Friday, April 20, 2012

What's your destination?

Earlier this week, I wrote about being on a new path. I told you about a new focus on treating my chronic depression that would include a new kind of therapy.
I didn’t write about where that new path would take me, though. I didn’t really think about my destination, except for my hope for remission.
Some of you who left comments to that post included references to healing, and my therapist used that word also.
So what would healing look like for me? How would I recognize healing when I saw it?
First of all, I decided that I would view healing as a process and a journey. I know it won’t happen all at once. I won’t wake up one morning and find myself in remission from depression or from obsessive-compulsive disorder. I know healing will never actually end.
I know that depression and OCD will always be with me, but I can work to make them have as little negative impact as possible.
I also decided to keep some words in mind as I journey along. In Roget’s 21st Century Thesaurus, three synonyms for heal are repair, restore and make whole.
I have ways of being and acting that need to be repaired. I need to be restored to a place where I recognize my very essence and its value. I need my life to be made whole so that all my “parts” are integrated and in harmony.
I am going to use those words to instruct and inspire me.
But what will my life look like as I move towards healing? What markers will tell me I’m moving forward?

Depression

During the therapy session when my therapist told me he thought we needed to focus on depression, he grew a diagram for me to give me an idea of where I was headed.


I’m not going into the detail that he did, but here are the basics that he told me.
This diagram looks at power. On the vertical continuum, there’s dominant and passive. Dominance tends to draw out passivity, and passivity tends to draw out dominance.
The intersecting horizontal line represents hostility and friendliness.
Broadly, there are four quadrants: dominant hostility, dominant friendly, passive hostility and passive friendly.
People who are chronically depressed usually spend a lot of time in the passive hostility quadrant.
The quadrants can be divided up. Where my therapist said I would be headed is to a friendly assertive state.
Specifically how would my life look different with depression in remission? Here’s what I came up with:
  • I would have interpersonal interactions that were honest and didn’t hurt the other person or myself (by stuffing anger and hurt, by feeling helpless).
  • I would be confident that I could handle what life brought to me. People with chronic depression tend to think, “No matter what I do, it won’t help.” I would no longer attend to that kind of thinking.
  • I would participate fully in life and do the things that reflect my priorities.
  • I would see each day as a gift, not as something I just need to get through.
  • I would have the energy to accomplish what I wanted and needed to accomplish.

OCD

  Sometimes my doctors ask me about my OCD symptoms. What percentage of OCD has been relieved, they ask.
That’s hard to answer. It’s difficult to see my time and my effort in terms of percentages.
So here’s a picture of OCD repaired to the degree that it would no longer control what I do:
  • Most days, after doing my best, I wouldn’t check to make sure I’d completed such tasks as turning off the lights, turning off the water faucets, closing the closet door, locking the front door, etc.
  • Most days, I would read a book without rereading needlessly.
  • Most days, after doing my best, I would let go of my writing without fear of having written something wrong or untrue.
  • Most days, I would have no clutter around me because I would have filed away and put away what I needed to.
  • Most days, I would be able to cook a meal and clean the kitchen without safety, checking and contamination worries making it nearly unbearable.
  • Most days, I would be able to turn my attention away from obsessive thoughts.
  • Most days, I would resist compulsive urges to relieve anxiety.

Anxiety

I have generalized anxiety disorder that makes me tense much of the time. My life without the rule of anxiety would look something like this:
  • Most days, my jaw would be relaxed.
  • Most days, I would face daily stresses and changes with humor and calmness.
  • Most days, I would be energetic and not feel drained.
  • Most days, I would pay little or no attention to fearful thoughts.
  • Most days, I would be able to keep worry at bay.
  That’s where I’m headed. I have a lot to do, and I’ll never reach perfection. But that’s OK. I’m not supposed to.
  I’m grateful for what I’ve accomplished so far on the journey, andI’m glad to be continuing on the path.
What is your destination? How do think of the journey?

25 comments:

  1. Tina,
    Healing is wonderfully powerful and freeing and it brings many new opportunities you never imagined existed! Keep you eyes wide open to the possiblities!

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    1. Powerful and freeing sound good! I'm excited by the possibilities. Thanks, Tracy!

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  2. Wow - great post. I think it's awesome that you've quantified what healing will look like for you. It seems like you've picked reasonable goals, as well. That's good that you recognize these things will probably occur on "most days." Even people without OCD, anxiety, and depression have some bad days.

    I think of the journey similarly. I actually feel like I've reached some of my destination. I no longer walk through my days feeling like my arteries will burst from stress. The world is no longer a frightening and painful place. In fact, I find now joy in the simplest little pleasures. It's like scales have fallen off of my eyes, and I like what I see. You use the word grateful and I think that word could not be more appropriate. Gratitude. It's at the base of everything in my life today. When every little thing is no longer agonizing, it's pretty easy to be grateful for the small things in life. The best part is that I finally feel like I am truly able to pursue the things in life that I care passionately about. Thanks for asking this question. It gave me some good food for thought.

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    1. Sunny, I absolutely love the way you describe your transformation. I am so glad that you are out from under the worst of the heaviness of OCD and depression. Your story is helping and will continue to help many other people. Thank you!

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  3. Tina, Forgive me if I'm getting too personal but I was wondering, are you taking any medication for your symptoms? I had horrid anxiety/depression and PTSD and a mediocre case of OCD. The medications I'm taking now have made a world of difference. Of course I would never, ever discount the merits of the cognitive therapies. I wonder where you're at on the idea of medication.

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    1. Grace, No, that's no too personal. I appreciate your question.

      Yes, I'm on medication. I've been on meds for OCD and depression since I was 26, and they have made a world of difference. I've been on different ones, and am now on a combination that is good for me.

      Which probably sounds strange, since I write about my depression and OCD. The thing is, the medication doesn't do it all for me. And the depression and OCD are such that I know they are directing some of my life decisions, and I don't want that anymore.

      Am I as bad off as I used to be? No way. My OCD is nowhere near as bad as it was before medication. I was in a living hell then. Truly hell. And my depression is tremendously better. I have been suicidal and felt like I was surely sinking into dark water, unable to get out and not wanting to get out. My life is so much better than it used to be.

      But I have that underlying depression, and it sometimes dips lower, and I was discovering that OCD was subtly keeping me from living fully. I was avoiding a lot because of it.

      I resisted CBT for my OCD for a long time, but decided to do it and it has helped. So did the book "Brain Lock," which teaches cognitive steps to take to accept the anxiety while refusing to give in to the OCD. Actually, my therapist uses a variation of that therapy for OCD.

      I am hoping the therapy for the depression will lift me up beyond what the medication has done. My therapist said I'll always be on medication, and that's OK with me. It has been a miracle for me. And he said the meds provide a "floor" on which to build up. He also said that regular CBT is not effective with chronic depression, but the CBASP is. Apparently, chronic depression is difficult to treat with JUST medicine.

      I am a believer in medication as an option for people to consider. I am not ashamed of it, and I take issue with it being considered a "happy pill" or a crutch. It's a tool, just like CBT. I have physical abnormalities in my chemistry that make me this way.

      I'm glad that you've been helped by medication too! Thank God for medications that help like that.

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    2. Grace, Let me add that for many years, I tried not to think about my depression and OCD. I felt like things were "good enough." I didn't realize that a lot of negative things in my life were stemming from the mental health issues.

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  4. Tina,

    It sounds like you've set some very achievable goals. Especially with OCD, it seems like there's a tendency for us to want to be perfect. Being able to enjoy yourself, have friends around you - those are great things to work towards.

    I thought I'd share with you something my new doctor told me. He said that the goal for OCD therapy is not to eliminate X ritual, or stop Y compulsive behavior. Instead, he said the goal was for the patient to be happy. I've puzzled a lot over these remarks, because happiness is something amorphous. In many ways I'm happy now: the practice of getting better little by little offers many rewards. And though I'm not where I'd like to end up, I am happy every time I conquer a small ritual or fear.

    I truly hope the best for you in this process. It seems like you've got a good deal of hope and courage, which is wonderful. I'm keeping you (and all the other OCD bloggers out there) in my thoughts.

    S

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    1. Sarah, Thank you for your kindness! That's interesting--the goal is to be happy. I can understand that in the sense that with OCD, we're usually having trouble seeing the forest for the trees. We're so focused on the individual obsessive thoughts and compulsions, we lose sight of what a whole life would be like. Thank you for sharing that--food for thought!

      I hope you are doing well. Every small step is important, and I'm rooting for you !!

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  5. My "healed" anxiety list would sound very much like yours. You can do this! I know you can. Stay strong and always remember that you are braver than you believe, stronger than you seem and smarter than you think.

    Also, I recommend reading "Eat, Pray, Love" if you haven't already. Even though my religious beliefs conflict with it entirely, it was still a good read and there were a lot of helpful suggestions. Making use of the phrase, "Ham Sa", for example.

    All the best!

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    1. Alisha, I loved "Eat, Pray, Love"! It was very helpful and inspiring, though, like with you, some of it conflicts with the way I would do it.

      I am finding that mindful meditation is helping me more than I ever thought meditation could. I've tried it many times, and I think I've finally let go of wanting to be perfect at it and it's helping.

      Thank you for your encouragement. It helps so much!

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    2. Oh, man. Letting go of wanting to be that "perfect person" is something that will DEFINITELY help overcome anxiety.

      That was always one of my biggest onsets. I am a child of divorced parents and I have spent my entire life trying to please both sides of my family. (The characteristics of my families are polar opposites too, just FYI.) It wasn't until I stopped trying to please everyone that I was able to get to a point where I could semi-control my anxiety.

      I still struggle terribly with it, but I'm not as embarrassed by it anymore.

      Just keep on doing what your doing, and know that you have a great support system to cheer you on! :)

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  6. I know you can do it! And keep on writing. You're very talented, lady!

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  7. Ok, mine has been a long journey. It is hard to be thankful sometimes because I still have such a long way to go..however, I have come so, so far and I just have to remember that. If I don't, my kids sometimes remind me. :) (I was in a very dark place at one time and now I enjoy life) Occasionally I take a few steps backwards (the whole waxing and waning of OCD) and that's when I have to remember that it can get better, and it always does.
    I would like to be OCD free, but realistically I know that probably will not happen unless there is some miracle cure. If as "good as it gets" is how I am today, literally, which is less than 2 hrs. a day symptoms then I still have many waking hours to enjoy.
    So my dream would be to take less than 1 hour shower; to me a ritual free 10-15 minute shower would be awesome. And barring that, I will settle for normal handwashing..whatever that is, cause I think I lost track of how to do that anymore. That is all I want. The rest I can deal with.
    You write your goals so beautifully. I tried to do something simular with the OCD Workbook and it just overwhelmed me.

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    1. Krystal, I love your attitude! You see the glass half-full--even if you have some OCD symptoms, there are a lot of hours to enjoy. Wonderful!

      My OCD waxes and wanes, too, but I, too, am much better off now. I think I'll always have some OCD manifesting itself, too. I'm just trying to get it down to a minimum. Your goals are very specific and, I would say, achievable. I'd like to cut down my shower time too. A lot of "little" rituals makes it too long.

      Perhaps you could start with those goals and then move on to others. That might help with the sense of overwhelming. I tend to get overwhelmed very easily and sometimes have to pull back a little and bite off a smaller chunck.

      Thank you so much for kind words!

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  8. Thank you for such an insightful blog entry. I think a lot of us have anxiety of some sort and OCD too. I think myself and one of my second cousins are similar in our patterns of doing dishes. A coworker of mine had told me that she became particular when her Mom made her wash a dish twice if she used a certain dish cloth to wipe a dish, as she had special ones that were for dishes and recycled ones for the counter. So who knows where and at what point in our life we pick certain habits and whether or not genetics matter.

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    1. Munir, I wonder about genetics too, and the whole nature/nurture debate. I think our backgrounds can affect how our OCD obsessions and compulsions play out, though they are based on the same basic fears and uncertainty. Dealing with those fears and uncertainty are the main things.

      Thank you for coming by and commenting!

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  9. Wow, how wonderful to have such concrete goals laid out! I think all of your goals sound excellent, and I have no doubt that you can reach them.

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    1. Thanks, Lisa. I need to print them out to look at everyday!

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  10. Your progress Tina is wonderful. Your description of the healing you are heading to and expecting is great. we can never expect a full quick healing and recovery as life will always send us surprises we need to deal with.My destination is to go Home, and be able to tell God: I did the best i could.

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    1. Nikky, Same for me. I hope I can someday say to God, I did my best. That's all that any of us can do.

      I've been enjoying your blog posts about your mother!

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  11. You really break it all down so well in this post.

    I love how you say a day without anxiety would be a day your jaw would be relaxed. I am dealing with a tight jaw myself today.

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    1. It's one of the hardest things to do--get that jaw to relax! I try to remind myself of that saying, "Lips together, teeth apart!"

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