slowly add in the rest of the ingredients until fully mixed.
  • Makes between 1-2 (up to 3) servings

Extra Info:

  • Optional ingredients: 1 tsp of ground flaxseed, chia seeds, sesame seeds, etc. for extra vitamins/minerals/fiber
  • Alternative ingredients A: add banana, avocado, yogurt, or ice to thicken the smoothie.  Or add less liquids
  • Alternative ingredients B: can substitute any apples and mixed berries for any fruits.  Can substitute almond milk for any other liquids.
  • Alternative ingredients C: I don’t recommend meat or eggs for protein.  Whey and soy proteins have a weird aftertaste.  I’m not vegan or vegetarian, but there are affordable, neutral tasting protein powders that work great in smoothies

Rice porridge aka congee in a slow cooker:

Ingredients:

  • 1 cup of white rice
  • 8 – 12 cups of liquid (vegetable-based or meat-based broth)
  • 2 stalks of green onions chopped fine
  • 1 lb of marinated protein (seafood, fish, chicken, pork, tofu, etc.) chopped or diced into medium-sized pieces
  • 1/4 teaspoon of grated or sliced fresh ginger (or 1/8 teaspoon of ground ginger)
  • Add ins: sesame seeds, peanuts or other nuts, mushrooms, sliced vegetables, salt to taste

Cooking Instructions:

  • Add the rice, broth, meat/protein, ginger, & half of the green onions to the slow cooker.  Cook on low for 6-8 hours.  Rice will look like a thick soup and take on color of broth.
  • Ladle the soup into individual serving bowls.  Add sesame seeds, mushrooms, vegetables, and fresh green onions on top and serve.

Extra Info:

  • I prefer to mix everything together and then eat, but it’s a personal preference.
  • some people cook the meat, fish, or other protein separately and add in just before serving**
  • I am lazy and often throw everything into the slow cooker at the same time.  It tastes just as good, but veggies tend to lose their crispness and meat can taste overcooked.***

Hot flavored water (makes individual servings):

Ingredients:

  • 12 oz mug or larger
  • Water of choice (I use tap)
  • 1-2 teaspoons of Honey (or to taste)
  • 1/4 teaspoon of lemon juice or 1/4 wedge of fresh lemon
  • Frozen or fresh fruit of choice (I tend to use frozen berries, mango, cherries, or pineapple)

Cooking Instructions:

  • Add honey or lemon to cup
  • Add frozen fruit to cup (fill 1/4 of cup max.)
  • Boil 6-8 ounces of water
    • Electric kettle needs a minimum of 2 cups
    • Boil water on stove top and pour into cup
  • Pour hot water into the cup and mix with honey/lemon/fruit.  Let cool down and enjoy
  • Pour water in cup and microwave on high for 2-3 minutes.  Or use the beverage option.  Take out and mix honey/lemon juice/fruit with water.

Extra Info:

  • Microwave option A:  Add honey or lemon or both and water to cup; microwave on high for 2-3 minutes; take out and mix
  • Microwave option B:  Add frozen fruit and water to cup; microwave on high for 3-4 minutes; take out and mix
  • For multiple servings: Bring water (best to use 4 cups min.) to a boil in medium-sized pot.  Add ingredients to taste.  Bring back to a boil, stirring lightly, until water changes color or flavors mix.  Turn off heat and pour into mugs.
    • If you prefer a drink without pulp, separate liquid from pulp using a strainer.
    • The pulp is great in smoothies, fruit bread, muffins, etc.

 

I hope the recipes, if you try them, bring you as much comfort as they do me.

 

Thanks for reading.

Nightmares are terrible experiences to work through at any time.  When you have alter personalities and switch in your sleep, the lack of awareness can cause problems.  By lack of awareness I mean not realizing when I am: shouting, screaming, crying, talking, kicking, punching, thumping, and so on while I am paralyzed (locked inside my body).  Usually my noise happens when I’m having a dream that involves anger and fighting.  All that means the neighbors get annoyed.  They start making noise.  And no one in the system is sure who or when or how the issue was resolved.

And yes, I’m having nightmares.  Or maybe reliving experiences as I sleep?  Or maybe I’m asleep and my alters are awake having flashbacks?  So confusing, yet so real.

As I told the admissions council during my second interview, some part of me is always awake.  I never truly sleep.  But I do get lots of rest.  And lately, my wireless headphones have been a blessing.  I can block out the construction, the neighbors, the cars, the wind when windows are open and get some rest.

Downside is that I can’t exactly hear when my neighbors bang on the door or the wall to get me to quiet down with the headphones on.  And when the neighbors do bang and shout, I’m not sure it’s me or someone else they want to quiet down.  Or if the new neighbors are moving furniture/drunk and walking into things, etc.

But I also have new neighbors.  They happen to be younger and louder than the others.  Also chattier and with chatty guests who visit at all hours.  And some like to smoke in the building even though that’s against the rules.  So any or all of this could be happening while I’m trying to sleep.

And whoever’s in charge at the time will take care of these issues.  So far, no complaints from the property manager about noise or other issues.  But the banging and music do startle awake and make some alters tense up.  To be honest, I’m not sure if any of us actually get out of bed to talk with the neighbors at night or just stay in bed hoping it will stop.  And I am kind of afraid of what could happen if one of us does try to chat with the loud neighbor.

As for basic coping strategies, here is this week’s list:

  • Airing out the apartment – warm enough to keep windows open a few days last week
  • Feeling comfortable (not to cold or hot) in bed
  • Gratitude affirmations
  • Deep breathing and meditation
  • Self massage and use of acupressure points
  • Letting the memories flow – aka alters share memories, experiences, thoughts, and feelings with everyone else
  • Listening to music
  • Listening to favorite nature sounds
  • Re-reading old favorites and some new books
  • Staying inside
  • Sleeping when I can; resting when I can’t; eating when I feel hungry
  • Letting myself be

It’s the downside to apartment living, especially micro-apartment living.  Small spaces crowded next to each other; soundproof that isn’t truly soundproof; and a basic lack of privacy from having neighbors so close.  Too bad I can’t afford my own house on a quiet street with very few neighbors and lots of beautiful trees.

But now that my secret life isn’t so secret anymore and we aren’t expending so much energy living two lives, maybe this lack of energy and need for solitude will lessen.  I’ve actually spent more time outside my apartment and interacting with people in the last two weeks than I did for the last 3 months.  And as much as I liked it (all parts in the system really enjoyed it), spending time chatting with people and in crowds really drained my energy.  So now we’re all back to figuring out how to refill the well.

Thanks for reading

 

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(from: https://www.pinterest.com/cookoutchef/quotes-about-food/)

A good reminder to eat healthy, tasty, nutrient rich food and drink lots of water or flavored water (with a few treats sprinkled through) even when I feel ambivalent.

It’s March again.

The depression and feelings of shame/badness/evil are back.  I had a panic attack between yesterday and today.  It felt different, but I still had to take  the day off to sleep.

The body memory pain lessens with each acupuncture treatment – cupping and body work are helping too.  But the other pain – pain that comes from the toxins clogging my face and abdomen – increases.

While I am grateful for the pain (it means the toxins are moving out of my body) the headaches and sinus aches are triggering and distracting.  The back pain and abdominal pain feel scary until I burp or fart.  Then it feels slightly embarrassing.  Also feels triggering.

All I have to do is focus on self care until my next appointment with the counselor.  That’s what we agreed on in today’s session.  Me take care of myself in the best way possible.  Sleep.  Cook.  Be active, but not too active.  Conserve energy.  Prioritize goals.  Work.

And maybe this time the feelings of being evil, incompetent, stupid, etc. will not win.

Thanks for reading.

Warning: Potentially triggering and detailed content in this post.  I tried to insert a “read more” tag after the “And yet…” subtitle, but please do not read past there if you feel uncomfortable

Background

I love cooking.  As a child, one of the ways I got personal attention and approval was through the cooking process.  There was a wealth of knowledge handed down to me as I sat or stood in the kitchen with my aunts, uncles, grandparents, and yes parents learning basic food preparation and storage skills.

When I think of the smells in my grandparents’ kitchen, I feel safe.

When I think of standing on a chair stirring sauce in a pot with my uncle, I feel loved.

When I try to remember how to “properly” marinate meat to get the tender, melt-in-your mouth feel, my mind draws a blank.

When I try to chop common vegetables like carrots, celery, onions, or broccoli, my hands start to shake.

And yet…

Read the rest of this entry »

My name is Darkness.  I am between 6 and 10 years old.  My name comes from holding some of the darkest memories and feelings in our system.  It was my job to protect the other parts from the monsters by creating walls between them and reality – aka a darkness that veiled the scary truth.  I was and still am a protector – strong and independent and capable.  I didn’t think that I needed any help; in fact asking for help was considered a weakness back then.

It wasn’t until the adults started going to therapy that I realized help is not a weakness.  Offering help feels good and lessens the feelings of guilt and shame for not being able to protect everyone all the time.  But accepting help?  Admitting I couldn’t handle all of the memories, feelings, and triggers by myself?  Admitting that I couldn’t do everything, protect everyone, prevent the others from remembering, maintain the dark veil?  That I refused to believe for a long time.

Because what would I do?  How could I be a useful part of the system if I wasn’t protecting everyone and myself from the scary memories?  How would I cope with the voices and the pain that came from lifting the darkness?  Who would want to help a monster like me?  One who lived in perpetual darkness reliving what the monsters did to our mind and body?

No, I didn’t believe anyone would offer to help me unless that offer was a trick of some kind.  I didn’t believe I deserved to be helped either.  So I ignored the offers.  And I denied needing anyone’s help.

Until the day, or was it evening, that I got caught in a trap that stuck me in the past and couldn’t get out on my own.

A whole group of alters (different ages and genders) came to find me.  They told me I could get out of this easily.  All I had to do was accept their offer of help.  I didn’t believe them at first.  I fought them.  I insulted them.  I hurt them.  I fought myself.  I insulted myself.  I hurt myself.  I pushed them away.  I hid from them.

They always found me.  They protected themselves without hurting me.  They offered compassion.  They stayed down in the pit with me and never, not once, left.

It felt like days, but was only hours – that last battle.  I was so tired.  I gave in and accepted their help.  As soon as I opened up to the offer, the trap disappeared.  No one was stuck anymore.  We climbed out of the pit and made our way home.  It was kind of embarrassing that the girl alters were stronger and faster than me fora long time as I recovered.

Boys are supposed to be stronger than girls.  Smarter and faster too.  But that’s a lie too.  Maybe boys are physically stronger because of the differences in body shapes.  But not stronger or smarter or faster in the other ways that count.  Anyone can be strong and fast and smart; it has to do with the individual not the gender.

Sometimes I forget that I”m part of a system who loves and accepts me as I am.  Sometimes I forget how important I am to the system; without me we wouldn’t be the AlterXpressions system (a unique, independent woman) and able to do so much.  And without them, I wouldn’t be able to learn, grow, and do my job as part of the system that makes up the woman we are.

A woman with masculine and feminine characteristics who is learning to embrace all parts of herself as I learn to accept myself and my part in our system.

Thanks for reading.

An unedited post…

There are 4 parts of DBT: Emotion Regulation, Mindfulness, Distress Tolerance, Effective Interpersonal Communication.  I learned them during my first time in a partial program.  They helped with anger management and emotional control.  At the time, I did not know about Dissociative Identity Disorder, alternate personalities, or triggers.  All I did know was that my anger and fear overwhelmed me to the point where I stopped thinking, stopped talking, and started reacting.

The partial program helped me deal with my present distress by teaching me to stop and think before reacting (mindfulness).  And after the experience, look back and analyze what happened to identify feelings and reactions to feelings (mindfulness).

Once I understood my feelings and reactions to them, I could plan ways to change my reactions or not react at all (distress tolerance) through coping strategies like distractions, self soothing, meditation, exercise, etc.

In order to do the above, though, I had to learn what emotions were and how they affected my body/mind/self (emotion regulation).  Then find ways within my control (diet, sleep, exercise, relaxation, positive experiences, self-talk) to help me regulate my feelings when I felt overwhelmed or distressed (emotion regulation).

And then I could find a language to help me communicate my feelings to myself and others without crossing boundaries or compromising safety (interpersonal communication).

This all worked great until I discovered that my distress feelings and triggers were not from the present time.  Most came from flashbacks, body memories, or remembered experiences triggered during stressful encounters with people or certain environments.  And as much as I tried to use DBT, it didn’t work.  And I got really frustrated.  Especially when my family shunned me and turned up the pressure to fall in line or else.

That brings me to the second partial experience.  It was not helpful or positive like the previous one.  But it did help me better understand the people in my family and their struggles.  It also helped me get in touch with my alters.  For the first time, I could clearly hear them in my head and recognize when I switched.  And we could communicate with each other.

My time with these people: younger and older, but not really in my age group, from different life situations and cultures reminded me that I am only responsible for myself and my choices.  I can’t change or help people who aren’t interested.  I can’t be around people who have issues accepting my real self too.  All three of those situations combined make for a very unhappy individual in an unsafe environment.

So I took what I learned from them and shared it with my therapist.  We agreed that my family wasn’t safe to be around at the time.  It was necessary to put my emergency plans in place and walk away for real.  And also to learn more about the voices in my head.  They needed the coping strategies and tools in my tool box as much as I did.

And when they started practicing DBT too, life got a lot less scary.  Communication at work improved.  My work environment got more comfortable.  I was able to take better care of myself at home because advocating for myself was easier.

And my alters had something to keep them busy while I worked.  Yes, multitasking again.  Different alters, alone or in groups, practiced DBT and other coping strategies on the inside while I or someone else lived and worked and did chores on the outside.  It became a main staple in “acting normal” and surviving in the outside world.  We set up an elaborate communication and transportation system so that everyone had immediate access to each other, but also privacy and alone time.

And I learned that solitude is very important because the “alone time” gives all of us in the system dedicated periods of “together time” like family time.  They all get a chance to be in control of the body and interact safely with the outside world.  We all get to do activities together and share information.  And there’s time for meditation or exercise and self care.  Everyone gets a voice and an opinion.  Sometimes the adults act like adults and make the final decisions.  Other times, it’s a community decision.

But we’d never have known this or be able to put ourselves first without having learned DBT.

And this is why I and others who write here struggle with how to write about what DBT means to us.  Because DBT is meant to be used in groups with other people and a moderator.  But we use it to help our internal system and work sometimes with our therapist, but not a professional moderator (like group therapy).  And our way of meditation is more like in martial arts (original training) or Buddhist practices not what Ms. Linehan teaches.

Now that I spend more time in the outside world, my solitude means a lot.  The times I spend walking from place to place during commutes are less about interacting with people on the street and more about catching up with my alters.  If that makes me less approachable, appear snobbish or remote, or act confused/abrupt, etc. then I’m okay with that.

I don’t want or need a lot of people in my life.  And the people in my life are ones I cherish and value; relationships to nurture and build on.  So yes, I put myself first and everyone else next.  Then I put time into relationships I care about with people I care about.  The rest will come as life changes.

Thanks for reading.

AlterXpressions

 

Different Post format today

Background

I practiced anorexia/was anorexic for 15-20 years; starting with childhood neglect (not always being fed) and “participation” in my mother’s diets as she tried to lose “baby weight”.  Diagnosis and recovery started in 2004.  Remission or full recovery started in 2015.  I wouldn’t be where I am now without a lot of help and support from my care team – especially the dietitian who helped recreate a healthy relationship with food.

Food has always been a big deal in my family.  Weight loss and weight-related illness is a big struggle for many family members.  Part of the anorexia started because I didn’t want to be like them – obsessed about food; unable to stop eating; sick all the time; having to take lots of medicine; being made fun of and criticized for my weight and looks.  Another part had to do with self-punishment and being in control of some small part of my life when everything else was out of my control; I love food and cooking so not letting myself eat and not cooking hurt a lot.  Finally, the anorexia was about body hate; I hated being female and having a curvy female body.

Recovery, Relapse, Restart

The first thing I did when my therapist finally convinced me I was anorexic (and this took 3 months of weekly counseling sessions) was buy a book about anorexia nervosa.  The second thing I did was try to talk to my parents.  Third, I asked my primary care physician for assistance.  Finally, I took matters into my own hands and started research/recovery with my therapist at the time in secret.

I started gaining weight and got really bloated.  The weight gain was noticed; I started getting concerned looks from some and gleeful looks from others.  Concerned by family members who worried that I was getting overweight and might develop diabetes.  Gleeful from family members who were jealous of my skinny body and happy that I was looking fat or fatter than them.  Then came the lectures on behalf of my mom who was “worried about me” since I “refused to listen to her”.

Those comments hurt, but I was committed to getting better.  I didn’t want to be in pain all the time or allergic to 35 different kinds of food.  I didn’t want to be tired all the time or constantly sick.  I wanted to be healthy and active again.  I wanted to walk and practice martial arts or yoga without knee and back pain that plagued me since adolescence.

Starting the Process

My first real relapse came in 2007 after I moved out on my own for the first time.  I lost about 8-10 lbs in 3 months.  It was the weight loss that spurred me into getting help again.  First a primary care doctor who I could trust.  She recommended me to a dietitian who specialized in eating disorders.  Later both suggested I start therapy again, so I started looking for someone.  This therapist did not work in trauma, but she helped with everything else.

Between the two of them (dietitian and therapist), I learned that I was:

  • Afraid of food
  • Afraid of my body
  • Afraid of looking attractive
  • Clueless about nutrition
  • and Confused about diets and dietary needs

Then my dietitian moved to another department within the program, and I got someone new.  Her approach was different, and I was wary at first.  We’ve been working together for the last 8 years with a lot of success.  The second dietitian helped me understand more about diets and nutrition.  We addressed my food fears and body fears with facts about how different kinds of food help improve different body functions – mini anatomy and physiology lessons.

Redefining What Food Means to Me

Through my work with the second dietitian, I rediscovered my love of food and learned to separate my body negativity from my desire to be healthy.  The last few years have been focused on getting healthy and discovering what healthy means to me not about weight gain or appearance (that didn’t come until last year).

So what does food mean to me?

  • Food comes from a plant, a fungus, a bacteria, or a living organism (fish, fowl, animals, etc.)
  • Food does not come from a laboratory or genetically modified living organism
  • Food can be created by processes like fermentation (beer, miso, tempeh, pickling, canning) and dehydrating to name a few, but not by chemicals and additives
  • Food is nutrient dense with a variety in calories.
  • Food is colorful like a rainbow and goes through a decomposition process after it ripens
  • Food can be eaten raw, cooked, or baked
  • A variety of food per meal is more tasty, interesting, and nutritious than the same foods all the time
  • Food has to taste and feel good going in (chewing), going through (digesting), and going out (removing toxins) in order to help me maintain my health
  • Food is separate from how I look in the mirror or what others think of my body

And how does that relate to health?

 

Once I learned to separate my negative body image and body self-hate from my food thoughts, I started to heal.  After I decided to let myself enjoy food, my food allergies started to go away.  Once I decided it was okay to be “fat” and gain weight, my weight normalized.

This means I eat when I am hungry; drink fluids when I am thirsty; used the bathroom when my body says it needs to release toxins; and exercise as much as possible to maintain flexibility, stamina, bone density, and muscle development.

My focus is on nutrient dense foods that I don’t have to eat a lot of and are easy to cook 80% of the time and everything else 20% of the time.  That gives me leeway to experiment or to try out new/different foods for grounding and self-soothing purposes as part of a coping strategy.

“New” Eating Habits 

  • Flexibility is key
  • Eat a lot of nutrient dense food in small portions throughout the day
  • Eat until I am full and then stop; I can always eat later
  • Remember to hydrate or drink soup with one or two meals to get enough liquids
  • Smoothies can be meals too and are easy to digest
  • It’s okay to eat junk food sometimes
  • Denial and restriction only make me feel worse not better
  • Too much dairy and animal protein causes digestion problems so eat sparingly
  • Eat what I love and love what I eat
  • It’s okay to NOT enjoy eating sweet foods, chips, and desserts; it’s like others not liking chocolate or ice cream

Final Thoughts

Diet books did not help much as I researched information about anorexia and food allergies.  Regular cookbooks did not help much because all recipes included foods that made me sick.  So I started looking at “alternative food lifestyle” cookbooks – aka vegan, vegetarian, raw foodist, and allergy friendly cookbooks – for inspiration and ideas.  That is partly how I rediscovered my love of fruits, vegetables, beans, nuts, seeds, and grains.

I am not vegan, vegetarian, flexitarian, pescatarian, or meatitarian as I’ve heard people refer to themselves.  I am a woman who enjoys eating real food that comes from plants (most of  the time) and living organisms (sometimes).  Most of the food is minimally or not processed, but a lot of it is processed in some way.  I eat a variety of different foods so that most vitamins and supplements are unnecessary.  High processed and chemical-laden food products make me ill and cause problems, so I avoid or eat them in small amounts.

I still have issues with body image and having a curvy female body, but those are topics for a different post.

Thanks for reading

 

 

A different post format today.

“It takes a village to raise a child”

I am not sure where that quote came from, but my therapist mentions it often in our sessions.  It’s a reminder that one person alone cannot handle everything, especially not something like recovery.  But finding trustworthy people to help and support recovery (support network) is not easy, especially not for people who feel helpless, hopeless, trapped, unsafe, or confused.  And putting oneself out there to meet new people; interview them; talk to them about such scary and personal experiences without really knowing them can be triggering.

Creating a support network takes courage, persistence, self-trust, and access to resources.  Courage to reach out and accept help that is offered through research and resources.  Persistence to follow through on research and utilize the resources available.  Self-trust to trust in one’s instincts about the people being interviewed as potential members of the support network.  And yes, this includes family, friends, coworkers, neighbors, and professionals of all kinds.

Why talk about it now?

Two reasons:

  1. I am leaving much of my existing support network when I move out of state in a few months and want to share some of what I have learned as I reflect on how to recreate a support network in my new home
  2. I feel less anxious about sharing some of my struggles with finding safe providers on the blog right now

Taking Responsibility for My Recovery and Care

Parents and legal guardians are responsible for the majority of their children’s care and support.  They choose doctors, schools, activities, social experiences, and even friends sometimes.  If, like me, the parents or legal guardians are also abusers, the child or children do not always get proper care.  But they learn that the care they receive is “proper” and “all they should expect”.

My pediatrician was also one of my abusers.  He got me pregnant and then forced an abortion when I was 15.  Before that, he kept me on a variety of allergy medications and other drugs to help my parents “manage” me and my constant illnesses better.  Shortly after the abortion, he died of a heart attack.  And I was told to “choose” a new pediatrician.  Except this pediatrician was the same one my cousins used.  She did not abuse me, but she also turned a blind eye to (what I now realize) all of the inconsistencies in my file and my symptoms.

Then I turned 18 and had to find a new doctor.  I also had my first experiences with doctors outside of my local community (college).  These doctors did not constantly brush off my symptoms and give me drugs to “feel better”.  They asked questions and followed up on any inconsistencies.  In fact, one told me that maybe the drugs were making everything worse; I might want to try not using them and letting the cold go away on its own.

Then I went back home to meet my new doctor.  This doctor who happened to be my mother’s doctor, and had been her doctor for most of my life.  I didn’t like her.  And she didn’t care about me.  Going to see her caused lots of anxiety.  And she didn’t care about my concerns or mental health problems unless they were treatable with medicine or by a specialization she approved of (aka physical therapy and orthopedic doctors)

Four years later, I graduated from college and started treatment with a clinical psychologist who treated one of my cousins previously.  We worked together ok, but she also wanted me on medication.  And she did not acknowledge trauma in any way even though she saw and heard (from interviews with my parents) that I was being controlled and abused by them before I did.

Her solution was for me to move out and start living my own life. That caused tension and a lot of distrust on my side; how was I supposed to do that when I couldn’t even find a regular job, let alone take care of myself?  Eventually I stopped seeing her.  The psychiatrist didn’t bother with me after I stopped taking the medicine he prescribed; and he was upset with me because he believed that I lied when I said the medicine was making me sick and sleepy and numb.

Around this time, I also tried working with a chiropractor; that was a positive experience until some new people were hired to work the front desk.  The new front desk people took a lot of pleasure in bullying me, and none of the other staff stopped him.  In fact, they egged him on.  So that place didn’t feel safe anymore.  I didn’t feel safe bringing up to my provider.  I left and never went back.

Then I moved out and had to find new doctors close to me.  I also had to buy medical insurance and make sure the premiums were paid on time.  A few months later, I also had to find a new mental health provider.  By now, I already knew what I did and did not want in a provider.  And I knew that finding one would require me to talk to people and engage them.  But working with the psychologist did help before.  And doing these scary activities was worth the effort if I could start sleeping and eating again.

That is how I took responsibility for my own recovery and care.

Shared Knowledge

Here are some of the criteria I used to find a primary care physician (PCP) – the cornerstone of my support network.

  • Location: Moving out meant giving up my car.  I needed to find a clinic and hospital that was easily accessible by public transportation
  • Accepted my medical insurance
  • Had staff experienced in working with mental health and/or trauma patients and who were taking new clients
  • Was female, mid-thirties to early sixties, and a fair amount of practical experience
  • Had an open mind about not using a lot of medication, was willing to work with me about mental health treatment, cared about finding causes more than symptoms, did not mind writing referrals to other specialists or that I went with a mental health provider outside of the care group, felt safe and listened without judging me

Here are some of the criteria I used to decide whether or not to stick with my dietitians for medical nutritional therapy

  • Location: accessible by public transportation
  • Accepted my medical insurance
  • Had staff experienced in working with mental health and/or trauma patients
  • Listened without judging or pushing a program/agenda on me
  • Answered questions; offered suggestions, guidance, and outside resources I could follow up on in my own time
  • Focused on teaching me how to help myself become healthy and stay that way
  • Checked in with me and allowed trust to build based on open communication and mutual respect – did not shame me or get offended when I expressed uncertainty about wanting to work with her during our first meeting

Here are some of the criteria I used to find and choose a mental health provider

  • Location: accessible by public transportation
  • Accepted my medical insurance
  • Or as an alternative was open to sliding scale fees, payment plans, etc. to help with costs of outpatient treatment
  • Specialized in trauma (or depression, anxiety, eating disorders if I couldn’t find a trauma specialist)
  • Female, between forty and seventy years old, with at least 20 years of experience working with a vareity of age groups
    • Female only because I am more comfortable with female providers than male providers; none of my childhood or adult female providers were abusive
  • Listened with respect and acceptance
  • Did not talk down to me, condescend to me, shame me, or dismiss my concerns/questions/issues in any way
  • Did not make me feel unsafe, unheard, or crazy during our first meeting
  • Felt safe and comfortable in her office during the first meeting

Here are some of the criteria I used to find and choose a psychiatrist

  • All of the above for mental health, plus did not try to push drugs on my once he or she realized the drugs were making me sick with symptoms and side effects

Here are some general tips

  • If you already have providers you trust
    • Ask what medical insurance they take and make sure you are on one of those plans for a primary care physician and specialists (psychiatrist, dietitian, podiatrist, etc.)
    • Work out a payment plan with the financial department (many major hospitals and clinics have programs and are supportive about helping figure out options as long as you talk to them) or your mental health counselor if you get into financial trouble
  • If you don’t have providers you trust
    • Try calling the phone number on the back of your insurance card
    • Try using the insurance company’s website to search their directory of providers
    • Then be prepared to make a lot of dead end phone calls and set up appointments to interview the providers
      • Dead end because many sites do not have up-to-date contact information
    • If the prospect of doing all of this research and follow up on your own is anxiety-provoking or triggering, try a third party organization or non-profit organization dedicated to helping people find providers
  • Always be as honest as possible and communicate your needs, concerns, or issues clearly when talking with providers.

Any provider who brushes your concerns and questions off is not safe or trustworthy.  Find someone else

Thanks for reading

 

 

Authors’ Note: this post took longer than expected, so we decided to polish this one instead of breaking up the series to post something else over Memorial Day weekend.  Sorry for the lateness.

Introduction

First thing I learned in therapy is that I have feelings.  I may not know what they are and how they relate to my thoughts or behaviors, but they exist and influence my life choices.  The first emotion I got in touch with was anger.  And only because the medication separated me so much from my body and mind that I could “see” volcanoes seething and erupting inside of me during therapy sessions.

Not until 2007 when I started with a different therapist did I start to recognize “fear” and “anxiety” and “sadness” as they overwhelmed my mind and body.  She didn’t tell me at the time, but a lot of what we did together was DBT or Dialectical Behavioral Therapy.  Part 1 of Emotion Regulation is acknowledging and identifying feelings.  Part 2 is using certain strategies to cope with those emotions and not let the emotions influence thoughts and behaviors.

The women only partial program I went to in 2009 focused a lot on DBT.  Depending on how long an individual stayed in the program, she could go through all 4 parts before leaving.  DBT group sessions were daily and mandatory.  I loved them; did not always say a lot, but I listened and learned.

My second time in the same voluntary partial program did not go so well.  The people running it in 2012 were different from the ones in 2009, and groups were run differently too.  Not that it was bad, but my needs were different.  And most of what I learned the first time was repeated again; not much new to learn and experience in terms of coping strategies and techniques.

OK, I can feel.  Now what?

The biggest takeaway from both times in partial programs was how others experienced and showed their feelings.  By observing the women in my groups (I went to a female only partial program because I wasn’t ready to deal with men in that kind of setting yet; and I understood males better than females having worked in a male dominated office for many years), I learned about how different women expressed feelings; how the experiences were different and similar from mine; and how important facial expressions and body language are in expressing feelings clearly.

To some people words mean everything.  To others, actions and expressions tell the truth instead of words.  The rest of the people are somewhere in between; words and expressions are used to understand emotions.  Between 2007 and 2009, I couldn’t articulate a feeling if I tried.  I could easily mold my features and body to express whatever feeling I was supposed to show.  But none of my real feelings showed; not in my voice; not in my eyes; not anywhere except inside my mind.

And there, I always saw destruction: witches toiling over a bubbling cauldron; sleeping volcanoes ready to erupt; the eruption; tornadoes and hurricanes blowing everything in their paths.  Rarely, a quiet lake appeared below a mountain ridge.  Or a meadow clearing deep inside a dark, twisted forest.  But getting there was akin to a hero on a quest.  And I wasn’t ready for that.  Neither were my alters.  Each of us had to go on a quest to find our quiet place.  And from there, find each other.

Knowing of each other; having limited interactions once in a while; hearing voices intermingled with the monsters is not the same as finding each other and working together to be whole.

The second time in partial focused on learning techniques, but not so much about trauma or real life application of said techniques.  In essence, I felt like I was teaching instead of learning to the point where some of my group members said in front of the leaders that I “should teach a group”.  My alters did not like being excluded from group interactions and ignored as if they did not exist – something I had to do in order to get through the different sessions with some sanity.

Definitions

Dialectical Behavior Therapy (DBT): Psych Central offers a good description with links: This website offers an introduction to DBT

Emotion Regulation (mine): Strategies to help me (us) not be controlled by our feelings and emotions. The often used phrase “think before you act”.  In my case, “think before you react”.

Partial Inpatient treatment programs: sometimes extra support is needed, but not to the point of being committed to and inpatient program.  Partial programs (voluntary or court-ordered) offer the extra support and group sessions in an outpatient setting.  Different programs specialize in different mental illnesses, treatment strategies, gender, age and so on.

Mimicry or Learning by doing:  By observing how people we liked and respected acted towards themselves and others, we learned how to treat ourselves and others with respect and acceptance.  By watching others who had and expressed feelings, we learned how to do the same.

The skills and personality characteristics we practice

Persistence: Ignoring feelings makes them stronger and more powerful.  Fighting them does that too.  We can’t make the feelings go away.  We can acknowledge and identify the feelings that come and go.  Odd thing is that acknowledging the feeling takes some of the feeling’s power away.  Identifying the feeling and welcoming it also takes power away.  The feeling is not so overwhelming; it’s not in control anymore.  But doing this is scary because it means that we have to experience all of the physical and mental sensations (thoughts, behaviors, etc.) that come with it too.  Eventually, though we can say to ourselves, “I feel ___.  ___ is expressed as _____ in my body and ____ in my mind.  If I welcome all of it, the feeling will go away faster and on its own.”  And the feeling does go away eventually.

Active Listening: I learned that feelings expressed in sounds are easier for me to understand, yet also very triggering.  Noise tends to disrupt me far more than anything else.  Specifically voices and movement are triggering.  Growing up, listening to voices and body movement kept me out of danger more often than any other sense.  So I stopped hearing actual words for a long time.  My focus was on listening to tone, pitch, and volume.  Those three pieces would let me know how much danger I was in and what kind in each environment.  Not until I started college did I realize that I had stopped hearing actual words, sentences, conversations, etc.  Most of the time I lived inside my head with ears tuned for danger or potential danger.  Then I realized that if I wanted to participate and socialize I had to listen to what people actually said and respond with my own words.  Later, when we all started communicating with each other, every alter had to re-learn how to listen actively, interpret the verbal and non-verbal cues, and respond using positive interpersonal communication skills.  By using active listening, we can identify how other people feel and react to our words so that there are less problems with communication.

Solitude: looking inside and working with feelings requires time with safe people, time with instructors, and time alone to practice and learn.  Solitude is not loneliness.  It is a way of making friends with oneself and enjoying one’s own company.  It’s a time to explore different ideas and skills without fear.  It’s personal “me” time in which the individual can do anything or nothing or something in between as long as the task is done with purpose.

Analytical or Critical Thinking:  a pause is an opportunity to use the logical side of the brain and ask “why am I feeling this way?  How will I react?  Do I want to react like that?  Or do I want to react differently?  How do my thoughts influence my feelings?  Am I feeling something else under this feeling that is pushing me to react?”  And by answering one or some of these questions, I/we have a chance to change our thoughts and reactions from negative to neutral or positive instead.  This gives us control over ourselves instead of letting the feelings control our reactions.

Empathy: empathy is difficult to understand, respect, and accept because many people equate it with weakness.  And others will be cruel by telling them that no one can feel what others feel because they didn’t “experience” it exactly the same.  But empathy is not about “knowing what others feel” so much as “being able to relate to others’ feelings and situations through shared or similar experiences.”

Observation: Please refer to any of the characteristic explanations above.  Each one provides many examples of observation.

Final Thoughts

I’d rather have feelings than live in a numb, colorless world.  My alters agree and disagree. Understanding feelings and how to express them is one step closer to being able to understand ourselves.  From there, we can understand others and use empathy to inform our choices and decisions.

No one gets hurt on purpose.  Learning from mistakes is not so costly.  And every success is a reminder to be grateful for the gifts we have and use to survive in a hostile world.

We all prefer to try any possible technique and strategy at least once.  That’s why we tried the partial program again.

Thanks for reading.