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.

Therapy, part 1: the times I didn't ask for help

Photo by Kristaps Bergfelds

I first recall the heaviness beginning to descend upon me fiercely the summer before eighth grade, on vacation in the Rockies with my parents and brother. The family reunion had been over for a couple days, and now the four of us were spending some time in the national parks. It was afternoon. We had come back from our hike, and dinner was not for another hour, and it all felt so underwhelming, so disappointing, so empty. I didn’t like the vacation or the food or the expectations or the loneliness or the ennui of summer, and most of all I didn’t like the me I inhabited.

A month later, a few weeks into school, the excitement of new classes and new friends and new activities beginning to wear off again, a hurricane rolled through Maryland that left us home from school for two days. Soccer was cancelled. Piano lessons were cancelled. And I lay in my bed for hours, writing in my journal and crying and feeling myself left alone with my thoughts far too long. The melodramatic short story I wrote in that hurricane, about a woman lost in a rainstorm, determined to carry on, is surely one of the great masterpieces of adolescent angst.

*

As long as I had been aware of my parents as real humans, I had begun to know the story of my dad’s depression, starting in childhood and most severe in his early thirties. I had come to know it as a story of the past, for it seemed, both in the way he spoke of it and in my own experience of my father’s humor, joy, and energy, that it was completely healed.

What happened next—years later, it seems—was that one day as I was talking to my father, he said something I’ve never forgotten. He said that because of his own and his mother’s history of depression, he had been concerned that my brother or I might inherit this propensity. He had watched us closely since we were small and had discerned, to his delight, that we had not inherited this curse. Though certainly I did not suffer in the severe way he had as a child, his statement clanged a dissonance inside me. It didn’t feel true to my experience. 

Funny—that is how I remember it happening. But going through emails, I discovered recently that this is what really happened:

It was midway through college, I was at a break in a relationship and in the midst of a total re-evaluation of all I thought I knew. My faith in God, that solid rock that had brought me through every previous challenge, was now a one-handed grip on a fraying rope. I told my dad, and he sent me an email in which he asked, “Might you be depressed? Though I watched you closely as a kid and you never seemed to have inherited my cyclical major depression, I know mental health can affect one’s life and faith. It’s okay if you’re depressed, and it’s okay to get help.”

Funny how we hear the things we want to hear. Then, I wanted a quick fix for loneliness and doubts, not a lifelong journey with mental health. Now, I wanted to remember this story as a long history of voices telling me I was fine, I didn’t need help. Turns out it was my own voice all along. I have always been the one telling me I didn’t need help.

*

Later on in college, when that relationship ended for the final time, after friendships had become even more fraught and anger had replaced disbelief as the mode of my faith, I noted the quantity of my tears and the changes in my usually robust appetite, and I wondered if I should see a counselor. The google search “am I depressed” turned up myriad online quizzes and evaluations, and some said I might be mildly to moderately depressed, and some said I was fine. Some days I thought I was depressed, and some days I thought I was fine.

At the end of most every quiz, after all the questions about appetite and sleep and hopelessness and self-harm, there was a question worded something like this: “Have any of the above symptoms affected your ability to carry out the activities of your life?” And I would look at my grades and my work and my unchanged outward appearance, and I would check “No.”

I think part of me wanted to get help, find someone to talk to, explore the idea of therapy. But the other part told me that it was self-indulgent to go to a counselor when (according to the internet) I wasn’t even depressed.

Besides, I was still pulling up my pants every morning. And I had learned that to be functional is to be okay. I didn’t yet understand that in mental health, there is more than functional. There is healing and growing and maybe even some version of whole.

But functional has a power over me, and for several more years after that it wielded its scepter: I lived in Tanzania for a year, the year of gulping teary fits, thoughtless peanut-butter gobbling, the feeling of being utterly alone. But of course that was just what it was like to live abroad, right? And it went away when I sang with the girls in the evenings. I moved back to Maryland and there were months of desperate phone calls to college friends. But of course that was just reverse culture shock and learning to be an adult, right? And it went away when I found the new friends and the garden and the laughter.

*

Finally, I met my match. In 2012 in the course of one week I went from single to married, city to country, community to isolation, employed to unemployed. It was too much all at once, I suppose. My mother-in-law had bought us an expansive, welcoming brown couch as a wedding gift, and it opened each afternoon to swallow me. I would binge on Netflix and chocolate chips and watch the afternoon fade, too apathetic to get up and turn on the lights. And all of the things from before—the desperate phone calls to friends, the feeling of being utterly alone, the teary fits, the weariness of being me—they all came back at once and threatened to undo me.

They certainly undid some of me. But even as I found a functionality in Cherokee—a job, a way of writing and running to get by—I felt in my own self that this was different. This thing was deeper than just adjusting to marriage and a rural place that was hesitant to accept me. I waited, as weeks turned to months and beyond, hoping for a ritual or a garden or a new friend to rescue me out of it. When they did not come I blamed my own failure, a failure to be outgoing enough to make people love me or spiritual enough to conquer the dark.

We moved to Durham, and I started anew, and I hoped those feelings would depart with new routines and new friends and new purpose. And although slowly built a network of people I desperately love and trust, yet still I would leave the library each day angry at myself for not trying harder. Still I would end up at home feeling sad and lonely, unable to focus or even get off the couch. I would panic as I looked ahead to a weekend without social plans.

My second summer in Durham, I interned as a chaplain, an experience full of  meaning and friendship. And then one day in a group meeting, pressed to explain my emotions, everything all seemed to collapse around me and I found myself crying under a table, begging to be left alone, my mind repeating over and over "I just want to not be me. I just want to not be me."

And I finally admitted to myself that it was time to ask for help.

---
Want to know what happened next? You can read part 2 here.

Cigarettes and chocolate chips

Three of my four grandparents died in the fall. This year, my first without any of them present, it seems an appropriate time to remember each of them and their gifts to my life. My piece about Papa was posted earlier this week. Today, I remember my Grandmother.

Photo credit

My memories of Grandmother are few. She was generous and fashionable and bought me my favorite dresses. Her Jacksonville drawl I did not much understand. When she visited us in Maryland, she would take frequent smoke breaks; when we visited her, she would watch TV in her den, cigarettes in hand. I came home from fourth grade one afternoon to find that my father was on his way to North Carolina because she had been taken by an acute form of leukemia and was not expected to live out the month. I did not cry then, nor when she died, nor at the funeral. We scattered her ashes in the garden at her church. The photos from that day are gray with strained faces, for her death was early and sudden.

I have learned, in the years since Grandmother died, to celebrate the connections I have to her. She left me some small things: my thick, curly hair and a pearl necklace and the small diamonds that now sit in my engagement ring.

Also, a painting. Grandmother was an artist and recently (after Grandfather died), I got to choose one of her paintings to hang in my apartment. I picked a beautiful oil still-life of cut flowers. The painting is bright with yellow and green and hope and light. Her life was not much these colors. Grandmother battled depression most of her life. Though I have never been clinically depressed, when I hear these stories I feel connected to her. I am certainly more like her than I am like my Grandfather, with his winning charm and his calm, loving approach to every situation. I have been broken and angry and sometimes wondered if I could dig myself out from darkness and apathy.

*

I was thirteen and summer whiled away. Camp and swim team were over and I was home in my room, writing in my journal. And in the August humidity I came upon the meaninglessness of life: how alone we are in our thoughts and desires, how futile the day-to-day can be. I wrote through it, hoping it would go away when school started, when I saw my friends again. But hugs were scarce and the Backstreet Boys could not give the right words to define my thoughts. There was a hurricane and I was at home in the gloomy dark in my room and the rain and the thunder and the tasks of life were gray and heavy on me. Homework, check, piano, check, soccer, cancelled. And no one to explain it to, and no way to explain it.

I was twenty and my head was swirling with images of small huts and banana trees and beautiful brown-skinned children; my head was swirling with the philosophy and science and scholarship that seemed to tear down my faith; my heart swirling with first love and first heartbreak and jealousy and anger and fear of the future. I collapsed into it, and for a year I was lost and alone and tearful, staying in on the weekends and skipping meals and sitting idly in front of the computer.

I was twenty-six and married and in a new place and I felt like I had left everything behind and I was alone on a couch with a subscription to Netflix and bags and bags of chocolate chips.

*

I don’t know the details about Grandmother’s depression, when it began, how bad it got, if it was precipitated by specific experiences. And I don't really compare myself to her. I have been graced to escape the brunt of darkness—for me there has always been sun and laughter. My strand of melancholy has probably just been about average. It gives me a little empathy, and a little extra passion to play deep melodies on the piano and write things raw when I can. 

But since I was nine when she died, that connection is what I have, along with the ring on my finger that reminds me of how Grandfather never stopped loving her, never lost respect for her, even with all she went through, even though he couldn’t understand it.