Thursday, November 24, 2016

The introduction to my book

This is an incomplete memoir. I won't be delving extensively into my unhappy childhood, angst-ridden adolescence, or confused young adulthood. While I'll allude to seminal events and phenomena from those days—my father dying when I was five, being bullied in elementary school, sibling rivalry, college highs and lows, ten years of aimless career surfing after graduation, being diagnosed with bipolar disorder, a suicide attempt, and a dating life that makes Taylor Swift look like Gloria Estefan—I'm focusing primarily on personal and professional anecdotes from my life after I decided to become a mental health clinician in my mid-30s.

Having bipolar disorder has made me both a better and a worse clinician. On the plus side, I know many symptoms inside and out and can normalize clients' experiences very effectively. I know the side effects of many psychiatric medications because I've taken them. I can instill hope because I know treatment can work and recovery is possible.

The downside is that my own dysphoric mood and anger can impede my interpersonal effectiveness, both with clients and co-workers. I've learned that even if you're competent and creative, expressing anger or emotional chaos at work will get you fired—in my case, more than once. Behavior that appears out of control will get you dumped by even the most patient boyfriend—in my case, more than once.

While I've finally found an exceptional psychiatrist and therapist, having an excellent pit crew is only part of the battle. You won't win the race unless you hone your driving skills—you'll crash and burn. That's a NASCAR metaphor for emotional self-regulation, something I struggle with every day.

For about 10 years I wrote a blog under the pseudonym “Ayelet Survivor” that I taglined “My life as a single, Jewish mental health professional who suffers from bipolar disorder and a keen sense of irony.” I explored my experiences with graduate school, working, dating, sex, and my religious observance, which waxed, waned, then more or less collapsed. The personal anecdotes in this book are drawn from that source and from my twitter feed, which as of this day has about 230 followers. There are more than 1300 blog posts and 7000 tweets, so obviously I've picked and chosen selectively. Feel free to visit the blog (or @ayelet_survivor on twitter) for a window into my brain at any given time.

In April 2015 I was asked to contribute an article to a now defunct online e-newsletter (“CBT for schizophrenia? You don't know Jack”). After I posted it to my LinkedIn profile, I was pleased to note that more than a few people were reading it, and decided to start writing anecdotes about other clients. After about 10 posts, some of my friends started saying, “You should write a book. You're like the social work Oliver Sacks.” Well, one friend said it, and I was hugely flattered.

I was also asked to contribute to the Chronotherapy blog on, which gave me the first opportunity to merge my professional and personal writing. I detailed my experiences with insomnia and seasonal affective disorder, and also wrote about other individuals' struggle with insomnia and other circadian rhythm disorders.

I've always loved writing. My personal blog was a tremendous creative outlet for me as I adjusted to a clinical career after more than 10 years of publishing and editorial work. I wrote poetry, stories, and plays as a child and young adult, which developed both my skill with language and my conviction that my true milieu is nonfiction. Nowadays I write progress notes, employee evaluations, and reports. Occasionally I'll bust out a villanelle or free verse poem, and I'll include a few in here.

I'm also committed to advocacy. Even before I became a social worker, I've been trying to explain the reality of mental illness in order to diminish the tremendous stigma that accompanies most media depictions. For a while I wrote numerous letters to the editor, which the New York Daily News was often kind enough to publish. I've engaged with the National Alliance for Mental Illness's efforts to provide a counterbalance to stigmatizing movies, television shows, and news coverage. On my blog I tried to portray my struggles with a sense of hope that it's possible to have a decent, even good life while managing a chronic psychiatric condition.

Most recently, I've been entertaining my Facebook friends with a series of updates that explain what circumstances will cause me to reject a man's Bumble or Tinder profile. More than one has asked, “When's the book coming out?” So I decided to include those, along with other dating anecdotes from my blog.

I also learned recently that I'm a survivor of emotional incest. For most of my life I didn't know that existed or that my experience with it had traumatized me. I just knew I was an emotional mess, sometimes more than other times, and that despite psychotherapy and medication, my problems persisted. As I write this introduction, I've just started a new kind of therapy to address this aspect of my life. It's an evolving story.

Friday, October 28, 2016

Ayelet comes out. In the Bronx. Does that count?

On Thursday, October 20, I flew to California to participate in a weekend of healing for survivors of sexual trauma. It was amazing, and I can't really write about it. Too huge. Very glad I went.

I landed the next Monday morning and stepped into a whirlwind of activity. Classes, conferences, meetings, I was all over the place. And that Thursday, I went to a conference at the Bronx VA.

The topic was holistic mental health recovery. Attending were clinicians, veterans, and peer specialists--people with lived experience of mental illness who then work with other people dealing with mental illness. They spoke openly and frankly about their struggles, side effects, and experiences as patients in a system that thinks eliminating symptoms is enough.

It's not. Recovery is about having a full like you enjoy, with friends, a nice place to live, and meaningful activity (paid or voluntary). And the psychiatrist on the panel kept droning on about how people with mental illnesses need to take medication, some people who have bipolar or schizophrenia, they need medication, blah blah blah. The peer on the panel respectfully noted that psychiatrists minimize even quite draconian side effects.

I raised my hand.

"I'm a clinical social worker, and I've spent a lot of time discussing side effects with clients," I said. "Mainly because their psychiatrists haven't. We don't have perfect medications, but we do have more than one option. I take three medications, and they work--pretty well. But not perfectly. Psychiatrists need to maximize the client's quality of life. If they gain weight on Zyprexa, give them Haldol with Cogentin! Think outside the box!"

Did I just come out as someone with a mental illness?

I was exhilarated and terrified, which involve very similar physical reactions. My heart was pounding; my head felt light; my breath was quick and shallow.

Did I just tell a room full of strangers and clinicians and colleagues that I have a mental illness?

Fortunately, they were the second to last panel, and the last panel was brief. After the conference concluded, I went up to the organizer. He's been trying to get me to go to one of his events for a while; after having to cancel twice, I finally showed up. How would he react?

With warmth. And a smile, and a handshake with a slow firm clasp. "Thank you so much for coming today," he said meaningfully. "Will I see you at the event on November 4?" (Sponsored by a different veteran organization.)

"I'll be there," I said. He smiled again.

The reaction was similar from the social worker who runs the local VA's suicide prevention/crisis line. "I'm so glad you spoke up," she said.

"I felt like I needed to," I said. "The peers were so brave and honest, sharing their experiences. I felt like I needed be honest as well." She's also looking forward to seeing me on November 4.

I'm not sure who else I'm going to tell, or when. But when I publish my incest article, I will use my name and photograph. One of the other survivors on the weekend is also a writer. She introduced me to World Pulse. I can tell my story there.
Copyright (c) "Ayelet Survivor"

Tuesday, August 23, 2016

Presumptuous as Hell

When you work for city or state government, it's often perceived that your salary is decent, your benefits excellent, and your job security rock-solid. I'm happy to report that my salary is excellent, my benefits are decent, and my job security is pretty good for someone who's not in a union. I can state unequivocally that I love my job.

Either that love shines forth from my LinkedIn profile like a beacon or people see where I work and think, "I could do that." I get a lot of requests to find people jobs. Once the landlord of a newly housed veteran asked me if I had any positions open for a friend of his, a social worker who didn't like her job. (I had called him becaues he was having some issues with his tenant.)

"Does she have any experience working with homeless veterans?" I asked.

"No, but I bet she'd really like it," he replied. After a moment he added, "You know, I know another guy who's really smart. He's not a social worker, but he's very smart and capable. Could you use a guy like him?"

For what? was my initial thought, which I kept to myself. I wanted to stay on good terms with the landlord, so I let him know the drill: sign up for a list and wait, wait, wait.

Anyone who actually works for the city knows that getting a city job is never a simple matter, especially for unionized positions. It often requires getting onto a civil service list, which is a matter of timing and luck. And people on those lists might wait years to be called for a job interview. I was lucky: I responded to a job ad for a newly created position within a newly created department, and waited only 16 days between interview and job offer. (And then waited about five more weeks for my start date, which felt glacial to me but for government jobs is blinding speed.)

Apparently many people subscribe to the belief that if you're the recipient of good luck, you should pay it forward by helping them get a job. I don't think they intend to be rude, but it's rather presumptuous. The morning before I spoke to that landlord, an acquaintance on Facebook accosted me:

Hey! I'm looking for a job. You should just hire me it'll be fun

He's the brother of someone I used to supervise. We talked about getting together for a drink, but it never happened. He's cute, but not very bright. Even if I were looking to hire, which I emphasize I am not, I wouldn't hire this guy. But I'm working on my tactfulness, so I didn't overreact.

Not in a million years ;) You wouldn't like working for the city. Tons of bureaucracy

That's diplomatic, right?

Aww boo but ok. What agency are you with ?

Persistent little bugger. But I told him which agency. He responded:

In the Bronx? Why can't I handle that

Not in the Bronx, that was my last job, which he would have known if he were actually paying any attention to my Facebook feed. Still, I tried to be diplomatic, because karma.

My program isn't hiring right now. I'm not sure if the agency is looking for case managers, but you have to take a civil service exam and be on a list for years before they call you

I hoped that would discourage him, and it did. Haven't heard from him since.

At least this guy has met me in person a few times and we used to work for the same agency. Recently I got an email from someone whose connection request I had hesitated to accept.

I hesitated because he's fairly junior, and at this point, not to brag, I am not. I was wondering if he was just connecting so he could mine me for contacts and job prospects. Against my better judgment I connected anyway, and the next day he sent me this:

Good evening Ms. Survivor, I'm very interested in clinical work with veterans. I was wondering if you know of any clinical positions available. Thank you, {name redacted}

I don't think he realizes how incredibly rude this is. I don't know anything about him aside from what he's posted on LinkedIn. If I were going to recommend someone for a position, it would only be someone whom I know well and trust not to make me look like a bad judge of skill or character. I can't say that for him.

I'm genuinely happy to help people I know and trust. Recently a recruiter emailed me asking to discuss a position as Deputy Director of Behavioral Health, offering a six-figure salary. Even though I love my job, I figured I had nothing to lose by talking to him. Turns out the job isn't right for me, but it's perfect for a former colleague; I called her and sent her the recruiter's contact information.

But I don't know this new connection. I've never seen his work. I don't know if he's a good person. Why on earth would I risk my reputation to recommend him for a job? I thought about responding to him along the lines of,

Listen, this is not how you network. You don't send an email to someone who doesn't know you and ask for a job. You get to know a person, and they get to know you, and then if they feel comfortable recommending you, they will. You come across as horrendously unprofessional and presumptuous.

But it's not my job to fix him, and I think that just ignoring his request will send the right message. If it doesn't, I can always block him.

This should teach me not to accept connection requests from junior-level people I don't know. If that sounds horribly pragmatic, well, it is. I got another connection request a week ago from a psychiatrist who's worked with veterans for 25 years. Hells yeah I accepted! But no more brand new starting out unknowns.

I've been used by enough men in my time; I don't need to extend exploitation into my professional life.

Copyright (c) "Ayelet Survivor"

Saturday, July 09, 2016

Aunt Luba drops a conversational cluster bomb

Two nights ago my Aunt Luba called to let me know she was sending me a sizeable check. Not because she thinks I need it, but because she loves me and wants me to have something before she dies. So the government won't get it, I guess.

We talked about my estrangement from my mother because she still lives with and adores the degenerate pervert. "I can't go to family events and see her," I said.

"You know, I was abused as a child, too," said Luba. "And had to see that person at family events."

WOW. During the ensuing shocked silence, I struggled to think of what I couldn't ask her. Who it was, of course; when and what happened; and if it happened to my mother too.

I bet it happened to my mother too. That's what the Prominent Sex Addiction Expert thought. Incest happens not only because fathers/father figures commit it, but because mothers/mother figures don't stop it, don't see it as wrong, or don't "see" it. They don't consciously ignore it--they're too emotionally distant to acknowledge it.

This verges into psychoanalytical territory, an area that is somewhat foreign to me, but it must be true. Because that's what happened. My mother knew the degenerage pervert tried to have sex discussions with me. He even tried in front of her. She told him to stop, but I don't think he stopped. She knew what was going on and she ignored it. Maybe not consciously. I'd like to think not consciously.

But if she was molested, or incested, then I can see why she doesn't think what happened to me was abuse. My Aunt Katya agrees with her.

Katya called me, and I spoke with her. We've always had a good relationship; she's always supported me. So I thought I could tell her what the degenerate pervert did, and name it as incest.

She said, "Oh, c'mon!"

That's a punch in the throat.

I tried to explain the terrible developmental consequences that kind of pornography exposure has on a teenage girl. She said, "Well, it might have felt like abuse, but it doesn't sound like abuse."

I feel very alone right now. I participate in a Tuesday twitter chat (#sexabusechat) which helps, but I desperately want a support group of women survivors of incest.

I went to a meeting of Survivors of Incest Anonymous, and the rigid 12-step format felt uncomfortable. As did the mandatory praying and chanting. (Well, you don't have to join in, but the chanting is all around you.) You can't talk about each other's experiences--you just listen as everyone speaks. I tried to say, "Like many of you, I have family issues" but was cut off: "We don't discuss what other people share!" But that's what I wanted.

Although listening to the others, I was relieved to learn I'm not the only person in the world who doesn't talk to her mother and sister. And none of them judged me. Which had to be validation enough, at least for then.

PSAE suggested I go to a survivors' weekend, which might be a good idea. It's a shame that there are survivors in my own family but I can't talk to them about it. I wasn't even sure I could blog about this. Some people would probably say that's a violation of Luba's privacy. But even though it's her story to tell, this kind of secrecy is what allows the abuse to continue. What allowed abuse to become part of my story and damage my life.
Copyright (c) "Ayelet Survivor"

Thursday, July 07, 2016

I feel like an elephant: another poem

It's hot, and I feel like an elephant,
massive and lumbering.
Elephants are emotional
creatures, loving touch and contact
with their own and other species. Elephants
are loyal, weeping when bereaved. Elephants enraged 
can charge and stomp, but never unprovoked. 
At least I hope it's never unprovoked. When I stomp
I'm usually not as destructive externally.

I feel like a hippopotamus, 
clumsy on land, barreling along
on stumpy legs. But hippopotamuses 
are elegantly graceful in their element, which is water.
Mine is supposed to be air, but somehow
I'm rarely graceful in it. So I wish
I were more like a hippopotamus.

I feel like a whale. Or I wish I did.
Whales are incredibly powerful, with
an amazing sense of smell, sense of self.
Whales can swim with their eyes open in the ocean.
I can't do that, it stings me.
Whales travel in pods, whereas I seem to run through friends
too quickly, either discarding those
that ultimately annoy more than companion, or 
detaching, sadly,
from all those who join new pods.
Facing the constant hunt and chase and acquisition
of new whales who can resonate at my
own frequency, just like the whales who drifted away
to love and cradles, backyards and the suburbs.

Copyright (c) "Ayelet Survivor"