Archives for posts with tag: psychotherapy

As a person with “no evidence of disease”, I am grateful. I am also grateful that I continue to heal physically, emotionally, spiritually, and yes, cognitively. I have written of the attention, concentration, working memory, and organizational difficulties I’ve had since being diagnosed with cancer. (Some people call this “chemo brain” though I didn’t have I.V. chemo.) These difficulties have slowly but surely improved over time. A huge boost came after I completed a cognitive behavioral sleep program and then later, when I took gaba pentin for a few months to reduce my nighttime hot flashes. I have also had improvements through working to reduce my anxiety and grief through my mindfulness practice and personal psychotherapy. Last but not least, writing this blog is one of the most therapeutic endeavors I have ever undertaken. It, of course, has side effects like any therapy in that my posts sometimes worry my mother.

Although a good deal of my energy has returned, I still don’t work full time. I find that it is too hard to maintain my emotional and physical health when I do this so although I sometimes schedule a full time or slightly overtime week, my average is about 80%. Prior to my diagnosis and shortly afterwards (I had to cram my schedule in order to take off time for surgeries), my schedule varied from week to week but I worked up to 150% of what is considered full time.

Despite my reduced hours, I am quite busy. Although most of my day is meaningful and productive, a good portion of my day is being busy for the sake of being busy, doing trivial things that do not fill me up. And some of the trivial things would not be trivial if I stuck with them for more than a couple of minutes. But I spent some part of my day alighting from one activity to another in rapid succession.

I do this less than earlier in my cancer treatment. The main reason back then was fatigue, boredom, and the need for fun. Since I was having trouble with sustained attention, I flitted around lot. Although I have never written as much or as frequently in my life, I stopped reading books. There had been no time in my life since about age 10 or 11 when I was not reading on a daily basis, with some breaks for a few weeks during adulthood, when my stress was at its peak.

I’ve been doing a lot of thinking about accepting the things in my life about which I feel feel, grief, and anger. I know that a common fear for people impacted by cancer is fear of abandonment. My husband worries about losing me. My daughter, although she denies it, worries about it too, I think. She acts very much like other teen girls with whom I’ve worked, who have a mother with a serious disease. I worry about losing my family, through decreased participation in family life if I were to get ill again and through my own transition to death, which may not come any time soon, but will come some day.

I had a epiphany last week. Although I was aware of my own abandonment fears, I realized that I was continuing to give myself busy work to avoid feeling lonely. I have been filling up spaces in my heart and mind with filler. I have too often disengaged from my husband because I associate him with our fear of my cancer as well as the stress we have in parenting.

Since that epiphany, I have made some changes. Trivia is okay but not as a main course. And trivia is much better when enjoyed with a loved one. I also realized that a lot of my life is serious and difficult. I have a serious job as a child/adolescent psychologist. I have personal psychotherapy, our family class on mindfulness and emotion regulation, and couples therapy with my husband. Between my job and my appointments, I spend the majority of my waking hours in a mental health facility. Last Friday in couples therapy, which we have been attending weekly I said, “I want less therapy and more fun. John, I want to spend more time with you having fun.” Our psychologist thought this was a great idea. John agreed, reluctantly, because this scared him. But we’ve been spending more time together. Yesterday, I received a note from a childhood friend. Her husband “out of the blue” told her that he is divorcing her, on the day before their 27th wedding anniversary. This has also reinforced my resolve to continue to work on my relationship with my husband. Too often people live separate, lonely lives, full of activities, suffering in silence.

I am not by nature, a lonely person. Cancer has a way of whittling away at security, even for those of us with “no evidence of disease”. Breast cancer also has a way of striking women at the prime of life in terms of professional and family responsibility. Many of us have full careers, children who are not yet independent, and elderly parents who may need support. It is easy when juggling these balls, to feel fragmented and flittery, to feel engaged with everything but intimately connected with no one, not even with ourselves.

Balance right now means more fun and more depth.

A big part of my work as a child psychologist is working with parents. I help them make goals and plans. I teach them skills to help carry out those plans. And then they leave my office. This process is repeated over the course of treatment.

Sometimes parents do not put their plans into action. They might say, “I was too busy.” They might say, “I didn’t do it because it was too hard.” They might say, “I tried it once and it didn’t work so I didn’t try it again.” They may even say, “I didn’t do that because I knew that it wasn’t going to work.” Sometimes I need to re-explain the rationale, the skill, or the fact that the skills are not magic tricks that produce instant success. Sometimes we set smaller goals that are easier to implement.

Sometimes, we do not get any where, week after week. An interesting observation I have made over the years is that even when parents are aware that they have not put plans into place as recommended, they still expect positive change to result because they made the plans and are doing SOMETHING. They are coming to therapy and paying money for it. They are talking about problems. And if it is believed that the skill is too hard to implement, there is often an implicit assumption that if one has a good excuse for not carrying out a recommendation that there will be no negative consequences for having not doing so. They think their child should improve, anyway.  As psychologists go, I am on the frank side. I try to be as sensitive as I can be and communicate clearly. Parents tell me, “I can’t do that. That’s too hard. I can’t be expected to do that.”  I empathize with the difficulty of parenting, the severity of their children’s challenges, but also say, “Yes, it is very hard and it is harder than what most parents have to do. But just because it’s difficult, doesn’t mean that it is not necessary for your child. What can we do to make this more possible?”

In the good case scenarios, the parents either start rallying and planning during the session, or upon thinking about it later, start re-adjusting their priorities and making things possible. They are able to get past “parenting shouldn’t be that hard” to the reality of their situation. Most of the time, this is what occurs. But sometimes it doesn’t and there is a seemingly endless spinning of wheels, complaining, and expressions of distress and despair. I respect that many of the parents with whom I work are going through a grief process of having a child with chronic difficulties. But some of them can get really really stuck.

There’s nothing wrong with New Year’s resolutions in and of themselves. They are a starting point. The problem is when we don’t implement them. Another problem is when we use them as an opportunity to beat up on ourselves about not having carried them out. Or we think carrying them out is too hard.

I have been working on changing a habit that has a negative impact on my family and on myself. I have been working on it as part of the 6 month long class my family is taking. One of the things each of us did was to write a little pros and cons list for the behavior we wanted to eliminate as well as for the behavior we want to replace it with. Then we were told to choose three of the pros and/or cons that we most important to us and to memorize them as a little script. The habit I chose is one I’ve been trying to modify for decades. For the first time, I am making progress on it and not only that, experiencing positive benefits.

Wishing you a happy and motivated New Year!

 

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