Friday, December 15, 2017

Therapy, part 2: seeds of growth

This is part 2 of 2. You can read the first half of this journey here.

Photo by Kate Ter Haar

On my first visit, I walked into my therapist's office sheepishly holding a filled-in PHQ-9, a commonly used depression screening. There had been a really bad week or two, but the last few days, things seemed more okay, so when I'd filled out the screening, I answered most of the questions from my okay state. Which meant: Did I really belong here? Would she give me a funny why are you here look?

I was lucky. She was kind and warm and immediately saw what I needed, saw what a long time coming this appointment had been. And she saw what seems obvious now, but what I couldn't see for a long time--that to want help is to need it. That regardless of PHQ-9 or diagnoses or medical coding, there was something deeper than I could control that was disrupting my life and relationships, preventing me from peace. And that was worth attending to.

From that day forward, she met me where I was, and that was enough.

She actually never told me how she diagnosed me. The diagnosis is not the point. Most of the time, I don’t think I meet the DSM criteria for depression or dysthymia. Or maybe I’m right on the line. If you read part 1, you might have noticed that the fog that has hit me so many times is not quite strong enough to get me flat on my back, or keep me there. You might notice that in seventh grade during the hurricane, apathy gave way to writing. You might notice that friends have at times been able to draw me out, that changing circumstances gave me hope at desperate times. 

Whatever semblance of depression or mood disorder I do have is still hard for me to claim, not because I'm ashamed but because I feel selfish to claim it. As I write all of this, part of me is apprehensive of overdramatization, knowing that my own mental health is mild compared with the struggles of many, and has certainly never been life-threatening.

But this is not about comparison. Each person's path to healing is her own. For me, the truth is that being functional, that having relatively mild and episodic symptoms, that being "less depressed" than others, that having no trauma to speak of—all these things have become excuses I make to myself for trudging on alone, for pretending I'm okay. In the end, no matter how well I can do the work and cook the dinner, no matter how many people fare better or worse than me, there is more wholeness and abundant life waiting if I am brave enough to get help.


Therapy, for me, has primarily been a journey in learning how to embrace and accept my feelings, rather than adding layer on layer of rationalization, apology, over-analysis, guilt, or control. It is important to say that to embrace or accept the feelings is not the same as embracing the injustices or sins that cause them. It is simply to be aware that to be alive can be sad and painful at times, and it is only human to let myself feel those things.

So I've been learning to lean in and explore the sadness, the pain, the loneliness.

There are times in my life that have been really, genuinely sad: My grandma died after a hard and beautiful year in and out of hospital and rehab. I’d poured my heart into being with her that year. As the weeks and months after her death passed by, I let myself cry. I did not put a timetable on my grief. I said no to social engagements when it seemed like they’d take too much energy. I was gentle and kind to myself in my grief. I somehow knew that there was nothing more I could have done for her. I knew that the grief was legitimate, real, something that had to be walked through.

More often, though, this is not how I respond to personal distress. If I feel lonely, I wonder about the ways it might be my fault. If I feel nostalgic about a distancing relationship, I think of how I might have tried more. If I feel anxious or angry, I push through and try to ignore it, until it builds up. That is, I’m usually not the best at being gentle and kind to myself.

The times I'm most upset look very similar. Sadness or failure rolls into self-shaming, and picks up speed as it heads down the hill. And then something or someone strikes that tender chord in me and suddenly I am shaking, crying the tears that are enough to make your chest quiver as you strive to catch your breath. I am thinking, I am not good enough. What if I am never good enough?


The first week of therapy, my therapist intuited much of this, I think. So she gave me a Self-Compassion Test. I failed. Okay, there’s no failure in therapy. I scored low.

Self-compassion, my therapist explained as I began to balk at any kind of self-care, self-love language (isn’t it against my religion to be selfish? am I good enough to deserve self-love?), is not about making excuses for yourself or trying to lower your standards. Self-compassion means that when you feel sad, you treat that sadness the way you would a friend’s sadness. You sit with it and listen to it and give it a pat on the shoulder; you don’t berate it. And after giving it plenty of time, you move on.

In other words, it is much more like the patience gave myself during that time of grief.

One week, as an exercise, my therapist gave me a sheet of paper called Loneliness. She asked me to act out my typical responses to loneliness. I can punch my loneliness square in the center, I can cower from it, I can crumple it in a ball and eat it, I can put it behind my back and pretend it’s not there, I can hang it in front of my face to further distance me from the world.

These are all the things I tend to do to complicate and increase my loneliness.

On the other hand, my therapist suggested, I can say to the lonely part of me, “You are doing the best you can.” I can pat it gently and let it stay at the table. I can fold it carefully and put it in my pocket, a persistent teacher in empathy and life in the world.


As I've slowly and fitfully learned to be more gentle with myself, I think it is even more slowly cascading out to the way I think about and treat others.

For example, as I look back on all the years and all the times I didn't get help, I see that I often and almost sub-consciously blamed my friends for my sadness. I have at times resented others for contributing to my isolation, or felt that if only I had more close friends, I would have been all right. The truth, of course, is that I have damn good friends in all the places I've lived, friends who have made me tea and picked me raspberries and called on my birthday and invited me to brunch or to live with them. The truth is that I have lived for the last five years with my best friend.

When I am sad and lonely, there is more going on beneath the surface, and it has not much at all to do with what deeper level of communion I desire or with adjusting to a new life phase or with moving from south to north or urban to rural or Africa to America. And it has everything to do with that kernel of thought I first remember thinking on a hotel bed in Colorado at thirteen, that I often don't like the me I inhabit, and that I have never known how to ask for help.

I see now that most of my life, help has only been a few moments away. And perhaps the more I grow, the more I will be able to extend compassion not only to my own feelings but to the many wonderful people in my life who are, just like me, not quite perfect but still ever so full of love and sincere effort.

All of this is progress, but all of it is slow. And it is really hard. There are so many times in therapy I've felt more like moving back instead of moving forward. I've had to entertain new ways of thinking that feel silly or sacrilegious . I've had to work harder than it seems one should have to work, often wondering if there is really hope for me after all since I will inevitably grow tired of the work, wondering if my previous sad but functional equilibrium is preferable to digging through so many layers of strange and awkward and painful. Even now I wonder with regularity, What if I never change? 

Perhaps I won't, or only a little. I've seen enough of humanity to know most of us move the needle only the tiniest bit throughout our lives. I will likely always wrestle with accepting grace, granting myself grace, believing deep down that God is grace.

But I know I'm gaining wisdom and perspective that will give me fuel for the wrestling.


This is what it has looked like for me, so far. I’m not fixed, and I still don’t think I’ll ever be good enough. I’m thankful now more than ever that God does not see me the way I see myself. And I’m thankful that the last few years have taught me to ask for help. Because as hard as it has been to stare down my weakness, it’s so much better than sitting alone in the dark.

Dear friends, I don’t think everyone needs therapy, but I do think we all need help sometimes. Whatever that looks like for you, I hope you will step into it when you need it, and keep reminding me to do the same.

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