In the Middle

When I was seen at Mayo Clinic, I felt sure that I would get a definitive answer to whatever was “wrong” with me.

However, upon reading the report from their head of psychiatry, there were hardly any answers other than that the current regimen of medication I’m on seems to be working, so keep on keeping on. One doctor said that my affliction could be attributed to borderline personality disorder, another said that my main problem was psychosis not-otherwise-specified, and they mostly agreed that I also have PTSD and a bad self-harm habit.

It is ironic that an all-or-nothing thinker like me would have such an ambiguous diagnosis. Regardless of the label I am given, what I do know is I have been more stable lately than I’ve been in years, and I would like to keep things that way.

Because I basically grew up in therapy, I learned to attribute many things that were not necessarily symptoms of mental illness to whatever the diagnosis du jour was. Any little bit of disappointment, sadness, or anger served to further my view of myself as incurably depressed and despondent. The idea of “recovery,” was such an important feature of my adolescence, yet somehow I never stopped to define “recovery,” and decide what it would actually look like in practice.

During one of my earliest stints in residential treatment, a former patient of the treatment center returned to the center to talk to the current patients about what life in recovery (in this case, from an eating disorder) is like. She said that she still dealt with the self-destructive urges that drove her to develop an eating disorder, but she handled them differently. At the time, I was horrified. What was the point of doing all this emotional work, gaining all this weight, learning to meal plan, and on and on if I was still going to fight with my brain over every little bite of food or moment of exercise?

I made a rather graceless departure from that treatment center, and I still wonder if I didn’t leave there sicker than I was when I went in. On the other hand, it’s possible that I was simply not ready to embrace some of the skills, ideas, and teachings that were presented to me there. What I know now is that while the woman who addressed us was right: I do still frequently entertain the idea of self-destruction, however that may manifest in life, but as I practice better coping skills, it gets easier to continue making better choices

I am, however, quite picky when it comes to coping skills. My therapist recently remarked that I do better with coping skill (by which I think she meant I am more likely to consider using them) if I at least believe I came up with them myself. As a result of this little tendency, I can be a little slow to implement even the most basic ideas from treatment into my life. For instance, it recently occurred to me that emotions are not permanent. Anyone who has ever spent time in mental health treatment–regardless of the intensity of the level of care–is bound to have been told that “Feelings pass,” at some point. But for whatever reason, it didn’t fall into place for me until recently.

There I was sitting on my couch one night after work, just hanging out with my cat. Suddenly, it was like a switch flipped in my brain. Marsha Linehan’s memoir Building a Life Worth Living, sums it up perfectly.

In the past, these moments have felt like an emergency, as if I really am being chased by Evil Katherine, who wants nothing more than to destroy the peace and stability I have worked so hard for. I felt like these awful feelings had been unfairly dumped in my lap and I had to do something with them, otherwise they would never go away.

Instead, I discovered the art of doing nothing, otherwise known as “sitting with one’s feelings.” My fear that if I didn’t do something to change the way I was feeling, I would either never stop crying or I would be so overwhelmed that I would never feel okay again, proved itself to be quite irrational. So, I just sat there on the couch, staring off into space, petting the cat, my journal open on my lap, pen in hand. I scribbled a few lines of stream-of-thought writing in my notebook, and when I looked at the time, about ten minutes had passed. “Holy shit,” I said to the cat. “I feel better and I didn’t even do anything.” (Thankfully, he did not respond.)

I used to be pretty adamant about my hatred of mindfulness. “Why would you want to think about nothing?” I’d argue with anyone who would listen. One of the things I actually do like about my mind is my imagination and creativity. When I’m somewhere I don’t want to be, I can retreat into a made-up world in my head.

Much to my chagrin, mindfulness is not having a blank mind, but instead can be described as being fully present in the moment without judging it. I spent several years under the misguided impression that I did not need mindfulness. Instead, I ruminated, I obsessed, and I became delusional due to the combination of psychosis and trauma I was experiencing at the time.

At the Mayo Clinic appointment, one of the doctors ran through a list of symptoms of PTSD, and concluded that I was “over it,” because I don’t have nightmares or flashbacks. However, it shouldn’t come as a surprise that the effects of rape outlast the incident. “I still think about it every day,” I told the doctor at the time. I explained that due to the nature of the attack, I do not like having people behind me and I do not like to be touched anywhere near my neck. I also said that it mainly affects me at work when I am on a register and there’s a line of customers at the register behind me. Most other places I visit (classrooms, movie theaters, etc.) I can sit in the back and I feel fine. The doctor offered to write a note to my workplace to ask that I am always placed on the last register, and while I appreciated the offer, I immediately shot it down. “I can’t go through life like that,” I said.

But for a long time, I did go through life exactly like that. I was trying to go through the motions of my day to day activities, and while I may have been physically present, my mind was stuck in the past. However, I have noticed little pinpricks of strength shining through the darkness of my past. They are small things, imperceptible to most people, yet massive to me.

Yesterday at work, one of my coworkers was training a new hire. I was stationed at the end of the register bagging the groceries, and the male trainer was helping me by placing larger items in the customers’ carts. As is my instinct, I watched him walk behind me each time so that I could see him for the entirety of the ordeal. After this happened a few times, I was talking to the customer at hand, concentrating on what he was saying while still trying to bag efficiently, and the trainer walked behind me once more. To the outside observer, it was a routine transaction at the grocery store. But to me, it was the first time in six years that my heart did not race when someone was behind me. Just as I gain momentum by using healthy coping skills in times of distress, I hope that I can hang onto this bit of progress and truly put the past away for good.

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