As I was going thru some old journals of mine this past week, I read some entries that recalled conversations I had several years ago with a friend about the nature of mental health and wellness. My friend had been on a journey of self-discovery at the time, helped along by therapists, and had gained great insight into herself and her conditions. In addition to her counseling, she was also going to Alanon, and taking Paxil for her anxieties, but in spite of it all, she was still massively unhappy.
Her pain was real. As a child she suffered traumas and neglects, growing up in a dysfunctional home, with a father who was an alcoholic and a mother who was emotionally abusive. But I found it rather disconcerting that she seemed utterly fixated on the emotional abuse she experienced as a child, and seemed mired in Anger Mode. Again and again, as we'd talk, she would bring up her childhood and the pain that still haunted her, seemingly stuck in an endless feedback loop of rumination, self-loathing and self-pity.
Lest I sound excessively harsh, I understand perfectly well what she was doing. I've been there, and at times I still do it, myself. I have suffered many years of low-grade depression laced with anxieties, ADD, and some OCD-like tendencies, and have had several episodes of severe depression, replete with the kinds of self-esteem issues with which my friend had been dealing. When things have been at their worst, I have been barely functional, a walking basket-case.
In fact, it all got so bad about twenty years ago that I sought succor from a series of counselors and therapists, taking the MMPI, reading book after book, spending hours in therapy considering what I thought my problems might be, only to leave each therapist's office frustrated and angry. Every one of them had a slightly different method, and all of them took a relatively passive approach to addressing my needs. The common thread was that they wanted me to discover - over and over - the roots of my pain. So time and time again, under their guidance, I'd delve into the past, but it felt like wandering some kind of mirror maze, on and on and on, with no resolution, and in the end I only felt more hurt and lost and hopeless.
If you've been reading this far, you probably have a question: yes, I have tried medication, several different ones, in fact, and nothing has really helped.
I can't say that there isn't a med out there that might help, but I simply haven't found it, and I've pretty much given up on medication. Thing is, for me the side effects have usually been as bad or worse than what I was going thru that led me to try them in the first place. I was told I should wait some 3-6 weeks for the therapeutic benefit to kick in, but I was never able to tolerate it that long. I guess I'm just extra-sensitive to the meds. Also, it hasn't helped that the Pscych Docs I've seen haven't been particularly kind or attentive. The Clinical Psychologists are trained to be caregivers, and the Psychiatrists are trained to dispense medications, and in my experience it's rare to find a Psych Doc who has strong patient skills.
Anyway, what I said about no longer trying medication is mostly true, but with a twist: I recently got a script from my Internal Medicine MD for a low-dose of an old-school anti-depressant which I use off-label for gut pain, and I can't say that it helps me with anxiety issues, but I feel it has helped me sleep somewhat better when I *am* going thru a period of excessive anxiety.
In the end, the thing that's helped me the most, really, has been exercise. I try to walk at least 10,000 steps a day, with at least a half-hour of that being aerobic. Study after study shows that for mild to moderate depressive episodes, as well as for anxiety, there is a very real benefit that accrues to the patient from doing regular exercise. When one is feeling down, sometimes that's the last thing one wishes to do, but for me it's imperative that I keep at it, as it's the only thing that gives me any physical relief to my symptoms when they flare up. And, hey, it's good for the heart, too.
Finally I was told by yet one more therapist, after our first visit, that he felt there was nothing he could do for me, that I had obviously learned all the jargon and lingo, that I was full of psychological insight, that the missing link for me was to go out and live my life. He said I was unlikely to ever be fully well, but that if I stopped picking at the scabs of my pain, I might at least get better. He further told me that if I didn't ease up on the counseling, I could well end up becoming a professional patient, learning little and accomplishing even less. Ouch. I recall feeling a flash of anger and resentment, as it felt to me that he'd pronounced me hopeless. It felt incredibly unfair that he would say that, and I went so far as to lock myself in the men's room after that session, and cried for nearly 20 minutes.
But upon reflection I realized he was right. At that point in my life I *was* becoming a professional patient. I *had* learned all the right terms and words, and had even done alot of hard work in self-discovery. What I had not done - and none of the other therapists had tried to get me to do - was to just get on with the business of living. Truth is, while it is possible to get better from a physical or emotional injury, it is often the case that one never gets completely well, and that one sometimes must just learn to walk with a limp or a cane, as it were.
And you know, there is a measure of Zen-like peace that comes from embracing the fact that one's wounds are real, that they will heal somewhat in time but that scars will remain, that there will likely always be remnants of the pain, that one might not ever fully recover but that our scars are part of our humanity. And I do believe it, even if I don't always feel it. Like most people, I *do* carry scars of old and recent hurts, and I'm unlikely to ever completey well from those wounds, but in time things do get better, if not well.
In the last couple of years, I *have* started seeing a therapist again, but he has made no bones about trying fix me. He practices a blend of Cognitive Behavioral Therapy with alot of active listening, and while no topic is off-limits in his office, he seems mercifully unconcerned with uncovering 'the roots' of things, and would rather try to get me to pay attention to the here and now. I see him every month or two to just talk about things, to talk with a non-judgmental professional who can help remind me to change the things I can change and to let go of the things I can't change, to try to do my ruminating with someone who can keep me focused on the matter(s) at hand. I have no illusions that seeing him is going to make me well, but it does help make me a bit better, and on alot of days that's enough.
Anyway, I wasn't convinced that my friend really needed more and more therapy. or at least, I wasn't convinced that the kind of therapy she was getting would necessariliy help her further. She seemed to have learned all the psych jargon that her therapists wanted to hear out of her, but she still appeared to be hanging on to the very real wrongs that were done her in the past, hoarding them so as to be able to continue to lay claim to a victimhood that, to my view, had long lived out its usefulness. In the end, at nearly 40 years of age, she seemed stuck in a holding pattern, waiting for her life to begin.
Over the years my friend and I have drifted out of each other's lives, and I haven't had any communication with her in some time. I don't know how she's doing today, but I do hope things are better for her, and that she's found some measure of peace.