Tuesday, June 23, 2009

Sometimes there are no explanations and no answers

Someone recently said to me, “Sometimes there are no answers and no explanations” – and I took that statement and I “saw” it, and “heard” it, and “smelled” it, and “tasted” it, and “touched” it…I tried it on and looked in the mirror – and it didn’t quite fit right on me. It had a bit of a vinegary taste to it, and it looked and smelled like a rain-soaked dog. The touch of the statement was rough, like a low grade sand paper and as I took the statement off, and placed it back into the box, I found myself wondering: If, in fact, “there are no answers and no explanations” then perhaps we are not asking the right questions…It seems to me that the MHPs think they “know” how to treat us. Of course there are different types and styles of therapy, but by what is *offered* - it seems to me as though from a clinical perspective, there are answers and explanations for everything that’s done in “treatment”. There are drugs that ‘answer’ symptoms, and there are explanations for each clinical diagnosis, there’s DBT for those of us who exhibit unacceptable behavior. I do think there is a missing piece though. I think the missing piece is that there are so many survivors who have tried on many different therapy types, techniques and therapists…they still haven’t found a good fit. Maybe the color is wrong, or it doesn’t quite fit right. And there are times we buy it anyway, take it home and try to make it fit – yet, we’re never quite comfortable…something just isn’t right –the jeans make our butts look big, the shirt shrunk when we washed it…But we buy it because that’s what we’re offered. The manufacturers don’t seem to care – they don’t send out survey’s or evaluations, they don’t poll their ‘buyers’ – they assume, almost in a flagrant way, they know what’s best. After all, they are the ‘experts’ – they know what *should* fit and feel *comfortable* - for us, we certainly don’t know. Why, we have no idea! We grew up in abusive homes, have no sense of normalcy…we have ‘maladaptive’ personalities and behaviors – and they have the treatment to save us, not ‘cure’ us, but to at least keep us alive.But when it comes right down to it…if you do your homework – there is very limited research, or studies that have been completed. I haven’t lost hope – from what I’ve read it appears as though the limited treatment and research findings evolve constantly – and what may be considered ‘this’ today – will, in fact, be ‘that’ tomorrow.But although I haven’t lost hope, at times I still shake my head that the majority of the clinicians don’t realize that WE are in fact, the ‘experts’, not them. We are the ones who have lived through it. And truly, as much respect as I have for DT, who has put up with a lot (and I mean A LOT!) from me, it isn’t she keeping me alive, it’s me.

And if, by some miracle, a clinician were to call me, I would tell him/her this: You might think that the answer is DBT, that we have no “emotional skin” – that if we can just shut up and behave and ‘change our thoughts – perhaps ‘half-smile’-or become Buddhists and ‘meditate’ or ‘mindfully wash a dish’~ we will be well- but it doesn’t work. I would elaborate by saying that the mindfulness exercises of ‘peeling an orange’, or ‘studying a flower’ ~ using our 5 senses to ground ourselves in the present…isn’t the answer, it doesn’t really work to ‘distract’ and ‘calm’ ourselves all the time. Sometimes we can stretch, watch Ellen Degeneres & Chris Rock, back to back – listen to soothing music and repeat the 5 sense exercise for an hour. We can go down our “list” of emotion regulation skills, and positive self-talk, and distraction – and there are times when we still can’t stop the emotional pain, the flashbacks. Yes, believe it or not, there are times when we cannot proactively identify a trigger – and there really are times when eating a peppermint will not bring us back to the present from the past. Sometimes – we can check off everything on the list and it’s all still there~ and it rolls us into a cocoon of pain, anger, sadness, and fear. And that’s when we turn to list # 2 –
and list # 2 is where the self-injury, the booze and the drugs are - and it isn't because we are 'manipulative', and it isn't because we aren't "trying" hard enough- it just IS the only option left. We are all different ~ and yet we are all alike...but stop lumping us all into a "one-size fits all" group. We need you to listen to us, respect us, and treat us each as individuals. Irvin Yalom, M.D. calls it, "Therapy designed for each individual" - don't herd us into a DBT group with Marsha Linehan as the Leader Cow - guess what? Some of us find her offensive and flippant with her responses to how WE should "deal" with our emotions - what does she know about surviving what we survived?

It's no different than 'trouble-shooting' a problem with an electronic or a car. You work your way down the list and when nothing works, you "reboot" or deem it irrepairable...a 'lost cause' (which, I think some clinicians see us as irreparable and lost causes - but we aren't). And unfortunately, there's no way to 'reboot' us...can't turn us off, replace the motherboard and start over - I wish it did work that way, but it doesn't.

It just doesn’t….
So ASK US! We WILL tell you!

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