You wanna’ talk about my therapy, huh? You want to find out what goes on behind the closed doors? You want to hear tales of my weeping and teeth-gnashing and my railing against the injustices in my world?
*sigh* Okay.
Except that it’s really not that dramatic. Good for me, I guess, but not so great for blog posts and your entertainment.
It all started many months ago when I went to see my doctor about something small and ended up crying in his office. It’s worth noting that he had a doctor-in-training there, as the clinic often does, and that five minutes before I started crying, I cheerfully gave permission for her to be present during my appointment. As it turns out, she spent that whole appointment looking uncomfortable and handing me scratchy 1-ply kleenexes while I repeatedly apologized to her for my weeping.
(When I ‘train’ someone, I do it thoroughly, I guess.)
Now, I wasn’t weeping about the contents of the appointment. I don’t even remember, now, what I was there for – but it was something minor. Something that should have taken 5 minutes to deal with in the office, I believe. As I cried, I asked for a referral to one of the health team’s counsellors. My doctor wrote it up and, well, it was just a matter of waiting.
This is where I put in a big plug for “Health Teams”. When I visit my doctor, I can be easily referred to other services “on site” – like therapists and dieticians and nurses and nurse practitioners and an awesome after-hours/weekend on-call services and assorted health-related programs. All of them are free. The wait lists for these free services are generally a bit longer than private – but, um, free.
This is also where I, once again, thank Kelly for the time she called me (or was it emailed?) to tell me that she had heard from a coworker that a new doctor was accepting patients, just shortly after I moved to this city. I had no idea how AWESOME it was going to be.
Anyway.
In order to get to the source of my “need for therapy”, we have to go back to 1993. For some of my readers, that’s before you were even born, but for me it was the first year that I was in university. That’s the year that my mother dropped dead of a heart attack, suddenly, a few weeks before Christmas. That event fucked up my life. She was overweight – but she had quit smoking a few years before and had been trying to lose some weight and get healthier at the time that she died. It didn’t make any sense to me or, it turned out, anyone else in our family.
It wasn’t for quite some time after her death that I came to understand that my mother had been hiding some health problems. I requested her medical records from our (small-town) family doctor, with the plea that they only include “things that might be relevant to me as I get older”. I was 18 at that time, so I wasn’t quite certain what would some day count as “relevant” but I figured the doctor would know what to send. I flipped through the pages but didn’t really want to read them; the envelope went into a drawer.
A few years later, I took her medical records, including the information from the emergency room on the night she died, to my own doctor in Toronto. I asked him to tell me what he saw in the medical terminology and the scribbled notes and the various medicines that I didn’t recognize. He told me, at some length, that my mother had heart problems. Her death should not have been a shock to anyone, really, if we had known about the medical tests she had done and the medications she was prescribed (but wasn’t taking) and.. right around there is where I stopped listening. I got it. She had appeared healthy but she wasn’t and she hadn’t done the things she could done have to get healthier.
When I asked my Dad for his knowledge of this, he denied knowing more than that she had gone for a few tests. He thought it was related to her father’s early death (in his mid-40s) but had no idea, or hadn’t realized, that my mother had any problems with her heart. Maybe my mother said something, maybe not, but I believe that he had no idea.
My doctor referred me for various tests, too, after my mother died. I did the cardiac stress tests and the nuclear-medicine-stress tests and had ultrasounds and.. well, I don’t even remember. But all of them came back as “good!” and my doctor told me I had nothing to worry about.
So, for a few years, I didn’t worry. I went for my regular physicals – including the cholesterol tests and blood pressure checks – and was regularly pronounced “fine”. On a few occasions my cholesterol or my triglycerides were elevated, but that was fully attributable to my love for those god-awful Lipton Sidedishes (mmmm, creamy alfredo noodles that you just add water to make!) and my daily indulgences in random crappy food.
In 2001, though, as my long-time readers know, my Dad dropped dead of a sudden heart attack in the middle of the night. This fucked me up in new ways – but I didn’t need his medical records to understand his death. My Dad had high blood pressure for as long as I can remember (medicated) and smoked a lot and was mostly sedentary and ate unhealthy and totally ignored most of what his doctor told him because he was, I believe, in a lot of denial. From a young age, I had always been afraid that my Dad was going to die, but the reality didn’t come easy. My Dad had, apparently, had multiple smaller heart attacks over the years that didn’t kill him, and that he didn’t even know about, and then one big one that did.
Fast forward a few years and I began to have panic attacks. After the first month (during which I literally had all-day and all-night panic attacks that were unbelievably awful) I mostly only had them in the middle of the night. Usually around 3 am. And they were terrifying because, as anyone who’s had a panic attack knows, the symptoms are pretty much the same as a heart attack – and they were happening at the same time of the night, give or take, that my parents both dropped dead.
Then i started to have them whenever I felt even a little bit ‘off’. I was waiting for my heart to stop. If I felt a twinge of pain, I was waiting for the big heart attack to hit. If I felt nauseated.. same thing. I got a little obsessive around reading “women’s heart attack symptoms” and applying them to pretty much every feeling I had. Seriously, pretend that your whole family (yes, yes, two people) died of major heart attacks, then read that list of “major symptoms prior to heart attack” and try to NOT panic about feeling tired or having an upset stomach.
I went to see a therapist to do some CBT around my anxiety – because I am ridiculously reluctant to take the meds. (This blog post is not about that, however, so I’m not going to explain or justify it here other than to say that I am NOT anti-meds for anxiety or depression or anything else at all.) It helped decrease my panic and it helped me to decrease the length of the panic attacks and, well, that’s all good.
Over time, however, I started to get more phobic? concerned? distressed?, I don’t know, pick a word, around my health. And instead of making an appointment with my doctor to discuss it, I convinced myself that he was going to see me as a malingerer or a hypochondriac. I avoided going to the doctor altogether, including for my physicals, because I was slowly convincing myself that I was destined to die like my parents. And I didn’t want to know.
I became convinced, too, that there was nothing I could do. I became anxious around the idea of exercise in general – I thought it would kill me. I’ve eaten fairly health-fully for quite a few years now, but figured the damage had probably already been done in the earlier years, so there was no point in even checking my cholesterol or other indicators of health.
So, y’know, I did nothing.
That’s right. Denial. Always a good coping mechanism, right?
But.. there I was in my doctor’s office for something small and minor. And he asked me something – I don’t remember what – and I just started crying. I told him that I was terrified that I was going to die like my parents – who, for the sake of conversation, died at the age of 42 and 54 – and that there was nothing I could do to stop it because.. genetics? fate? who knows.
The funny thing, as I told him, was that I knew my denial wasn’t actually helpful. But I had a six month old blood work requisition form on my desk that I couldn’t bring myself to have done. I hadn’t had a pap in a few years (since before moving to this city, in fact) because I was afraid.
I’ve never, ever been afraid of the doctor before. Never.
And that’s why I needed the therapist.
During my time at school, I discovered that I learn best by talking. The easiest way for me to work out a challenge is to talk about it. If I don’t fully understand a concept, I talk about it. Explaining something to a classmate, or my husband, was a beautiful way for me to learn things – even if, at times, Coffee really wasn’t interested in learning what I was teaching.
So, I went to the therapist (let’s call him Brad) and I talked. I talked and I talked and I talked. And he listened and he listened and, on rare occasions, he got to talk a bit too. I told him about my family history – and I told him about my fears around my heart, my health, cancer, diabetes and everything else I had catastrophized in my head. Then I told him how ridiculous I was being and how all of those things could be treated or managed or cured, depending, and how I didn’t want to be like my parents. That the only way to avoid being like my parents was to take control of the situation.
After the first session, I booked a physical and I went to it. Then I got my blood work done, after a brief delay (because, seriously, fasting blood work is pretty much impossible for someone like me who starts her day with a mug of coffee and some conversation with her husband AND who couldn’t handle missing any classes for it, either).
Everything came back fine.
Actually, everything came back better than the blood work I had done in 2007 when we had our pre-adoption physicals. My cholesterol was lower and my triglycerides were lower and everything was in the “normal” range. My pap was clear. My blood pressure was fine (and normally I’m a “white coat hypertension” sufferer).
Then I joined a gym. Because I knew I wasn’t going to drop dead if I raised my heart rate for a while.
I’ve been going to the gym fairly regularly since February. I’ve missed a bit due to having the plague for a while (and, after I was feeling better, when I wanted to avoid making other people uncomfortable with my ungodly hacking cough that persisted). I’ve missed a few days due to PMS or some kid-related incident or an evening where I had something else that had to be done for school. But, mostly, I’ve been going to the gym and working out like a maniac.
(And it feels lovely, by the way, but that’s a whole other blog post!)
So..That’s right; I did all of that after one appointment with a therapist. This is because I was, in those formal therapists’ terms, “motivated toward change”. I just needed someone to hear me talk about it, and to hear myself talk about it, so I could talk myself into all of it.
I went back to the therapist again, since we had more appointments scheduled, and we started working on the problem that’s secondary to my “I’m going to drop dead” fears: my need for detachment. This one.. oy vey, it’s not going to go away easily.
When you are afraid that you are going to drop dead, it becomes very hard to attach to people. It becomes hard to make plans, to dream big. It becomes hard to think about what’s going to happen tomorrow, let alone next year, because .. well, what’s the point?
For several appointments, we’ve worked on this.
With my kids, I have spent a lot of time trying to keep them independent because I do not want them to be in the situation I was when my mother died – she controlled my life (in a big, ugly way) and when she died I had no ability to make my own decisions or figure out what I wanted/needed and, man, that fucked me up. This serves my kids well, I think, but I sometimes find myself drawing away from them out of fear that they will endure what I did (when my mother died).
I talk about this out loud, of course, and I hear myself say how ridiculous it all is. I cannot spare my kids the pain of loss, regardless of what the future brings. I cannot make it so they never miss me, simply because I teach them how to clean up after themselves. I can’t prevent my own death by making sure they don’t need me too much.
With my husband, I fear leaving him clueless about things that my mother left my dad clueless about – things like the cost of groceries and how to deal with kids and how to clean the counters. If Coffee wasn’t as incredibly non-stereotypical-guy, I believe my relationship would be a disaster of anxieties. The good news is that he is equally as engaged in life around here as I am. But I still worry. I still find myself, sometimes, disengaging and forcing him to engage more.
I talk about this out loud, too, and I hear the ridiculousness. I know that Coffee would miss me in a huge way, but that he would manage to deal with the practical things. (Then, of course, I get anxious that he won’t miss me at all which is a whole other thing).
With friends, well.. yeah. Those of you who’ve tried to spend time with me already know that it’s nearly impossible to get me out of the house. This part is probably the most complicated. It is due to my fear that, if I am not in sight of my loved ones, they will die. It is in part because, thinking I could die any minute, I can’t bear the idea of not spending every second with my loved ones. (Interestingly, this also gives me a great deal of anxiety because I imagine that if my loved ones die, I will have no one left in the world – because I try very hard not to let people get very close in a meaningful way, even those people that I truly love). I remember how, after my mother died, everyone around me disappeared. I remember how, when my Dad died, I insulated myself and it was less painful.
This one.. well, I talk. I try to work my way around it. I can’t. It’s too big. I find that I do ‘spontaneous’ friend things better than planned – short notice – because if I’m given a week or two to think about stuff, I’ll find a way to back out due to anxiety. I try to focus on how much I love my friends – and I do love them – but they have their own lives and there’s this weird thing about not being a big enough part of it.
It’s like when I try to imagine what I’d do if my kids and husband died, and it was just me in the world, who would pick me up? And I can’t think of anyone whose life I could fit into without being in the way. So I avoid the idea. I focus on what I have and what I do not want to lose.
This part is complex. I am not finished working it out – and, to be honest, I’m not sure I can do it before my scheduled sessions run out. I don’t really want to talk about; I’m not comfortable talking about it. I keep shoving a huge block in front of this.
But at least I’m healthy, right? And the therapy is free. So I have no excuse not to slowly work on it.
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