Thursday, January 28, 2010

BPMS

That's short for "bipolar pre-menstrual syndrome."

From Saturday night to Wednesday night I was cut-my-throat miserable. I slogged through work, somehow not being completely rude and nasty to clients, but not exactly channeling Carl Rogers. On Monday I had to cover a group for young "adults." Actually, they're supposed to be called "young adults," but in actuality they're a bunch of sullen, overgrown teenagers.

"Miss, you annoying," said one when I told her to take out her earbuds.

"Miss, you ugly," I wanted to respond, and didn't. I felt like a very strict nursery school teacher, telling them to sit up, watch the video, keep their eyes open. There's a very good reason I don't work with adolescents: I don't like adolescents. And of course, the newest counselor at the agency is sitting in to watch how we run groups here. Greeeeeeeeeeeeeat. Fortunately, he was basically impressed that I didn't kill/yell at/criticize/belittle or otherwise abuse the clients.

So I got home cranky. And wasn't much cheered by a phone call from JV, who seemed to notice all the things I would hate about going skiing: the chair lift, trying to balance while sliding down a mountain, the cold, the damp, etc.

"You don't sound like you miss me," I said.

"I know," he said.

"You don't think that's a problem?" I asked.

"No," he said. "I do."

Fantastic. I went to sleep and had a very creepy nightmare about being sexually molested by the son of a family I was visiting, not being able to push him away from me, not being believed when I tried to tell people about it.

Tuesday started out a little better, if only because I got to sleep late and start work at 1:00, but then of course I had to stay until 9:00. I also had a two-hour relapse & recidivism group with a pack of federal inmates on work-release.

The federal clients are on a very tight leash -- very strict rules about participation, conduct, attitude, etc. Technically, they're still incarcerated. And some of them are testing me, because I only started covering the group a few weeks ago.

One of them -- who's on my caseload, incidentally -- pulled out a little bottle of hand sanitizer and started using it during the second hour. Last week he got up five minutes before group was over and announced that it was over, "right, Miss Ayelet?" I had to take him to task about this during individual session, which for him is once a month right before group.

I shouldn't have to tell a grown-ass man that you don't engage in personal grooming during a therapy group. You don't eat, you don't sleep, you don't clip your toenails, and you don't put on hand lotion or sanitizer. Already I'm dreading having another conversation about this crap with him.

That night I dreamed that I was some kind of amateur detective in a murder mystery, trying to figure out where some husband had concealed his wife's body. (Somewhere in the radiator, I think.) My dentist was in the dream, but he wasn't the murderer.

Wednesday was hell. One client I had to discharge for noncompliance called to berate me for not caring about him. Another -- who seems to think he can come to treatment whenever he's in the mood, and skip whenever he's not -- took offense when I told him his parole officer and I agreed he needed to go to inpatient treatment. And flipped out when I suggested that his heavy marijuana use -- and his wife's heavy marijuana use -- was probably part of the reason they lost one baby to crib death and another to miscarriage.

Maybe I shouldn't have said it. And maybe he needed to hear it, even if he didn't want to. He pitched a fit, which fortunately the assistant clinical director was there to catch.

I came home in a foul mood, and for some stupid reason decided to call JV to remind him that when he talked about his vacation, all he was talking about was how I didn't fit into his life.

"That's not what I'm saying," he stressed.

"That was the subtext," I insisted. He patiently heard me out.

"Do you... would you consider going to couples counseling?" I asked.

"You asked me that before," he said.

"It wouldn't be a frum therapist," I said, knowing that during his marriage to Mara those were the therapists they saw. Sorry, Nefesh, I won't be posting a referral request to your listserv.

"I'd be willing to do that," he said. "Can I ask you something on a happier topic? What can I get you from here?"

"You don't have to get me anything," I said. "I didn't get you anything from Vegas."

"I know, but I want to," he said. "The thing is, I'm not sure what you would like from here."

Here's where the PMS really kicked in. I realized that I had completely terrorized this man, so that he was afraid to give me a spontaneous gift if he wasn't sure I'd like it -- so greatly did he fear my reaction. I almost started to cry. I definitely teared up.

"I like maple sugar candy," I sniffed. Suddenly it was important to me that he not buy me anything permanent, so that when we broke up, there would be fewer things around to remind me of him. What has he given me? A pair of earrings, a pair of boots, and a toilet seat from Home Depot. I didn't want any more evidence of him in my life.

I went to bed miserable, dreamed that a co-worker who hates me (he wanted to be dual diagnosis program coordinator) asked me to be his family therapist, working with him and his sister. Turns out that he -- a tall black gay man -- was adopted. His family was a bunch of white Southerners. They had an amazing selection of sweeteners to put in your morning coffee -- apparently as their therapist, I was also their house guest. Right before I woke up, I was admiring the crystallized honey but wondering where the hell the actual coffee was.

Strangely, I woke up relieved. As I wrote almost a year ago,

My period started today, and it's like all the crazy just flowed out of me along with the lining of my barren uterus. I feel happier and calmer, and nothing's essentially different. Jockitch still doesn't want to marry me, and my job is still stressful.

Kinda sad how little has changed.

Today I was not a counselor. I was not a therapist. I was a rock star. I rocked my early recovery group. I departed from the handout, improvised, got all of them (well, almost all of them) to participate spontaneously and enthusiastically, illustrated different rates of addiction with bell curves (first illustrating the bell curve concept, and they totally got it), and showed them I can't be intimidated.

How? One participant, who seems like a nice kid -- asked serious questions about the addictiveness of nicotine as compared to crack -- brought up the topic of sexual addiction.

"I think I have a sexual addiction," he said.

"How old are you?" I asked.

"I'm 22," he said.

"You'll outgrow it," I said, to some laughter from the others. "Now getting back to marijuana..."

"Miss, no offense, but can I ask a question?" another guy asked.

"Sure," I said. Doesn't mean I have to actually answer it. Counselors are good at parrying inappropriate questions.

"Does it make you uncomfortable to talk about sexual addiction in a room full of men?" he said.

"No," I said easily. "I've just never sent a guy to rehab for jacking off too much."

A shocked second, then a burst of laughter and applause. And we got back to marijuana. I think we will talk about sexual issues and addiction next time, though -- how people might substitute sex for drug use or emotional intimacy. Stuff like that. Thank that 22-year-old, guys, because next week you're going to spend a whole hour talking about your feelings.

And the rest of the day went pretty well too. I thought about calling JV to tell him I was more or less back to normal, but decided to leave well enough alone. I'm going to an oneg Friday night and a party Saturday night -- JV has the kids till Monday morning. Whenever I see him, I'll tell him about the PMS.

My good friend Boaz also put a more positive spin on JV's un-Ayelet assessment of his vacation. "It shows you were top of mind the whole time," said Boaz. "Everywhere he goes, everything he does, he's thinking about you." True enough.
Copyright (c) "Ayelet Survivor"

8 comments:

  1. Hey, you're annoying too? Welcome to the club! My children tell my I'm annoying all the time.

    :)

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  2. A very positive post!

    I have weeks (or even months) sometimes where I'm so irritated and angry and depressed and even suicidal, and then somehow it passes, and I can find my energy flow again. Whether it's hormonal, seasonal, or just your own natural emotional rhythms, I'm glad you've hit bottom and dipped back on the upswing again. Just try to remember next time it's a low, as I do, that the up comes back.

    Your dreams were very interesting, by the way. Hard to interpret but our minds have a way of working things out for us during sleep. I know mine does. Maybe your wacky and sometimes awful dreams helped you process some of the bad feelings you are having, and that helped you get back to yourself.

    Good luck. And please don't think that I'm not being supportive if I'm not always "Go Ayelet GO!" or super-huggy. You're doing good, and I'm glad I get to see it. But I'm also human and sometimes I get annoyed or in a bad mood, myself. I've been having a rough time lately. I'm hoping that's close to over, but it's why I've been less responsive or less positive. So please understand that.

    Best,
    --S

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  3. wow I think it's kinda horrible that you would tell someone you think their marijuana use had to do with a miscarriage and a crib death, there is absolutely no scientific evidence that marijuana use would cause anything like that (crack, coke, heroin, yes, marijuana no), so it seems to me you just told him that to try to get him to stop smoking. Not cool. If I was him and you said something like that to me I would flip out to- you basically just accused him of killing two of his kids, based on completely inaccurate information. Wow. Just...wow.

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  4. so I went and looked it up on google scholar and found this from an abstract:
    "Low birthweight, short gestation, and major malformations occurred more often among offspring of marijuana users. When we used logistic regression to control for demographic characteristics, habits, and medical history data, these relationships were not statistically significant."

    What that bolded part means is that yes, marijuana users have higher miscarriage rates, but that this is completely attributable to other characteristics they also have (characteristics that are correlated with being a marijuana user), and not attributable to the marijuana use itself.

    Some laypeople have decided this means marijuana causes miscarriage, but as I love to tell my students: Correlation does not equal causation. In fact, these findings implies there is NOT a causal effect, because if there was the relationship between marijuana use and miscarriage, the relationship would remain statistically significant after controlling for other characteristics, which it does not.

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  5. AE, a search on Google Scholar using the phrase "marijuana crib death" turned up about 8,940 articles. That is one HECK of a correlation. Moreover, marijuana smoking is usually part of an overall unhealthy lifestyle (poorer nutrition, for one thing) that is not conducive to healthy families.

    Achieving sobriety means more than just putting down the blunt; it's changing your entire life and outlook. People think marijuana is a "harmless" drug. It is not. It has been associated with a host of negative health consequences from testicular cancer and infertility to respiratory illness and weakening of the immune system. And if you're on parole -- as this client is -- marijuana is fatal to your freedom.

    So I'm sticking by my decision to tell this client a hard truth: that his and his wife's marijuana could have contributed to the loss of their children. I'm not in a popularity contest. Sometimes being a good therapist means telling people exactly what they don't want to hear.

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  6. R. Max, glad it's not just me. Are your kids teenagers?

    S., you are always a great support and a blessing. Please don't think I meant you when I was kvetching about "friends" invalidating me.

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  7. I gotta agree with Abandoning Eden. 1 out of 3 women experience a miscarriage at some point in their lives. Over 2500 babies die each year from SIDS in the US. Neither of those are correlated with marijuana use. I think your comment to your client was an offense to the many non-drug using parents who have suffered through miscarriage and/or SIDS, as well as misleading and therefore potentially damaging to his recovery. I bet he has enough bad actions to feel guilty and responsible for, without adding guilt for two terrible events that probably were beyond his control. Focus on the known effects of marijuana use - memory loss, poor decision making, etc.

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  8. Out of more than 4 million babies born each year in the U.S., only 2500 (.0625%) die of SIDS. One of the major risk factors is having a mother who smoked or used drugs during pregnancy. Don't take my word for it, listen to the Mayo Clinic.

    Unless you're willing to tell me something more about your credentials, Anonymous -- unless you work with substance abusers, or you're a medical researcher, or something along those lines -- I'm going to follow my supervisor and co-workers. So far, my co-workers believe I said the right thing. I'm talking to my supervisor on Monday.

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