Destination DBT

I recently made the switch to a new therapist.

This change has needed to happen for some time now, and I reached a tipping point when I last saw my psychiatrist. The past several visits with him have felt unproductive and frustrating; I’ve been complaining that I am still depressed and very anxious, but he has remained unwilling to make changes in my medicine. I understand where he’s coming from. I’m on several different types of meds, and from his perspective, I’m doing better than I think I am. Essentially, I’m high-functioning, despite feeling quite low a lot of the time, and the depression and self-destructive tendencies would be better remedied in therapy.

The problem with therapy, though, is that I seemed to have stopped progressing with the therapist I’d been seeing for several years. I would go into the session wanting my therapist to be proud of me and how well I was doing (in many areas), and wouldn’t talk about the things I actually needed to be working on–like self-harm.

When I saw my psychiatrist a few weeks ago, he once more suggested I try dialectical behavioral therapy (DBT). He recommended a few practitioners he knows personally, and I agreed to try it, mostly so that he would shut up. I’ve dabbled in DBT before and hated it, and I told the psychiatrist as much. He suggested I try breathing exercises. I left the office feeling angry and unheard, with a list of DBT therapists I could call and very little hope.

I’ve been seeing this new therapist for a few weeks now. I wasn’t expecting anything revolutionary. If anything were to change, I thought, it would be like it’s always been: I find something that helps, I use it for a little while, and then I revert to self-destructive habits. I certainly wasn’t open to meditating, nor did I want to consider introductory mindfulness exercises such as “stone flake on a lake,” which make me feel like I am even less sane than I already am.

On the other hand, I was really, really desperate. My main goals, which I shared with the therapist in my first session with her, were to build self-esteem and stop self-harming. After a seven-month period of abstinence, I had faltered in my determination not to hurt myself. I learned a lot during that period of cessation, but the relapse taught me lessons as well. I realized there is a jarring difference in how I perceive myself when I am actively self-harming, versus how I see myself when I am not. Looking back, I really liked how I felt during the period of cessation. I liked who I was, how I spoke to my friends and myself, and the things I was writing. Although a relapse is never ideal, I think it is a generally positive sign that this time, it was easy to throw away the razor blades and get back on track.

With the desperation to learn how to manage these emotions so they don’t become as overwhelming as a guiding force, I begrudgingly agreed to attempt meditation. I found a five-minute video that I didn’t hate, and tried to follow along with it every morning for a week. As someone who really enjoys the structure of being a student, I like that this new therapist gives me tangible homework assignments. So when we talked about my meditation assignment the following week, I was surprised to report that it had actually been beneficial.

Encouraged by the success of this first assignment, I started to think that she might actually be able to help me. Today, I talked to her about a recent, ongoing challenge I’ve had with some of the subject material in my classes. I have a professor in a creative workshop class who wrote a collection of poetry titled The Rape Kit. The book is deep in my to-be-read pile, but its subject matter comes up in class quite a bit, especially because another one of my classmates is quite vocal in her poems about her experiences with rape and sexual violence. At the beginning of the semester, the professor issued a sort of blanket statement about the unimportance of content or trigger warnings for our work, and as a result, there have been a few times in this class where I have found myself extremely upset by some of the work I’ve read. Because the class is held on Zoom, it’s actually a lot easier to take care of myself when these things happen. With my camera and mic off, I am still in class, even if I am also on the floor, snuggling with my cat.

When I explained the situation to my therapist, she was shocked. “Does [the professor] not realize how upsetting that can be for some people?” she asked me.

“I guess not,” I shrugged. Ultimately, my therapist and I concluded that this is going to help desensitize me to the word rape, which even after all this time still sends a jolt through my spine. I told her that when this occurred most recently, I just left the Zoom call, but still had a panic attack, which hasn’t happened in a really long time. Immediately, she asked me if I’d self-harmed. I was so caught up in feeling like a failure for not being able to handle a class discussion and worrying that my professor would be upset that I’d left class that I hadn’t even thought about alternate courses of action I could have taken. “No, I didn’t,” I said. “I took my meds and just got into bed.”

“That’s huge,” the therapist said.

This semester, I’ve had the opportunity to be a teaching apprentice in a seminar-style class on Mental Health Literature. Getting a little bit of teaching experience has made me very excited about the future, and strengthened my convictions that becoming an English professor is what I want to do. There is also no one else from whom I’d rather learn than the professor who teaches this class. Because the course tries to provide a variety of perspectives on mental health, there is a hefty reading list, and we cover a huge range of topics. We’ve read anthologies of personal essays written by those who either have a mental illness themselves or who have a close friend/loved one with a diagnosis. We’ve also read a YA novel, a bioethics textbook, and a novel-length folktale.

While many of these volumes seem quite unlike each other, there are also some striking similarities. Nearly every narrative we’ve encountered this semester had some element of shame, of stigma, some idea of, “I cannot tell anyone about this because I will be judged.” It has been fascinating–on a personal level as well as on a professorial level–to watch the students do their part to dismantle this stigma. It’s been a process, just like acclimating to any class, but as we’ve all grown comfortable with each other, read the literature, and done the projects and homework, some very important conversations have occurred. Like myself, many of the students in the class have had experiences with mental illness, and some of them are quite open about it. The fact that we are having these conversations in a classroom gives me hope that they are also reaching places where stigma still stands strong, and breaking down barriers so that more people who need help can access it and live happy lives–regardless of diagnosis.

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