From Both Sides of the Couch

A therapist reflects on her time with patients, and her time as a patient.

A Fall From Grace is Inevitable

You can build a toolbox of coping skills for when you sense a fall is coming.

One lesson that I’ve learned during my extended recovery from mental illness is that falls will happen. I’ve fallen hard and I've fallen easy, and I will continue to fall. The key is turning those tumbles into chances to learn in more ways than one.

I need to understand what caused the descent in the first place and try to avoid the same situation in the future. At the end of April when my father passed away that set off a downward plunge in my mood. I won’t face the death of a parent again as my mother passed away a number of years ago, but what about other relatives and what if a friend dies unexpectedly? Grieving is expected and normal, sliding back into mental illness is not.

What is considered an easy fall? Until about two years ago when my therapist, Dr. Adena* went on vacation, I had an extremely difficult time. She took relatively long vacations because she went to Europe to visit her family for the Jewish holidays. The thoughts that her plane would crash and that she would decide to stay in her home town abandoning her practice would be at the forefront of my mind. I could not make it through the time that she was away without having a session or two with the psychiatrist who was covering for her.

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Gradually, through smaller “vacations,” — when Dr. Adena would have to miss one session (I used to see her twice a week) due to having to attend a conference, or I would have to miss a session due to an unexpected work commitment — I came to look upon these missed sessions as a break for me, financially and from the intensity of our meetings. Now, when Dr. Adena tells me that she will be on vacation, I feel a mixture of emotions — still some anxiety and sadness, but also pleasure for I anticipate a vacation for me as well.

Another lesson that I’ve learned is that I can be proactive to keep from falling too far when I realize that I’ve started to slide. Two months ago was my most effective example of how I fought off what was certain to be a hard and fast fall.

As I mentioned above, my father had just passed away, additionally the workload at my job was becoming overwhelming, my migraines had become so severe that my neurologist was recommending migraine surgery and in addition to the pain from my migraines, I was dealing each day with the pain from fibromyalgia.

Several friends has made the suggestion at different times that I look into yoga. Early one morning when I could not sleep I began to surf the net for yoga classes near my home. I stumbled onto a free introductory class at a studio about 25 minutes from my apartment. I was hoping for something closer but what the heck — it was free.

I walked into a large, airy and oddly shaped studio with lots of windows that dropped from the ceiling three-quarters of the way down to the floor. From the windows on two of the walls was an incredible view of the Hudson River. Oh my God.

The instructor was kind, gentle, patient and had a sense of humor. She took her time allowing for the fact the most of the people in the class had never taken yoga before. I made the decision to stop looking for a studio closer to home. At the end of the class as we stood at the front of our mats with our hands clasped together in front of our hearts, our eyes were supposed to be closed but I peeked once more at the Hudson where the edge of the water met the sky and the boats sailed on blue ice. This was my studio.

The next day in the newspaper there was an article about how yoga is a good exercise for people over 50. The timing is right, I thought. This was meant to be.

 

 

I’ve encouraged some of my patient to try yoga, espousing its benefits but not disclosing that I’m taking classes. One thing that I noticed about my classes — and the instructors at the studio (to my surprise) — is that there are women and men of all shapes and sizes. There is a church several blocks from our office which offers yoga classes. I’ve pointed out the banner with the phone number on the fence of the church parking lot. Nobody called to obtain information about the classes.

None of my patients have experienced a linear progression in their therapy. They are concerned when they hit a setback; sometimes they’ve fallen easy and sometimes they’ve fallen hard. My job is to give them the coping tools and the skills so that they if that have to fall at all, it will only be a little bit. My job is not to catch them, because then they will expect me to catch them the next time and the next. If I set up that pattern, what will happen when I’m not there?

The old cliché is true that practice makes perfect. If my patients are willing to embrace tools and skills and practice them while they are in therapy with me, bringing back to session what they tried and what worked and didn’t work, they can fine tune their skills so when they are on their own, they are confident.

But if they don’t at least try the first skill or another one or a different one, they won’t know what works for them. It’s unlikely that the first thing someone tries will be the most effective — if a patient only tries one tool how will they know?

I thought writing was enough for me. That’s before I was in physical pain. I used to be content sitting on my couch or going to a café and writing for hours. Now I need to move and stretch and breathe and yoga fits the bill for someone in my condition. It’s not a bad thing, I’m realizing, to have more than one skill in my toolbox.

When I fall again — and I will — I have the ability to catch myself. I know which of my skills will work in different situations and while I can’t pull out my computer during yoga class, when I’m writing at home, I can always hit the carpet and go into downward dog.

 

* Names have been changed

 

Gerri Luce is a licensed clinical social worker who publishes under a pseudonym.

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