Depression, as a Responsibility

Okay, hear me out.

I’m going to go with heart first, and then head.

Heart:

Depression is real, and it is crippling. It is fueled by anxiety, and stress, and chronic pain, and trauma. It can come in waves, from mild to severe, and it can last a day or (seemingly) a few years. It shreds self-esteem, it takes away joy, it leaves you feeling numb and empty and without hope that things could ever or will ever change. When I conjure an image of depression, I picture the time when everything in my life appeared to be perfect: wife and home and kids and church and job, that time when I kept a giant smile plastered on my face, but on the inside I felt unworthy of love, isolated, torn to pieces. I felt like no one could or would see me, and I truly believed that happiness would forever elude me. I know what that dark, soul-crushing space feels like, and I know it can last for so long. Empty prayers, empty heart, empty rooms, empty me. I was merely existing. I once wrote suicide notes in that space. I know what depression feels like. It is real.

And now, Head:

Depression is a condition. A medical condition. It has a place in the medical books with a list of symptoms that follows it. It’s something that happens to people, most people if not all people, at some time in their lives. It’s a human condition, and thus part of being human. Some people struggle with it mightily and for their whole lives, while some only have depressed days or periods from time to time. Just like some people are born with a genetic predisposition to diabetes or asthma or heart disease or addiction, some might be born with a predisposition for depression. It’s a condition, and one that must be managed, with personal responsibility. And that requires an education, and understanding, and healthy life management around the condition.

Example: Diabetes has everything to do with blood sugars, and can be regulated with food intake and exercise. In some more extreme cases, it requires medication, or a doctor’s care, but these conditions too can be managed, even if it means facing some life alterations or restrictions. Managing diabetes requires being educated about diabetes. It means learning what to eat, and how. It means knowing when to rest, and when to exercise. It means carrying insulin or fresh fruit or juice or candy to help manage the condition when it is out of control. It means educating others about the condition. It means… being responsible for it. For those who don’t manage it, who indulge and give little thought to consequences, they become burdened with the symptoms of the disorder, with low energy, frequent cravings, chronic pain, etc. For those who manage the disorder, despite the struggles that accompany its management, the burdens become easier to bear along with the healthier habits.

And in that same context, depression has everything to do with how the brain produces endorphins. It can be regulated with healthy relationships, nutrition and exercise, hydration, sleep, pain management, stress management, and coping mechanisms. And in some more extreme cases, it requires medication, or a doctor’s care, but these conditions too can be managed, even if it means facing some life alterations or restrictions. It must be managed.

There is a line from a Jason Mraz song that provided me with a lot of comfort when I was coming out of my own depression. The song is called Details in the Fabric, and it eloquently states in the chorus:

“If it’s a broken part, replace it.
If it’s a broken arm, then brace it.
If it’s a broken heart, then face it.”

If we as humans are responsible for ourselves (and we have to be!), then part of that means managing our own conditions. Whatever it is that is causing the depression has to be faced up to. Poor nutrition? An unhealthy relationship? An unfulfilling career? A disability? Chronic pain? The loss of a loved one? Too much stress? A lack of friends? Cold weather? An addiction? A broken heart? A low self-image? A traumatic childhood? Whatever it is, we have to take care of our own struggles and push through. We have to learn to get better. We have to be responsible for our own conditions.

In therapy, I frequently coach clients on how to get through the little tough moments. Little activities they can participate in to increase endorphin production in the brain. They don’t fix trauma or mend a broken heart, but they do help get through tough moments, hours, and days. And over sustained periods of time, we can break bad habits and start climbing out of the depression. The days get a bit easier a bit at a time. This is a ‘lose one pound per week for fifty weeks’ approach, as opposed to the ‘lose fifty pounds in one week’ approach that many hope for. Fixes aren’t often quick. New lifestyles take time to sustain.

Here’s the list. The brain naturally responds with serotonin and dopamine when we engage.

  1. Healthy eating. (Try being happy when you’re hungry or eating the wrong things).
  2. Water. (Try being happy when you’re thirsty or drinking only soda or coffee or energy drinks).
  3. Exercise. (Try being happy while consistently sedentary).
  4. Healthy human contact. (Friends! Therapy! Opening up and sharing with others!) (Try being happy when isolated, in stressful relationships, or while only engaging with others on social media).
  5. Sunlight. (Try being happy while remaining in dark rooms with the shades drawn).
  6. Achievement/getting things done. (Try being happy while constantly overwhelmed by what isn’t done, or while bored and lacking purpose.)
  7. Sleep. (Try being happy when sleeping too much or too little).
  8. Anti-depressants. (Medication isn’t always required, but vitamins and positive supplements are important. This also means avoiding stimulants and depressants, like too much alcohol and coffee, or other chemical-altering substances that exacerbate depression. Alcohol is the worst decision here).

We can not always control life circumstances, or even whether or not we have depression, but we can choose to participate with ourselves in our recovery from it. My depression, when I struggled with it, came from a combination from many things. My father had depression. I was sexually abused as a kid. I grew up gay in a world that told me gay people weren’t welcome. I grew up in a religion that had very high expectations, and left me feeling empty when I couldn’t measure up. I was physically abused by a step-father. I had scoliosis, and struggled with chronic pain. All of that, plus family stressors, before I was 18. I wasn’t responsible for any of those things. They were things that happened to me.

But somewhere along the way, given the stack of cards that I was dealt, I had to choose how to handle those things as an adult. I did a lot of things right: college, friends, therapy. But I did a lot of indulgent and difficult things as well, like too much food, further participation in the religion that was hurting me, and struggles with reconciling my own sexuality. I chose to get married and have children. I chose to keep eating, even when I became obese. I felt like there was no hope to make changes, and I participated in that hopelessness. And thus passed my 20s. A decade spent, responsible for myself and not handling it correctly. Wasted years. Good things came out of those years, like my college degree and my children, but they came from inauthentic spaces.

The process to healthy living for me required owning my past, my hurt spaces, my sexuality, my religious upbringing, my family culture, my food habits, my approach to relationships. It required exercise and healthy habits, therapy, journaling, financial responsibility. It required being a grown-up who loves themselves. It took work. And it got a bit easier, a bit at a time, over days, and weeks, and months, and years.

It required me loving myself, putting me first, along with my children, and healing from my past. It required me managing money appropriately, spending time with friends, learning how to process difficult feelings (like lonely and scared and angry and sad), keeping my home clean and tidy, exercising. It required me being responsible for me.

No one will just come along to save you. No prince will ride up on horseback, no surprise job will give you purpose, no lottery winning will take all your pain away. Because with the depression, even the magical things that happen feel like too much. The prince, the job, the lottery winnings, they feel just as hopeless as the rest.

And so back to heart: I know what it is like to live without hope. And I know what it is like to live happy. Life isn’t always easy. I have tough days. But it’s different. It’s so different. Struggles are manageable, temporary. I have tough hours or days, not a lifelong struggle of feeling broken. I got here. I did it. And now I’m working every day to stay here.

And I believe you can too. Be responsible for you, even when your insides tell you that you can’t. It’s so worth the effort. After all, what’s the alternative?

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Self-disclosed

Part of being a therapist is being absolutely elastic. Clients come in with different motivations, some of them outwardly stated and some silent and under the surface. They are paying for a service (or sometimes their insurance, or some benefactor is paying for them) and they want to receive that service in a unique way. The most difficult part of the job is knowing how to meet that for each person. This can wind up leaving me feeling like I am auditioning over and over for people, trying to convince clients that I’m a valuable practitioner, who is worth their time and money. It can be an uncomfortable reality in my field. A lot of clients want a particular result without having to put much effort in. It can be exhausting.

I often meet new clients with some sort of introduction that can prove my worth. “Hi, I’m Chad. I’ve been doing therapy for this many years, and I specialize in these types of services. I try to utilize an approach that meets clients where they are, validates their pain, and also pushes them into positive growth, but this can often take time. The therapeutic relationship forms over a period of weeks. I’m here for you. Now tell me what brings you in?”

I like to think that I’m an effective therapist in most situations, and I think most of my clients would agree. I continually ask myself what my role in a given situation is, and in these situations I have to remind myself that my job is to be the therapist my client needs me to be during the time that I’m with them. They live their entire lives before and after our sessions, and there are no quick solutions. I have to listen, be attentive and consistent, and push hard, but not too hard.

I’ve had a number of clients complain about me over the years. These are isolated experiences, but they do happen. And I’m human, so every time, the negative feedback leaves me sad, frustrated, self-critical, or vulnerable.

self

“I felt you weren’t listening.”

“You were too tough on me.”

“You weren’t tough enough on me.”

“I told you I was suicidal and you didn’t take me seriously.”

“You should have realized I was suicidal even though I didn’t say anything.”

“You were too critical of my life choices.”

“You told my wife to find a safe place for the night after I hit her, but you didn’t even hear my side of the story.”

“You aren’t competent enough in _____.”

“You shared too much about yourself.”

“You are too closed off.”

And on and on.

On days where I see many clients in a row, I feel different parts of myself being challenged each time. Some need a coach, some need a best friend, some need a kid brother, some need a confidant, some need an emotional sponge, and some need a parent. Clients may come in and willfully withhold information, testing to see if I can sense that they are hiding something. They may come in aggressive and take out that aggression on me, their nearest target. They may come in silent, or sleepy, or in pain, and expect comfort, or nurturance, or challenge. And they expect the therapist to be fully present and adaptable to those needs, spoken or unspoken, no matter what the therapist is going through personally. (And trust me, therapists get headaches, and get sad, and have family problems, and…)

On top of that, the therapist has to be able to manage time. Sessions last for fifty minutes. Clients need a balance of reporting HOW they are doing, while being kept on a continuum of working toward their goals. (And some clients have VERY specific goals, while others have NO goals).

Most clients expect some kind of therapist who has life experience with struggle. They want to know their therapist has an understanding of depression, and anxiety, and addiction, somewhere in their personal lives, but they also don’t want the therapists to have ANY problems currently. And so self-disclosure becomes necessary. I use self-disclosure sporadically with clients. I use it to demonstrate understanding of a particular issue, to create a bit of a personal bond with a client, or to increase empathy between us. Self-disclosure is expected by most, if not all, clients, at least to a degree, but it has to be brief while also being frequent.

These interactions with clients get extremely complicated given three basic facts: 1. I am a human, who has human problems and human emotions. 2. I genuinely care about my clients, each and every one of them, even when they get on my nerves. 3. I have feelings, and I won’t always do everything right, even when expected to.

A few examples of self-disclosure follow.

“I know what that feels like. Before I came out of the closet, I went through a period of deep depression. It can be so hard to do the work it takes to get out of it, but it is so worth it. It’s the difference between hope and despair. What do you think would help you move forward?”

Or “I hear you! Being in a relationship is so hard! My partner and I fight over the stupidest things sometimes, and we see things completely differently. Communication means compromise, though. Meeting in the middle. The other day we argued about ___, and then we got through it by ___. Tell me about your last fight.”

Or “Maybe taking a break from church is a good idea for a while. You are talking about how conflicted you feel when you attend every week. I wouldn’t recommend quitting all together, but taking a few weeks off so you can get some clarity. When I was in my faith crisis years ago, I needed room to breathe, and it helped immensely.”

Self-disclosure in therapy can become tricky. It builds bonds, but those bonds have to be kept within certain boundaries. The client can’t feel like the therapist is over- or under-sharing. There needs to be a friendship without the two being friends. Co-dependency can form, as can romantic attraction, or emotional distance, or overstepping bounds. In fact, because these are human interactions, not only can they happen, but they will happen, and then they have to be managed along the way.

After 16 years in this field, I’ve learned a few things, but above all else, I’ve learned that I have to be organic. My job requires me to be knowledgeable, competent, kind, and consistent, to manage time and goals, to be accepting of everyone, to be both soft and hard in approach, to keep clear boundaries, to be human, and to be adaptable. And despite all of that, I have to realize that I’m human, that I’ll make mistakes, that I can’t help everyone always, and I certainly can’t please everyone always. I also need to know that it’s okay to say sorry, to receive criticism, and to trust myself all while doing my best to help those in front of me.

I love helping others, which is why I do what I do. It’s a calling. But it is also a job, and just a job. And I have to leave work at work and then go home. And so, like every other day, I’ll do my very best, one client, one hour at a time.

Seattle Part 6: the HMO

October, 2014

On my first day, it took me nearly an hour to get to my new job, though it was only about 8 miles distance from my residence. I had to drive down a long, narrow, busy Seattle street through traffic and stoplights, then get on a congested freeway. Traffic moved very slowly across the lake, and there was no other way to get there.

I worked on the top floor of a medical clinic, the local face of a busy HMO (Health Maintenance Organization). The mental health clinic employed around ten therapists, and we were all kept significantly busy. Clients who held a particular insurance were given good rates to see a doctor or a counselor at the HMO, and they were charged a lot of out-of-pocket expenses to see anyone else, thus we always had a long list of people waiting to be seen by a provider. Someone might call in in some sort of crisis and then not be able to see a counselor for six weeks afterward, based on current openings.

I had worked at community health centers before, so I understood the medical model of therapy. I was a clinical social worker, or LCSW, meaning I could get higher than standard reimbursement rates through various insurances, including Medicare and Medicaid, and the company seemed happy to have me there. But this place worked at a much higher pace than anything I had ever experienced before.

First of all, consider therapy itself. A counseling session requires the therapist’s all. There can be no distractions, no phones or music or computers. It’s just the therapist and the patient. There can’t be errant thoughts, or outside stressors, or headaches, or upset stomachs, or sleepiness. The therapist can’t yawn, or stretch, or eat a snack. The client requires one hundred per cent of the therapist’s focus, as well as their clear memories of past therapy sessions, like names of loved ones and therapeutic goals. On top of that, therapists are often dealing with clients who have extreme trauma issues. They hear stories about combat, suicide, rape, abuse, grief, and pain. And when one client leaves, the next is generally waiting, and the therapist can’t still be thinking about the first or she won’t be able to focus on the second.

Doing three or four therapy sessions in a row requires a tremendous effort; doing seven or eight becomes downright exhausting if not impossible. The HMO required more. And doing that day after day, well, it’s not for the faint-hearted. In standard clinics, even busy ones, I became accustomed to doing four therapy sessions, having an hour lunch, then doing three more, with the last hour of the day being reserved for case and progress notes, treatment plans, and correspondence. It was already at a taxing schedule.

But at the HMO, the expectations were much higher. They had competitive wages (about 45 dollars per hour, consistently, on salary) and a great benefits package. But they had their therapists on a very rigid schedule, seeing a patient basically every forty minutes with no time for case notes built in.

A standard schedule might go like this, for one day:

8 am: ten minute staff check-in

8:15: first patient (let’s say an elderly woman with Alzheimer’s whose husband just died)

9: second patient (a teenage girl who recently attempted suicide)

9:45 third patient (a refugee worried about her loved ones in her home country)

10:30: fourth patient (a couple going through extreme marital issues)

11:15: fifth patient (a veteran struggling with PTSD issues)

12: thirty minutes for lunch

12:30: sixth patient (a single mother of four processing stress)

1:15: seventh patient (a woman with a new baby, struggling with postpartum)

2: eighth patient (a mother processing stress over her son coming out of the closet)

2:45: ninth patient (a man referred by his boss for losing his temper at work)

3:30: tenth patient (a ten-year old boy whose parents recently divorced)

4:15: eleventh patient (a woman with borderline personality disorder, recently out of the state hospital following a suicide attempt).

Then, after that, once your notes were finished, you could go home for the day. Every other week or so, there would be a staff meeting of some kind. And every second or third day, a client might cancel or not show up, giving a chance to catch up. But that many patients per day, every day, four days per week, generally meant between 36 and 45 people seen per week. Sessions had to be shorter and more goal-directed, and a failure to adhere to the schedule meant knocking multiple clients back. If a client came in in crisis, very little could be done to manage it without having to cancel another session afterwards completely, and openings after that became hard to find.

I came into the job with boundless enthusiasm. The team of people I worked with were amazing, funny, friendly, and supportive. The agency had great diversity representation, several gay therapists, and a good camaraderie. But as I finished my first week of work, beaten down, grey, and bitter, I began to realize how tired everyone was. It was like working in an emergency room, without breaks, day after day, every day. With an hour’s drive each way.

In Utah, my therapy work had almost exclusively been with LGBT people who were struggling to align their sexuality with their Mormonism. Here, I was seeing people from every walk of life, all struggling with their own sets of problems. The word Mormon wasn’t being brought up anymore, but there was constant depression, anxiety, trauma, grief, and emotional pain. And within two weeks, I found myself unable to offer my client’s my all any longer. Instead of being an incredible therapist, I was becoming a mediocre one, simply to survive the rigorous page.

And with the reality of the new job settling in, Seattle didn’t feel quite so magical. It felt wearying, and expensive. Some cracks in the foundation of my dream life began to show.

And every night, there was the phone call to my sons, who remained far away, and who I missed very, very much.

Published

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I clicked ‘Publish’ on the final edit of my book, and then sat back, tempted to slam my laptop closed.

I expected a rush of elation. I wanted to rip my shirt open, incredible Hulk style, and smash my fist down on the ground in triumph. Instead, I felt my heart rate increase. I was nervous, and I felt an ache inside. It felt a little like exhaustion, and a little like heartbreak. Why?

I thought my book might be ready for publication about one week prior. Nervous that it would come out with typos or mistakes, I asked a few key people to give it one last look over, and I did one more myself. I quickly realized it wasn’t ready. Instead of publishing then, I gave the book a final edit. I pored over pages of vulnerable material, right from my heart space, cutting out paragraphs, deleting references, and combing over it line by line in order to make the book more effective, more readable.

I spent days, moving from one makeshift workstation to another. I would read a chapter at my kitchen table with a cup of coffee, then lay down on the floor in front of the fire place for the next chapter, then move to the hot tub for the third, propping my computer up on a towel placed on the folded back covering to keep it dry. I went through the book a full time, then again. I trimmed the book from 300 pages to 230, then had friends give it another read through. I saw the book shift from something dense and overly done to something succinct, smart, sharp, and wonderful.

Yet publishing felt so sudden, so jagged. Needing to chat with someone who understood, I messaged my writer friend, Meg.

Meg, I did it. I published.

Chad, that is huge! You did it! How do you feel?

Weird. Numb. My brain is empty. I feel purged, yet proud. I’m anxious and confused, yet accomplished and powerful. 

I’ve been there and I understand. It’s weird, right? What’s going through your mind?

Ugh. Everything. Will anyone read it? What if no one reads it? Oh my God, what if someone actually reads it! Is it as good as I think it is? Did I price it too high? I priced it too high. I’m so proud of this! Did I say too much? Did I say enough? Will it resonate with anyone? 

Chad, that’s normal. You basically just gave birth to a child. Stay calm and focused. This is all so good. And it’s going to be amazing. 

I’d been talking about writing a book for years. Something I, um, talk about in my book. I remember all the conversations I’ve had with those who read my blog about how they’d love to read a book by me. I thought of my mother saying she knew I’d write a book one day, with my best friend where he told me to make a book happen. I did it. And it felt amazing.

But there is something about a blog entry. You just type it up and click publish, and then people read it or they don’t. It feels like a journal entry, and it doesn’t even bother me if there is a typo or two. But a book, a book has promise and potential. It has permanency. It’s an entirely different caliber. It feels… amazing. Frightening.

I once published a comic book, the Mushroom Murders. It took me years to get it finished, coordinating with busy artists who also shared my passion for the book. Four years, actually. Then I had to work with a small press publishing company to help me market the book. I paid around $5000, a charge that went on my credit card, to print the book, and several boxes of product arrived at my home. I spent years selling it at conventions, in stores, to friends, and on Amazon. It got amazing reviews. And now, the final few hundred copies occupy dusty cardboard boxes in my storage room. I didn’t want that experience again.

This time, I printed my book per order, through an organization called CreateSpace. It markets the book through Amazon. No initial costs on my part. The book is printed per order. If only one copy is ordered, only one will ever be printed. Will it sell one, none, dozens, hundreds? Will anyone care? And because CreateSpace is the one to list the book, I don’t see until days or weeks later if any orders have taken place, or how many total. There are no little messages that indicate when a sale has happened. Not knowing if it is selling fills me with a different kind of confusion.

I had to shut my computer down and take the night off. I saw a movie. I grabbed a drink with friends. My boyfriend ket gripping my arm, squeezing, reminding me that things were fine, it was going to be okay. I breathed, calming myself. Writing didn’t usually feel this way. Such a weird stew of emotional ingredients behind all of this.

Well, I did it. I wrote a book. I designed a cover, edited it, and put it out there for the public. Years of life experience. Dozens of hours writing. A finely honed talent (I hoped others would agree). A stirring, powerful, and inspirational message. It could be… well, this could change my life. Or it could wind up in a box in my storage room, untouched within a few years.

Regardless, I did it. I accomplished one of my lifelong goals. I have no idea what might happen next, if anything. I’m powerful, vulnerable, and strong, and I wouldn’t change a thing.

And, in order to sort out my feelings, I decided to write a blog. About the vulnerability of writing and publishing. And maybe that tells me more than anything.

 

 

 

 

 

 

 

the Band Bus

 

 

 

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As the bus sped along the southern Idaho freeway, hurtling toward home, I looked outside at the dark horizon and yawned. I was exhausted.

I was 16 years old, and a sophomore in high school. Early that morning, all of the members of the high school pep band had gathered at the high school and boarded the bus, and then we had driven several hours from south-eastern Idaho to south-western Idaho, where we played upbeat songs for a sports team during their match. The school fight song, “Wooly Bully”, “the Hey Song”, and other inane tunes still blared in my brain during the long drive home. My clarinet was safely tucked into its case underneath the seat.

Sarah sat next to me, a senior. She played the flute. I didn’t know her well, but I’d always found her nice. She was quiet, a good Mormon girl, modest, friendly. Pretty in a homely kind of way. Toward the back of the bus were the more raucous kids, wild with laughter and teasing each other, blasting music and playing cards. Sarah and I sat at the front of the bus, among other kids who just wanted a quiet easy ride. The unspoken rule was that the more well-behaved students sat closest to the bus driver, and the more wild ones sat farther away.

The bussed had lulled into a steady dark drive, only occasional chatter now. I wasn’t really aware of anyone around me. I just felt the vibrations of the wheels against the road and listened to the sounds of traffic, and I pulled the pillow I’d brought from home up next to me, resting it against the window and pressing my head snugly into it. We wouldn’t be home until past 2 am, and I hoped to sleep the rest of the way. Sarah had a pillow also, and after trying it out behind her head and then on the seat in front of her, she asked nicely if she could rest it against my arm.

“That’s fine,” I yawned again, and she pressed the pillow against me and was soon sleeping. I fell asleep not long after that.

A few hours later, I woke up as the bus pulled into the high school parking lot, a building designed, on purpose, to look like a spud cellar, a building that housed potato on farms. Our high school mascot was a potato, and the architect had apparently felt this would show school spirit. I slowly came aware and realized that Sarah’s pillow had shifted downward until it was in my lap, and she lay there sleeping soundly, bent at the waist. My pillow, meanwhile, had moved to her shoulder, and I had been sleeping soundly there. I tapped her on the shoulder, indicating that we had arrived, and we both gathered our things and got off the bus, stretching the kinks out of our backs and necks along with everyone else. It the the middle of the night, and winter, and I pulled my coat tightly around me. As pre-arranged, a friend gave me a ride home, and I immediately went inside, changed to pajamas, and went to sleep.

School was back in the next day, so I only slept a few hours. I woke up at 7, got ready, and headed in for my usual schedule of classes. History, Math, English, Economics, lunch, Seminary, Band, Theater. The day felt a lot like it normally did, routine and easy. I did my homework, bantered with my friends at lunch, and visited my locker to change books between classes.

It helped that things at home were quiet right now, routine. It had been a few weeks since Kent, my step-father, had lost his temper and thrown all of my mom’s things out on the front lawn, screaming insults and terrible things to her while Sheri, my little sister, and I had cowered in our rooms. Usually, after one of his violent and angry spells, things got really good for a while. Kent was a great father figure in between those spells. He made meals, took us to movies, and planned family events. There was always the threat of another storm, but for now things were okay, and being at school felt safe.

And then it was time for band class. I entered and took my seat in the row of clarinet players, getting out my instrument, assembling it, and attaching my reed. With the flutes in front of me and the saxophones behind me, we waited for the band leader, Mr. Marr, to begin class. He walked out of his office, took his place in front of us, and then started to yell.

“It has come to my attention from those who chaperoned your pep band trip that some of you in this room took advantage of the fact that I was not there to engage in inappropriate behavior! The things I heard about some of you doing on the bus last night were unacceptable! Reports like the ones I received, they do not reflect the morals and standards of this band at this school! And if you think I don’t know your names, then you are wrong, I hear things. I know what happened between people like Chad and Sarah on that bus!”

He continued yelling, but I didn’t hear another word. My head filled with cotton and my stomach immediately became nauseous. What was he talking about? What had he heard? That we fell asleep in the same seats? Had someone made up a rumor about us? My heart was thudding wildly as he stopped yelling and angrily lead us through our band routines for our upcoming concert.

For the rest of class, I only pretended to play. I couldn’t calm down. I’d felt all those eyes on me, some of confusion, some of concern. A few times, Sarah had looked back at me, her face pale, and we’d exchanged looks of utter bafflement. What had he heard?

In time, the bell rang, and people made their way out of the room toward their next classes, having only four minutes to get there. I put my instrument away and waited as the room emptied. Then I walked over toward Mr. Marr’s office to ask him what he had heard.

Without even waiting for me to speak, he looked up at me from his desk. “I don’t want to hear it, Chad. What you did was not okay, and today is not the day to talk to me about it. Try next week when I’ve calmed down.”

My mouth was dry. “But, sir, I didn’t do–Sarah and I barely even– we didn’t–” I was stammering, unable to finish a thought.

“I said not today! I don’t want your excuses! Now go!”

He shouted and I rushed from the room. My fingers were shaking as I fumbled at my locker, putting my instrument away and grabbing supplies for my last class. I felt like running away. Being yelled at like that, it felt too familiar, like everything that was going on at home, me being screamed at when I hadn’t done anything wrong. I walked on autopilot into the theater class, seventh period, and took my seat in the front row. The bell rang and students around me were laughing and chatting. I just clutched the desk, my heart in my stomach, my skin tingling, feeling nauseous.

Mr. B, the drama teacher, stood in front of the class to introduce what we would be doing that day, but he didn’t get far before the tears started falling from my eyes. I sat there and wrapped my arms around myself, hoping no one would notice, but then I started crying harder. Little gasps escaped my mouth, and a sob escaped my throat, and suddenly I was sobbing, quietly and then more loudly. I gripped my desk and bent my head forward and just sobbed, my body overcome with anxiety at the same time. And then the sob was a small wail.

Mr. B emptied the classroom quickly, moving everyone into the auditorium, instructing my friends Lynda and Jill to stay with me. One grabbed tissues while the other rubbed my back, telling me it was fine, it was fine, what’s wrong, you’re okay, it’s okay, calm down, you’ll be fine. A minute passed, then two, and then my stomach seized, and I bolted out of my chair and rushed down the hallway, making it to the bathroom just in time to vomit.

Jill and Lynda waited for me outside and walked me back to the classroom, where Lynda asked me, “What in the hell is going on?”

I bit my lip, unsure what to say. “Just, things aren’t great at home, and just got in trouble in band for something I don’t even know what, and I’m tired and–”

Within 20 minutes I was home. I ignored Kent when I entered, said I wasn’t feeling well, and went to bed, my puppy sleeping on my knees. Sarah and I never talked about what happened. I never again asked Mr. Marr what he heard. And while I’d never had a breakdown like that before, I still had a few more to go before Kent was out of our lives once and for all.

Repressed Memories

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“So I have this client who thinks that something might have happened to her when she was a kid. She wonders if she might have been abused or something, but she doesn’t have any specific memories.”

I nodded. “Okay, and is that something you are exploring in therapy?”

The clinician I was supervising tapped his pen against the pad of paper, collecting his thoughts. “I’ve been looking into it some. If there are repressed memories, it seems there are a number of ways to discover them and heal from them. Hypnosis can work, dream journals seem to help, regular meditation. I’m just not sure that I’m all that equipped to help her. I’m brand new in this field.”

“The operative word in your previous paragraph? If.”

I watched him write the word IF on his paper. “If. If there are repressed memories.”

“Right. She doesn’t know if there are or not. If there are repressed memories then hypnosis and those other methods might help. If there aren’t?”

“Then there wouldn’t necessarily be anything there. Okay, interesting.”

I let him collect his thoughts, then began asking questions. “So the first thing to wonder, why does she think she might have repressed memories?”

He smiled, enthusiastic. “I actually asked her that question. She had a decent childhood, so far as she remembers, but some traumatic stuff happened to her later on. Now she is realizing there are blank patches in her childhood memories, so that leads her to wonder if something bad happened and her subconscious mind blanked it out.”

“Okay, good job exploring that with her. There certainly could be repressed memories. In times of trauma, for adults or kids but particularly for kids, the brain can enter a mode where the person shuts down for a while or where they kind of leave their own body in order to survive. There are also times when the brain can hide or omit memories from the consciousness as they would be too disturbing to the person. When those memories show up, it can be in the form of flashbacks or panic attacks, and it usually happens after something triggers the trauma memories, or, ironically, the memories can show up during times of safety, when everything feels comfortable and okay for once so the memories are able to finally come to the surface.

“But the key here is she doesn’t know if she has repressed memories. She might and she might not. She’s simply wondering at this point if there might be. During the 1990s, there was a lot of repressed memories topics showing up on talk shows and soap operas, and suddenly everyone was coming forward as having repressed memories. It became kind of a craze. But wondering if something bad might have happened in childhood, or even wondering if more memories should be there where there aren’t any, that doesn’t mean there is any evidence of repression.

“Of course, it also doesn’t mean that there isn’t.”

The clinician clicked his pen in frustration. “So what do I tell her to do?”

I smiled, knowing this would annoy him. “What’s the first question we always ask ourselves?”

He rolled his eyes. “‘What is my role here?'”

“And your role in this case?”

“Is as her therapist.”

“So what is your job regarding this?”

“My job is to help her meet her goals. We are working on getting through depression and PTSD.”

“Right. So your job is to help her talk about it. Which you are already doing. Help her talk about her trauma, about why she thinks she might have oppressed memories, about her actual childhood memories. Then explore with her the options of other treatment methods if she feels they can help. There is hypnosis, there are mindfulness groups, there are dream journals. All of those take effort, time, and money, and she can pursue any of them that she wants to. But regardless, your job is to be there with her, week to week, whenever she is in front of you and needs help.”

“Okay, right, but are repressed memories an actual thing? Is that something you have come across?”

I moved my tongue along the inside of my cheek for a moment, thinking of the best way to answer. “Well, yeah. But it isn’t as simple as all that. Trauma can impact a person in a myriad of ways. It can show up as anxiety, as depression, as apathy. It can result in withdrawing from relationships, in sexual promiscuity, or in crippling fear. We can research trauma for years, but we can never have a clear mapped path that shows its results on a particular person. Even if we understand how a trauma effects someone, that effect can change with age or time or stress. Someone can live with trauma unseen for years and then have it show up much later in life.

“Here, I’ll use a personal example. When I was a kid, I went through a period of sexual abuse at the hands of a family member. For years, I didn’t understand how serious that was. As a kid, I also knew I was different from other kids, but didn’t know what that meant. As an adolescent, when I began to realize I was attracted to boys and not girls, I didn’t have any context to understand this, so in the beginning I automatically assumed that the abuse was causing the attractions, when in fact there were no direct correlations.

“When I was 20, and on my Mormon mission, I hit a slump of pretty low depression. Life was very much routine. I was mugged and knocked unconscious one day, which was its own separate trauma. But something about that particular incident seemed to knock something loose, pun intended. I began getting flashbacks after that back to the abuse from when I was a kid. Full on trauma flashbacks. Like in my brain I was the young kid for a while, then I would come back into my own adult skin. I wrote down everything that was happening, in detail, to get it out of my system, and after a couple of weeks, the flashbacks went away.

“So using that example, we can see the impact of trauma on development, and we could run down the list of trauma symptoms. Yet those symptoms showed up differently in childhood and adolescence than they did in adulthood. And a separate trauma caused me to have flashbacks of my childhood trauma.”

The clinician was scribbling notes. “So would you call those flashbacks that you experienced repressed memories?”

“I wouldn’t, actually. But some could. They were memories that, for whatever reason, I had to relive in order to move on. And they were repressed. But they weren’t forgotten, or omitted by my subconscious. I had no sense that parts of my childhood were missing, yet they were also memories that I avoided completely because they caused me discomfort.”

“Okay, okay.” He underlined something on his paper. “I get it. It’s complicated. We can study the topic, but it’s gonna show up for the individual person in different ways at different times. And my job is to be there with them, talk it over, help them meet their goals and explore their options.”

“Right.”

He gave a deep sigh. “What we do isn’t easy, is it?”

“It most certainly isn’t. But we get to help people who ask for help. And that makes it worth it.”

Emotionally Obese

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When someone comes out of depression, they have to learn how to feel all over again. It isn’t some magical shift, where the depression is replaced by joy and ease. Those positive feelings are there, sure, but the negative feelings have to be felt as well. There is a learning process to feeling sad, scared, mad, and guilty again, and then learning how to use the emotions to create positive experiences.

Somewhere along the way, we grow to believe that “emotional” means “weak”. We say things like “My husband just died, but I can’t let the kids see me cry. I have to be strong” and “I know I was diagnosed with cancer, but I’m not going to be scared. I just have to stay positive.”

We expend exhausting amounts of energy toward avoiding feelings that make us uncomfortable, feelings that are a natural part of the human spectrum. We can’t avoid feeling those feelings any more than we can avoid feeling hungry or tired; we can pretend all we want, but the feelings will come regardless.

The human spectrum of emotions is beautiful and complex. There are the feelings we enjoy, like happiness, gratitude, peace, joy, and security; and then there are the feelings we believe are unhealthy or unpleasant because they bring with them a bit of pain, like sadness, fear, guilt, and anger. When people deny themselves the ability to feel and experience those emotions in healthy ways, they are dumping half of the crayons out of the box, and restricting themselves to the other half of the box. Black just doesn’t work as well without the white to contrast against, and red in only one shade isn’t nearly as beautiful as an entire spectrum of red.

Like physical and spiritual obesity (discussed in previous blogs), emotional obesity sneaks up on you, slowly over time, one pound of emotional weight added at a time. For years, I didn’t let myself feel sad or scared or angry. In fact, I believed it was unhealthy, selfish, even indulgent to waste time on those emotions. I kept a bright smile on my face while I was miserable on the inside.

It took me several years to learn a very fundamental lesson, that pushing away sadness, guilt, anger, and fear didn’t eliminate those emotions or mean that I didn’t feel them; the emotions were still present, pushed deep down where they did damage and caused pain. The only possible response to pushing emotion away is depression. Depression comes in many forms, from moderate to severe to crippling.

There are classic signs of depression: disinterest in pleasurable activities, poor sleep habits, poor nutrition habits, isolation from loved ones, lack of self-esteem, a lack of motivation, a lack of purpose, feelings of shame and worthlessness, and even recurrent thoughts of death and dying. Someone who is mildly depressed may grow to feel that walking through life sad and empty and numb is normal and natural; someone with severe depression may grow to feel that the world would be a better place without them.

My years in the closet were fraught with varying levels of depression. I grew accustomed to feeling sad and empty. I had a wife, a child, a home, a calling in my church, and a successful career, and I felt empty and numb on the inside so regularly that I thought I would never feel anything different. I even grew to believe that that was what God expected of me: to be sad until I died so that I could be happy finally.

I remember a particular time being at Disneyland with my wife, and seeing a gay couple nearby cuddling during the fireworks show. I couldn’t take my eyes off of them. They looked so happy. I muttered something about being disgusted that they were being affectionate in public, while on the inside I envied them, knowing deep down that I would never have that, that I would never be able to find something like that. Looking back and realizing that I once saw no happiness in my future, well, that just breaks my heart.

Turns out, depression isn’t a natural state. Emotional obesity is a learned behavior, something we choose to participate in, just like physical obesity. Depression is a real and powerful force, and it literally steals lives away. People sometimes spend their entire lives feeling trapped by their environments and situations. Women stay in codependent relationships for decades, where they are abused or confined, because they convince themselves they can’t be happy outside of it; really, they won’t let themselves feel scared and do something with the fear. Men spend lifetimes lonely and feeling unworthy of love; really, they have never learned how to experience sadness and do something about it.

I had to learn, slowly and steadily over time, that emotions that are perceived as negative are truly beautiful. They are unique, and they are crucial to survival.

I love my sadness now, in all of its powerful forms. I love being able to be blue and lonely,  I love grief, for myself and others, the ability to look back on the difficult hand life dealt me, to be able to miss my best friend, to regret the years lost, to feel a bit empty after something I hoped for didn’t turn out like I had hoped. I think my sadness is beautiful and powerful. I listen to it, and I feel it, and I don’t let it overwhelm me. I feel it, then I choose what to do with it.

I love my anger now, in all of its powerful forms. I love being able to be frustrated when I hit the tenth stoplight in a row, the ability to feel and express the full spectrum of annoyed to enraged when injustice happens around me, to clench my fists when someone I love is hurt, to feel steel in my stomach when I experience rejection or betrayal. I think my anger is beautiful and powerful. I listen to it, and I feel it, and I don’t let it overwhelm me. I feel it, then I choose what to do with it.

I love my fear now, in all of its powerful forms. I love listening to my mild fears and discomforts in uncomfortable situations, the ability to embrace nervousness as anticipation or dread and confronting those feelings head on, to feel gooseflesh and heart thumps when I worry about a result or a reaction. I think my fear is beautiful and powerful. I listen to it, and I feel it, and I don’t let it overwhelm me. I feel it, then I choose what to do with it.

I love my guilt now, in all of its powerful forms. I love listening to the unsettling parts of myself that have a lesson to teach me, the parts that regret a bad food choice or a harsh word, the parts that ache over lost years and missed opportunities, the parts the deliver hidden messages from my deepest core and help me to course correct and make authentic choices. I think my guilt is beautiful and powerful. I listen to it, and I feel it, and I don’t let it overwhelm me. I feel it, then I choose what to do with it.

Being emotionally fit means not only listening to my emotional spectrum, it means embracing it. It means opening my arms up to the wind and loving my life in all of its forms. It means putting myself first before seeking to make those around me happy. It means choosing healthy, balanced relationships. It means keeping every crayon in the box, and using all of them often to color the most beautiful pictures possible.

 

(Final obesity blog coming soon on being Mentally Obese).