struggles

I've written here before about how it is much more difficult for me, as a psychotherapist, to deal with the folks I see who are physically crumbling, hurting and in pain. I can deal with anxieties, depressions, wild ideas, bad judgment, bad behavior, as well as the lost and lonely, but the the suffering from illness, pain, especially when it is chronic and in a few cases, fatal, is the most draining for me.

Now, in my own home, my wife is dealing with a disease that is probably going to be chronic, is a long way from fatal, but is certainly life changing.  Although she has always been strong, healthy, active, alert, and for the most part living a much more correct and risk free life than I have, she has somehow contracted diabetes, in a form that seems to be a mixture of both Type 1 and Type 2.  Suddenly, from a life that was open and free flowing she has to take measurements, count carbs, and take a regimen of shots and pills that is still being calibrated.

I have no doubt that she will do all that she needs to do, and find a way to balance her life. Yet being hit with this, with really no warning or any way to anticipate that it would come, except for a sudden thirst and weight loss over a period of only a few weeks, is such a shocking smack of mortality that it has just washed me over with the sense of melancholy that comes with the realization that we are all so fragile and ephemeral.

As a husband, it is frustrating because I cannot reach in and turn her pancreas back on and drive away the virus, or toxin or whatever it is that has shut down that organ. I can only be here as best I can.

As a therapist, who works with so many other people who are suffering, and who has done so for so long a period, it seems to highlight how slow, inexact, and inefficient the process of psychotherapy is.

Since this has begun I have been more tired, and I have had to make an extra effort to be focused and attentive in my sessions.  What I see is that so many of the patients, who I have come to care so much for, really are more deeply troubled than I had wanted to see before.  Part of the way I work, which has been successful, is to regard all the people as basically able to function, and even if they are messed up I try to draw out their strengths and show them the expectation that they can improve their lives.  I am sure that this helps them reach for that too.

But when I really dig into their lives and minds I often see how difficult what they have to deal with is, and how their thinking  has been crushed by either/and emotions, family, illness, society or just bad luck.

And, as it is with my wife, all I can rally do is be there, reflect upon it, and talk to them about it.
These are not very powerful tools.

I am OK -- but..

I am OK.  In fact I am doing surprisingly well. This has been a great summer.  I am in good shape and healthy.  My eye is better, my knee is better.  Nothing really hurts.  I have been very active kayaking, biking and chasing my grandgirls -- only one of whom can actually walk, so it's not that hard -- but the one who can walk loves to run away.

I like hot weather, so the summer has been good to me.  We go off to the beach house and play.The kids have been coming and bringing their kids. Friends have been coming. We discuss how the world is  falling apart while sitting in great comfort.

Then I go to work and things are different.  but that is the nature of what I do.  People very rarely come to me to tell me how happy they are, or how excited they are about the interesting, creative, fulfilling things they are doing.  That happens occasionally, but that means it is the last session.

But I have been doing this for years.  I can deal with depression, even terrible depressions.  Anxiety; hey, everyone I see is anxious, also I can be helpful for loss, loneliness, confusion, stress, relationship problems, addictions, even violence. Hey, let's talk about it. My kind of therapy at least doesn't have side effects.  It won't make you constipated or gain weight.

But you know what upsets me.  Dealing with people who have chronic, physical pain.  I mean pain that has lasted years and comes from degenerative diseases.  Diseases that not only resist treatment, but that the treatments for them seem to create other painful conditions.  The drugs lead to passing out, or digestive disorders or kidney failures.  Pain raises blood pressure, the drugs for that causes dizziness, people fall down, cut themselves and go to the hospital and pick up a staph infection. The antibiotics for the staph infection cause colitis, which leads to a colostomy.  But still the pain, from the degenerating bones, or the pressure on the nerve from the back injury, or whatever it was that began the whole process goes on, and no one can really find it, and if they find it they rally can't do much about it.

Part of why it bothers me is that I am getting older, my friends are getting older and my clients are getting older.  For me, I can no longer run and jump.  For me, who played basketball for 25 years with the same group of guys it is a loss.  But I can cope.

What i know is that more is coming.  More of my friends have had knees replaced, hips and shoulders too.  They are on all kinds of meds because this or that number comes up too high. I take one little pill. Other friends have stents in their bodies, or have difficulty getting out of chairs, or even, are dead already.

So far, most of my friends and family are basically OK.

I plan to be immortal, until I am dead.

Pain 4

Well, it's finally breaking up. The pain is abating, some flexibility is returning, my outlook is improving and there is hope on the horizon.

What is disappointing is how difficult it was to get real help, and how, in the end, I had to find it and do it myself.

So many people my age have been through this sciatica thing. Everyone has their own cure. That's mostly because, most of the time, it goes away by itself. So whatever anyone was doing at the time was what they believe in.

Because I always worked so hard to keep in shape, I really set myself up to be locked out of shape once my body shifted. I actually have spent about 20 years setting this up.

But getting help was not helpful. No one really looked at the whole picture of who I was,and what my muscles, ligaments and bones were doing. What I did for work (sit a lot), and how I worked out.

The doctor (MD) used "evidence based medicine" and recommended for me to follow the course of what most people would need. Unfortunately this course would be very slow, very expensive, involve a dozen different people, and then end up right where I am now-- stretching.

The chiropractor said rest, ice heat, which was fine in the beginning. He couldn't move my bones though, because the muscles were too tight.

The message people were great, but I can't get a message every day. They found the problem, but really didn't offer a solution.

I found all the stretches on Rebuild Your Back.com. I am doing 7 stretches 5 or 6 times a day and it works.

So, I am getting my life back. I have cut my schedule of clients 10 to 20%. I am trying not to get back to the 115% level that got me into this in the first place.

But people keep calling.

I guess they think I have something to say. Or else I just listen really good.

pain 3, the doctor

So, after suffering too long and trying alternative solutions I went to the medical doctor today. I haven't been to a regular doctor, except for my eyes, in years, so this was a new guy in a big medical complex.

He was easy to approach, thoughtful, and reasonable. He did a few pokes and squeezes and twists and agreed that yes, I had sciatica. He said it has lasted a bit more than normal so that isn't a good sign. Then he wrote orders for tests.

I left some blood there at the lab, so they can see if I have cancer, and then I'm supposed to get an MRI. I buy my own insurance and have a $2000 deductible, so this will probably eat all of it up, especially if I get the MRI, which they said is about $1200. In Taiwan an MRI costs $125. I will have to pay for his insight, for the lab, for, and later for the guy to read the MRI, then the new people at the back clinic, and then the Physical Tx people. by then it will be over $2K so I will only pay 20% or something, who knows.

But the medical alternatives seem to be drugs and/or surgery, and I'm not keen on either. He offered my a few drugs to control the pain. that was friendly, but they are not the kind that will dampen the inflammation and heal the problem. They are more the kind that many of my clients try to buy on the street.

He also offered me anti-inflammatory meds, but said it would be cheaper to just triple my doses of Advil.

So, I'm taking more Advil, I will give the acupressure guy and the chiropractor another week to work magic or else I get the MRI and enter the medical world, but I am very reluctant to do so. I guess, as a psychotherapist I remain an "alternative" kind of guy.

For now, I am back to my favorite weekend medication, which is Jamison. It doesn't do much for the future, but it makes the present brighter.

Everything in moderation!

pain 2 -- loss of arrogance

I didn't really realize it before, and I'm kind of startled by it, but now that I am going through this pain thing, it's become clear.

Part of what I've learned is how, as a therapist, I've been carrying around an underlying arrogance, and I don't think that's a good thing.

But somehow, even though I have even posted here about how aware I am that one slight random event can completely change your life, I guess I never really thought that would be me. Yes, I was grateful that nothing really terrible had happened to me, but like most people, I attributed it to my own abilities, foresight and planning.

Yes,I am a good, caring and understanding therapist, but I also always somewhat, put on a very subtle display as having a good life. I was in shape, I was financially sound, I have a long-term marriage,and my kids are grown and doing pretty well. I was not yet rich and famous, but perhaps that would come too. I guess, in some ways, I felt I was a good model. But it was also a kind of arrogance. Kind of "see, I can do it, you should do it too -- maybe not just like me, but like you want it.

Now, I've been in pain for six weeks. This is the kind of thing that is common, and happens to everyone, but it still isn't really over, and it has been very limiting and debilitating. Now, I can show that I can stand the pain and the adversity. I have many clients who have much worse and more chronic conditions, but I am still in the midst of mine.

And I don't like it. it sucks, I'm sick of it.I'm getting treatment and improving, but it's slow. I get worried that it won't end, I get tired and irritable.

The severity of what I am going through is also partly my fault because I don't ask for help. That's part of the arrogance. I had always worked these things out myself. A few pills, ice, stretching. So, I just kind of denied, or hid the problem. That was part of the arrogance too. I caoul handle my problems myself.

So, now I'm finished with that. I'm going for help wherever I can find it.

Anyone who can push the magic button will get a big kiss.

They say it will take time. That's what I say to all my clients.

But this is America -- I want to be better now.

pain 1

Wow, it's been a month. That's quite a while, even for a fading blogger like me.

Well, there was a reason, pain. I have this sciatica thing, pain, running right down my leg. It's mostly better, but it's still there. It makes it difficult to sit in a chair and type at a computer unless I sit exactly right.

I have learned a lot during this month, about myself, growing old, living with pain, and how I react.

I don't like it, this pain thing. I don't recommend it as a learning experience. But it seems now that I will survive.

It has given me insight into some of my clients, and into how no one can really tell how much pain you feel. So many people I see in my practice are sent to me because many doctors feel these people are in pain, but not THAT much pain. It's very difficult to tell.

Some people want drugs, some people want attention, some people want excuses. But many are just in pain, and it kind of sucks.

I will have a lot more to say about this. I've got to stand up now.