One Pound At A Time

As I am typing these lines, I am 100 g or 3.5 oz away from reaching the weight that has been my target for the past 15 years. When I do – and since the aquafitness class starts this week, I have no doubt that I will – it means that I have successfully lost all of my excess university weight. It’s been my goal for such a long time that I don’t even know what the next one should be. Most likely, I’ll just try to lose another 5 kg / 11 lbs and take it from there – but I am also aware that muscles are heavier than fat, so my short-term goal is losing visible belly fat rather than a certain number on the scale.

There’s a certain genetic predisposition for weight gain coming from my maternal family’s side. Even on the oldest family pictures we own, that pre-date the First World War, my ancestors appear stocky and rotund. The only difference between them and me is that I am quite a bit taller than they were.

I was born a chubby baby, and never lost that appearance. Robust build, strong muscles; not fast, but good stamina; extracting every last calorie from a meal. Genetically designed for foraging or farm work. But unlike during prehistory (and most of history), I don’t have to actually find or grow my own food. There are no famines anymore in my part of the world where those “genetic gifts” would have made the difference between life and death.

Without the thyroid problems, I still would have been overweight. No illusions about that. They pushed me firmly into obesity territory, though, and ever since I have been struggling to leave it. Every ounce lost is the result of great effort, as if my body was desperately trying to hold on to the weight.

My husband, who easily eats twice as much as I do, has a different kind of metabolism. He used to be skinny, and even though he isn’t anymore, all it takes for him to lose some pounds is to exercise more. Within two weeks of starting his new job (where he’s on his feet all the time) he began looking visibly slimmer. If he put his mind to it, in a few short weeks he’d probably lose the 8 kg it took me over a year to get rid of.

I’m really hoping that the exercise will make the difference. My eating habits are pretty good – not perfect, but I very rarely exceed my calorie limit. Anything excessive makes me sick quite quickly anyway – fast food or junk food usually results in digestive problems. The only time when I can’t seem to go without it is when PMSing…

My ambition is not to become thin; that would be unrealistic. I never was, never will be. Sometimes, I wonder what that would be like. Would I carry myself differently? Would it influence my behaviour? Because being large has certainly left its mark on my psyche – I had my fair share of ridicule from strangers, and criticism from relatives. I never forget that I am fat, not even when alone. I wonder whether there is a certain point where I would?

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How Welfare Saved My Sanity

One of the biggest contributing factors towards my mental health improvement was getting on welfare. Or rather, not having to worry about how we’d be paying all those bills and the rent. There’s a lot to be said for financial stability, even if it is only the state-defined minimum. No more letters threatening to turn off the gas or electricity, no more anxiety attacks when checking the mailbox.

The public image of welfare-recipients in Germany is just as bad as it is elsewhere, but I learned long ago to tune such things out. Most of those who are judgemental don’t really know what they are talking about – and they certainly don’t know my husband or me.

And it looks like our “leeching off the system” is coming to end. My husband landed a respectable full-time job a few weeks ago which should see us completely independent of state support by the end of the year. I had paid off my old bank account within a year and thus by summer my name should get deleted off the “financial offender” list and my credit rating be ok again.

What the occupational future holds for me, I don’t know. Right now, my husband is the breadwinner, and I do all the paperwork that comes with his job. I don’t plan any further than six to nine months ahead anymore – none of the long-term plans and goals I held in the past came to fruition. I’ll deal with that topic once I actually become capable of holding down a (part-time) job.

I will forever be grateful to be living in a country where a welfare-system even exists. It wasn’t always easy – you sign away a lot of privacy and become the employment agency’s little bitch in exchange – but that is a thousand times better than what we went through before.

The relationship with my mother has gotten a lot better once it was not strained by financial dependency anymore, too. There are different factors playing into this other than money, since her hospital stay very much became a game changer that altered the way we interact, but there is no denying that money used to be a contributing factor to the tension between us.

I’m Going To Quit University

Instead, I will enroll at the only state-maintained German distance teaching extramural university, starting next autumn. The idea was actually proposed to me by my mother and sister, because my sister is considering doing the same, and they thought it might make studying easier for me. I also discussed this with my husband, and slept over it, so while this was a relatively sudden decision, it’s not a rash one.

Arguments in favour of the change:

• You study online and out of books. Apart from the written tests, there are only two weekends during the entire Bachelor’s programme where you have to attend a seminar in person – and one of the study centres where you can do so is easily accessible to me, even without a car. Since I waste about 75 % of my energy in class on fighting off depression and only the remaining 25 % on taking notes or studying, I believe I will actually be able to study more effectively that way. You receive the materials and literature lists via mail, and you send in your homework and term papers online. There also are video streams of lectures and special software programmes for learning. At any time, you can contact qualified docents if you need additional help, and should you need to see someone face to face, you can also visit the study centres.
• It’s cheaper than a regular uni. Money is always a factor for me. And you pay for the classes you take only, not a fixed sum regardless of whether you actually take any classes at all. So, if shit hits the fan and I have to take a sabbatical (which I hope never happens, but we are talking eventualities here) again, I don’t have to pay just for staying enrolled in the programme.
• It’s more time flexible. I can adjust the learning to my personal schedule, because nobody cares whether I study something on Tuesday morning or Thursday afternoon or Sunday night, as long as I send in my homework punctually.
• Academically, it’s worth just as much as a degree from a regular uni.

Arguments against the change:

• I’ll not have a semester ticket for public transportation anymore. But: With the money I’m saving every semester on fees, I can buy a good number of tram tickets if needed…
• It sets me back to square one. But: I only took 6 hours per week last semester, and the next one would have been the same – I might actually be able to take more classes than that and thus eventually make up for “lost” time.
• They have a limited offer of subjects you can study only. And geosciences is not one of them. That is, in the end, the only heavy argument against it, in my opinion – and the reason why I never thought about making this step before. It would mean changing my major again. But: You can study psychology with them, and that is something I would be really interested in.

In the end, I believe the scale tips in favour of going ahead and doing this, because there are also arguments which fall outside of the pro-and-con-scheme listed above. The days of fantasizing about becoming a world-famous archaeologist are long over, and I don’t see myself crawling through the Andes or Alps, looking for rare minerals, either. What I want above everything else is to finally have some kind of degree and become employable; I’ll happily work as a secretary or a boring office job afterwards. The pipe dreams of glory are firmly buried.

And there are some obstacles in my current university course which did not occur to me when I had to make a quick decision in August 2011, and which I pushed into a remote corner of my mind afterwards: field trips abroad. I can’t do them – it would be ok if I got my own private hotel room at the end of the day, but going abroad and sharing a cabin with people who are essentially strangers for two weeks horrifies me to no end. I have worked really hard on my social phobia, but that is a problem I don’t think can be “treated out of my system”. On top of that, you also have to pay for those trips and all the equipment needed for it in addition to the semester fee, which runs up sums of several hundreds of euros every time, and I just cannot afford that.
Finally, seeing how the current semester ends on Sunday, I could actually apply for welfare myself instead of hoping some cryptic system where I take over from my husband works out – I haven’t been able to pay for the next semester yet, so all it needs is a phone call that I won’t be returning and I’m out.

Maybe it makes me look fickle in the eyes of some, but over the course of the last three semesters I realized that most of my problems with uni stem from the system itself, and I genuinely believe that my mental health would profit both from taking a break until October and even more so from getting out of that system. I love learning and writing papers and all of that, and I want to focus on this instead of how to effectively hold back tears in a classroom.

Back From The Psychiatrist

And thus begins the new treatment regimen with Venlafaxine (Effexor), starting tomorrow.

Everything went well; I was a little nervous first and not particularly in the mood for dealing with a stranger, but the psychiatrist turned out nice. He asked: “What leads you here?” I told him that I was in therapy for chronic  depression for two years and generally was really satisfied with it, but couldn’t get a handle on some symptoms like concentration problems and energy, and wanted to see what medication could do for me in that regard. He knows my therapist and has a superficial idea of the CBASP programme I’m in, and I guess that was enough credit to not let me do all the lab tests and ECG again. I also gave him permission to send reports to my general physician.
I recounted a brief history of symptoms and the treatment I received so far: First depressive episode at 12, second at 16 (this time with suicidal ideation), since the age of 19 / 20 only oscillating between different stages of major depression; panic attacks at 30, treated with citalopram, then therapy; therapy major success, but then the start of a slow decline. The psychiatrist asked about living situation, family, family history of depression, school education, what I am studying. Whether I smoke, drink, ever did drugs, take any kinds of medications.
He performed some tests on my cognitive capacities, because I had complained about them:
– “Spell the word ‘radio’ backwards.”
– “What’s the difference between a river and a lake?”
– “What’s the difference between a ladder and stairs?”
He had me memorize the words “street, traffic lights, flower” and asked whether I remembered those in between other questions, and had me do a chain of mathematical exercises: 100 – 7, then subtracting 7 from the result again, and again, and again. I scored 100% and obviously am not demented.
Some questions on differential diagnoses: do I see or hear things nobody else sees or hears, do my thoughts race, do I think I am being watched or that people talk about me behind my back, etc.?
The most difficult question actually was, “How do you feel these days?” I honestly had to think about that, and answered, “On average days, I feel subdued. Pessimistic.” I told him about the insomnia, problems falling asleep and the stomach aches, that I like to withdraw from people, worry a lot and occasionally get anxiety attacks because of the worrying.

All of that took about half an hour, then he proposed that due to my previous experiences with SSRI in the form of citalopram, I should try out what an SNRI does for me. He explained that SNRI give most people more energy, explained possible side-effects and finally gave me a prescription for venlafaxine. Unless I experience really bad side-effects, I’ll see him again in four weeks.

Edited to add: Yikes, maybe I shouldn’t have googled venlafaxine / effexor, because the results sound pretty bad… “The antidepressant everyone loathes to have taken.” Sounds like I am in for a bumpy ride…

… And Little Strokes Fell Big Oaks

(Not that I’m a big oak. More like a weeping willow. Or one of those windswept, crippled conifers.)

On my old computer, I used to have a .pdf-file of a text-book on personality disorders. Unfortunately, I do not remember the title anymore, and so this source of information remains lost until I gain access to my old hard drive again. Said text-book not only gave me plenty of insight into the mechanisms of my own mind – many of the characteristics of avoidant personality disorder can also be found in my own avoidant behaviour – but also educated me about my mother’s obsessive-compulsive tendencies (my family displays an abundance mental health problems, namely depression, social anxiety, OCD, and borderline streaks – we’d make for some fantastic study material).
From this book I know that my mum’s rules are just a way of coping with what she perceives as threatening. Her constant criticism is born out of an urge to make a chaotic world appear controllable: for example, by blaming the gastritis on something I did wrong – “you are eating the wrong stuff / cooking unhealthily” – she reduces the emotional helplessness for herself, because in a world where I get gastritis just out of the blue and nothing can be done about it, she is helpless and at the whim of fate.
The problem is, I already am “out of control”: I am depressed and have a plethora of symptoms which come and go seemingly randomly, leaving me unable to function at times. Of course, my mother worries, and tries to bully me onto a path which she believes will keep me safe – oblivious to the fact that her criticism drives me even deeper into depression.
This phenomenon is not so rare, actually: whenever some outrageous crime happens, like a child being abducted and getting killed, you will hear comments from other people afterwards, blaming the child’s parents for something they did wrong or neglected to do – because if they admitted that we are living in a world where such cruelty can happen at random, without anyone who could have prevented it, they would have to face the fact that the same could happen to their own children. This, however, is too painful; it would destroy the illusion of absolute safety – it is so much more comforting and easier to believe the other parents failed and that they are doing a better job.
So, whenever something happens to me, my mother blames it on some shortcoming on my side, because that means she did not do anything wrong and that she is still in control.

From an unemotional point of view, I completely understand her behaviour, and it is obvious that my mum is not aware of the patterns herself. But that does not excuse the fact that my emotional well-being gets thrown under the bus time and again: it’s hard enough to live with what I’ve become, without having to deal with all those other flaws and failings I supposedly am responsible for.
There are a few things I will have to do to ensure my own well-being: short-term, I’ll have to talk to my mum about all of this. The problem is that either I’m in a state of anger about what’s happened, which makes me snappy and defensive – not a good basis for a discussion. Or I am not angry, which by default makes me lack the guts to breach such a difficult topic with her.
Long-term, I need to gain some more distance from my parents, emotionally as well as geographically. And financially. I just want to get to the point where I can have my own life at my own terms, without feeling guilty or pressured all the time.

Constant Dripping Wears The Stone

(Source: Dan Piraro)

I am not entirely serious about the comic strip; it’s more of a hyperbolic comment on my life, but I need some humour and the chance to vent in order to deal with today. My mum has been cavilling me since the morning, a constant trickle of criticism and petty jabs. And even though I am fully aware that I am not the reason for her jibes, but merely the most convenient target for her projections, it still hurts. Drip.
The individual remarks are trivial, not worth getting upset over, one should think: one was about my doormat having been dirty for “at least three months”, when the handymen who are currently renovating the flat next door had left the crumbs of mortar and concrete only 36 hours ago – which have been cleaned away since Friday night already. Drip. One was about me relating a news article of local interest I had read online which according to her was “old news” – despite the publishing date being yesterday. Drip. One was a degrading remark because I had to take a nap this afternoon, “just because you had to go shopping at 10 AM” – even though I’d had a really bad night with only 5 hours of fitful sleep (when I need 9 hours because of the depression) and still had gotten up without complaining. Drip.
What upsets me the most is that my mother makes these comments because she is upset with another person, and then takes it out on whoever crosses her path. I’ve been through this in therapy so many times and know exactly what I should do and say, but she triggers an automated behaviour in me which just makes me sound sulky and defensive instead. We are not really interacting with each other, but acting parts in a pre-determined script. There is so little self-reflection on her part…

My sister is between jobs right now, with another month to go before her new employment starts. Being divorced and unemployed, she and my mother spent a lot of time together: eight, ten, twelve hours a day, for the last three months. My sister also has started seeing a psychiatrist and taking antidepressants; generally speaking, a very good development. So I understood that my mother would be preoccupied with all of that, since it indirectly concerned a large part of her own day.
My mother has strong tendencies towards OCD-behaviour, with a myriad of unwritten rules one better not crosses. Doing something in a different fashion than the one she uses will give her a very hard time. She is also “orthorexic” in so far that she is obsessed with nutritional properties, minerals, vitamins, and whatever positive qualities an ingredient might have. So when my sister decided to try a vegan challenge, or go at least vegetarian for a while (she took a break for Christmas), my mother was all over that.
Now, I don’t have anything against vegans or vegetarians. I understand and even agree with a lot of the reasons why people would choose to eat this way. In fact, I try to have a vegetarian day or two every week, but I could not go without meat for a longer time, and my husband is quite the carnivore. I respect the choice others made, and want mine to be respected as well. But once my sister embarked on her vegan adventure, my mother’s occasional negative remarks on what I am buying / cooking turned into a steady stream. Drip, drip, drip.
Thanks to the antidepressants, my sister had the urge to walk a lot, and so they would go out together, walk two or three hours every day – and are now bragging about the weight they lost. Some days, they make me feel like a fat, blubbery pudding; the German word I have in mind is Trauerkloß, literally a “mourning dumpling”. The idiot who is too slow and pathetic to get on with her life, the fat fuck who always sleeps. Of course they do not use those words, but this is the effect their little verbal needle pricks have on me. Drip, drip, drip. And it took two years of psychotherapy just to come to the conviction that the problem is actually on her end, not mine.

Not only are they together 90 % of the time these days, but on the rare occasion I see my mother without my sister, she incessantly talks about her. And while I understand that this is on the forefront of her mind due to the many hours they spend in each other’s company, I would very much like to talk about something that is important to me once in a while. I feel like I am going to have a melt-down if the situation goes on for much longer.

Looking Back At 2012

The first half of the year is characterized by a very tight and stressful schedule regarding both university and the bureaucratic acts of getting married and starting my husband’s immigration process. Eventually, this proved too much activity, and at the beginning of the second half of the year, I fell into a pit of lethargy and low moods. With the end of the summer, I began working my way out of that, and tried to maintain a healthy equilibrium.
The most important facts of what happened in 2012 are all in this blog, even if not always in as much detail as planned or wished for. On top of that, I already had two retrospective posts this month. Due to this, I decided to employ the form of last year’s review and “count my blessings” by writing about what I am grateful for in this year past. After all, it is a good exercise in shifting the focus on positive aspects.

My husband: I am thankful for his company and for his willingness to embark on the adventure of immigration. For waiting so many hours together with me in front of various offices, even when his presence was not required. For talking to me at 2 AM even though he was tired. For not talking to me in the mornings much, because that is when my brain does not function. For making sure I don’t oversleep. For comforting me many mornings when I would cry because I did not want to leave for university. For foot massages and back rubs. For accepting me the way I am. For encouraging me to pursue what I enjoy. For understanding how depression and anxiety work. For saying sorry and meaning it. For not feeling threatened by the feminist and lesbian blogs, websites or videos I read and watch. For hours upon hours of discussion on Breaking Bad, Game of Thrones, Downton Abbey, The Hobbit, etc. For paying honest compliments. For believing in me. For making me smile. For making me laugh.

My friends: I am grateful for them reaching out when I retreat too far from contacts. For listening. For taking me out of my own mind. For making me laugh. For sharing their own experiences. For their kind and comforting words, even when they cannot do anything about my problems. For their encouragement. For providing a faithful readership for this blog. For rooting for my husband and me all the way through the bureaucratic labyrinth to marriage and immigration.

My parents: During the first months of the year, there was a lot of friction between my mother and me, so I am especially appreciative of her becoming generally calmer over the last months. I am thankful for the financial support from my parents. For being so nice towards my husband on Christmas. For their occasional donations of food / groceries and clothes. For increasingly trying to understand what is going on with me.

My sister: The day before my wedding, we had a major fallout, and for months afterwards I carried underlying resentment with me, because she would never apologize for the things she said that day. As a result, I am really grateful that she appears to have mellowed out since. That she is seeking professional help from a psychiatrist now and taking medication which makes her moods more stable. That she took us out on her birthday and thus allowed my husband and me to enjoy something we could not have afforded otherwise. That she is becoming more approachable.

My niece: I am grateful for her being the kind of person she is: kind-hearted, quirky, bubbly, never shy to express her fondness. For her not hesitating to extent the same sentiment towards my husband despite the language barrier.

My mother-in-law: I am thankful for her financial support and for her friendliness towards me, a person she has never met.

My husband’s daughter: I am grateful for her being in my husband’s life again. (It’s a long and complicated story, but not the right place to tell it.) For her being the friendly, funny, open-minded person she is.

My therapist: I am grateful for his continued professional support, both in the sessions and via email – especially when I am at my worst. For helping me grow. For encouraging me to try myself out and providing a safe environment for that.

A very happy 2013 to all of my readers!

Happy Holidays

The official part of Christmas is over – visiting relatives left, the big dinner is eaten, all the presents are exchanged. And for the first time in many years it was a really happy holiday for me: neither did the stress prior to Christmas Eve get too much to handle, nor did anything happen which threw me off balance during the celebration.

It was the first time my parents would officially have my husband over; they had met before, but never longer than for just a few minutes. Since my parents do not speak English and he does not know enough German yet, they cannot really talk without a translator, which is part of the reason why this was only happening now, but in the end it went really well.
My niece, who comes to visit us quite often and is not bothered by the limitations of her school-English, helped bridge the first few minutes of shyness, and my former brother-in-law can converse in English as well (my sister had it in school for a couple of years, but never became an actual active speaker), so there were no awkward silences. That was what I had worried about the most;  I knew everyone would be friendly and civil to one another, but was afraid that it might turn into a strenuous affair. And while for my husband it was all about meeting people he did not really know and wanting to leave a good impression, it was also an unusual and new situation for me because I never before brought any girl- or boyfriend over to meet my parents, ever! Fortunately, the whole evening was a success.

We’d spent the morning running errands, and in the afternoon my sister, her ex-husband, my husband and I went to watch my niece in a nativity play. None of us is religious and I personally have strong reservations towards the Catholic Church as an organisation, but it was only a lay-service for the neighbourhood and my niece loves playing theatre, and in years past it also proved a good opportunity to get out of my mother’s feet for a while. This year, she barked a bit, but did not bite anyone.
Afterwards, I went to help with the preparations for dinner. On the menu were: freshly squeezed mandarin-orange juice with lemon balm leaves as starter; coronation chicken as first course; the main course was pork filet with Roquefort-sauce, potato gratin and French beans; as dessert we had banoffee pie – all home-made. (For any British reader this might sound somewhat ordinary, but I can assure you that for Germans, there’s an exotic element to most of these dishes as they are not common here at all.) At five o’ clock everything was ready and I went to change into nicer attire and to get my husband.
Since in Germany presents are traditionally exchanged in the evening of December the 24th, we took a break after the main course. My niece was the only child of the group and she likes to draw out the whole ceremony to keep the thrill of suspension alive, so in my family one gift at a time gets unwrapped, meaning that it takes at least an hour until everyone’s finished. My husband and I mainly got practical presents, but given our age and financial situation, we could really appreciate them. Eventually, we returned to the dining table for dessert, and finally just sat together on the sofa for talking and watching my niece try out her presents. At nine o’ clock, we bid the rest adieu: mainly because the cheese-based sauce made my lactose intolerance kick in, but also because I felt that after four hours, my husband could use a break.

On Christmas Day, my aunt and grandmother came over for coffee in the afternoon (to my parents’, that is), and with their departure, the official part of Christmas ended. December 25th and 26th are both public holidays in Germany, and in my family, the latter is reserved for laziness. You sleep in, eat leftovers or meals which do not require a lot of preparation, go for a walk to get some fresh air and a little bit of exercise for your legs (mine start hurting if I sit around too much – they get rather stiff quickly as a result of my inability to relax physically), and otherwise do whatever you want: watch TV, read, play a computer game… Considering the fact that I need a lot more time for recharging my batteries than the average person does, I really appreciate this opportunity for relaxation after a busy and exciting start into the holidays.

Come A Little Bit Closer

The news about the TV appearance were not the only unusual part of the last session. Two years of therapy mean that eventually, the appointments start to resemble one another; the discussions are important, but you know the routine and after a couple of weeks you recall brief scenes rather than the whole meeting.
Over the course of spring and summer, the hospital wing where my therapist sits got renovated and he had to move out of his office temporarily. He’s been back in the old location since September, but had decided to furnish the room differently: the set-up of desk, armchairs, file cabinets and the exam table is mirrored now. All of this was reason enough to break the routine and to make me feel uncomfortable at first. I got so used to always having the same perspective in that room that the familiarity of sitting in that armchair gave me a sense of security. Before that background, the last session took place.

Practicing alternative behaviours is a huge part of our routine: my problem is that I tend to do nothing at all and just remain silent when I should speak up instead, and so my therapist lets me reenact scenes we discussed, but where I behave the way I should have for getting a more desirable outcome. He lets me repeat phrases until I get the words and intonation just right, and then some more to “hammer” them in.
This is by far my least favourite part of therapy as it goes completely against my instincts of hiding myself away. When the acting was still new to me, I would occasionally break out in giggle fits due to the embarrassment, but that wouldn’t let me off the hook. My therapist would just sit there with a smile on his face, wait until I calmed down, and ask me to try again. Of course, I could just refuse and sit in my chair for the rest of the appointment, but that’s not what I go to therapy for… So, the best way to handle this for me is to get it over with as quickly as possible – the more I concentrate and the sooner I get it right, the fewer repeats we’ll go through.
Last time, however, my therapist decided to take it a step further: he had me stand up from the chair. I repeated my little speech two or three times, then he said:
“Come a little closer, please.”
I made a small step towards him.
“And even closer, please.”
Eventually, the distance had shrunk so much that I could have reached out and put my hand on his shoulder; since my therapist was still sitting in his chair, I had to look down on him – a position which makes me feel extremely uncomfortable, and he knows it. I had to repeat my sentences again, then he asked:
“What did you just think?”
“I was thinking about my arms, about how I have been clasping my hands at this really weird, crampy angle.”
“Your arms looked just fine. Why don’t you try a different position?”
I tried to relax my limbs and folded my fingers in front of me, but since I had also inched back a little in the process, I had to step closer again.
“How does that feel?”
“Ok. Better than the crampy clasp.”
“Try something else – why don’t you just leave your arms hanging?”
I did, but immediately felt like they ceased being a part of my body and turned into two dead appendices rather. I stretched and flexed my fingers nervously, hid my hands behind my back and then let them hang down again immediately.
“How does that make you feel?”
“Nervous. Extremely uncomfortable.”
“But you look more relaxed and more approachable. If you fold your arms, you are creating a barrier. And to me, these positions are comfortable. I don’t feel threatened by you at all.”
In the past, we had talked about how this particular constellation – he sitting, me standing up – made me feel like I was being this huge mass ready to bulldoze him. Like a gross, obese entity crushing him under my excessively large body. I am (by now) completely aware that a lot of the negative self-image and negative thoughts exist in my mind only, and that they are very much over the top, but that does not make them go away.
“How do you feel now?”
“Still nervous.”
“Look at my face. What do I look like?”
“Neutral. Relaxed.”
“How can you tell?”
“There are no signs of stress in your face. No creased forehead, relaxed eyes and mouth.”
“It’s good that you can see this!”
We talked a few moments about how I hardly ever relaxed when sleeping either, that I often woke up with my hands clenched into fists, and the muscle pain I had from that.
“How do you feel now?”
“A little better. Still uncomfortable, but not as much anymore.”
“Good! It’s very important that you experience this!”

When I was finally allowed to sit back into the armchair again, I felt fairly exhausted. We have done similar exercises before, but never that long and intense. Rationally, I know what this is all about: by exposing me to an uncomfortable situation and having me observe that the effect on my therapist is not a negative one, my self-image gets altered. Physical proximity is not a bad thing, and I am not causing negative emotions in another person by standing close to them. At the same time, I am forced to endure a situation I’d usually avoid, so that I can experience how the discomfort starts decreasing after a while.
Strangely enough, despite experiencing mostly negative emotions, thoughts, and despite how stressful this was, I felt really good after the session. In my family, nobody would ask how I felt, and if i talked about it, the standard response would be to pull myself together. In fact, that is what I used to do – so much so that I always downplayed all of that or ignored it even, and it felt good to acknowledge the existence of those emotions and having them taken seriously.

Looking Back At Two Years Of Psychotherapy

Exactly two years ago, I was officially accepted into the therapy programme and started sessions. I still remember the relief when signing my name under the contract – finally an official diagnosis, finally a glitter of hope.

Psychotherapy is a long process, at least when you are talking chronic conditions. At the age of 30, I had a depression history of almost two decades, and you don’t wipe those away in just a few short weeks. There were aspects of the depression which vanished within a few weeks, and others which I am still labouring around with. But generally speaking, a bad day now still is better than a good day two years ago.
Psychotherapy also is a lot of work. Hard work. You revisit a lot of bad memories. You get confronted with your own shortcomings. You have to practice both in the session and outside of it, relentlessly. I won’t lie: there have been days when I got fed up with all of this. Days when I cried, when I got frustrated with myself, when I didn’t want to do my homework. What’s worse, the majority of people you meet will never know how much effort you put into recovering from depression – be it because they don’t know you are suffering from it, be it because they don’t have enough empathy to put themselves into your shoes.
However, I do believe it was worth absolutely worth it, not only in terms of symptom reduction, but also because it made me grow. I changed more in those two years than in the ten years before. I feel like I am much more in charge of my reactions than I used to be: where I would just run a “standard response programme”once triggered by certain emotional stimuli, I am now actually aware of what is happening, of how I react, and why. I am more confident, more secure of myself.

I already wrote a post exclusively dedicated to my therapist in August 2011, and everything I said there still rings true. However, almost a year and a half later, I find that our relationship has matured. For a while, during the first therapy year, I was under the spell of transference regarding my therapist – not that I was in love with him, but I saw something like an ersatz-parent in him. He gave me the kind of emotional response I would have liked to get from my parents: protective, but not smothering me, and at the same time encouraging me to try myself out.
I think that kind of transference is not only the rule in CBASP, but actually accounted for as part of the therapy process. After all, chronic depression originates in the childhood. I believe my therapist was both expecting and aware of the transference, but never mentioned it to me, and I didn’t breach the subject either. Maybe I was more susceptible for it because at the time my husband was back in the United States and I was feeling lonely without him, and I could talk about this situation much better to my therapist than with my parents. That actually still is the case, but since my husband and I are not geographically apart anymore, the need to talk about this has naturally vanished too.

Back in the day, I would email my therapist at least once every week, to keep him up to date about my life – which had been his idea, not mine. Every other week, I’d have a session and see him in person.
Now, I have sessions in intervals of six weeks, and I email him maybe once per month, if something really important happens. The therapeutic relationship mimics that of parent and child again, and it looks like “I’m growing up” now and become independent from him. In fact, I do not need him anymore for my everyday life. The transference has faded away.
Does that mean I could do without him? Absolutely not. I am still looking forward to every session, but now in a strictly professional way, because I still want and need to work on myself. I still need the “security net” he provides, take great comfort in knowing that I could get in contact whenever the need arose. If shit hit the fan, he’d be only an email or phone call away. And I’m not quite ready to let that go. Yet.