Study Break: Theories tomorrow. Cognitive Behavioral Therapy. I'm reading the 2 assigned case studies, because I motherfucking LOVE case studies. They fascinate me to no end. The chapter on CBT in the book? Given the obvious, that our professor will show us no fewer than approximately 100 Power Point slides on CBT, we'll discuss the case studies, then wind up with a class presentation on it is, in light of the fact it's the type of therapy I've been involved with as a client for--what is it--almost 4 years now--a lil' bit of overkill.
Though speaking of overkill, and while suicide is certainly, understandably, undeniably nothing about which to crack jokes, the case study of the suicidal clinical psychologist who was in CBT to quell her overwhelming disappointment at the loss of a boyfriend, had me at least chuckling to myself because the dialog between the therapist and his client (herself, like I said, a clinical psychologist) is, I guarantee you, almost eerily similar to therapy dialogues in which I have been the heartbroken, downtrodden, disenchanted, arm-slashing-with-a-steak-knife difficult, snide and argumentative client.
My life, admittedly, has been wrought with more failures than successes, which has been a philosophy of practicality my parents mapped out for me when I was very young, and, well, you know, self-fulfilling prophecies and all. But ne'er was I more inept at the successful completion of a task than when I tried committing suicide. Everyone...from concerned friends (Rule #1--never entrust a friend that you're suicidal who is a firefighter/paramedic, with all that duty-to-report you shit), puzzled and angry family members, social workers (the cockroaches of the psychology world) to ill-equipped quasi-talk-therapists from Lutheran Social Services, to police officers to paramedics, all engulfed me with good intentions, I guess, as I lied under bright lights in the emergency room.
So stinky ass drunk that I barely found my keys when the authorities SWAT-teamed my apartment, I left for the hospital without any shoes on, having nearly finished an entire jug of that awful Gallo wine that comes in giant gallons in one night. I was so *used* to drinking that I never vomited and never had a hangover. I called my friend Wes at like 2am, and basically just told him that Luke was better off with Craig, I had ceased to find one glimmer of hope--not even my son--and that I was planning to just quietly, uninterruptively cease to exist. I don't know if was my mental disease or the alcohol numbing all of my senses, but I can honestly say I just didn't give a damn anymore. (This was early May, 2007, and coincidentally, the night before my mom's first breast cancer chemo session.)
What did the team of experts conclude? That it was agreed...I was stinky ass drunk. The hospital team's solution? Close the curtain, dim the lights, send everyone away for the night and have a case worker see me in the morning, after I'd sobered up. No counteractive drugs. No stomach pumping. No attention, whatsoever. The "sleep it off" remedy, after which I would meet and gather phone numbers to various routes of assistance, my brother drove in to take me home (shoeless), and I promised I'd stop drinking. "Promised."
My brother bought me some Wendy's for lunch, a half-filled glass of wine still on my porch steps, and we talked for a while, before he went back to De Kalb. I, meanwhile, was wrangled into attending a Cinco de Mayo dinner at church. I came home and got stinky ass drunk all over again, the drink-to-blackout modus operandi would continue until the following winter. Hell, a week later, I threw a big 35th birthday bash at my house and all of my friends and I got plastered beyond recognition, en masse.
Speaking of alcohol, what IS this about young women soaking tampons in vodka and shoving them up their hoo-hah's? I understand the inherent biological concept, as well as that as "butt-chugging," or administering yourself an alcohol-fueled enema. The liver and stomach are bypassed and the alcohol rapidly enters the bloodstream and instead of it taking a heavy drinker 4 hours to become obliterated, such drastically disgusting tactics can get you really, super drunk really fucking quickly. Neither option sounds particularly pleasant nor safe to me, but it's becoming more and more popular, especially at the collegiate level. Either kids have gone crackers or I was raised in an old-fashioned culture.
In my heart, truly, did I want to die that night? In hindsight, no. In the moment, that severe edge upon which no one right-mindedly would teeter, seemed like the only logical way out of what was otherwise a totally irrational, permanent solution to the issue at hand (which, admittedly, I don't even remember).
When alcohol no longer satiated my pain, I turned to self-mutilation, the details of which I know I've explained to 100 people 100 times at least. What my first CBT therapist told me was that I cut myself because it worked....really, really well. Like I've said, it's so gory and painful, that when done with skill, the underlying layers of skin begin to actually feel very cold. You also, momentarily, while experiencing this agony, block out whatever icky thoughts have overtaken your head space. But once properly medicated and following the CBT therapist's behavior modification exercises, I overcame self-mutilation, roughly a year after I quit drinking altogether.
Cognitive behavioral therapy is wonderful, inasmuch as it advocates mindfulness, the Sanskrit representation of which I've chosen as my next tattoo, that I'm still debating with The Overwrought and Exhausted Guy Friend Whose Lack of Tact Nearly Keeled me Over On the Phone for a ride and more time together. (I've been listening to "Alone Again Naturally" and picking he-loves-me, he-loves-me-not flower petals for days, and am admittedly depressed at his supposed utter and complete rejection of me.)
The therapist in the case I studied, during which he fought her every ounce of negativity with a positively reinforcing opposite thought or behavioral pattern, fortified the client with her capacity for rational thinking and underscored her multi-layered successes versus her intake dogma for that session, which in summary, essentially implied, "I'm about 95% sure I'm totally going to off myself, but I figured what the fuck, I'll tread one more lap around the toilet bowl." It's the remaining 5% that, as a clinician, concerns me. True, the odds pointing toward her life perpetuation greatly outweighed her self-perceived futility. And the goal of any therapy session is to have your client walk out the door in a better frame of mind than when he/she/they entered the session.
It was an interesting dichotomy in the case study how the suicidal clinical psychologist was entirely capable of administering provoking thought, workable plans, hope, courage, and mindful assistance to her clients, while she was internally rotting with all-or-nothing visions of catastrophe based on the premise that the breakup with her boyfriend scarred her so deeply that she doubted she'd ever want to enter an opposite-sex circle of date-worthy, eligible males herself, having resigned herself to a life of lonely celibacy.
It's certainly possible that I'll come away from class tomorrow knowing something I didn't previously know about CBT, especially if I'm forced to rate how I *feel* about CBT on a scale from 1-10, determining my inherent anxiety on a worksheet in an effort to gauge, yet again, the strengths or weaknesses regarding my "automatic thoughts." With regard to the popular worksheets, that's not to say I wouldn't eventually ask that of my future clients, but I would be more than sympathetic if the worksheet experience didn't work for them.
If I had to define automatic thoughts to a layperson, it'd be loosely translated as those ideas, mores, values, opinions and impressions one has held in his/her head since childhood which manifest themselves in ugly, destructive ways when people are faced with things like anxiety, disappointment, heartbreak, or extended grief. These negative thought processes are psychologically called "schemas." CBT aims at reversing those deeply rooted lines of negative thought and replacing them with positive, affirming, healthy behaviors. That takes a lot of dedicated work on both the therapist's and client's part, as the client only gets out of CBT as much as he/she is willing to actively engage. (I DID do the worksheets for a while, early on, then told my revolving door of therapists that I'd only consent to that type of treatment if no extracurricular paperwork was involved.)
I liked the therapist in this study's dictation that indicated in great detail what behavioral modifications he employed with the suicidal client and got her to re-frame her negative schemas with positive schemas. His techniques worked (at least temporarily), or until the client had another shitty week and came back to start at the first step yet again. Like recovery from any addictive or habitual pattern, abstinence or dilution of symptoms takes practice and careful thought. The brain has the capacity to retrain itself, and humans have the capacity to alter lines of thinking or belief.
After Best Male Friend wrote Guy Friend a 6-page Annie endorsement and ass-whooping, Guy didn't say much other than something about it being a fascinating read and something I should cherish forever, which I certainly will. Late tonight, Guy texted that I wasn't the only one on ignore mode and his 16-hour days were wearing him thin, but that he might have time to catch up on Friday. Woe is he, but I'm not feeling particularly charitable after his glib proclamation over the phone Thursday night that he was flattered by my attraction but didn't share the attraction, which every friend I have thinks is a blatant lie inconsistent with his behavior and advances. I'm still unsure of what the hell is going on, but I guess I'll find out. All I can say is dear God, I'm NOT getting into another phone call with him talking about our relationship. If he wants to discuss heavy shit, he can meet up with me and tell it to me to my face, once his face is done beaming at the very sight of me approaching.
"Guy Friend, please take this worksheet and rate your emotions towards me on a scale of 1-10, with 1 being "OMG, you're heinous and I loathe you" to "Yeah, ok, I shouldn't be and it's a sin, but I kind of think I actually do share your feelings, but I'm scared to death of them." Only time will tell which pair of balls he's wearing the next time we interact.
OK, kids, I have to hit the hay. Don't fill up your below-waist orifices and drive carefully!