Wednesday, September 20, 2006

Putting myself under the microscope

Med students are famous for imagining that they suffer from the disorders they study; it's a form of hypochondria. I know I don't have hypochondria, because I'm actually sick -- I'm living with a disorder. And I learn about my illness almost every day in class.

It's painful sometimes. Tonight in "Introduction to Cognitive Therapy" we reviewed beliefs and other cognitive processes that people with depression experience. And I saw myself in almost everything. The thoughts I had prior to my suicide attempt? They derived from my core belief (a foundational concept of cognitive therapy theory; core beliefs influence all your other beliefs and behaviors) that I was a failure and didn't deserve to live. As I said in my first blog entry,

The night I overdosed, I couldn't fall asleep. Schizophrenia is hearing voices that don't exist. Depression is hearing your own voice in a relentless wave of criticism -- "I'm a failure. I'm lazy. I'm almost 30 and still not married. I'll never get married. I'll never have children. I'll never have a normal life. I haven't achieved anything worthwhile.

"I don't deserve to be alive."

That last sentence was implicit in everything I was telling myself. I didn't express it directly, but it underlay my whole miserable outlook.

It's unsettling to watch a professor talk about "them" -- the clients -- the maladaptive way they think and behave, and blithely assume that you're not one of them. Even if the prof is talking about ways to understand their feelings so you can develop empathy with these clients, and sincerely believes that they're suffering. It's still us vs. them, but I'm both.

I was also struck by the concept of strategies that people adopt to help themselves cope with upsetting core beliefs. Say you're an insecure person and think that people don't like you. To cope with the distress produced by this belief, you try to come up with strategies to get people to like you. For example... you might tell jokes in class, meetings, slow-moving city buses, etc. Again: I'm looking at myself under the microscope.

In some ways I think having a disorder will make me a better psychologist; I probably know better than anyone else in that classroom what it feels like to be sick. (Unless they're also on medication.) And I've definitely got a lot of insight into myself, which is essential for a therapist; you have to be aware of your own feelings and reactions in order to understand other people's issues; otherwise, you might assume that your problems are theirs.

But it's difficult, sometimes, having to read about myself in a textbook or listen to a professor talk about me in class. And because I'm not "out," I can't talk about how this makes me feel with anyone at school.

That's why sometimes, between classes, I run to the computer room and blog. I guess I'm putting this material out there so that someone will read it, and understand, and empathize.

I wonder if I need to be back in therapy. The writings about cognitive therapy make it seem like it can cure depression. Would it be possible for me to go off my medication someday? I have to talk to my psychiatrist about that. And maybe Dr. Leahy, if I do end up doing my externship with him.

I hate taking medication. I've considered electroconvulsive therapy, aka shock therapy, but it has serious cognitive side effects, including permanent memory loss. (If I could choose which memories to lose, though, I'd sign up in a heartbeat.) I've also wondered about using a vagus nerve stimulator, but that involves brain surgery, and I don't think my depression is considered serious enough to warrant that. If I could really cure my depression through talk therapy, I'd be the happiest girl in the world.

They say that the most well-adjusted people in the world are cognitive-behavioral therapists, because they're continuously practicing the principles of dealing adaptively, rather than dysfunctionally, with stress. Maybe becoming a therapist is the best therapy for me.
Copyright (c) 2006 "Ayelet Survivor"

1 comment:

  1. old HS friend9/22/2006 1:35 PM

    CBT can be very helpful with depression, if you really put in the work and challenge your lifelong core beliefs. Ayelet, you have doubted your purpose all of your life. Let yourself accept what your nieces and friends know -- the world is a better place because you have been here. You would be missed. Then stop questioning your existence! You belong here as much as any Dr. Jerk, with or without a PhD.

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