Maybe a keeper

Had my second session with a potential therapist tonight.

Joe Bauserman was my first and best therapist — local when we lived there, and by phone when I was going through PPD. I always thought I’d be able to “see” him by phone again if I ever needed to. He’s gone, now, though; melanoma, early this year.

So one of my projects for this year was to try to find someone new — so that next time a crisis hits, I won’t have to scramble around looking for someone I can work with, having to start all over with the whole history and background and getting to know one another and all.

I researched online, made a list of potential folks in the region and some who offered phone sessions, and started sending emails and making phone calls. Eventually landed an appointment at this office, a month ago. This lady is old enough to remember ice delivery, is a psychologist (from past experience I am skeptical of social workers and pastoral counselors, at least for me), and works in a Christian office. The first appointment was basic background questions from her, interview questions from me, and me realizing (duh) that just interview questions and answers would not tell me all I need to know. I’m going to have to actually work through some stuff with her before I can know if we’ll work well together or not.

So I made another appointment — tonight, a month later.

She listens well. She is open to clarification — I mean, when she suggests an interpretation, it’s not set in stone, and she doesn’t get huffy if I challenge or try to clarify. She takes notes. She has good ideas. She isn’t too hasty.

By the end of the session, I had that good kind of shaky feeling — the intensity was just about right for a productive, fruitful session.

So tonight I made another appointment, for next month.

I need to find out how much, if anything, our insurance will cover, but if it’s financially feasible, I could see a monthly session potentially being quite fruitful for a while.

On being a therapy veteran

I called the South Bend Samaritan Center yesterday, in my ongoing pursuit to find a new back-up therapist — someone I could go to in case of another crisis or if I ever feel the need to do more deep therapeutic work.

The receptionist I spoke with was patient and polite and attentive. I like that.

When I explained that I wanted to interview some potential therapists, she was a little surprised, and with a little laugh said that they’d never had anyone want to “interview” their therapists before.

(She was willing for me to make appointments with either of the psychologists on staff, but the person I was most interested in was not available on the days Mark is available to watch Amy, so I postponed appointment-making until he and I could work that out.)

Reminds me a little of the place I went to last year — I had an intake interview where I had to talk about my situation to someone who was not a therapist, and especially not my therapist, so that they could determine which therapist I would see. I complained, and they said it was standard procedure.

When I was new to therapy, I didn’t know about any of this stuff, either. I hadn’t read anything that talked about how to find a therapist, questions to ask, warning signs, etc. I count myself blessed to have been referred to such a good therapist for me, by someone I trusted.

I get the feeling sometimes that some therapists and therapy offices don’t really welcome a veteran — they don’t always want to be questioned, or to let the client choose which therapist to see, and so on.

I can understand that, to an extent. Why welcome someone who might be critically comparing you with their previous therapist(s), or constantly wanting you to do things the previous therapist’s way, or questioning you in general.

And yet, I hope I can find someone who will consider my past therapeutic experience a good thing, a foundation to build on.

Interviewing therapists

One of my summer projects was to interview new therapists — so that in case of another crisis, another major depressive episode and / or string of panic attacks, I’d have someone. It’s no fun to try to find a therapist in the midst of a crisis.

First, I searched around online and made a list of potential people. A month or so later I eliminated one because his website bothered me, and emailed another, whose schedule is full. A week or so later I emailed two more, both in Chicago.

Both agreed to an interview, and although I forgot to mention it until the next round of emails, both agreed to possible phone sessions. Both also agreed to interview via email.

I sent my questions.

One said that after reviewing my questions, she thought it would be beneficial to interview by phone. I was willing to do that if really necessary, but I told her how I’m a visual person and if we could interview via email I wouldn’t have to take notes and would have time to really process the answers. Then she said that she didn’t think even phone sessions would work for her, and that she thought I’d be better off with someone else.

The other hasn’t responded to my questions at all yet.

I guess I’m not that surprised.

I wish the first one had just explained why she would rather do the phone — I was willing, if need be. If she couldn’t even handle my rather gentle pushing on that issue, I suppose she wouldn’t be a good therapist for me anyway.

She also wanted at least one in-person meeting before doing phone sessions, and I agreed to that, provided the interview went well. Perhaps if she’d insisted on an in-person interview, I’d have been willing — I would have rather strongly preferred to have a good interview first before taking the trip to Chicago, but I would have been open to negotiation on that point. Again — yes, I pushed back, yes, I resisted, but hey — that’s part of what therapy is for (not that I was resisting just to be difficult). If a therapist can’t handle what I think is a reasonable amount of resistance, they’re probably not a good choice for me.

I might ignore the second, or I might email again asking when I could expect a response.

If you saw my list of questions, you might say something like “What did you expect? No one has the time to write out thoughtful answers to all those questions!”

And yet, that’s me. I HAVE all those questions. I’m not in a hurry. I can wait — I can accept one question answered at a time. I can even work with “I can’t answer this one fully, let’s try to rephrase it to something more reasonable for a first interview.” I could have even worked with “Let’s do this by phone — that way I can see which of these questions is really most important to you, and how much of an answer you need for each one right now.”

I can’t work with being ignored or being dismissed with only paltry attempts at communication.

Maybe sending my overwhelming list of questions is as good a way as any to weed out therapists who don’t really have the time or energy to deal with someone like me.

The other thing is that I’m not looking to do regular therapy right now — so I wouldn’t be a source of income for anyone right now. There’s not much motivation for a therapist to take my name in case of a crisis. Again, though, I wish I could find one who would have the guts to tell me so — who could say “I would need to have three or four weekly sessions with you to establish a working relationship first; then I would be willing to be a standby in case of crisis.”

What a bummer that the one I had a working relationship with, the one I could have returned to, is dead.

Reading Joe, mid-August to mid-September

A good many of Joe’s posts were about the fear of the Lord, translated to the fear of the self — fear of self-government, self-reliance, self-trust. Fear of letting go of God, fear of separation from him.

Abstract like that, it sounds reasonable.

I know that I am wayward, and I have learned that when I am discontent or anxious or feeling empty, it’s a sign that I’ve strayed, and I should turn back, and I am being called back and that’s how I recognize my waywardness.

But some of his posts seem so strident, like he couldn’t rest in or enjoy any little thing because of his fear, his confidence, that there is sin in it.

I think I must be missing something, because that doesn’t really sound like the Joe who was my therapist. Joe so often counseled me to know and trust myself — to have a more internal locus of control — to listen to my intuition.

It reminds me of my little theory of health — that what looks like holy behavior and holy words can come from either sub-healthy or super-healthy places — the sub-healthy is no self, but a doormat, a robot, an empty vessel. The super-healthy is so secure in Christ that he or she no longer needs to protect and defend self.

You can’t get to super-healthy without going through healthy first, which looks a lot like what secular psychology tells us — good boundaries, self-awareness, reflection, all that sort of thing. Not a lot of cheek-turning yet, because a developing self must learn to protect and defend itself before learning how a greater Protector and Defender bests its own efforts.

It is so difficult to discern anything.

I want something — is it something God wants? Is it something I am allowed to want? Just because I want it, does that mean God is against me having it?

I fear something — is it something that should be feared? Is it something God wants me to flee or to face? Is the solution I imagine God’s plan of deliverance that he is revealing to me, or my own attempt?

I suppose the main point is to stay with God — not to fear leaving him so much as to hope, intend, and desire not to leave him, and to trust him to bring me back when I do stray. Perhaps someone who, like me, struggles so much with general fear and anxiety, does not need more encouragement to be fearful, but more encouragement to trust — and to fear the right things.

But again! Discernment! How does one trust God and fear waywardness, and still live in this world, making use of all the resources that have been provided, such as food and therapists and friends and computers, but not making idols of them?

Not a map, but a navigator — not a checklist, but a guide — “not a religion, but a relationship” — I need to more and more be relating to, interacting with, talking to, listening to, following God, and not just thinking and talking and writing about him.

Lord, teach me to listen, and to hear you. Please answer my questions. Please guide me. Please give me faith and wisdom. Because it would sure be a lot easier to trust you, and to obey, if I could know for sure where you are, what you look like, what you want me to do, and all that sort of thing.

PS — It’s funny how much I fear becoming so “holy” or “close to God” that no one wants to be around me, or that I don’t want to be around anyone, or can’t enjoy anything. Again, I’m pretty sure there’s some deep misunderstanding involved in that fear. I have been around people who are annoyingly “holy,” but I have also been around people who are restfully, beautifully, welcomingly, inclusively “holy.”

Emotions and interpretations

I’ve been reading Joe’s blog, the one he and his wife kept while he was going through cancer treatments, up until he died several weeks ago. I just started at the beginning and am slowly making my way through. In his near-daily reflections there’s a lot that I remember hearing in therapy, and it’s good to be reminded.

One post I read today tells a story from Joe’s past when he was feeling burnt out as a therapist and went to complain to a friend. The friend told him he needed to remember who he is in Christ, and assured him of his confidence that the Lord would help him.

My mind has been chewing on the story today, in the background as I play with Amy, make the bed, do the dishes, contemplate how sleepy I am, wonder why I keep getting fraudulent calls purportedly from American Express.

One of the things I learned from Joe is that emotions themselves have no moral value. Whatever you feel, it’s valid — it’s true — it’s real — that is, the feeling is valid, true, and real.

And so, if you’re feeling burnt out, frazzled, in the pit, surrounded by rotten turnips, you can acknowledge those feelings and experience them in their full reality.

At first glance, Joe’s story seems to be contradicting that — you might be tempted to think his friend was telling him to buck up and deal, stop feeling sorry for himself, stop complaining — telling him he was wrong to feel the way he was feeling.

But that’s not quite it. The correction isn’t directed at Joe’s feelings, but at the way he was interpreting them and thus the way he was interpreting reality.

And that totally meshes with what I learned through DBT, particularly the prompting event worksheet. That worksheet has you name your emotion(s), describe your physical and mental state during the emotion(s), list the interpretations you apply to the emotion(s), and then challenge those interpretations as needed.

Most of us resent being told to stop feeling a certain way. My hunch is that most people who give such advice might be confusing feelings with their interpretations.

Another thing. Part of my response to this post of Joe’s was / is to be annoyed with God, and a little dismayed. Isn’t there ever a time when I’m allowed to complain, allowed to acknowledge that not everything bad in my life is my own fault? WITHOUT having to also acknowledge my participation in the bad, my need of repentance, my waywardness? And I have to remember that it isn’t that God is out to make me grovel, to keep me down, to take all possible joy away from me — and that it is exactly his goodness and mercy that allow me to see my sin without despair and excessive grief. Humph. Sort of.

Goodbye, Joe Bauserman

My friend called last night to let us know that Joe Bauserman had died.

He had a brain tumor. He was able to spend his last days at home.

He was my therapist, for a few years when we lived in Virginia, and again when I was going through PPD.

When we moved from Virginia, first in NY with the PPD, and again last year with another major depressive episode, I looked around for a decent local therapist. I didn’t look very hard, because I knew Joe was there — and that it would be more cost-effective to stay with someone with whom I already had a solid therapeutic relationship, than to keep searching and have to work through all the beginning stages again with each new therapist. I tried two folks in NY before returning to Joe by phone. Here in IN, I tried one person who lasted a few months — at the time it would have been a burdensome financial stretch to go back to Joe — when I decided that therapist just wasn’t working well for me, I was stable enough to just quit instead of looking for another.

Now Joe is gone. If I ever have another major episode — not unlikely given the nature of depression and my history — I will have to look harder to find someone new.

Theoretically, I know there are other good therapists out there — people who have integrated faith and psychology in a solid, cohesive, thorough, sensitive, reflective way, and not just pasting one on top of the other — people who can think and listen and relate and talk in paths that I think and listen and relate and talk in, so that we’re really hearing each other — people who understand and respect the subconscious and the emotions and don’t just tell patients to try harder or stop thinking that way.

I hope I will, if it becomes necessary, find one of those people.

Meanwhile, I remember Joe — with deep gratitude for his service to me, with grief for his family, and with prayers for his clients that they would likewise find new therapists who will serve them as well.

Obituary from the Richmond Times-Dispatch

The decision that seems to be making itself

Have I had much positive to say about my current therapist?

It seems that, while it hasn’t been a catastrophic failure, this round of therapy has been relatively unhelpful from the beginning.

It could be that what I most needed at that point back in May was to try Zoloft again, and that talk therapy wasn’t as needed.

It could be that the improved social situation has boosted my resilience, hope, and confidence.

It could be that my current therapist really is fairly simplistic; perhaps good in crisis, but not so helpful in the subtleties of fine-tuning during functioning non-acute seasons.

The two bits of art therapy we’ve done were pleasant, but not particularly useful or insightful as far as I can tell.

Talk is usually short, full of generalities, and platitudinous. She points out negative self-talk. Reminds me not to try to read minds. Wishes I could get out of my head more and not overthink everything. Something about our interaction puts an end to conversations. It’s not so much that I feel she is wrong, or that I think she wants me to stop talking about something, but that when she brings out a statement of the obvious, I no longer have anything to say about the topic.

I tried to talk about that today, but it didn’t really go anywhere either. She expressed complete willingness to get specific and in depth, but it seems dependent on me to direct, and I’m not sure how to go about that.

Previous thoughts about quitting this round of therapy have been alarming and dismaying, but now I’m feeling a little more steady about it — I think I can survive without therapy right now. Not that I’m all better and no longer have any issues, but that I have some skills to practice and ideas to remember, and my life situation is fairly supportive.

I have another appointment in two weeks. I plan to go to that one and see how I feel then.

Meanwhile, some questions for y’all:

Do you think some people, sometimes, act out of mere politeness without actually being interested in you (or someone else), or do you think that people will let you know if they don’t want you around? How do people send the message if they don’t want you around?

What do you do when there are people in your life you don’t particularly want to be with much — do you try to send that message (if so, how?) or try to hide it?

Pastoral care

A week ago — or more? I sent email to our current pastor and our former pastor from NY, asking prayer and counsel about some of the things I’d been thinking and writing about, such as family planning and therapy.

Both wrote back today with some good and helpful responses.

One of the things Steve mentioned was the need to act in faith and not be driven by fear or pride. But that acting in faith can include using available resources such as contraception and therapy. For family planning, he (and Nate) talked about wisdom and stewardship — taking account of how well we perceive we could provide for a given number of children, and planning accordingly.

Steve’s mention of fear and pride troubled me for a while. When does any decision of mine not involve fear and pride? But being afraid or proud and being aware of it doesn’t necessarily mean being driven by it. I know that’s pretty obvious, but for me it’s tempting to think that if I’m afraid of something, I had better go do it — that my fear will so influence me that any argument against the feared thing must be driven by that fear.

Silly, and obvious, but it occurred to me that being wrong is not the end of the world. It’s not like God is on edge, waiting to strike me as soon as I make a wrong decision. Not that I can be indifferent and dismissive and make decisions merely on impulse and whim, but neither do I need to find the single right answer with absolute clarity and certainty. If I follow Jesus, and think as well as I can given my limits, then I can decide with faith, confident that either my answer is one of the right ones, or that my redemption can work with my wrong answer.

Steve also mentioned that he believes common grace includes so much of what humanity has learned — in medicine, psychology, or any other field. Nate mentioned that all truth is God’s truth, and just because something doesn’t come from an explicitly Christian source doesn’t mean it is wrong or ungodly. Again, not that discernment is unnecessary — just because an option exists doesn’t necessarily mean it’s right to use it.

Nate was particularly helpful in suggesting I write down my goals and expectations for therapy and see if I think my current therapist could help with some or all of them.

I am blessed.

Lord bless these men and their families, and care for them as they care for their flocks.

What am I so afraid of?

Here I sit on a lovely drizzly day, wearing the pants I’m never sure I can quite get away with — the black rayon ones with the tiny tan flowers all over — so bright, so — patterned! And no coordinated top for me — no — I’m wearing a green ribbed tee with pretty trim around neck, sleeves, and hem — a Salvation Army find.

I’m thinking about fear. (And dress hems; I’m almost done with that brown knit dress, but I got tired of pinning the hem so I’m taking a computer break instead.)

Yesterday was therapy day. The session was fine — indifferent, almost, apparently. We talked a little, first; a bit about some dreams (my former best friend, acting normal — an indoor flood that waited for someone to arrive — an someone barging in not once but three times), a bit about other things. Finally I asked hey, are we doing any art therapy today or not, because last time she said she wanted to do that.

Into the art room. We did what she called mandalas — not the fancy real ones with sand in intricate patterns, just a circle drawn in the middle of a big paper. Inside I was to put how I felt. Outside, describe myself as I see me and / or as others see me. (During the art we talked more, by the way.)

Art therapy is supposed to help me connect with the wordless place — get out of my head a little and go a little deeper to earlier and more fundamental things. But this exercise, at least, felt rather silly and still very intellectual — I thought about the questions, chose items to draw, drew them.

Later, the nagging negativity that accompanies most sessions so far (this one was #6) was persistent enough that I mentioned it to Mark, wondering yet again if this particular therapeutic relationship would help me or not. I thought maybe I ought to commit at least into the new year before deciding.

Mark wanted to know what we would do if I did quit. I guess I hadn’t thought much about that. I’d just assumed I’d be out of therapy and that’s it. But his question made me question. Would I be okay without therapy or not? Could I predict that or not?

Thoughts and feelings swirled some more, intermittent waves, and I wrote in my journal at bedtime.

My final question was, what am I so afraid of? What hope do I have that I think is so unlikely to come true?

I have come to suspect that the fear and despair are nameless, wordless things — things that hide in the dark, things that tug and whisper but don’t show themselves.

One of my best strategies for fear is to look it squarely in the face and see how likely it would be to destroy me. Like the time I was anxious about teaching at a dulcimer, because I have trouble tuning and take longer to do it than most people. What helped most to dissipate that fear was to imagine the worst case scenario — I would go, be out of tune, not be able to tune, break all my strings, have a nervous breakdown, kill someone, be blacklisted and never allowed to play or teach dulcimer ever again. Could I survive that? Yeah. Not that it would be exactly pleasant, but it wouldn’t destroy ME.

So what am I afraid of?

Being broken — being the one impossible to heal, impossible to help, the one who can’t love anyone, the one who will hurt everyone, doomed to suffer and cause suffering all my days.

Being alone — the one no one really gets, the one no one really wants to be close to, as well as the one isolated by my own strong walls.

Being wrong — not being able to answer questions like what do I need, how do I feel, what do I want, what is the right way to think about x, what is the right thing to do about y, and so on.

Being sad. Being scared. Being lonely. Feeling empty and meaningless.

What is any of this but pain? And is anyone immune to pain? And is any pain enough to destroy me?

Again — not that pain is nice, but I CAN stand it. I CAN tolerate distress. Even if it kills me. Because death is not the end for me — even death cannot destroy me. I’m pretty sure I can’t even destroy myself — because God loves me, has adopted me as his own, and is sovereign — he will redeem me and restore me in joy and peace forever amen.

I can even taste it now. Because I know that I am not always in pain. Sometimes I laugh. Sometimes I like things. Sometimes I sing. Sometimes I am happy. And sometimes people love me.

It’s not so much the fear and the despair that’s the problem — it’s the being afraid of the fear, and the being dismayed by the despair.

Nothing major

Today was therapy day, and I didn’t have anything pressing to discuss.

I’ve been doing pretty well, and when I’m like that I have a harder time connecting with the things that bother me when I’m more vulnerable. We talked about that a bit, about how I feel I have some deeper work to do with therapy, but have a hard time getting to it and doing the actual work, whatever it might be.

She suggests we do some art therapy. Cool.

We talked about the summer, about gardening and other things, including her new secondhand Eeyore jean jacket. (Her shirt had pictures of fruit slices on it; I think part of my resistance to her is that she’s a little like the kind of people I have trouble connecting with — cheerful people, who can make something with glitter and frame it and display it in their office. It’s probably good for me to have a therapist like that — I might learn something.)

We looked through pictures on the blog, too, which she enjoyed.

And that’s about all.