Saturday, April 18, 2009

In Which DuWayne Discusses HisTherapy

This last Friday, was my last session with the therapist I have been seeing. Her internship is up and I am probably going to be out of therapy until June.

I am very grateful for the experience that I had in eleven sessions with Theresa and can state categorically, that she is one hell of a therapist who will serve her clients well. I was rather reticent in the beginning and she admitted yesterday, that she was as well - for some of the same reasons. For my part, I was concerned about her lack of experience and the fact that she's a women. She was concerned because she believes that I am more intelligent than her and that I would find therapy more effective with a male therapist.

I have been trying to figure out how to explain the methods used in my therapy with Theresa and keep running into something of a wall with it. The reason is that the therapy was by needs, rather unconventional - utilizing a great many tools that are not generally used together. The diversity of the problems that I need to deal with make any singular approach simply impossible.

The first thing we did was to define the issues I am dealing with and my goals. This was excruciating, to put it mildly. We discussed a great many, very difficult issues in a very short time and explored issues that I was mostly unaware of. The biggest issues were figuring out where the cognitive problems end and the neurochemical issues begin and helping me recognize my emotions. The former is not something that can be accomplished with absolute accuracy. What we were really trying to do is help define broadly, the parameters of my neurochemical issues. The latter was and is, far more of a problem. When I first walked in the door, I knew that I needed to learn to deal with my emotions more effectively - instead of just shoving them away, into the recesses of my mind. What I understand now, is that I have very little grasp of my emotions.

On top of all this, we were also dealing with the nuts and bolts of managing the situation with my family and my reaction to it. This was in part, the hardest aspect of therapy to deal with - mainly because it really was what caused the realization that I have very little grasp of my emotions. It was also the hardest, because the situation with my family has been so absolutely insane.

In working out the parameters of my neurological issues and their interface with my cognitive issues, Theresa really probed my understanding of managing cognitive issues. Not necessarily in direct context to my own experience, but in a more generalized context. She then probed for how I've been dealing with a lot of my problems - what has helped and what has not. Finally, we delved into my experience as a child - not so much what was happening around me (though that was explored some as well) but what was happening in my head. Through this we were able to make some reasonable assumptions about where this therapy should be focused and also where my discussion with my doctor should be focused.

Exploring my problems with emotion was considerably more complicated. This is also where Theresa's ability as a therapist really shined. It's not that I was purposefully skirting the issue, it was just very hard to bring me to the place that I could actually see what's been going on. She had to ask a lot of questions, sometimes pretty much the same question - restated after we had managed to work out another point. She had a very good grasp of what was going on, but due to a need for me to figure it out myself, we had to get there the hard way.

Like any effective therapy, it was entirely based on asking the right questions and through that leading me to figure out what the hell is going on. When the problems being discussed are as diverse as my own, a baseline difficult task becomes huge issue. And to make it far more difficult for Theresa, I came into therapy with a few beliefs about who and what I am, that turned out to be entirely wrong. I truly believed that I had a pretty solid grasp on my emotions - I just didn't think that I was really capable of many of the emotional responses to various situations, that I saw in most of the people around me. While it the context in which it was said is important, alexithymia came up and I wasn't the one who mentioned it. She was clear that she didn't think this was a perfect descriptive, only that based on our discussions, she saw some alexithymic tendencies in me and the way that I manage my emotions.

One of the very few times she actually pointed something out to me directly, was when I came in and told her that the short-form assessment I had taken at the doctor's office had claimed that I suffer depression. This was certainly news to me and my surprise at this was pretty obvious. She then pointed out that when I was very young, I had desperately wanted to die - that when I got over wanting to die, I then moved to simply not caring if I died. Then she asked me how I felt about dying now, to which I responded that I don't want to. It finally sunk in when she asked me why I no longer wanted to die, which I explained was because of the boys...Not because I had somewhere developed a desire to live, but because I have children who need a dad. Just to make sure, she was clear that most people, even people who aren't really afraid to die, want to live and would really rather put off death - excepting those who get particularly old, or who suffer some debilitating disease or injury.

No, I'm really not a moron. This does however segue well into another important focus of my therapy - my own little world, the world that I built for myself when I was really young and wanted to die so badly. The world that I built as a form of self-medicating. The world that I thought was no longer a factor, after an early version of it shattered when I was thrown out of my church so many years ago. The world that has continued to be a huge aspect of my life since I was nine or ten, though it has seen a great deal of remodeling over the years.

A great deal of my life is spent inside my head. There is a rich and diverse universe to experience there, where I will never run out of ideas to explore, sculptures of words and music to explore and occasionally attempt to express on the outside and completely abstract mindscapes to ride, like a helicopter ride over the most beautiful landscapes this planet of ours has to offer. I have always been pretty capable of occupying myself for extended periods of time, with minimal external stimuli (I basically did just that when I spent a little more than a month in the woods once, completely isolated from human contact).

A side effect of spending this time in my head, has been my presumption of self-awareness and my ability to compartmentalize. Combined with my ability to feel at all, I firmly believed that I really understood my emotions and what I was capable of. I just believed that I wasn't really suited to feeling the way a lot of other people seem to manage.

I am not setting a course to vacate my head though. It is an important aspect of who and what I am. I am working on spending less time there and deconstructing some of the more prohibitive aspects of my own little world. Mostly, I am trying to learn who and what I really am - learn how to feel what I am really feeling and embrace it in all it's glory, horror, pain and ecstasy. I am trying to learn what DuWayne is actually capable of feeling. Thankfully, outside the parameters of therapy, I have found the most remarkable help with that.

One of the earliest discussions that came up, one that's pretty relevant, was about my belief that I am incapable of feeling romantic love, the same way most people do. I believed that I am incapable of loving a women the way women should be loved. I explained that the reason I had been so keen on my children's mom, is because I thought she was pretty much the same. I have since discovered I am very, very wrong. And while there are issues to iron out, Juniper is all about working it out together and loving me, in spite of my rather fucked problems with feeling, which she is aware of.

My therapist was excited when I initially told her about Juniper and was positively thrilled when I told her that I had told Juniper I love her. And while there are definite logistical issues that complicate our relationship, it has it's advantages for a person who is as broken as I am - offering a chance to explore feeling and understanding it, without the pressure of my lover being with me most of the time. At the same time, we both get the support that can only come from someone who loves you so much that it hurts - and both of us need that support.

I am far from done with therapy. I doubt that I will ever not be in therapy, though the focus and needs will change with time and context. I am a firm believer in those who work as psychotherapists should always be seeing a therapist for their own sake. And I am going through a hell of a run with school that is only going to be more challenging - not to mention the situation with my kids is not going to get easier any time soon. I need the help maintaining, above and beyond learning how to be not broken. But I am definitely in a much better place than I was when I first walked through the door and sat down with Theresa to talk.

And I have a supporter and teacher who provides me with something that no amount of therapy could begin to challenge. A remarkable, brilliant woman who accepts my love and beyond reason loves me as desperately as I do her.

17 comments:

Anonymous said...

Help me get a better bead upon you. One simple question, have you ever not looked before you leaped?
What did it feel like?
Scary? Joyful? Empowering?
Have you ever made a gut decision?
Sure you have, but how did you feel?
Feel?
Happy? Upset?
For shits & giggles, what is your Myers-Briggs?
Please, don't go off on it.
Malingering.
Drama.
Ego-tripping.
Are open with your therapist?

DuWayne Brayton said...

Isabel, if you are going to comment here, you need to be coherent. I haven't the least interest in dealing with rambling, disjointed bullshit.

Michael said...

Interesting. I still have a problem with the notion of the "real" self and "real" emotions. Real as opposed to ... what? My problem is I'm not quite sure what people mean when they say this type of thing, or use terms like "authentic" self, emotions, etc. What are inauthentic emotions? Is, for example, trying to calm yourself when you're tense inauthentic? Or is it inauthentic when you channel tension into, say, anger or some other emotion?

My other problem is that I resist terminology like this, for reasons I don't completely understand. It just rubs me that wrong way.

Sounds like something to bring up in group tomorrow. You give me the best ideas! :-)

One other comment, which I hope you won't take the wrong way. I've noticed you often use "women" rather than "woman" to refer to a single female. Is there a reason for this, other than spell-checker not catching it because "women" isn't a misspelling? Despite a background in copyediting, I don't make a habit of querying people's word choice, except when I genuinely don't understand the choices.

Anonymous said...

Best wishes

Toaster Sunshine said...

I wonder whether varying alexithymia (I had to look that up) is part of the Nerd State...makes sense.

DuWayne Brayton said...

Sorry Toaster, I totally forgot to throw a definition in the post.

I think that while it may not be an absolute, it certainly could be a fair generalization.

DuWayne Brayton said...

Michael -

It's not so much a dichotomy, as it is an incompleteness. It's not that the emotions that I do manage to feel (which I suspect are actually their own emotions) are any less legitimate than the ones I don't, it's that others are missing - shoved away in a corner, if you will.

And the real me, is quite similar. It's certainly unreasonable to assume that who I have been for most of my life isn't real - I am. I think that it's probably more accurate to say that rather than talking about the "real" me, I am really talking about a more "real" world in which I exist. I.e. it's not me that's not real, it's the world around me as I understand it.

I will think about this and try to formulate a better response.

I suspect that the implication that baseline me is not "real" or more accurately, not legitimate is what rubs you the wrong way. If that's the case, I think you have a very valid concern (not that it's not valid if that's not the case). Unfortunately, I can't entirely put your mind to ease in that regard. While I wouldn't go as far as saying that baseline me is not legitimate or real, it is inherently problematic for me to remain that person - which is why I'm in therapy and taking meds.

At the same time, I want to be clear that my need to change and better understand myself, the world around me and where I can fit in that world, is an issue of functionality, not legitimacy. And it's not entirely accurate to say that I am becoming a different person - I am becoming more complete.

And thank you very much for pointing out what was indeed a mistake. I am all about one very specific women....

PhizzleDizzle said...

You and Juniper!!! Wonderful! I love it.

good luck with your off-therapy time.

Michael said...

D -- Thanks for your expanded thoughts. I hope I made it clear enough that it wasn't your use, specifically, of these terms that bothers me, it's the widespread use.

I guess I wouldn't call repressed emotions inauthentic. I would call them repressed. That, I presume, is what you mean by "others are missing - shoved away in a corner, if you will." While there's nothing wrong with wanting to change yourself or your understanding of yourself or your understanding of the world around you, I wouldn't characterize any of these these as a quest for a (or the) real you.

I think you're right about the "legitimacy" connotation being a big part of why I resist terms like "real" and "authentic" in these contexts. It implies that people can be illegitimate, whether they see themselves or others that way. I bristle at that notion. People, and the emotions they feel, can be misdirected, misapplied, repressed, unrestrained, etc., but they can't be illegitimate. I guess my reaction results from a fear that people searching for their "real self" are too often also searching for ways to invalidate others.

I am all about one very specific women....One women? Not one woman? You are messing with me!! :-)

DuWayne Brayton said...

Oh hell, I am just not very attentive at the moment. Seriously, I'm not fucking with you at all - I'm just scrambling to get everything finished by the end of the semester...

Anonymous said...

Dude you are fucked up. I don't mean that in a bad way. I are one also. Point being is if that is the truth and we can't change that because that is what the truth is then what is the alternative. Well My thought is you are who you are. Well if I believe that this is how my brain works and I accept this fact then I am who I am. I also found someone who loves my for all my character defects and committees that role in my head and it doesn't matter. I've found that if I focus on the now and not the then or the what will be then I have found some peace. Peace to you brother.

Bustedsbro

Juniper Shoemaker said...

This weekend, when I first read this comment thread, I thought, "Oh, look! Isabel's written you a (bad) poem!" You're just so irresistible to so many bloggers, DuWayne . . . maybe it's a love poem-- of the lady-doth-protest-too-much variety? Maybe I should be jealous? :)

Back to gravity. I'm glad you have posted about your sessions with Theresa. Even though we've been discussing the degree to which you've been unaware of some of the most profound of your emotions and the way you've been managing them, it's always good to have another opportunity to understand you better. Additionally, many of your other readers wanted to know what your therapy specifically entailed.

Small point: I wonder about your characterization of your therapy as "unconventional". Isn't most cognitive behavioral (or even just modern) psychotherapy all about a cafeteria-style approach in terms of methods? I think all of my psychotherapists have characterized their approach as largely CB. This is especially true of my two most recent therapists, whose assistance I equally value.

However, these two had diametrically opposed approaches. One let me "intellectualize" during most of our sessions. Her focus was almost entirely on encouraging me to exchange the standards by which I graded my self-worth with rational ones. We concentrated on identifying the irrational ones and the logical fallacies they represented. We also more frequently discussed the degree to which race and gender "informed" the standards with which I was seriously hurting myself more frequently than we discussed my family per se.

The second therapist quickly understood that I am far more comfortable "intellectualizing" than I am expressing certain of my feelings without disaffectation or some other means of self-defense. So she eased me into several exercises meant to circumvent this tendency. I don't know what psychologists would call these. Each was apparently designed to break me open like an egg. For example, I'd tell her something about my present life. When she discerned that I was vividly remembering an ostensibly unrelated and long-ago event while I was talking, she asked me to describe the memory instead. Then she asked me to tell her what the Juniper in that memory wanted to say about what was happening in it. Ack. This proved emotionally brutal.

With the second therapist, there was a lot more focus on my childhood and my family. There was the working assumption-- which I accepted-- that the children of parents with x issues develop with a peculiar emphasis on coping with stress from an extremely early point in life. Possibly in utero. By extension, there was more acknowledgment of the role neurobiology plays in mental illness.

(See? I'm "fucked-up", too. Just in a different way than you are. :)

Incidentally, the first therapist worked with me during the last years of my unswerving refusal to admit that I really, really needed to be on meds (before I got suicidal again) and I couldn't just think my way into being all-powerful and successful and whatever. The second therapist worked with me after I agreed to take medication and fully committed to the idea of becoming a more "grounded" person, no matter how honest with myself or emotionally vulnerable to the therapist I had to be to do it. I think the second therapist had a WAY easier time working with me in these terms. This was good for both of us. So I'm very glad that you found a therapist who helped you effectively incorporate an understanding of your neurochemical issues into your work with her.

I didn't know what alexithymia was, either. I too had to look it up. Bless Teh Intertubez!

I am not setting a course to vacate my head though. It is an important aspect of who and what I am.WORD. In college, I listened to too many Purveyors of Woo (usually of the Alternative Medicine Is Everything and Science and Shrinks Are Bad sort) who insisted that it was somehow not "right" or "authentic" to be "cerebral" or "preoccupied". Bullshit. As long as you're healthy and functioning and achieving what you want to achieve and all that jazz, it's just as legitimate as anything else. Besides. Where the fuck do these people think science and art come from? People who don't have a gorgeous, enthralling landscape in their heads?

There's so much to comment on here. But I have to go eat dinner and write something now.

I love you very much, you know.

DuWayne Brayton said...

People who don't have a gorgeous, enthralling landscape in their heads?You just get better, every day. I love you too - even if you left a frightening image with your first, mocking para...

DuWayne Brayton said...

And peace to you Busted, thanks.

I take ownership of my fucked up...

Comrade PhysioProf said...

Dude, thanks for sharing in detail your therapy experiences! Eleven sessions is only the first minute beginnings of a taste of the benefits that a full multi-year process can bring.

Isis the Scientist said...

I am so happy for you two. You both are two of the most genuine people I know.

DuWayne Brayton said...

CPP -

I don't expect to cut out of therapy before I finish school - I'm honestly not sure I could manage school without it. After school, I'll be doing at least some clinical work and will be in therapy while doing that. So I fully expect that I will be in therapy from now, until I retire.

I will probably be discussing it in more detail, as I work my way through the discussion about how I became me. Whatever else might come out through that discussion...

Thanks Dr. Isis...