Surfacing After Silence

Life. After.

the pleasures of shame and guilt


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A–Let’s see if I remembered how to insert a picture into a post correctly!

B–Now that I am blogging again, I have like a zillion and one topics in my head to write about.  So please accept my need for a creative outlet.

Shame and guilt.  Let me tell you about my heart.  First, let me address a private message I received regarding the last post that told me I should not make fun of people with heart problems because their heart may actually be dying.  So for those who have just started reading this blog–my heart actually is dying.  Or, to be specific, the right ventricle is dying.  The rest of the heart works pretty well.  It’s a genetic form of progressive degeneration, AKA Arrhythmic Right Ventricular Dysplasia (ARVD), which means that the muscle cells of my right ventricle are slowly dying and are being replaced by fat cells, thus enlarging that portion of the heart and affecting the electrical functioning, causing dangerous arrhythmias such as Ventricular Fibrillation (VFib), or the always fun Sudden Cardiac Arrest (SCA), which I have experienced.  And honestly, it wasn’t all that fun.

BUT.  In the process of seeing doctor after doctor and getting test after test done and finally being diagnosed with the actual illness (it’s really kind of rare and not the first illness people look for, especially since it’s particularly difficult to see) I was never once asked any of the following questions:  “Why is it happening?”  “What did you do?”  “How could you have prevented it?” and further along:  “Why aren’t you better yet?” “Are you working yet?”  “Why aren’t you at least volunteering?”  What I did hear was, “OMG, I am so sorry!”  “Is there anything they can do?”  “is there anything you need?”  “Is there anything I can do to help?”  and further along the road: “How are you feeling?” “Are you getting rest?”  and “Will your brother be okay?”  (he was tested and he does not have the gene)

People were supportive and as understanding as they could be and dropped off meals for me to eat and took me places when I couldn’t drive due to my arm being in a sling after the surgery.  The cause of the distress wasn’t wonderful, but my friends and family were.

Change the scenario just a bit and tell people you have Bipolar II, and while the doctors feel that it can be managed, they have realized that–in my case–there is a high chance for relapse and that our job is to catch those relapses sooner than before and treat them effectively sooner than before.

Questions I was asked:  “What did you do?”  “But you were fine last year.”  “Aren’t you taking your medication?”  “Why is it taking so long to get better?”  “What haven’t you done to help yourself?”

In other words:  This is obviously your fault and why aren’t you choosing to get better?

I realized while journaling the other day some things about my therapist in MO.  A) I made a shit ton of progress with him, more so than with any other therapist.  B) I thought he was the best therapist I had ever worked with and was sorry to have to terminate with him.  C) There were times I would walk out of his office and start crying because I was so ashamed and guilty, and also pissed off at him for bringing up these feelings.

One of my problems/addictions since I was in junior high has been self-harm.  I “discovered” DBT therapy in 1999 and it helped a great deal.  My therapist in MO used DBT therapy with me while I was in MO.  Part of doing DBT requires doing a Chain Analysis if you do engage in self-harm.  Basically, you write down every single little thing you did leading up to the event and then go back and write down what you could have done differently.  This can be helpful.  It can also make someone feel like, “Holy shit.  Why didn’t I do that?  What is wrong with me?  When am I ever going to get this right?  Why didn’t I think of that?”  Going through a chain analysis typically made me feel worse and worse as the session went on because I really did know the skills I should have used but didn’t.  And near the end of my time working with him, it made me feel even worse.  Once, I went eight months in between instances of self-harm, and his first question was, “Why didn’t you _______?”  He did not say, at any point, “Wow.  Eight months is a long time for you.  Good job for making it that far.  How can we do that again?”

Then I was hospitalized in May of this year.  Again.  And I was there for a full month.  I was ashamed to walk back on the unit because the staff all knew me, and what would they think of me being back yet again?  My favorite nurse saw me, said, “Hi stranger! It’s been an awful long time since I’ve seen you here!”  And then she gave me my night meds and said we’d talk in the morning.  She said she was proud of me for seeking help, and that she had seen an amazing amount of progress since the first time she met me nearly six years ago.  I was ashamed because I was even there at all.  She said it showed progress because I didn’t go jump off the bridge and realized I needed help and asked for it.  I would come to her on the unit and say, “I feel like cutting.”  And she’d say, “I’m glad you came to talk to me.  What can I do to help?”  There were no recriminations, or questions of why.  Just an acknowledgement of the fact that I asked for help before things got to the point of restraints and IMs, thus avoiding those situations entirely.  When I told my psychiatrist I had cut, I was scared about the lecture I was sure to get.  Instead, he said, “Huh.  Well, you haven’t done that in a long time.  How is this current medication regimen helping or not helping?”

What I learned is that it is much more helpful to hear someone tell me I’ve made progress than to hear someone ask me what the hell happened.  I don’t mean to say I want all that fake bubbly-all-positive-self-esteem bullshit, because at some point I do have to talk about what happened and all that.  But hearing someone say they’re proud of me?  That does a whole lot to push away the shame and guilt that come with many mental illnesses and addictions, and makes it much easier to discuss things openly.

People did not choose their illness or addiction, but recovery is, to some extent a choice.  one hell of a terrifying, difficult choice.  And there will be set backs.  We know when we take a step backwards.  We’re not stupid.  What we need to hear, without judgment, is encouragement to get back up again.  And along the way, we need to hear that we’re doing the right thing by taking our medications, going to the doctor, avoiding bars or anywhere that triggers an addiction.  Saying, “Thanks for taking your meds lately.  I really hope they’re helping” is actually a nice, comforting thing to hear, and a reminder that someone’s got our back.

 

update:  thank you to all my friends and family who have been supportive and encouraging and have stood by me through all of this without making me feel any guilt or shame.  Because of all of you, I wear short sleeves in public (and a bikini when I go swimming!) and am learning not to be ashamed just because I have Bipolar II.  Thank you to anyone who has helped me see that mental illness is a physical illness and needs to be addressed and talked about.

 

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August 1, 2014 - Posted by | addictions, bipolar disorder, Communication, coping, depression, Eating Disorders, family, feelings, guilt, heart, progress, recovery, relationships, responses, self harm, shame, suicide, therapy

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