countertransferancve

Transference and countertransference
I have already talked about intersubjectivity.  Remember?  Intersubjectivity is how I feel about you and how you feel about me.  But it also includes my sharing with you what my experience is of how I feel about you.  Countertransference, on the other hand, is also how I feel about you but it is not something I would share!
Transference is the idea that a client will transfer their feelings, either positive or negative, about other people including their mother or father, on to the therapist.  When we recognize that a client is attributing some attribute to you which is clearly incorrect, then we can work on why a client may be misidentifying other people's responses to them.
For example, I was working with a kid in foster care.  We were playing catch and at one point, because I have no athletic skill whatsoever, I  accidentally hit him.  We were playing with a very soft ball because I have no athletic skill whatsoever!  However, he cringed and said, " Please don't hit me!".  I said, "Don't you know that I would never hit you?"  He said, "Well , I am 99% sure."  This is countertransference.  The kid was transferring his idea that all adults will hit him on to me.  I am 100% sure I would never hit him, and even though he felt pretty safe and comfortable with me, he just couldn't imagine that there could be an adult who would not hit him since that was what he experienced with his parents.
Now, countertransference is a whole other ball game.  Countertransference can either be useful or it can be very detrimental to the client relationship and the therapy.  I think this is especially useful when working with kids, because I can always ask myself, "What would it be like to live with this child seven days a week?"  There are many kids who elicits a desire to throw them right out the window!  I have not had very many clients who I have disliked.  When I do dislike them, I know this is something about them that needs to be addressed.  That is eliciting behavior.  The client is eliciting this by their behavior.
But sometimes the countertransference is something that I am transferring on to a client's and this is not useful for the therapy.
When I was working at LifeLink and had just been diagnosed with MS, this became a much more powerful issue for me.  I had many clients, the parents of the foster children, who were attempting to recover from drug addiction.  Something like 80% of kids in foster care, and least in Chicago, were placed there because their parents were addicted to drugs.  I had many parents who were attempting to recover from heroin addiction.  Heroin withdrawal is especially painful, and I would have many women say to me that they couldn't stand the pain and had to relapse.  This made me crazy because it was very hard for me to think that they were having any harder time than I was, and I didn't need to be on heroin!
Of course this is a very false analogy, and I knew that it wasn't fair of me at all to suggest that are situations where similar in any way. Most of these women were from the south side and the projects and had no education or even opportunities for education.  They were in the cycle of poverty and had been brought up in, at the very least, unsupportive families and at the worst, abusive families.  Most of them could tell me about horrors they experience when they were young, including physical and sexual abuse, homelessness, parents being addicted to drugs, you name it.  Did you ever see the movie, Precious?  As horrific as the experiences depicted in this movie seem, they are not far from the truth.  Most of the time, when working with parents who had been through these experiences, I had a lot of compassion.  After the MS, it was more of a struggle.
Okay, now that I've gotten all intense, I want to keep writing about countertransference, but with the idea of letting you know that kinds of things that therapists think, that they will never share with you.
But that will be a topic for another blog.

Fatigue

Before I start, let me just say that another reason I know that I am not a writer is by the frequency that I put off completing started projects.  I have lots of ideas and first lines,  but  getting them  to some kind of fruition remains somewhat futile!
Now that I've said that, let me talk about today's topic which is fatigue.  You may think that fatigue is only feeling tired and needing to go to bed or take a nap.  However, fatigue includes muscle fatigue or even mental fatigue.
Did you know that most people will have to quit working because of MS actually do so because of the fatigue.  I always thought I was pretty lucky that I don't have seriously excessive tiredness. I do have to go to bed early and sometimes would like to take a nap in midafternoon, but I generally am functional during daytime hours.  However, I am actually greatly impacted by muscles fatigue.  It really doesn't take much. In the morning when I go to work out, I can walk in relatively quickly and park my cane while I use the  weightlifting equipment.  At least two to three times a week I get on the elliptical machine.  I actually think it's kind of fun because, as I have said before, this is not a movement I can do in real life.  It's as close as I can get to running!  My goal is usually at least three quarters of a mile.  If I'm feeling pretty good after that, I will continue on for a whole mile.  I can tell when it is time to get off the machine when my knees start to knock together and a have to use more hip muscles to get my legs to move the pedals. I am not winded.  I am not breathing heavy or sweating.  I would love to be able to stay on for half an hour or longer, but I also like to be able to walk to my car.
 Even on the days where I don't get on the elliptical machine and only do weightlifting, it is still a struggle to get to my car without tripping.  Once the car door is open, I literally cannot lift my leg high enough to put it into the car.  I have to just sit down and then lift our legs physically with my arms.
This is the kind of muscle fatigue that is pretty debilitating. People who have jobs where they have to stand or do physical labor or  lift things, it makes continuing to work an actual impossibility.  For professionals such as myself, the need to stand is limited.  They need to lift is limited.  And, apart from picking up toys, there is just not much physical labor involved in what I do.  This is why I have been able to go close to 18 years with multiple sclerosis and still work.  And until I got laid off, I was actually working two jobs the entire time that I have had MS, because I have always maintained a private practice.  Now that I only have one job,  I absolutely remain ambivalent about not working.  I probably over identify with my role as a therapist.  Because I am not a real writer, the writing life does not seem to be a viable option for something else to do, and I really do love the work. But I am tired and they are days where I think I am shortchanging my clients because I am so not with it.  Even when I use tricks like trying to space out my clients, I just lack motivation and energy.
Despite my ambivalence about stopping working, it is a real frustration that I am not viewed as someone who is  not handicapped enough.  I guess just because at any moment I might trip and fall, or because I might fall asleep in a client session (this has actually happened), the Disability Administration does not consider me someone who deserves to benefit from guaranteed health care or financial security.  I know I sound a little whiny and bitter and petty today.  But really I am not angry.  I am just very confused about the definition of disability and am not sure what someone has to endure to receive some benefit. I am not trying to say that I want  to be one of those "takers".   I'm just fatigued and tired of wondering when I'll HAVE to stop working.  I guess in a world where I have no control, I would like to feel a little control over my career, and being able to know that my insurance will not be at risk, will let me be a little bit more in control of my destiny.

rewriting

I accidently deleted a blog I spent all morning writing!  That is the kind of thing that I do it makes me so incredibly angry! 
It wasn't saying anything spectacularly wonderful but I still don't want to have to re-write the entire thing and now I am wondering whether what was saying was  anything worthwhile anyway.  The ironic thing is that I was writing about depression and being able to override the anhedonia (or lack of enjoyment in life), and the feeling of being so unmotivated.  The other ironic thing is that anger is very motivating and energizing so I will try again to write about depression and try to say something worthwhile.

Did you know that 41% of people with multiple sclerosis suffer from some form of depression.  This is partially because the having the illness and dealing with all of the struggles.  It is also partially because of physiological changes in the brain.  Due to the plaques and the scarring the brain is less able to produce serotonin or to transmit serotonin between neurons.  Physiological depression is more difficult to override than situational depression.
Therapy and mental illness are highly misunderstood.  When I meet new people and I tell them what I do I frequently have people say something to me like "I'd better watch what I say to you"!  The fact that people say that at all is actually diagnosable, but I generally don't spend a lot of time thinking about other people's mental or emotional difficulties if they aren't in therapy with me.
Actually, I think that everyone could benefit from going to therapy at least a few times.  No matter how healthy you think you are, there are always things that shaped our behavior.  We all have our memes, or entrenched belief systems that may or may not be accurate in therapy can help you to uncover these things and be more present in your life.
Depression is a continuum.  The depression that I struggle with is very mild.  The kid that I write about on this blog sometimes is not on the far end of the continuum on the other side, believe it or not.  He functions.  He goes to work and is able to get out of bed in the morning and do what he needs to do.  People with the most severe depression can't even get out of bed in the morning.  They are overwhelmed by sadness and hopelessness. They see suicide is a viable option to end the sadness and pain.  These are the people who need medications the most!  Most people with depression fall somewhere in the middle.  These are the people who can benefit the most from therapy and who may or may not benefit from medications. These are the people who need to learn how to think different thoughts and change behaviors in order to keep from being overwhelmed by negativity.

I started this blog in order to feel that I can give  people some insight into what it's like to have MS.  I also started it in order to battle the very things that sometimes keep me from doing it! This blog keeps me feeling that I remain relevant, and this keep me from feeling overwhelmed by thoughts that I am worthless because I can do what I used to do.  So here is my blog.  Well written or not, it is as much for me and my sanity as it is for imparting any knowledge.

I started the blog that I deleted with this thought.  I am not a real writer.  Real writers write.  They see a blank page and they want to fill it with their thoughts.  They know how to share those thoughts encrypted in wonderful prose or in poetry.  They know how to arrange the words into pleasing sentences in such a way as to grab the reader's attention and convey their messages  so that people will want to read them.  I am trying to arrange my words and my thoughts on the page so that you will want to read them.
I hope that you will continue to read it and that I won't delete any more of them on accident!