The Crucial "C's"

The Crucial "C's"

There are many reasons to hate being in the hospital.  Everyone tells you need to rest, but they come to your room  every 10 minutes to check your vital signs. They make you wear that hideous gown with the open back so everyone can see your full moon. And every doctor ask you the  same questions every time they do an examination.  But, for me the main reason I hate being in the hospital has something to do with the crucial "C's".

I was having some problems with my duration and stamina and in recovering after becoming worn out . I was also ( embarrassingly enough) , having some major leakage problems, if you know what I mean .So I called my neurologist to see if I could  get an appointment in the next few days. when I told him about my symptoms and he heard about the leakage problem, he told me he was concerned enough for me to go to the emergency room.

I really should have said no because I honestly didn't feel it warranted an emergency room visit .  However,  being the obedient girl that I am, I went .  They took a urine sample, which made sense, and they ordered an MRI which I thought was sort of overkill , but then they told me they were going to admit me and that felt like, not only overkill , but extreme murderous overkill. That's when I should've said no.

Instead, I put on the hideous gown , had the MRI, and let myself get checked in .  I was put onto the neurology ward next to a lady with Alzheimer's who kept screaming for someone to come and fix her blanket. I was labeled a falling risk and given some ugly yellow slippers with rubber soles and told not to get out of bed unless I called the nurse to help me .They also put these electronic leg massagers n me to avoid blood clots since I "don't walk very much". I kept telling them that I do a mile on the elliptical machine every day, but they just nodded and smile and looked condescending. 

 The crucial "C's" are personality attributes which everyone needs in order to feel confidence in the world .  These are courage, capable, connect , and count .  We all need to feel that we have the courage to be to face situations in our lives.  We Need to feel that we are capable of conquering  those situations .  We need to feel connected to other people in our world,  and we need to feel that we count and that we matter.  (As an aside, I actually have a Bachelor's degree n music, and while I do nothing with it, I did use my "musical ability" to create a neumonic device for myself and set the crucial "C's" to Row, Row, Row your Boat.)

 Being in the hospital took away every one of my crucial "C's".   Although I tried to be courageous, my safety nets were unavailable for me .  I had  grabbed my phone and Kindle when going to the ER,  I  did not grab the charger for either one   as I didn't know I was staying the all night.  It  took away my sense of connection to others. I definitely did not feel capable of even being able to walk to the bathroom by myself .  And when no one really listens to you and talks to other people as if you are not there, it is hard to feel as if you matter .

 The hospital employees were perfectly lovely and even the doctors were very nice and gracious to me . but it is hard to make up for the fact that you're reduced to being someone needy whose symptoms are more important than your personality .  And did I mention the fact that everyone could see my ass every time I stood up?   Dignity doesn't start with a C, but it is just as crucial in order to feel like a worthwhile person.

Although it is one of the crucial "C's"  I am very aware of my need to  feel competent.  Feeling capable means you feel able to do something.  But feeling competent means you feel you can do it well.   I think I have spent me whole life proving to myself that I am competent. Nothing like that ass-exposing-no-one-listening-disconnected experience to strip away any semblance of competency. 

Needless to say, by the time the neurologist saw me and declared that I could leave I was ready to mutiny and leave AMA (against medical advice) if they asked me to stay another night. 

So next time you are feeling anxious or just off, check  you crucial "C's" and adjust accordingly.


Here's the neumonic device

To the tune of  Row, Row, Row your Boat.

Courage, capable connect and count.
Cucial "C's" Crucial "C's".
We need a large amount

Distractions

Distractions

Here are the things  that have kept me from my blog.   

My computer, my phone and my washing machine all died within two days of each other.  Getting  a new computer up and running meant trying to recover critical programs and files. My phone required switching users since US Cellular stopped serving the Chicagoland area. Taking care of this business and watching a growing pile of laundry was just a little too much.  Once I got all of these issues managed, lo and behold, my son decided to graduate from high school requiring a whole series of events including becoming mired in maudlin nostalgia and mid-life crisis.  Currently I am battling  an enormous swarm of termites for my computer space.  This constitute not only a disgusting annoyance, but a whole lot of terrifying economic possibilities.  Therefore, I am being kept from my blog. 

M life is in flux. I am facing the empty nest come August.  This has some positive aspects.  I will no longer get out of the shower and realize that every last towel in the house is currently in my sons room.  I will no longer listen to the sound of Zombie battles from the ubiquitous Xbox.  And, I won't have to sort through 200 pairs of socks to decide which are his, which are his dad's and which are being used as dust rags by the cleaning lady.
But mostly, My son leaving home, is making me feel sad and confused by how life went by so fast and what is going to happen in part 2.

My MS symptoms have begun to impact every part of my life and have been determining what I can and can't do with working and my career.  I will be  share my musing more frequently in an effort to inform and to figure it out myself.  So look for more frequent posts.

  Right now, though, I have to go kill some  frigging termites...

Informed Hope

I have a confession to make.  I have a crush on Michael J. Fox.  It sort of makes sense that I would have an affinity for him now that he is an outspoken activist for stem cell research. But,  I have had a crush on him since the 80s when he was Alex P. Keaton.  Despite my disagreement with Alex P. Keaton's politics, his interactions with the Courtney Cox character on the show made my heart beat faster.  Some guys just know how to be romantic.

Now, after reading his biography recently, I feel no shame in saying that my crush is absolutely justified.  Here is a man who is dedicated to his family and kids.  He is optimistic and has a wonderful self-deprecating humor about himself. And, best of all, he has faced a devastating illness with grace and courage.  He's truly someone to emulate.

In his book he discusses faith versus hope.  Faith is blindly leaping into the depths with the idea that someone will be at the bottom to catch you, based on an idea or someone else's assurance.  And hope can be false hope that it is based purely on blind faith.  However, education leads to informed hope.  Michael J. Fox has educated himself about stem cell research and the possibilities that are informed by scientific research and successful experimentation.  Informed hope is not a false hope or a blind faith.
I have never been focused on a cure for multiple sclerosis.  I have an informed hope that it will be cured in my lifetime, but probably not in time for me to benefit from it.  My informed hope focuses on being able to  live a full life with a chronic illness and a possible handicap.

 But I may be selling the scientific community little short.  And maybe living with informed hope that someday there will be a cure for multiple sclerosis is one of the things that helps me live a full life. 

I also have informed hope that the world will move forward.  Stem cell research will be the wave of the future.  Someday embryonic stem cell research will be the norm and we will look at the controversy the way we look at the controversy over mixed-race marriages.  The universe is not set up to allow us to go backwards.  Forward momentum is inevitable.

In quantum mechanics, there are particles which move faster and become louder to protestbwing destroyed.  Maybe it's quarks.  That's how I see the push against forward motion.  People don't want to give up their old believes because they bring a sense of safety.  Moving into uncharted territory is scary and so when we don't want to do it, we protest louder and louder and jump up and down and wave our arms and tell everyone how horrible this new thing is, in the hopes that we can remain safe and comfortable in the old ways
.
But I will say again, forward momentum is inevitable.  It is not a leap of faith going blindly into the fire.  It is an informed hope based on education and knowledge that changes will happen and science will discover new things and that someday there will be a cure for multiple sclerosis. 

Coincidence?

Coincidence?

Did you ever have the experience of thinking about something and then happening onto  a tv or radio story about that particu;lar thing?  It is probably coincidence or a matter of selectivw intelligence (look up the invisible gorilla on youtube). And then there is the possibility that the universe is conspiring with you to provide you with more information or confirmation about what you're thinking.  I choose to believe that it is number three.
I have been thinking so much about midlife crisis and what it means to see your ball, that you worked so hard to get to the top, starting to roll slowly down the hill toward the termination site.  And wouldn't you know it, but I heard a story about someone else struggling with those same issues on NPR (of course).  The story mirrored many of my own issues and feelings.  The line that struck me the hardest was that we all have to eventually realize that the future is finite.
I was watching a show years ago, some vapid sitcom are another, when one of the characters said that her brother was upset.  He had seen his name on a tombstone and he figured that meant he was going to die.  The other characters said  "Technically, if you see your name on a birth certificate it means your gonna die.". I love that line.  And now I love the line that we have to realize that the future is finite.  I think, as you age and your body starts to betray you, your world gets  smaller.  You travel within the confines of a smaller and smaller circle.  Your acquaintances and family start to die off.  The actors and actresses you see in the movies get younger and younger and you recognize fewer and fewer of them, so you go to fewer movies. You weed out possessions. You quit driving at night or driving into unfamiliar places.  The conversations are limited, as well.  You are just as likely to be talking about how many medications you take in the morning as you are about what book you just read.
Multiple sclerosis makes your world smaller, too.  I can't see to drive at night very well.  There is absolutely no hope that I will go on a walking tour of Europe someday, or even that I will go to Disney World.  Rather than looking forward to new steps toward a brilliant career, I am just looking to keep it going for a little bit longer.
I've figured it out. The future is finite for me.

Erik Erikson outlined the stages of human development.  Starting from infancy, he identified diametrically opposed psychosocial developmental stages. Hopefully I have made it through the earlier stages effectively and now I am in the middle of generativity versus stagnation and leading up to integrity versus despair.  Midlife crisis is contained within the generativity versus stagnation  stage.  Humans want to continue to produce.  They want to leave their mark in the world.  That is why giving up work is an important milestone.  How do I continue to be generative and productive? And when I am ready to give up the idea of being productive through my work, how do I step down with integrity rather than allowing myself to spiral in to the despair?

I could choose to see multiple sclerosis as a gift.  It allows me to examine how we move through our lives and ultimately into the great mystery of the beyond.  So I will choose the gift and in the meantime I'll keep trying to reach the Nirvana of getting the perfect body before summer... or just continuing to stay upright!

I'm back from middle-life purgatory

Hello again, poor little neglected blog.

 I think I may have figured out a few things about why I have not been motivated to post.  I am very firmly in the midst of my midlife crisis, exacerbated by having multiple sclerosis. I think  midlife crisis, for me anyway, has to do with having to look at the fact that your ball is starting to roll downhill instead of up.  

My son is graduating from high school in a few weeks.  He's going off to college in a different state.  I know I'll always be a mother, but my role as a mother will significantly change very soon.
I am also seriously downsizing my private practice.  Rather than frantically trying to get new clients, I am trying to quietly maintain the ones I have and finishing up them without worries about replacing them.
Other people at age 50 may start to look forward to being able to retire, but it is still far enough into the future in order to feel like just a distant wish.For someone with multiple sclerosis, the future is very much now.
 My body is failing me in ways that I should not have to deal with until I am much older or at all.  I see people in their 70s traveling, spending time with the active hobbies...heck, just going to the mall and being able to walk to more than three stores without having to stop!
So my midlife crisis is this:  how do I transition into the next phase of my life with integrity?  How do I maintain relevancy without my role as a therapist trying to grow a practice?  Growing my career, rather than downsizing my career has been my focus for my entire adult life.  How do I continue doing...  things that contribute? 
Although I know that there are no new thoughts in the world, and in my writing voice is not stupendously great, I need to continue to explore my thoughts, to expand my subject matter, and remain connected to the world.
So poor little neglected blog, I am going to make a much greater effort to contribute to you, to find my voice, and create connections.

Personality Priorities

Personality priorities I just got back from a Play Therapy conference.  Two days training with Terry Kottman, a former professor at the University of Iowa in the prolific writer and trainer in the field of Play Therapy.
I have seen Terry present before.  I may have even seen her five or six times.  I actually kind of know her, and we are, in fact, birthday buddies.  That is, we have the same birthday!
Terry is the kind of Play Therapist I wish I could be.  She is smart and funny and so knowledgeable.  She is the developer of Aderlerin Play Therapy.  I learned something from her every time I go to see her even though many of the things she presents on are repeats to me.
One of the things I love and use frequently is the idea of personality priorities.  Personality priorities is anAdlerian  concept or idea  that we all have a specific thing that our personalities strive to create.  Terry has assigned different animals to each priority.  Before I tell you which is which and how it works, think about this.  Which animal of these for do you feel most connected to or the most like?   I did not say the one you would most want to be.  There is a difference.  So of  these four, which do you feel that you are most like:
1.  An eagle
2.  A lion
3.  A chameleon
4. A turtle

Do you know which one?  Now I will tell you what the four personality priorities are.  We all tend to strive for one of these four things: comfort, control, superiority, or people pleasing.  Can you tell which animal is which?  Here's how it works.  Eagles strive for control and strength.  Lions strive for superiority.  Chameleons are people pleaser's, and turtle's strive for comfort.  Many people have one personality priority that is evident throughout their lives.  Many people have one priority and one secondary priority.  I am also convinced that priorities can change due to circumstances.
My personality priority is superiority.  Within superiority, there are actually two subtypes.  There is out- doing or being superior to other people.  We all know somebody who was always trying to one up us in some way or another!  But the other subtype, achieving, is trying to outdo your self into as many things as you possibly can!  This is my personality priority (superiority), and my subtype (achieving).
I have known that trying to achieve many things as possible has  a priority for a very long time.  In high school, I was definitely an achiever, and was probably trying to be an outdoer as well.  My goal in life was to have the most entries in the high school yearbook of anyone in my class.  I am proud to say that my name in the index of the yearbook has more lines than anyone else.  I sincerely hope that this is not the crowning achievement of my life!
I was well on my way to continue the trend of trying to achieve more and more things when I was diagnosed with multiple sclerosis.  What I wanted to achieve in my life, was to make a name for myself in the field of Play Therapy.  I became a registered Play Therapist in about 1994.  Becoming an RPT-S (registered play therapist at the supervisory level ), was a relatively new credential, so on my certificate, my number is something like 420.  That means that there were only about 400 people in the entire world who were registered as play therapists!
I really like to present and train so a major goal of mine was to  try to present as many places as possible and become a world-class, well known Play Therapy presenter.  Although I was diagnosed with MS in 1996, the symptoms and disabilities were not really noticeable until much later.  I had several exacerbations, or worsening of the symptoms, but primarily I could walk around without a cane and hide many of the other small, annoying issues such as weak fine motor skills, or becoming fatigued easily.  I presented in Iowa and Illinois at state Play Therapy conferences, and actually presented at the national conference in St. Louis in 2001 or 2002.  (I forget which).  But the symptoms were becoming more and more evident, at least to me, and I was becoming less and less able to do anything other than work and be a mom.  Of course, I was working a full-time job in maintaining a part-time private practice which in itself is kind of a lot to do!  But I was becoming less and less able to do anything extra.
When I was laid off from my job as a supervisor in community mental health, I was hoping to have the time and energy to do a lot of the things that would move my career forward.  I briefly looked into going back to school for a Ph.D. in clinical social work and even took the MAT-Miller Analogy Test.  The test is scored with percentiles rather than with an actual score.  I scored in the 98th percentile of people taking the test who wanted to go into clinical social work and in the 99th percentile overall.  I just had to tell you and brag a little bit!  However, even as I was exploring the possibility, I realize two things.  Number one, I didn't want to spend the money when it was getting so close to my son's graduation and entering into college himself.  But the other reason was because I really don't have the energy to study for long periods of time while continuing to work.
Although I later realized that getting a Ph.D. would only be a way for me to achieve something else, this was the first time I realized that I am no longer a spring chicken and  that the MS really does have an impact on my ability to do the things I'd like to do.  I also realized that I cannot maintain the level of energy I need in order to be able to present to large groups of people.  You need to be able to stand and move around a lot in order to be an effective lecturer or presenter.  That is just not in my capacity any longer.
One of the things that people who have superiority as their personality priority strives to avoid, is feeling meaningless.  I have known for a long time and I do not want my life to be meaningless. I am sure this is why I have always wanted to achieve something that will be remembered long after I am gone.  Terry Kottman will be remembered long after she is gone.  But I have had to learn to be content with the fact that my legacy will not be people remembering my name.  I am not leaving behind a book or some new Play Therapy technique that will revolutionize the world of play.  I am just going to continue to do my very small part by maintaining a private practice for as long as I am able.
What I have to remember, is that my legacy is not tied to my ego, this body, or this name.  And just because I am not leaving some sort of corporeal reminder of my existence, doesn't mean that my work and my legacy is not reverberating into the future.  I have to remember that doing good therapeutic work in and of itself is enough of a legacy and will hopefully reverberate by helping people to achieve greatness within their own lives.

A Change of Subject

I have discovered that posting about MS has its limitations.
 How many times can you talk about what a drag it is to not be able to go shopping?  So, while this  blog will remain primarily a place for me to have a forum for discussing life with multiple sclerosis, I think it will be a lot more interesting if I talk about life as a therapist.  My life may be  slow and boring, but being a therapist and getting to know my clients is a lot more interesting!
I really want to talk about what it's like to be in the process of doing therapy.  I know I could talk about diagnoses and what is known as "best practice therapy", but that's a lot less personal and a lot more boring.
I talked a little about countertransference in my last post.  So I want to give you know a peek into the head of the therapist in the process of being a therapist.
My very first therapeutic job was as a "psych technician" on the mental health unit of a hospital, which was really just a glorified babysitting job.  We were expected to observe patients and see what they were doing, write in the patient charts at the end of the shift, sit with a patient while they were on suicide watch, that sort of thing.  But we also got to run some groups or talk with the patients one on one if they requested it.
This hospital had a mixed unit of adults and adolescents.  I'd usually worked with the adolescent.  I'm sure, in those days, that sometimes it would be hard to tell me apart from the patients.  I was just out of undergraduate school which meant it could be as little as four years between me, an authority figure, and the kids on the unit.  Of course, at the time, I had no concept of how the clients may be responding to me as a peer rather than a grown up.
With my bachelors degree in psychology, I was barely equipped to understand issues which would land teenagers in hospital psychiatric unit!  At the time, there was a diagnosis called Over- Anxious Reaction to Adolescents, also known for us OARA.  This is a defunct diagnosis because it's really sort of describing every single adolescents in a way, isn't it?  It is likely that most of these kids had anxiety disorders, or depression, or were being abused, or were just engaging in some of the antisocial behaviors that teenagers engage in!
Nowadays, kids who are hospitalized have to be considered a danger to themselves or others, but at the time, I think parents could arbitrarily have their kids admitted for an attitude adjustment or something!
When I think about this job, they're actually at least four or five kids, and some adults as well, from whom I met a great deal about the therapist and patient interaction.  I'm pretty sure I didn't do any long-lasting psychological damage to any of them!  But I'm not sure that the interactions I had were anything other than just trying to listen to them.  A really large part of being a therapist is really listening without judgment.  This may have been my first learning experience of what it means to just listen.
It is much easier to give  advice or send somebody to a psychiatrist for medication than it is to just listen and make a serious attempt to understand what is actually being communicated.
I think one of the most profound experiences of learning to listen was actually with one of the adults in the unit.  When I look at pictures of myself now from that time, I realized how incredibly young I was and how incredibly young I looked!  I can't imagine how anyone took me seriously!  I look like Alice in Wonderland!
When the patients were suicidal, they are placed on something called "constant observation".  This was the  boring job of just sitting outside the patient's room and making sure that they didn't do anything to hurt themselves.  Most of the time, the patients would just ignore us, but sometimes they would engage us in a conversation.  I actually do remember having a lot of respect for the adults.  There were a few who were psychotic.  One elderly lady, who was obviously a very sweet and dignified woman when she wasn't psychotic, asked me to write a letter for her.  She dictated to me "I am being held prisoner and someone is watching me."  She then said, "Sweetie, what is your name?"  I told her my name was Amy and she said, "Okay.  Write this down.  Nurse Amy is the worst most horrible  f ***ing bitch  in the entire world." So, I diligently wrote what she said, addressed  the envelope to her son, and told her I would put it in the mail right away.
It would have been very easy to take this personally, or to try to explain to her that no one was holding her hostage.  I'm not so sure that colluding in her delusion was such a smart idea, but I certainly could have  made things a lot worse by becoming defensive.
Although this was a good exercise in just listening without judging or trying to fix things, there were other times as well when listening without fixing was the only course of action I could take.  My inexperience and lack of training were large contributor to learning to listen as a course of action in interacting with the patients.  I remember sitting with a woman and listening as she told me that she was powerless to change things in life.  I remember trying to get her to understand that she had choices in terms of how she reacted to situations.  I can't remember what her situation was, I do recall that it was something that was well within her ability to change.  After an hour of attempting to get her to see that she did indeed have choices, and having her continue to tell me that he didn't do what I was talking about, I left her room feeling defeated and worthless.  A few of the psychiatric nurses were very understanding with me, and one of them said "It sounds as if you have an expectation that you are a failure if you can't get a client to listen to you and make changes.".  That was a statement which resonated for me for a long time!  The therapist is not responsible for the changes in the clients.  You can only listen, make a concerted effort to understand, and then invite your clients to listen to you while you provide a different way of thinking.  The healing part is not in the advice.  It is in the interaction.
That is enough for today, and I will try very hard to keep neglecting my blog for so long next time.