Posted by Racer on June 9, 2004, at 15:21:58
First off, please tell me if I understand the concept of a "10": it's ten things we're grateful for, or ten positives, or ten of whatever it is that we can look to to hang on? If that's right, mine is not entirely a "10" by those standards. It is a list of ten things that I am trying to hold onto as "enough." Or, at least, "enough for now."
So, this list is not a list of ten positive positives, so much as a list of ten not-entirely-negatives. Not a "real" ten, but it's what I'm trying to hold on to right now.
1. Even in my current state, without any real hope for recovering from this, I can step back and look at what's happened and see that there were steps all along the way that Dr EyeCandy or one of the Therapists From The Swamp Creature Factory could have done to improve my outcome. In other words, I can see that my failure to respond was not entirely my fault. I can see places where the outcome could have been improved greatly by a small act on their part.
2. The failures in number one have led me to see things that can be done now, which would improve my chances of recovering to whatever extent. (I really have given up anything like what I would consider a meaningful recovery. Maybe it's a mark of the depth of my depression, but it's real right now, so please don't just deny it. Respect that it's real to me now, even if you disagree.) I can use these ideas with my next therapist to try to improve the outcome with her. I can also take the list relating to medications to my next pdoc, to improve the outcome with him. (Or her.)
3. Despite my recent adventures in suboptimal therapy, I can still see hope that a good therapy experience will help me improve my experience of life.
4. Thanks to the bad experiences, I have gained insight into what a "good" experience might look like, and specific steps that influence the creation of that good experience.
5. I still have the capacity to find external validation for the perceptions that I've been told are totally distorted. For example, I just read a protocol about prescribing anti-depressants for severe depression. It defined "adequate treatment" and included the comment that, while the definition was used in their study, the researchers considered it the absolute minimum standard of care acceptable, rather than truly "adequate" as that word is usually understood. Guess what? The inadequate standard of "adequate" care used for the study is considerably more than I've been getting, by any measure. That gave me something to hold onto, because the level used for the study is basically what I'd like to ask for, but have been told is unreasonable by the clinic. (Things like bimonthly follow-up by telephone or in person when starting a new drug. NOT daily reassurance, just a way to get support for problems that arise.)
6. I am still capable of seeing some of my strengths. Maybe not very well, maybe I am not really accepting them fully, maybe I'm not even thinking that they mean anything at all, but I can see things that I can do 'well enough' if not 'well.'
7. I can recognize patterns. This includes patterns of behavior, in myself and in others, and in myself in relation to others. It may not be any help in reaching a solution to my problems, but recognizing it is the first step, and with the help of a good therapist, I hope to be able to make the next step. (I'm scared to death right now about that. I'm having such a hard time trying to talk right now that I'm afraid I'll be so withdrawn that it'll recreate the same situation I had with the last therapist. On the other hand, I think the last therapist had interpreted the Withdrawn Racer as a Sullen Racer, and the new therapist is supervised by our marriage counselor who has probably already warned her that I am depressed and withdrawn, and I have expressed my concern that the depth of my depression will make it very difficult for me to do myself much good in therapy right now. In other words, I do feel safer, even without meeting her.)
8. I still have the impulse for contact with someone, somewhere, and I've acted on it by writing this for you.
9. I've got a good, scientific/engineering style thought process, which I'm still capable of using. The medication trials that have failed so far have actually given me some ideas that I think are worth following up. I don't hold out any hope that Dr EyeCandy will go along with any of them, nor that he'll provide the sort of follow-up support that would improve the chances of a good outcome, but at least when I get to another doctor, I'll have my little list of suggestions.
10. I did a little Racer History Test, and realized that, while I've had this problem before with county-affiliated doctors, I've never had this sort of problem with private practice, or even group practice doctors. Ha! That little tidbit helped me more than you can imagine. And I also saw the pattern I go through when faced with this dynamic: I lose faith in the doctor, which then translates to losing faith in my ability to recover with their help, which moves on to hopelessness. What's happened each time so far has been that I've improved almost immediately with the private doctor that I see next. Now, that's probably because the private doctors have A.) Listened to me, B.) Taken my concerns and suggestions seriously, and C.) Treated me with respect and as though I can recover. (The clinic through which I see Dr EyeCandy actually *told* me to resign myself to a marginalized life because of my depression. Maybe that's influenced my ability to hope for something better from life?) Seeing that pattern might be enough to make into a touchstone for the next six months or so. I'm not sure it can sustain me, but I'm trying to hold onto it.
Anyway, there's a pretty pathetic attempt at a list of ten positives, but a pretty danged good list of ten realistic assessments of what's holding me to life right now. Take is as you will, they are the closest I can come to actual, legitimate positives right now, and they are valuable in themselves, to me at least.
(Yeah, I'm pretty defensive about them. For example, I get lost into telling myself cruelly that I really am the reason nothing has worked, that these therapists were great and I just wouldn't work hard enough; that I have to do the work, so what does it matter how good or not good the therapist is; etc. I'm also beating on myself for making such a negative '10' list, when it's supposed to be positive. Etc. My Inner Critic thinks my life is an Oliver Stone movie right now, you know?)
Thanks for reading this far.
poster:Racer
thread:355177
URL: http://www.dr-bob.org/babble/social/20040602/msgs/355177.html