Monday, October 30, 2006

Weird Al should get a Nobel Prize

I am fed up with studying for midterms, and since the only one I have left is a take-home that I have not yet received, I'm completely unmotivated. I'm also in a lot of pain from my knees, and so the normal things I'd do to blow off some steam, like taking a walk, don't seem advisable.

So I'm hanging out on youtube a lot. It feels kind of pathetic (a friend of mine told me last week that he could spend hours on youtube, and I told him he shouldn't spread that information around too much), but it's a good distraction. Especially because you can get music videos on it, which you can't really do on MTV or VH1 anymore.

And one of the artists I'm searching for is Weird Al Yankovic.

I call him an artist because good parody is an art form, and his parodies are brilliant -- meticulous attention to detail, diabolically clever lyrics.

I've had so much fun watching Gump, Amish Paradise, Fat, Smells Like Nirvana, White & Nerdy, The Saga Begins, and so on, that I decided to write Al a letter:

I just wanted to say your videos are extremely therapeutic, and I mean that literally.

I am getting a doctorate in clinical psychology and am also a survivor of bipolar disorder and a serious suicide attempt. Thanks to great medical care and the love and support of family and friends, I'm thriving, but I still struggle with the disease every day.

I've been having a really tough time lately, between school stress (I'm in the middle of midterms) and the rest of my complicated life, including a serious knee injury. Being a single girl in New York City is far from easy even when you don't have bipolar.

I just got DSL, so I checked out your video "White & Nerdy" on youtube. Then I watched a bunch of your other videos. Before long, I was in a much better mood.

I know that when you lost your parents, much too early, you said that you had to keep performing or you'd be unable to cope. I just want you to know that your music is helping me cope as well.

Laughter is the best medicine.
Copyright (c) 2006 "Ayelet Survivor"

Sunday, October 29, 2006

Peter Pan got it -- why can't the faculty?

Never ascribe to an opponent motives meaner than your own.... We tend to judge others based on their behavior and ourselves based on our intent. In almost all situations, we would do well to recognize the possibility -- even probability -- of good intent in others.... sometimes even despite their observable behaviour.

J.M. Barrie (quoted in Stephen M.R. Covey's The Speed of Trust, excerpted in O: The Oprah Magazine, which I enjoyed a lot more than I expected to)

I was an English major in college. I think that the great authors were more astute observers of behavior and judges of character than almost any modern psychologist or psychiatrist. Novelist and playwright J.M. Barrie is but one example. Decades before Lee Ross formulated the fundamental attribution error, Barrie nailed it.

And the faculty simply doesn't get it.

But: I have to stop harping on that. This post officially ends my kvetching about how the evil faculty has it in for me. (I reserve the right to post more about Dr. Jerk should he manifest something really egregious.) It will just make me more defensive, and they'll judge me even more harshly. More important: it's not helping me.

Yes, they have no right to judge me. Yes, I have every right to be in the program. But I can't obsess over the temerity they had in telling me, one month into the program, that my boundaries are loose.

Keep your eyes on the prize, says my psychiatrist. I didn't want to hear it, but I need to. All I need to do is pass, get my degree, and get out of there. I don't need to make the faculty love me. They just have to let me finish.

Besides, I'll do better not only professionally but personally if I choose to be optimistic. Optimistic people live longer and healthier; people who obsess and ruminate about the negative things in their life -- i.e., pessimists, i.e., Ayelet -- get sick and die younger.

Optimists also go further in life; there's no denying it. It's fine to be right, but it's better to get along. And I had some evidence this weekend that a little social grace goes a long way.

I was walking home from dinner with a group of people when we ran into a girl I vaguely recognized, who vaguely recognized me. But she didn't really pay any attention to me until I realized that I'd met her at a party months ago, when she was sitting on the sidelines nursing a sprained ankle.

"How's the ankle?" I asked her.

The transformation was instant and enthusiastic: "Much better! Thank you so much for asking! How are you doing?" It was like flipping a switch. Suddenly she was attentive, interested in me.

So even though I'm not a big fan of social niceties -- it seems somewhat hypocritical to be nicey-nice to people I don't like -- I need to get over that distaste and just do it. Say good morning, please, how are you, thank you. Even to people I can't stand. Especially to people I can't stand.
Copyright (c) 2006 "Ayelet Survivor"

My fame spreads

I got another email from someone who read my piece in the Jewish Week.

Dear Ayelet -- Thank you so much for publishing your article.

I have a friend who I think is struggling with feeling very lonely. I am worried about her, and have recently encourage her to get involved with the beginners minyan at [a local synagogue], because I think that part of her problem is that she has not realized that she needs to make an investment in becoming part of a continuous community.

She understandably got very down just last week because she is in her mid-forties, and is not married, nor does she have a child, but a good friend of hers had a baby. She is a beautiful, talented amazing person, recently laid off from her job. She is consulting with a psychiatrist/psychologist on a weekly basis, but by phone rather than in person, which is in my mind a continuing symptom of her difficulties.

Could you be kind enough to give me a resource or two in Manhattan to give her if/when she calls me feeling "down"? I would like to be in a position to give her more psychological support, but I work full-time and just started attending grad school at night, and don't feel I can do much more than try to make helpful suggestions.

Thanks so much for writing your article, providing your contact information, and certainly for reading/listening.

Sincerely, Laura Goldberg

I wrote back:

Dear Laura -- Thanks for writing.

I very much understand how your friend is feeling. I've been laid off from a number of jobs, and watched most of my friends get married and have children. I agree with you that she needs to make more of an effort to become part of a community -- social support is so important in preventing or dealing with depression and loneliness.

I think you're smart to advise her to try the beginners minyan at [a local synagogue]. I happen to be friendly with the rabbi and his family, so if she wanted to go to their house for a Shabbos meal, she could contact me and I could arrange it. And I'll go with her so that she doesn't feel like she's going in alone. They have several kids who are always thrilled to get attention from visitors; within five minutes the 5-year-old will be sitting on her lap, asking to be read a story. I always have a blast when I go there.

I would also add that she could join any kind of club or group that does something she's interested in -- hiking, or some other hobby. That way she'll meet people who share an interest with her, which facilitates friendships.

I agree with you that a strictly phone relationship with a psychiatrist is not optimal. Occasionally I have a phone session with my psychiatrist, but that's usually when I'm not feeling well enough to go see him in person or, in a few instances, because I forgot about the appointment and he was able to reach me by phone (very embarrassing).

My psychiatrist is very expensive, but not all of them are. Mount Sinai School of Medicine has a program that matches people with psychiatric residents, who are supervised by experienced clinicians, for treatment at reasonable rates. Your friend might do well to look into that option. Also, the Albert Ellis Institute offers low-cost therapy.

Your friend should also look into support groups. The Depression and Bipolar Support Alliance and Mood Disorder Support Group are two good options. She also might meet some people and forge some new friendships.

I hope this is helpful. Please don't hesitate to give my email address to your friend if she wants to contact me directly.

Sincerely, Ayelet
Copyright (c) 2006 "Ayelet Survivor"

I miss the kids

Up since 3:00 a.m. -- I hate terminal insomnia. And I'm sick of studying, so I might as well blog about how much I miss my nieces and nephews.

I may have to swallow my pride and put up with Jerusha's rudeness and abuse, because I miss the kids so much. I need to see them.

I've been thinking about my oldest niece Malka's concept of olam haba -- the world to come, aka Heaven. She told me she learned in school that in olam haba, you can be any age you want to be, and you can look any way you want to look.

"So Aunt Ayelet, let's be 15, okay?" she said eagerly.

Hm. Adolescence was very painful for me, and 15 was not a very good year. However, in college I blossomed, and 19 was pretty good, although I experienced my first adult depressive episode and first (very mild) hypomania.

"Let's be 19," I suggested.

"But that's so OLD!"

"Trust me," I told her, "19 is better than 15."

"Okay," she said. "And we're going to have loooooooong hair -- down to our ankles. And we're going to be tall and skinny."

"And my hair's going to be red," I said. I've always loved red hair, although it wouldn't suit my complexion. I always thought that if I married a guy who really wanted me to cover my hair completely, I'd get at least one shaitel, and it would be red. If I had to wear a wig, I'd need to have fun with it.

But I digress. The main point is that my niece wants to be -- assumes she will be -- with me in olam haba. That's an enormous compliment; eternity is a very long time.

Nobody loves me more than they do. And as much as I love Tikva, I still need my nieces and nephews.

After I stormed out of the house motzei yomtov, got home, and unpacked my bags, I found a piece of paper that my little niece had put in my purse. She's just learning to write, and she had written on the page, several times, "Aunt Ayelet + Shira." Just looking at it makes me smile and feel a little sting of tears.

Sigh. I hate the thought of spending a weekend with Jerusha, but I miss the kids terribly. I don't know what to do.
Copyright (c) 2006 "Ayelet Survivor"

Friday, October 27, 2006

Reports of my mania have been greatly exaggerated

I had a busy day today. Woke up very early (darn that terminal insomnia!) and decided to be productive. Installed my new DSL. Wrote a take-home midterm exam. Unpacked, tried on, and put away several items of clothing and a pair of shoes that I purchased online. (Happily, everything fit perfectly.) Went to the salon for a haircut and blowout. Hiked down to Filene's Basement and bought a new tote bag (love the bag, hate the fact that I threw away the 20%-off coupon I got in the mail a few weeks ago, because it would have saved me a whole $6.00). Did some grocery shopping but unfortunately couldn't find several of my favorite items (in Manhattan, if it's not on the shelf, they don't have it in the back).

By the end of all this activity, I was tired, hungry, anxious, and sad. I didn't covet the beautiful items in the store windows, as I would if I were really hypomanic. I wanted to go home and eat 200 Entenmann's donuts. (I stemmed that desire with 2 pounds of watermelon instead.)

I also started worrying. I worried that I'm alienating my classmates by sharing too much about my difficulties with the faculty; last night after class, while I was complaining to someone who knew my situation and someone who didn't, the latter wore an expression of marked distaste. (At least, I think it was marked distaste. With WASPs it's often hard to tell what they're thinking or feeling.)

I worried that my over-sharing would get back to the faculty and it would count against me. I worried that when making an appointment to see Dr. Octopussy again, I came off sounding needy and gave her more ammunition against me. I worried that the faculty would kick me out of school. I worried that I would become hypomanic and then depressed again. Worry, worry, worry.

One thing I really hate about my disorder is the constant need for vigilance. If I start getting happy, if I start getting sad, I need to watch myself very carefully so that my mood doesn't snowball into mania or depression. This means that I have to be mindful of all my negative thoughts -- and as I know from first undergoing and now studying cognitive therapy, ruminating over your negative thoughts sours your mood.

Any remaining elation from the sexy, booty-loving MRI tech's compliment has completely drained away. I was looking at my face in the mirror for more than an hour as the hairdresser painstakingly cut and straightened my hair, and I look FAT. That definitely contributed to my negative affect, as we say in psychology school.

Another thought I had about my past hypomanic shopping sprees: even though my mood was euphoric, it was a false euphoria based on brain chemistry, not my situation in life. So even though I felt good, I was still missing several key things in my life: a set career path, a marriage, children. I think part of the impetus for coveting and buying so many things was the need to fill those gaps in my life. So I bought and bought -- but the holes were still there.

When I decided to get my master's degree in psychology, my shopping dropped off dramatically. Of course part of that was a matter of spare time -- at work 9 to 5, in class several nights a week, and of course all the study time I put in didn't leave me much time to browse and shop. (Although if I'd been willing to sacrifice some sleep I could have shopped more; the internet is open 24/7.)

And I thought I'd feel the same way when I began work on my doctorate. But I don't. Instead of filling those gaps, this program is punching new ones in me. And that's what's driving me to shop. My excuse is that I need new clothes and shoes to look as hip as the twentysomethings in my class. But I could be buying electronic gadgets (I need a new Palm Pilot; my old one is incompatible with my new computer), or books, or DVDs to watch on my computer (I don't have a DVD player -- see "electronic gadgets," above). I think that buying anything right now -- hello, FreshDirect? I need 500 cups of yogurt -- would give me that temporary respite from the gnawing anxiety, the emptiness, the frustration.

But it's temporary. I wore the new shoes that just arrived on my errands today. They couldn't have fit better if they'd been made for me. They are classic and timeless, funky and hip. I'm going to get tons of use out of them.

But they can't make me happy.
Copyright (c) 2006 "Ayelet Survivor"

Am I just a little too happy?

I've been feeling really good lately, not quite sure why. The weather has been beautiful, chill but very sunny, and since I'm in school and not working 9-5, I get to spent a fair amount of time outside. Sunlight is very important to me -- I usually experience a slight dip in mood when daylight savings time hits and I'm not getting as much sun. (Of course I wear sunscreen and sunglasses to prevent cancer and wrinkles.) So when I get plenty of sun, I'm happier.

I've also been taking megadoses of flaxseed oil supplements, which are natural mood boosters, since they support good neurotransmitter functioning. And I might be at a point in my menstrual cycle when my hormones aren't promoting dysphoria.

But I wonder why I'm feeling so good, despite Dr. Jerk's antipathy, midterms, being a lonely single girl, the pain in my knees, and the rotten news from my orthopedic surgeon that after I spent a ton of cash, my MRIs were basically normal. (That does not bode well for a lawsuit against my gym.)

When I feel too good, it's called hypomania, and it's an aspect of my mood disorder. I won't rattle off a laundry list of signs and symptoms; read about them here if you're interested. I don't want to go into too much detail about my hypomanic episodes, because frankly, they're very embarrassing to recall. I will say that hypomania has lost me jobs, friends, and money -- because when I'm hypomanic, I need to shop.

I don't say I like to shop; I say I need to shop. One of the signs of hypomania is an "excessive involvement in pleasurable activities." That could be sex, music, movies, or shopping. My strongest urge when I'm hypomanic is to shop, because I want to possess almost everything I see. I don't just buy a CD -- I join Columbia House and buy 50. I don't buy a shirt, I buy 12. I buy a new boom box that comes with a microphone and a little karaoke tape -- then I buy 12 karaoke tapes. I want, I want, I want. The appetite is voracious, and a hypomanic person with a credit card can do some serious damage.

And right now, I want to shop. I have no income -- I'm living off savings -- so I've tried to be careful. But I feel like I need pretty clothes, and I don't have enough of those for the weight I'm currently at. I'm trying to be very, very careful -- I'm only buying on sale, and I'm not buying very much. But I really want to shop, and it's distressing not to; I've even started ordering my groceries from Fresh Direct instead of going to the grocery store, because I love online shopping, it saves time, it saves money because many of the products are cheaper than in the bricks-and-mortar store... and I have to eat, right?

I've never gone into major debt due to hypomania, which I guess is something good. And hypomania is definitely easier to control than depression; I just have to watch what I say and do very, very carefully. Because when you're hypomanic, you're not always aware of the effect your behavior has on other people, and you're not always amenable to suggestions that you tone it down a bit. That's how you lose jobs and friends.

I've learned from past hypomanias, and right now I'm watching myself carefully to make sure I don't spiral out of control. Because the initial euphoria of hypomania can be replaced by intense irritability and anger -- which then spirals down into depression. And I can't afford a depression right now; I will not be able to handle grad school. (And wouldn't Dr. Jerk be pleased.)

I'm waiting to see what happens when daylight savings time arrives this weekend. As I mentioned above, I usually get a little depressed around this time of year. I'll be watching myself very, very carefully over the next few weeks.
Copyright (c) 2006 "Ayelet Survivor"

Thursday, October 26, 2006

I test a loyal fan

So a few days ago I gave an IQ test to a very nice young woman, Simcha, who reads my blog, and we had a lot of fun together. After the test we chatted for a bit before she had to head out to another engagement.

I really would like to be friends with Simcha. For one thing, she knows about my disorder and still likes and respects me -- to the point of wanting to help me vanquish the evil Dr. Jerk. (I feel no guilt over contravening his instructions and finding one of my own participants. People in other labs have told me that they didn't bother exchanging participants with each other AT ALL -- with the full collusion and support of their T.A.s. Just my luck that I got stuck with a scrawny blonde control-freaky stickler-for-the-rules T.A. ....)

Simcha's also bright, caring, and interesting to talk to. I enjoyed her company; I felt like we had a lot in common, despite a significant age difference, and were on the same wavelength. The more my relationship with my sister Jerusha deteriorates, the more I value the connection, validation, and companionship I get from my friends, who love me for who I am. Simcha seems like she would be a good person to add to the support network that helps me function and keeps me alive -- literally.

But: in a few months, I'm going to be learning the Rorschach test -- or rather re-learning it, since I already studied it in my master's program. Fortunately, there's only one system for learning to administer it, so I already have all the books. My cousin promised to buy me a Rorschach when I got my master's; I have to find out where to purchase an official copy, since it would be a good thing to have. Our testing library at school does not have nearly enough copies of the tests we need to administer -- something that causes my classmates and me tremendous anxiety when we have a test-giving assignment coming due and there are no tests to be had.

However... back to the point: I would like to be friends with Simcha. But when I take the Rorschach course, I will need to test four people that I don't know very well. And since Simcha was willing to take the IQ test, I was hoping she'd be willing to take the Rorschach (and maybe talk three of her friends into taking it too). I can't get to know her any better, or I won't be able to administer the Rorschach to her.

So I asked her if she'd be willing, in a few months, to take the Rorschach for my next class. Bless her generous heart, she said yes, and I told her that after the Rorschach, we can hang out ;)
Copyright (c) 2006 "Ayelet Survivor"

At least the MRI tech thinks I'm hot

Recently I put $1200 on my credit card (if only it gave back frequent flyer miles...) to pay for an MRI of my knees, which my insurance wouldn't cover.

As I lay on the narrow table, the tech had to place blocks around my body to immobilize me. "What happened to your knees?" he asked me. "How did you get hurt?"

"I was working out with a personal trainer at the gym and she overexerted me, so I got injured," I told him.

"Not for nothin'," he said, "but she must have done something right, cause you look GREAT."

Hm. Apparently the approximately 10 pounds I lost on the Dr. Jerk diet have rendered me somewhat attractive again. Silver lining!

Of course, the tech was African-American, and men in his community tend to like women with a little meat on their bones (remember "Baby Got Back"?). It's also possible he was just making pleasant small talk. But it was still nice to hear. I'm corresponding via e-mail with several potential suitors, and it's nice to think that if we do end up meeting in person, they might not think I'm fat.
Copyright (c) 2006 "Ayelet Survivor"

Wednesday, October 25, 2006

The inscrutable Dr. Jerk

I will never understand Dr. Jerk, not even if I get my psychology degree summa cum laude.

Dr. Octopussy, the deputy director, was not available for a meeting soon, so I needed to respond to Dr. Jerk's last e-mail. I wrote him back this morning (cc'ing the program director, of course, and bcc'ing the classmates who helped talk me through the problem):

Dear Dr. Jerk,

I apologize for my lateness yesterday morning. I will do my utmost not to be late for the remainder of the semester.

I apologize again for missing that class in September. As I told you the week before, I was being driven to the wedding of a very dear friend and if I did not miss the class, I would not have been able to attend the wedding. I obtained notes from two classmates and did all of the assigned reading. At the time, you thanked me for notifying you in advance that I would be missing the class.

I am sorry that you perceive my lateness as an issue after these two incidences. Please be assured that it is not a reflection of my commitment to your classes or the program.

Sincerely, Ayelet Survivor

This afternoon he replied. Seeing the email in my inbox made my stomach contract. I dreaded opening it. I feared the worst. And this is what he had to say:

Dear Ayelett [sic],

Apology accepted - Please make sure that you get the notes so that you are not at a disadvantage.

Best, JJ

My good friend Boaz told me not to look a gift horse in the mouth, so I won't. But oh, the relief!
Copyright (c) 2006 "Ayelet Survivor"

Tuesday, October 24, 2006

Stress and coping

This morning I was on the phone with the insurance company and the MRI provider place, arguing and pleading -- to no avail -- for some kind of help or installment plan to pay for the MRI. Subsequently, I was 45 minutes late to class. Dr. Jerk didn't say anything at the time, and responded to me in his usual way during both classes he teaches: half the time he ignored my raised hand, and half the time he actually let me ask a very relevant and useful question.

But later in the day, just before class with Dr. Adorable, I ran into the computer room to check my messages, and I really wish I hadn't.

Dear Ayelett [sic.],

I am writing to let you know that I expect students to arrive to class on time (you were 45 miunutes [sic.] late this am) and that timely and reliable attendance are part of the evaluative process for the class. This is particularly an issue as you already missed an entire class a few weeks ago.

Sincerely,
Jack Jerk, Ph.D.
Associate Professor of Psychology

I had to take an extra painkiller and two tranquilizers to sit through Dr. Adorable's class, which I usually enjoy. Today, it was torture.

Now I can understand Dr. Jerk being annoyed that I was late for class, and I didn't go up to him after class to apologize, but after our last one-on-one encounter, I'm very wary of engaging him directly. And when I missed that class several weeks ago, I told him a week in advance, I apologized profusely, and he was benevolent and gracious; just told me to get the notes. Well, I got the notes, and I did all the assigned reading, as my classroom participation (when I'm allowed to open my mouth) should make abundantly clear. It's unfair for him to pull that out as an example of my lack of commitment to his classes and the program. I really don't think two instances of lateness show a pattern of disregard that merits a decrement in grade.

But, interestingly, the topic of the second Dr. Jerk class of the day was stress and coping. He taught us that optimistic people, who are active problem-solvers/proactive copers and believe they have social support and other resources at their disposal, are happier, healthier, more productive, and live longer than pessimists, who avoid troublesome situations instead of trying to find a solution, believe they have no control over what happens to them, isolate themselves from potential sources of support, and ultimately give up entirely.

Well, I'm not about to give up. I have worked too hard and spent too much money to let Dr. Jerk drive me out of school. So I employed proactive coping measures: on the subway home, I asked four of my classmates, who are familiar with my situation, what I should do.

They were very empathetic; they can't believe Dr. Jerk and the rest of the faculty are being so critical, judging my behavior so harshly and cutting me so little slack.

Their advice boiled down to this: Ask Dr. Octopussy for another meeting to discuss the faculty suggestions for my loose boundaries and the situation with Dr. Jerk, which has deteriorated to such a point that I don't know how to handle it. At that meeting, ask for a meeting with both Dr. Octopussy and Dr. Jerk to clear the air and achieve a courteous relationship.

After my first meeting with Dr. Octopussy, I sent an e-mail to her (with help of my friend Boaz, who ghost-wrote it):

Thank you for bringing the faculty's concerns to my attention. I understand they've chosen to draw some tentative conclusions based on my performance thus far, but it's still early in the term, and I think we can implement a course correction and move forward in a successful and meaningful way.

I look forward to receiving your feedback and suggestions for future participation in class and colloquia, and to working with you in the future. I also plan to meet with my adviser.

She responded:

The faculty will be meeting today and I will let them know you are eager to receive further feedback and want to work with us to remedy the problem.

Tonight I sent her this note, with the subject line "Follow-up meeting":

Dear Dr. Octopussy,

I would like to meet with you to discuss the faculty's recommendations for how I can bring my behavior more in line with what is expected, and also to discuss how best to handle my situation with Dr. Jerk. I am meeting with my adviser on Nov. 2 but would like to touch base with you as soon as possible.

Please let me know when would be most convenient for you to meet with me.

Many thanks, Ayelet

I had wanted to get my lawyer involved, but my classmates thought that bringing in a lawyer might be premature, even though it's clear that Dr. Jerk is creating a hostile study environment and wrongfully threatening to dock my grades. (Consulting a lawyer about this matter and starting a paper trail, on the other hand, might not be a bad idea.)

I should just get used to the idea that he's not going to grade me fairly. He just won't. But I don't need to get the A's that my work will merit; I just need to pass. I have to let go the anguish of getting a B- for work that deserves an A. It's just not worth it to agonize over a grade; that kind of rumination and pessimism can only make me sick.

Literally. Numerous studies (as we've been reading about this and last week) have shown that people who avoid dealing with their problems and ruminate over the injustices done to them have higher rates of mental and medical disorders, from depression and anxiety to heart disease and cancer. People with a lot of hostility are especially vulnerable to heart disease.

There's another little silver lining. Dr. Jerk is clearly seething with hostility. Is it too much to hope that he won't make it to the end of the year -- or semester? ;)

I was greatly amused to see that Dr. Jerk is only an associate professor, not a full professor, even though he's been at this school for more than a decade and brings in tons of research grant money. Another concept we've been studying recently is Baumeister's threatened egotism. Baumeister rejects the prevalent theory that low self-esteem leads to violence and aggressive behavior. On the contrary, he argues, violent people tend to have highly favorable opinions of themselves -- but they commit immoral, hurtful acts when they feel their self-image is threatened by others.

Maybe that's why Dr. Jerk is so hostile and rude toward me. I challenge him, and he can't stand to be challenged. His ego is so fragile that he can't countenance any contradiction. I know his ego is fragile because he's always bragging about his incredible therapeutic success rate -- certain ailments, he alleges, he can cure in one or two sessions -- and how much money people pay him for this treatment.

My theory is, he's not curing them -- he's alienating them. They stop coming to therapy because they can't stand him, not because they're all better.
Copyright (c) 2006 "Ayelet Survivor"

Monday, October 23, 2006

Inadvertantly, Dr. Jerk provides the solution

It would have to be inadvertant, because he'd never actually go out of his way to help me.

One of the articles on stress and mental illness that Dr. Jerk assigned to us (if you want the citation, e-mail me at helpfordepression@gmail.com) examined proactive coping as a way of decreasing the stress one experiences. I was especially struck by this paragraph:

[M]edical students with an internal locus of control were more likely to report having accepted relatively unchangeable stressors, such as hostile professors and an impersonal work environment, than would students with an external locus of control.... Optimists reported working actively to fix problems appraised as controllable but reported using strategies to manage their emotions in the face of problems appraised as uncontrollable.

Locus of control "refers to an individual's generalized expectations concerning where control over subsequent events resides" -- internally, within himself, in which case he has a great deal of control, or externally, in which case he is the victim of circumstance and fate and has no control over his life.

I decided to find out if I have an internal or external locus of control by taking this web survey. Unfortunately, I scored exactly in between the extremes. So I apparently have both an internal and external locus of control.

I need to let my internal locus of control dominate. That's the only thing that will help me deal with a hostile professor and an indifferent school environment. And I need to work on my optimism and strategies to manage my emotions in the face of uncontrollable factors, such as Dr. Jerk's hostility and the rest of the faculty's lack of support.

Unwittingly, Dr. Jerk is also helping me with my weight problem. I'm so stressed out by his harassment that most of the time I don't want to eat. When I notice my hands shaking or I feel dizzy and shaky, I know I need to eat something, and I force myself to. But I've lost more than 10 pounds, without much physical exertion because of my knees, since school began about seven weeks ago.

Years ago, during my first depressive episode, I was hit with the same phenomenon. I was in a very bad relationship; I wouldn't say my ex was emotionally abusive, but he was definitely taking advantage of me. I became severely depressed, stopped wanting to eat, and lost a ton of weight, dwindling down to a size 2 and 99 bony pounds. I called it "the Steve diet."

That's not going to happen this time, if only because I'd have to lose at least 50 pounds to come close to that perilously thin condition. Also, I am mindful that I need to eat regularly, and I make sure that I do.

But I badly need to lose weight right now, and I can't exercise. So there's a tiny silver lining in the huge Dr. Jerk storm cloud: he's helping me lose weight and lower my cholesterol. I wouldn't say I'm getting healthier, though, because who knows what he's doing to my blood pressure and blood cortisol levels. It's a miracle I haven't gotten sick (kinahora) this semester, since, as the next article on my list affirms, stress can cause immune system dysfunction and greater vulnerability to infection.

It's a good thing I won't be visiting my sister's kids for a while, then. Their house is always a germ factory, and somebody's always sick.
Copyright (c) 2006 "Ayelet Survivor"

Sunday, October 22, 2006

My friends should probably stop reading this blog

Of course I say that tongue-in-cheek, but it's kind of funny how so many of my friends read a very negative post on here and then call or e-mail or IM me, very worried about my mood, or call each other and discuss it among themselves. (And I never should have told my mom about this blog.)

One friend challenged me today to write about something positive in my life. There had to be something good going on, he said, despite the severe physical pain, my crummy insurance company, the hostile Dr. Jerk, the unanimous and harshly judgmental faculty, and my status as an aging single girl. At the time I rebuffed him, but then I thought I'd give it a shot.

So I'm going to write about my friend Ruchama's daughter, Tikva, who is 3.

Tikva and I have a special bond. Even though Ruchama's four other children try to grab some of my attention when I'm there for a shabbos meal, Tikva always demands top billing. She's the one who gets to sit on my lap (the older kids aren't interested, but the 6-year-old wouldn't mind a turn chez Ayelet). Tikva always sits next to me (or on me) at meals, and when she has to go to the potty -- being newly trained -- I'm the one she wants to take her. (As an experienced aunt, I'm not put off by this, since this is exactly how my nephews and nieces act when I'm visiting. "Aunt Ayelet! I need to go make!!!")

Over Simchat Torah, Ruchama invited me to have Shabbos lunch -- the last meal in the succah -- with her family. We ate in the synagogue succah, and I spent the entire meal doing three things:

1. Cutting up food for Tikva
2. Asking Tikva what she wanted from the various dishes on the table (Ruchama's a fabulous cook)
3. Taking Tikva inside to use the potty

There were a few false alarms, because Tikva's still new at this potty thing, so we made several trips back and forth. Tikva also thoughtfully provided a comprehensive blow-by-blow of the process, so I wouldn't miss any important details:

"It's a pee-pee...."

"It's a poo.... It's a BIG poo. Yesterday I had a baby poo...."

"Finished!" (after producing a fanfaronade of gas)

And there's no better way, as far as I'm concerned, to spend lunch. I managed to eat enough, in between trips to the potty and cutting up Tikva's food, and I got to spend a lot of time with someone whose regard for me "borders on idolatry," in the words of her mother.

I pushed her home in the stroller (at her demand: "Not Mommy! Ayelet push the stroller!") and she fell asleep in the warm autumn sunshine; as she napped, I spent some time in grown-up talk with Ruchama, while the other kids played or read. When Tikva woke up later that afternoon -- a little cranky, as many children are when first waking up -- she didn't go to her mother. She came straight to me and snuggled on my lap. "Ayelet no go home," she said.

So screw Dr. Jerk and his unreasonable, unprofessional, ultimately pathetic hostility toward me. Tikva and her family think I'm the greatest thing since computer games. And theirs is the opinion that counts.
Copyright (c) 2006 "Ayelet Survivor"

Friday, October 20, 2006

It just gets worse

I just found out that my piece-of-shit insurance company, to whom I paid more than $5,000.00, won't pay for an MRI of my knees.

I could gleefully strangle my primary care physician. I went to him in August with severe pain, and he sent me back to the fucking gym instead of ordering me an MRI while I still had decent health coverage from my last insurer. Only when I went back to him in complete agony did he think there was something wrong and send me to the orthopedist.

And now it's too late. Somehow I'll have to come up with $1200 for the MRI or just go on limping.

Life's a fucking bitch.
Copyright (c) 2006 "Ayelet Survivor"

Former therapist weighs in

I sent my blog to a former therapist, who now lives and works in another city, and asked for some input. He thought it was a helpful resource, especially with the useful links on the left, but I wanted to know more specifically what he thought about my situation at school. Since he's a rather recent graduate of a different program, I thought he might have some perspective. He responded:

I think you always have the option to quit the program.

Which of course is a set up because if I said that to you you would rip my head off and tell me that would never happen which would allow me to slip in the fact that people like Dr. Jerk are part of the challenge of successfully getting a degree. We have all had Dr. Jerks try to stop us from achieving our goals. All this time invested in a battle you know you can't win could probably be better used on more academic demands or possibly even more pleasurable activities.


Also, remember this: the cathartic process (journaling, venting, etc.) has a paradoxical effect on anger. In other words, you may think you are feeling better by venting to the world but really most people when getting angry get a chemical/endorphin boost which seems to reinforce the anger.

Simply stated, anger begets anger. Refer to Martin Luther King, Jr who said "
The ultimate weakness of violence is that it is a descending spiral, begetting the very thing it seeks to destroy. Instead of diminishing evil, it multiplies it. Through violence you may murder the liar, but you cannot murder the lie, nor establish the truth. Through violence you may murder the hater, but you do not murder hate. In fact, violence merely increases hate.... Returning violence for violence multiplies violence, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that. Hate multiplies hate, violence multiplies violence, and toughness multiplies toughness in a descending spiral of destruction.... The chain reaction of evil -- hate begetting hate, wars producing more wars -- must be broken, or we shall be plunged into the dark abyss of annihilation."

It's not exactly what I wanted to hear -- just like yesterday I didn't want to hear my psychiatrist telling me to tone down my strong personality just a little, so I can get along with everyone. But they're both right, and I think it goes without saying that MLK, Jr. was right. Just look at the situation in Iraq. We're not winning the war on terror by being aggressive crusaders. It's doing more harm than good.

I wrote back that instead of venting about Dr. Jerk I'll stick to mocking him. My former therapist replied succinctly, I agree with Roda.
Copyright (c) 2006 "Ayelet Survivor"

Thursday, October 19, 2006

Dr. R weighs in

Saw Dr. R tonight before my second midterm in as many days. I didn't get to tell him about the community programming I'm working on because I had to talk about how the unanimous faculty, Dr. Jerk, the bitch TA, and Jerusha are all trying to kill me with stress and misery.

For a while he was saying things I needed to hear but didn't want to: even if I am factually correct, there must be something about my manner that is alienating all these people and causing them to criticize me. (Well, nothing would make my sister happy, and Dr. Jerk has hated me from day 1, but the TA and the faculty could be on to something.)

He recommended that I just tone myself down. "You don't always have to show them that you're smart and you know the material," he said. "All you need to do is pass."

He's right, of course. My grades don't really matter as long as I pass, and I doubt Dr. Jerk would be able to justify flunking me if I demonstrate a good grasp of the subject matter. So I really just need to back off. Less is more.

I thought grad school would be a place where students could be free to be you and me... but that record's way out of date. I need to come on less strong; one of the criticisms the deputy director lobbed at me was that people thought I had a very strong personality. I need to tone it down. I don't have to change; I just don't have to charge forward at 100% all of the time. Don't need to give it to them with both cylinders.

I wasn't happy to hear this, but I had to admit he was right. If they're not going to know about my disability, then I need to work extra hard to conceal it.

As I was leaving, one hand on the open door's handle, I said, "I just can't believe Dr. Jerk can get away with treating me like this."

Dr. R took off his glasses and beckoned me closer: "Treat him like a patient."

"?"

"If you had a patient who was very angry at you, unfairly, you would not be angry at him, no? You would not react to his anger because you are a professional. So treat this professor like a patient and do not react to him."

That was lovely to hear. Of course Dr. Jerk is irrational and unreasonable -- he's a psychiatric patient! I need to be patient and understanding with him, and not make any demands because he can't tolerate them.

Of course, this is a slightly condescending view of patients, and if he were my patient he wouldn't have all the power over me that he has now. But I think it's a useful metaphor.

So I'll try to react to him as if he were a "difficult" patient. It will be good practice. I'm planning on working with criminal offenders who suffer from Borderline Personality Disorder. Little Mary Sunshines they are not. In fact, they might even remind me of him.

So I guess this is a blessing in disguise, of sorts. A very heavy disguise. Like a gorilla suit.

Even though I felt a little better after therapy, I still had to rush to make it to my midterm, and of course the trains were all delayed. I ended up taking two clonazepam. It's an anticonvulsant that's also used as a tranquilizer. Not as dreamy as lorazepam, also known as Ativan, but it does the job and it's less addictive. I have to say, I sailed through that exam. Thought calmly and clearly, worked out the answers, finished in record time. If it turns out I did well, I might just pop one or two clonazepam before every exam, at least while my behavior's under the faculty microscope and my professor despises me.

I'm not really worried about getting addicted. I've never had a problem with drinking too much, and I really love the way I feel when I'm slightly drunk. But I go months and months between drinking; then I have a few drinks, remember, wow, how much I like it -- and then I forget it by the next morning when I wake up, and go for months without drinking again. If I'm addicted to anything it's Entenmann's cakes and donuts, on which I gained 20 pounds during my last hellish depressive/anxious episode, and I've gone cold turkey.

With all this unavoidable stress in my life -- today, before my appointment with Dr. R, it was so bad that I couldn't eat or study -- I need something to take the edge off. I can't change my daily medications; I'm at the maximum dose that I can tolerate of all three. Without clonazepam, I don't know how I'll function when things get really harsh and I'm stressed beyond endurance.

It's better to take two clonazepam than to take an entire bottle of lithium and pray to die.

And I have to say, I haven't even come close to finishing my last clonazepam prescription, which I filled almost three months ago. Although I asked for a new prescription tonight. Just in case.

I'm also going to go for a blood test to see if I can try upping my dose of lithium. I used to take Depakote as well as lithium and could only tolerate a certain lithium level -- they're both very demanding on the liver. But now that Depakote's out of the picture, I'm hoping I can increase the lithium. It might balance me out more, and right now I could use that. I need to roll with all of these punches being thrown at me.
Copyright (c) 2006 "Ayelet Survivor"

Wednesday, October 18, 2006

Hangover blues

In the middle of a midterm tonight, I noticed I had a headache. By the time I was finished, I also felt nauseated. At first I thought it was due to the constipation that the Tramadol induces in me. Then I realized it's a Tramadol hangover; I took too many pills today.

I already swallow a fistful of meds every night. Topping those off with Tramadol is really wreaking havoc on my system. I eat tons of fresh fruits, vegetables, and whole grains, and yet I'm still wretchedly constipated. And I obviously popped too many painkillers today; the headache and nausea are proof of that.

I don't know how House eats as much Vicodin as he does. When I tried vike, I got a really wicked hangover -- a pounding headache that woke me out of a sound sleep.

I miss Oxycontin. I took that for back pain -- back in the days before idiots like Jack Osbourne used it to get high and ruined it for the rest of us.

I guess I'll have to tolerate more knees pain, because the cure is now worse than the disease.
Copyright (c) 2006 "Ayelet Survivor"

He hates me. He really, really hates me.

I met with Dr. Jerk to ask for a reasonable accommodation: please let me ask students in other labs for participants, since my labmates aren't coming up with people I can conveniently test. He turned me down flat.

"You've been asking for special treatment since day 1," he said. "The first day of class you wanted to change your lab." I tried to explain that I'd been trying to finalize my schedule and since my lab TA wasn't in class that day, I didn't know when lab would be and whether it would conflict with my schedule. (It's all my stupid TA's fault!!!)

No dice. I tried to give him a better sense of my knee injury, the amount of pain I was in, and he was equally adamant. "You're coming to classes, so you must be able to get around fine. If you're really having such difficulties meeting the requirements of the program, maybe you should take a leave of absence to take care of your health."

He'd like that, wouldn't he?

I'm not having problems dealing with the program requirements; I'm having problems with his arbitrary and inflexible rules. But he's obviously pegged me as a whiny, lazy, difficult student, and nothing I can do will change that.

I mentioned that my labmates weren't coming up with people for me to test, whereas I had come up with a number of viable candidates for them, and he said, "You know, it's nice that you brought in 11 people, but so what? You need to ask your labmates for more participants."

I can't believe that one encounter at the beginning of the semester has so poisoned him against me. I realize that it's his failing, but it's creating a hostile learning environment for me. And with the faculty unanimously aligned against me, I can't ask them for help. The program director has probably been poisoned against me by her assistant, my TA. I guess I could talk to the dean of students, but I don't want the whole school to think I'm a troublemaker. (I also had a nasty time with the dean's secretary when I was trying to get transfer credit for my graduate study elsewhere, so I'm probably persona non grata in his office as well.)

At least I know it's his problem. I spoke to my former professor, who graduated from this program, and she said with a knowing sigh, "I see Dr. Jerk hasn't changed." Apparently she had a few unpleasant encounters with him as well.

She recommended I talk to my adviser again, whom I've already consulted about Dr. Jerk. And when I ask the deputy director if she's come up with that list of recommendations to tighten my boundaries, I'll let her know that her suggestion I ask Dr. Jerk for help resulted in another unnecessarily hostile, unpleasant confrontation.
Copyright (c) 2006 "Ayelet Survivor"

Monday, October 16, 2006

Letting in my friends

I'm slowly telling more people whom I consider friends about my disorder and the blog I use to deal with my feelings and spread the word that recovery is possible (although setbacks can be frequent).

Recently I sent my blog to a good friend, a little afraid that she wouldn't be able to deal with my diagnosis and dark thoughts:

Dear Chaya,

Because you have become one of my very close friends, I want to share my blog with you. It is where I write about coping with my various ailments, some of which you know about and some of which you don't.

I trust your discretion, since you are an attorney, after all. If you find the material on my blog too disturbing to continue as my friend, I hope you will let me know but keep the blog a secret.

I suggest you start with the first entry. The rest of it, well, you can read chronologically or not. I hope it doesn't freak you out, because some of it is serious.

But when I write about how my friends keep me going through my difficulties, I want you to know, you're one of them. You really are.

Love, Ayelet

And she proved me wonderfully wrong:

Ayelet, I love you and nothing can change that. I will keep the blog confidential and am honored that you are sharing this with me. I admire you so much.

I feel Hashem has given you an important mission to help so many. You would probably not be surprised at how many people suffer alone.
Yasher koach for giving so many strength to know they are not alone.
Copyright (c) 2006 "Ayelet Survivor"

Not so down that I can't reach out

Got another e-mail asking for some help, and even though I feel like yesterday's leftovers, I did my best to help:

In your article you say that you were diagnosed as bipolar. Why not unipolar depression? My husband is having a problem with this right now, and I don't know how to differentiate when there is no "manic" phase,just agitated depression. Any advise would be appreciated. Thanks -- Anna

I wrote back:

Unipolar depression can include anger, irritability, and agitation, but not the "highs" of mania, which would include feelings of euphoria, little need for sleep, an increased desire for sex, and an increased desire to shop. Sometimes a manic person becomes very egocentric or arrogant; the high of the mood temporarily inflates their self-esteem. Generally, then the mood swings down and the person becomes irritable, then depressed.

Depression and anxiety are related, so for a depression that is very agitated, a tranquilizer like Ativan or Klonopin (which I take from time to time) can be helpful. I would recommend that your husband try one of these medications in addition to an antidepressant. Also, it is helpful to see a psychiatrist who specializes in mood disorders. 

Anna responded:

Thanks so much for getting back to me, Ayelet. I haven't heard about the two meds you mentioned, but will look into them. Thanks for your help and support.

I can't drop out of school. I have too much to do. I am needed, and this is something I'm good at. Screw the faculty: I will not let them keep me from reaching my goals.
Copyright (c) 2006 "Ayelet Survivor"

Dr. Jerk is killing me

One commenter on this forum was really nice, volunteering to let me administer him/her the IQ test. Please write me at helpfordepression@gmail.com. What Dr. Jerk and that bitchy little TA don't know won't hurt them. I've had it with doing it their way.

The other course I'm taking with Dr. Jerk is psychopathology, and we're reading several articles about how stress makes you sick -- mentally and physically. That is, I read them when I can sit still and concentrate on dense psychological jargon. I usually don't have a problem with that, since I'm a pretty smart girl, but I'm still so shaken by the events of last week that even a fun Simchat Torah, with lots of social support from friends, didn't really calm me down.

At this rate, Dr. Jerk's ridiculous hoops that I have to jump through to get participants to practice on are creating major stress in me. Not to mention his rude and contemptuous treatment of me.

Unlike most people whose reactions to stress are studied -- they generally get colds, stomachaches, heart disease, or transient bad moods -- I get profoundly depressed. Including suicidal thoughts. (Of course, my sister's bad treatment of me is also exacerbating my depression.)

I've thought about taking the rest of my painkillers in the bathroom at school. Although I'd probably be caught and taken to the hospital, where they'd pump my stomach, and then I'm sure they'd make me withdraw from the program. So it totally wouldn't solve anything, and would only create more problems.

While I really don't think I'll do it, I'm so miserable and stressed that such thoughts come to me unbidden. I fantasize about the suicide note I'd leave:

Blame Dr. Jerk. And Jerusha. And the unanimous faculty. They chose not to be kind to me when I needed kindness, and judged me harshly when I needed forgiveness.

Of course, the more concrete my plans get, the less realistic they seem. And honestly, I do not want to die. I don't want to be in all this pain, and I don't want to feel like every day my life gets worse, but I want to live. I still believe I could be happy. I still believe I will fall in love. And I want to see the children in my life -- whether or not I ever produce my own -- grow up and become interesting people. My friends.

I also don't want the faculty and my sister to "win." To beat me down. I want to triumph over them. And I know that they'd get over my suicide.

Sure, Jerusha was miserable when I was in the coma, but that hasn't kept her from being a total bitch to me now. She should know that her actions have real repercussions. But my life is too precious to teach her that lesson.

So I need to get into a better frame of mind.

I'm not sure how to go about it. I need to let go of this anxiety and anguish. I have so little control over the things going wrong in my life -- maybe I should just assume things will go better, even in the absence of any evidence that they will.

One of the studies I did manage to read described how men who were diagnosed with HIV and then lost a friend or partner to AIDS -- in the days before protease inhibitors -- were more likely to come down with AIDS. UNLESS: if they were able to find meaning in the loss -- or if they were irrationally optimistic that they wouldn't get sick. Then they actually did better. Either they didn't come down with AIDS, or it took longer to strike and kill them.

So I guess I should take a few tranquilizers and painkillers, and just hope for the best.

Maybe I'll get terrible grades in Dr. Jerk's class, unfairly. That won't kill me, although I've always been proud of being able to get good grades. It probably won't keep me from getting the externship that I need to have next year. I met someone at a recent conference who works at Mt. Sinai, she's on faculty there. Maybe I could try to get an externship there through her. Wouldn't be my first choice, but it would suffice.

I really thought these would be years of interesting growth and challenge, not this kind of grinding down my spirit.

Tomorrow I'm going to talk to a former professor from my master's program. She went to the school I'm in now. Maybe she'll be able to help me navigate this morass. She also wrote me a wonderful recommendation letter, so she definitely sees at least some good in me.
Copyright (c) 2006 "Ayelet Survivor"

Sunday, October 15, 2006

The faculty flunks Psych 101

A basic concept in psychology is the Fundamental Attribution Error: the tendency for people to over-emphasize dispositional, or personality-based, explanations for behaviors observed in others while under-emphasizing the role and power of situational influences.

According to one study, middle-aged people are less prone to this error than young or older adults. Not the faculty at my school. Instead of assuming that the pain and stress of my injury led me to display some questionable behavior, they assumed I had loose boundaries.
Copyright (c) 2006 "Ayelet Survivor"

Friday, October 13, 2006

The political game

I can't believe how stupid I've been.

I didn't think about the fact that my evil lab TA -- who's apparently threatened by her inability to control me and make me act happy-happy-happy despite the fact that I'm not getting what I need to fulfill the requirements for the course -- works for the director of my program. The director who subsequently quizzed the faculty to see if everyone agrees with the TA that I contribute too much and my boundaries are too loose, and then sicced the deputy director on me. Because I'm not making nice with the TA who is not helping me, I've been blacklisted.

Apparently I don't have to just kiss Dr. Jerk's ass, I have to kiss the TA's ass too.

This is really putting a damper on my graduate experience. Is this what the world of psychology is like? A bunch of people so insecure to challenge that a strong personality is threatening? Is this what I want to have to deal with for the rest of my career?

They could drop me from the program. I have very little control over that. And I don't know where I'd go or what I'd do if they did.

Today I hung out with a friend from the program who was considerably appalled by my treatment at the hands of the faculty. She doesn't think my boundaries or contributions were inappropriate, and she was horrified that after only a month in the program, I had to sit through such a humiliation at the hands of the deputy director. We were also pissed that the director of the program, who acted sooooooooo considerate and sympathetic after I disclosed in colloquium, is now leading the hunt against me.

My friend advised me to talk to my adviser, which I'll do, and also another member of the faculty who seems warm and supportive. I've already had some dealings with the latter person when I was trying to get my transfer credits, and she was both nice and genuinely impressed by my previous studies. Maybe she doesn't see my boundaries as terminally loose.

It was great to have support from a classmate whose opinion I respect. She's very well-liked among our classmates, and she likes me. That was a relief.

Of course, then I had to talk to Jerusha after ignoring her all week and listen to her blame me for her rudeness. Apparently I'm so incredibly annoying that she can't help but belittle and mock me every time I stay at her house. I do everything wrong. It's all my fault.

Just goes to show that you can't rely on your family. I need to strengthen my ties with my friends and classmates and let them be my support. My family just can't do it for me.

And as much as it galls me, I'll have to make nice with little miss TA. Because she has more power than I do, and she's not afraid to abuse it.
Copyright (c) 2006 "Ayelet Survivor"

Thursday, October 12, 2006

Gd kicks me when I'm down. Again.

My life is never so bad that Gd can't make it worse.

I've been miserable all week because of the bad way my sister Jerusha treated me over chag. The pain in my knees is getting better, but I'm still at PT for hours at a stretch. And school is stressing me out unnecessarily.

I need to practice administering the Wechsler Adult Intelligence Scale (WAIS), a widely used intelligence test, to four people. Two administrations before Oct. 31, a date rapidly approaching. Dr. Jerk, in his infinite wisdom, thought that we should bring in the names of willing participants and share them with our labmates. I brought in 11 names. I got 4 back. One decided she didn't want to take the test after all, one won't return my e-mails, and one lives in Brooklyn.

I am trying not to travel overmuch because of my knees. The agony is no longer constant, but I'm still balancing caffeine and painkillers so I can stay awake during class and not be in pain. So I wanted to test people in Manhattan. A number of the people I found, whom I do not know very welll, live in Manhattan. Nobody has been able to give me other people to test in the borough.

I don't think this is an excessive request; I think it's a reasonable accommodation for a temporary disability. I told my bitch of a TA that I don't have two Manhattan test-takers, and she told me to ask my labmates for more names. Which I did, and they don't have any.

I am being punished because I did what I was supposed to do and they didn't.

It gets worse. Today the deputy director (Dr. Octopussy) of the clinical program called me into her office to say that the faculty unanimously thinks I have loose boundaries and act inappropriately. In plain English, they think I talk too much and about myself to an inappropriate degree. My disclosure during the guest lecture was the key example. Apparently Dr. Leahy was expecting people to talk about problems that a client of theirs might be having -- not their own problems.

I was stunned. I had always heard that self-disclosure was expected, even required, in a grad program. Not at my school. And after the colloquium the program director came up to me and asked how I was doing. Now she's siccing the Dr. Octopussy on me to chastise me for opening up my big fat mouth.

It was completely painful and humiliating. Dr. Octopussy told me I wasn't supposed to think that they all disliked me, or that I wasn't suited for the program; I was just being given a warning so that I could correct my behavior. When I was able to talk, I asked for some concrete guidelines -- how should I know what is and isn't appropriate? She said she'd ask about that at the next faculty meeting, get some feedback for Ayelet the blabbermouth.

She also told me to e-mail Dr. Jerk and ask if I could ask the rest of the class to try to find me another Manhattan test-taker. I did; no response so far. I'm not optimistic. I'm just furious at my TA, and my stupid lab-mate who brought in only 2 names that turned out to be duds. And the deputy director, and the director, come to think of it. She was all nicey-nice to me after the colloquium, and now she's punishing me for it.

I'm not asking for special treatment. But I am in a lot of pain, and I expected reasonable accommodation. Can you imagine if I told them I have bipolar disorder? How quickly they'd condemn me for disclosing something completely relevant to what I'm supposed to be studying?

If I had gotten in anywhere else, I'd look to transfer. But I'm stuck here. I considered re-applying, but I really don't want to go through the agony again. It was a miserable experience.

I thought all I had to do was show up, study hard, and be myself. I can't believe I'll have to pretend to be someone I'm not in order to get my degree.
Copyright (c) 2006 "Ayelet Survivor"

Monday, October 09, 2006

Dr. Aunt

Over Succot my oldest niece, Malka, who's 9, asked me what I'm studying in school.

"I'm learning how to talk to people who are unhappy, to help them feel better," I said.

"Want to practice on me, Aunt Ayelet?"

Hm. On the one hand, I sure can use the practice. On the other, I'm definitely not an expert in developmental issues, which in the case of a child are extremely relevant. Also, child psychologists do much of their work by observing children play, rather than by talking to them, since kids aren't always able to describe what's going on in their lives and how they feel about it. Talking to kids isn't always productive or straightforward.

But we gave it a try, and spent more than an hour talking about a problem she's been having with a friend at school.

("Does it always take this long, Aunt Ayelet?" Malka asked. I didn't have the heart to tell her that I wasted 8 years with my first psychologist.)

She didn't want to call the friend by name even though I guessed who she was; instead, she referred to her as "Hannah Montana," the titular character of one of the silly Disney kid sitcoms she watches.

The frank chat reminded me of how glad I am not to be a child anymore -- the struggles with peer group acceptance and ostracism, the arbitrary rules imposed by grown-ups. Her friend struck me as very controlling (I've never liked Hannah Montana); I tried to encourage my niece to stand up to her.

I hope the outcome is positive; if not, well, there's one more thing Jerusha can blame on me.

I always used to think that I'd be happy if my (hypothetical) kids were happy, rather than exceptionally smart. But I don't know if that's true. While playing an alphabet game with my nieces, I learned that my older niece don't know much about geography, and it bothered me.

The game goes, "A my name is (name that begins with A) and my husband's name is (name that begins with A). We live in (place that begins with A) and we sell (commodity that begins with A)." And so on, through the alphabet, then beginning again with A.

I came up with a number of location names -- Easthampton and Kalamazoo are two examples -- that Malka rejected out of hand because she'd never heard of them. And I was fairly shocked and disturbed by this.

I already knew that her spelling is atrocious; the geographical ignorance made me first worry about her, and then wonder at myself. Because Malka also said, at one point, "Aunt Ayelet, does this game bother you? You know, with all the husbands?" Which is a pretty impressive display of empathy for a 9-year-old.

Shmuley Boteach, of whom I'm not a tremendous fan, nevertheless has a good parenting outlook; he was quoted in an interview as saying that he worries less about his children's grades and more about their development into interesting, compassionate people. And my niece is clearly a very considerate child. Isn't that more important than knowing where Kalamazoo is?

But I'm still buying her an atlas for Chanukah. And I'll sit with her and go over the major geographic markers, telling her what I know about them.
Copyright (c) 2006 "Ayelet Survivor"

Sunday, October 08, 2006

Siblings: Definitely mixed blessings

Spent the first days of Succot with one of my "successful" siblings, Jerusha, and my parents. She and her husband are both high-powered professionals, live in a nice suburban home with a big yard and tons of square footage; her bedroom closet is almost as big as my kitchen.

I love the kids, I love my parents, and I guess I love Jerusha. But she can also be a huge pain in the neck, and I get very angry almost every time I'm there. She's the world's least gracious hostess -- makes me feel like I'm eating them out of house and home if I take a snack from the fridge -- am I supposed to shlep out to the boondocks with my luggage AND food for the space of my stay, scrambling on and off a bus and a train? I've got a bad knees!

I can't even write coherently, I'm so angry.

The funny thing is, I know Jerusha loves me. She cried and cried when she finally saw me awake in the hospital, after the coma. She told our mother that she didn't know what she'd do if I died. (Of course, when I was recovering and neglected to return one of her phone calls immediately -- can't a girl check her email? -- she said to me, furiously, when I finally called back: "I knew I should have taken pictures of you in the coma to show you how awful you looked! That was a horrible week for me! When I call you, call me back!!!")

My mom tried to pacify me tonight, saying that Jerusha's under a lot of stress. Hello? Who's the expert on stress? The girl who always has to worry about her totally inadequate health insurance! The girl who worries about paying rent and tuition! The girl who still has years of school ahead before she starts earning a decent salary again! The girl who takes a handful of pills every night and STILL has to work three times as hard as anyone to manage her moods!

The difference is, Jerusha takes her stress out on me, and I don't return the favor. Maybe I should. Maybe I should be as nasty to her as she is to me. Abuse her for things that aren't her fault. Mock things that are important to her. Belittle her ideas and ambitions.

She doesn't understand how vulnerable and alone I am. How I've had to do so much for myself. Friends and family can only help you to a certain extent. She's never been alone like I've been alone for more than a decade; she met her husband in college. She never had to move to a new city by herself, try to make friends, then watch her friends get married one by one, leaving her alone. Scramble to earn a living and to get invitations for shabbos. She's never had to spend Shabbos completely alone. She has no right to judge me.

And when I'm a guest in her home, she should try to make me feel at home. Not like an unwelcome interloper that's eating more than her share. (Right now, I really don't need people commenting on how much I eat.)

It's hard visiting my siblings and their neighbors in suburbanland. They're all happily married, own their own homes, have kids. They have everything I want. And none of them wants to go out of their way to help me. They don't even attempt to network or ask around about available single guys. When one of Jerusha's neighbors asked her to ask me about a single guy she knew, it took my sister MONTHS to convey the message -- during which time we spoke on the phone more than once. By then, he was off the market.

I realize people with kids and houses are busy. Kids are an incredible drain on a person's resources, both financial and emotional. They're incredibly needy, and they're a lot of work. Same is true for houses and yards.

Some married people still manage to make the time to try to make shidduchim. Not nearly enough of them, though. The "singles crisis" is a community crisis. We're not being introduced to each other. It's very hard to approach a total stranger and strike up conversation. No earlier generation was expected to do this. Instead, the community took initiative and tried to introduce compatible men and women. And very few people are doing that today.

I know I'm not the only lonely single person wondering why some people get lucky (in the frum world, that means get married) and others don't. I'm about to face yet another Simchat Torah on the West Side, which is kind of like the Olympics of frum singledom. People descend upon the area from all over and try to hook up (which in the frum world means make a connection that leads to marriage).

And I'm Michelle Kwan -- injured, trying gamely for the gold, but always denied. (Although I do find her kind of annoying. Probably that's how Jerusha sees me.)
Copyright (c) 2006 "Ayelet Survivor"

Thursday, October 05, 2006

The first meeting

Fabulous initial meeting with the local rabbi, the UJA liaison, and the social worker who's a Partner in Caring (PiC) at a few other shuls. A PiC (social worker or psychologist) at our shul will enable us to do many things and will help us maximize the strengths and talents of our community.

First, we can identify and mobilize mental health professionals in the community who can either provide short-term, pro bono services, or who can accept new clients into their practices -- a referral list. (Which will NOT include my former therapist. Not because I'm spiteful -- because she was either grossly incompetent or grossly negligent. I don't want her telling some other family not to hospitalize their loved one, and have that person succeed where I failed.)

The PiC will be able to make a shidduch between the client's needs and the community member's clinical strengths. Of course, if the person doesn't want to see a community member, the PiC has access to UJA's vast array of services and treatment options as well. (Which, the rabbi advised me, I should avail myself of as well. I beat him to it; I've already got my eye on their program for people facing huge medical crises. If I'm off my feet for two weeks in January, recovering from knee surgery, I'm going to need some home care, and they might be able to help.)

Second, we can recruit and develop community volunteers to provide empathetic support systems for vulnerable people. I have a few ideas, and there were some suggestions from the Safe Spaces meetings this summer. We can put some of those into development. Ultimately, I think we'll also develop support groups; for dating, troubled marriages, bereavement, caregivers -- whatever are the largest needs we identify.

The PiC will also be able to make short-term interventions and either resolve situations or stabilize them, then refer the person/s for longer-term treatment. All of this will make our congregation more responsive and supportive for people facing serious crises.

I am very excited to be the synagogue's point person on this initiative. It was also great to speak openly about my disorder with the PiC, the liaison, and the rabbi, because I knew they wouldn't judge me. In fact, the rabbi said something that was actually very sweet, although I found it a bit annoying at the time. He told me that I shouldn't view it as a "disorder" -- it's an aspect of me that was given me by Gd so that I can do the work I'm embarking upon. He told me about a family that gave birth to a child with severe disabilities, and their advocacy and drive to secure services for that child ultimately led to the founding of the March of Dimes.

I'm well aware of the role grassroots advocacy can play in building engines for change; NAMI is but one excellent example of this. But -- here's the rub: he said, "It's not a disorder," and it IS. It's a disability.

I'm happy to assign meaning to it -- I wasn't targeted randomly; instead, Gd chose me to have this so that I would become more compassionate and work to help others . (Although He could have just sent me a dream or a vision.)

I can't, however, see my disorder as something discrete and in the past. My suicide attempt is a thing of the past, and I truly hope and believe there will be no follow-up. But the effects of my illness are with me every day. Every time I get angry and wonder if I'm spiralling into a depression. Every time I'm tremendously happy and, in the back of my mind, feel a pinch of fear that it's the onset of mania.

The rabbi was doing his job, of course; he's supposed to provide pastoral counseling and he's pretty good at it. He's very in touch with the empathetic aspect of being the leader of a big congregation, and he is a very sensitive, caring person. I have to let him know that I don't see myself as inherently damaged or blemished -- I have a disorder, but it doesn't define me. If we used psychiatric labels, then I'd be nothing more than a narcissistic manic-depressive. Does that fit with the entirety of my actions? Not really (I guess I do love the sound of my own voice. Maybe my TA had a point).

He thanked me for being persistent in setting up the meeting and told me to continue to remind him to speak, in his sermons and other communications, about how having the need for care and support is normal, human, and something we want to help with. Next time I remind him to sermonize about it, I'll tell him I see myself as he sees me.
Copyright (c) 2006 "Ayelet Survivor"

Dear TA: You're not my mom!

UPDATE: Turns out my T.A. didn't have anything so horrible to discuss. She just wanted me to contribute a little less in class. She thought the other students weren't getting a chance to air their opinions.

I felt very uncomfortable because she kept asking me how I felt. How do you think I feel, you scrawny little blonde bitch? You're telling me I talk too much in your lab even though I've really got the most to say. You're setting me up to fail: while professing enthusiasm for my contributions, I'm told not to make too many. And not given any concrete suggestions of how to gauge what would be too many. Instead, how do you FEEL about this??

I told her I'm not passive-aggressive and wouldn't stop contributing entirely in lab, and I'd try to negotiate a better balance. She wanted more, I could tell. She wanted to know what I was feeling.

And I didn't want to talk to her about that. How I feel is none of her business; she's not my therapist, she' s not my mother. I felt targeted and criticized -- how could I not? -- even though I rationally knew that's not how she meant it. And I needed time to absorb and get over the shock. So it wasn't fair of her to ask me at that moment how I felt. Ask me in a week or two, when I'm not hesitating before every word I say, when I'm not COMPLETELY self-conscious about my demeanor and behavior in class.

All during lab I was very self-conscious and cranky; I was never sure if I was saying too much, and I was working hard to make sure other students had time and space to speak. I felt like she was watching me and conscientiously going out of her way to try to be nice to me. Even though I was a "bad" student for not telling her how bad I felt, she could sense that I was distraught and was going to fix it for me.

Maybe she's threatened by my age and prior education. Or maybe I'm being paranoid. Whatever. I'll feel totally fine in a day or so, but at the moment I felt punched in the stomach. And I really didn't want to talk about it with her.
Copyright (c) 2006 "Ayelet Survivor"

Wednesday, October 04, 2006

When bad therapists happen to good patients

Last night I saw more than myself in my cognitive therapy reading: I saw my evil ex-psychologist, Dr. Incompetent, the one who almost killed me.

I mean that literally. Dr. Incompetent talked my mother out of hospitalizing me by saying that if I went into the hospital, I'd never get another job or get married. I proved her wrong on one point, and I'm doing my darndest to prove her wrong on the other.

This week's class topic is therapeutic empathy. Because cognitive therapy is more formulaic than traditional psychoanalysis or psychodynamic therapy, some have accused cognitive therapists of being cold and uncaring. Au contraire, say the cognitive therapists: a healthy rapport with the patient is essential. If the patient feels patronized, or if the therapist becomes defensive, that damages the therapeutic relationship and leads to a less successful outcome.

Well, defensive is what my Dr. Incompetent was. Massively so. When I felt that she was cold and withdrawn, she told me that everyone else found her warm and compassionate. Implication: what is wrong with you, Ayelet?

Her hostility was palpable. I didn't like Dr. Incompetent the first time I met her but thought that I needed an orthodox Jewish therapist to help me. Let me tell you: NOT TRUE. I felt more comfortable during my first private session with a clinical social worker on the psych ward. She wasn't even Jewish, but she really understood me and we got along well.

It's hard for me to believe that I spent eight years -- and thousands of dollars -- with such a horrible woman.

The morning of the day that I overdosed, my mother called Dr. Incompetent, frantic. I wasn't returning anyone's phone calls. She was terribly worried about me.

"Ayelet's out of control," said Dr. Incompetent.

What a load of crap. I wasn't out of control -- my illness was out of control. And Dr. Incompetent was out of her depth. She thought she could cure me. Even when I told her I wanted to find a new therapist, she insisted I had to stick with her through this crisis. Refused to help me find a new therapist -- which is standard procedure when therapy isn't working.

So I stopped going. And Dr. Incompetent kept billing me. She also never suggested that I enter a partial hospitalization program -- intensive outpatient treatment where I attended therapy during the day but slept in my own bed at night. That's either gross incompetence or malpractice. Or both.

After I overdosed, Dr. Incompetent called the hospital every day. I'm sure she was only thinking about her potential liability if I died. Because after I woke up and spoke to her on the phone, she was cold and callous.

I asked Dr. Incompetent if she had any suggestions for what I should tell my co-workers about the episode. Long pause, then she said, in a voice marbled with sarcasm: "I don't know why you would think I'd have any suggestions about that."

Um, because you're supposed to be my psychologist?

Dr. Incompetent sent me a bill for all those sessions I missed. And like an idiot, I paid it. And enclosed a note thanking her for our work together and telling her my attempt wasn't her fault.

I wish I hadn't. I wish I hadn't paid that bill, and I really wish I hadn't tried to make her feel better. Because she was directly responsible for my attempt.

One of the suggestions that came up in the wake of the tragedy this summer was creating a referral list of West Side mental health professionals for shul offices to keep on hand. I don't know if that's been followed up on. Tomorrow I'm meeting with my rabbi and a person from the Jewish Board of Family and Children's Services to talk about setting up a Partners in Caring program for the shul.

I'm going to ask that we look into some other programming as well. Including that referral list. And I want to compile it. Not out of revenge, but out of concern. I don't want Dr. Incompetent telling another family with a person in crisis that she can help them without resort to hospitalization. Because she can't.

There's actually legal precedent for me to sue Dr. Incompetent for malpractice, but I doubt I'd win. For one thing, her husband's a hotshot banker and VIP at another local synagogue. Suing them could potentially make me look very bad; religious Jews aren't supposed to sue other religious Jews. For another, she comes from family money, and I don't. I'm having enough trouble paying for grad school, let alone a lawsuit. If I do file suit, it will be against my horrible den-of-torture gym to recover the money I wasted there in search of better health.

But I truly believe she's not only incompetent but uncaring. Dr. Incompetent became defensive and hostile when therapists are supposed to be caring and acknowledge their own limitations. She's one of the worst therapists I've ever encountered.

Sadly, this kind of therapeutic ineptness is fairly common. Studies have shown that therapists routinely overestimate their own empathy and their patients' regard for them. And when patients don't find their therapists sympathetic, they don't get better; only patients' estimates of therapeutic warmth and empathy correlate with recovery.

Ironically, Dr. Incompetent got her doctorate at the school I'm currently attending. Fortunately, I know that a lot of changes have been made to the curriculum in the interim. But I still wonder if anyone on staff remembers her, and what they thought of her. They must have thought she was pretty good, or she wouldn't have graduated.

They were wrong.
Copyright (c) 2006 "Ayelet Survivor"

Monday, October 02, 2006

Emphasis on the agony

One of the places where I can be myself is the NAMI-NYC-Metro's Media and Advocacy Group (MAG). We write letters to the editor expressing our concern that people with mental illnesses are not being portrayed in a respectful manner. We lobby state government to stop putting mentally disordered offenders in solitary confinement, where they decompensate and suffer terribly. And we have a Yahoo group that allows us to organize meetings and bounce ideas off each other.

One member posted recently,

I've been reading Primo Levi's "Survival in Auschwitz" and I stumbled on:

Strange, how in some way one always has the impression of being fortunate, how some chance happening, perhaps infinitesimal, stops us crossing the threshold of despair and allows us to live. It is raining, but it is not windy. Or else, it is raining and is also windy: but you know that this evening it is your turn for the supplement of soup, so that even today you find the strength to reach the evening. Or it is raining, windy and you have the usual hunger, and then you think that if you really had to, if you really felt nothing in your heart but suffering and tedium -- as sometimes happens, when you really seem to lie on the bottom -- well, even in that case, at any moment you want you could always go and touch the electric wire-fence, or throw yourself under the shunting trains, and then it would stop raining.

I never thought in terms of how easy it would be for someone in the camps to commit suicide. When I think how overwhelming it is for most of humanity to contemplate life in the camps, and I realize that most didn't hit the point of trying to commit suicide, I feel we're not communicating how horrific depression and mental illness can be. People just aren't getting it. Putting a mentally ill person, especially with depression, in solitary confinement is a horrific, horrific action, only made worse by not providing them with the means to take their life...?

Somehow the movement at large needs to work harder to communicate how horrific these mental states are.

I agree with her entirely. The "normals" don't understand how painful these illnesses are. I gained 20 pounds a year ago because eating cake temporarily shut out the agonizing anxiety I was feeling, until the medication kicked in and I felt better. I wanted to kill myself a hundred times, and stopped myself only by knowing that the pain would ease. Six years ago, I didn't have that certainty, and I almost died.

It's hard not being able to talk openly about overcoming this pain, with the help of medication, my psychiatrist, and my friends and family. Especially when it's difficult for me to maintain a balanced mood. I know my professors and classmates are watching me -- and they don't know how handicapped I am. (I'm not a fan of the term "disabled" and I really hate "differently abled.") When my behavior seems odd or inappropriate, they'll call me on it.

I wonder if I should confide in one of my professors. They've already admitted me, and they should be understanding of someone suffering from one of the illnesses that we're being trained to treat.

I did talk with my faculty advisor about Dr. Jerk. Unfortunately, the adviser's a big psychoanalytic type -- I'll call him Dr. Freud -- so he didn't have all that much to contribute to the conversation. He did give me props for coming to him to talk it out, though -- said that too many people let things get out of hand before asking for help.

I'm slightly anxious because I got an email from the T.A. for Dr. Jerk's IQ testing class. She wants to meet me before lab. I don't know exactly what it's about , but I don't think it can be good. Again, I would love to tell her that I suffer from bipolar disorder, if she thinks my behavior seems a bit off. That I'm struggling to stay on an even keel, and it's extraordinarily difficult.

But I won't confide in her. I'll see what she has to say, and I'll deal with it as best I can. Without the context that would make a significant difference in how I'm judged. I want to plead "Not Guilty by Reason of Insanity," but in the courts that plea is rarely raised and even more rarely successful.
Copyright (c) 2006 "Ayelet Survivor"