Reader question #30: New town, old blues, and the case for therapy.

Dear Capt. Awkward,

I feel like I’m an inveterate fuck-up. Everything I touch eventually falls apart, and I make decisions rashly and avoid the fallout by never peering too closely at myself. My most recent debacle started when a guy I was sleeping with in another city introduced me to his friends in this new city I just moved to, with the warning that I was not allowed to sleep with two of his closest friends in the group. So, of course, I made out with one of the guys the very night I met him, and eventually ended up sleeping with both of them. I wonder sometimes if I’m a sociopath; sure, the first boy probably shouldn’t have made such an irrational demand, but in the long run it comes down to my knowing that doing something would hurt someone I cared about and doing it anyway.

I’m not exactly suicidal, but I feel sincerely like it wouldn’t matter if I died. I’ve moved 13 times since 1997, and while I have friends, I mostly communicate with them over IM or Facebook. I place way too much importance in what other people think of me, and a large measure of my (mostly non-existent) self-esteem comes from how many people IM me first, or invite me along with them to whatever they’re doing at the time.

I am aware that I would probably benefit substantially from therapy; I grew up with a bipolar mother who was only diagnosed a few years ago (my comment upon being told that she was diagnosed? “Wow, that makes my childhood make so much more sense.”) She was emotionally abusive and neglectful and at 12 told me she didn’t want me and sent me to live with my father and stepmother, who also mostly didn’t want me. I crave being wanted. Unfortunately, I’m unemployed and have no money to spend on therapy. Oh, that’s another issue. I think I might be depressed and deliberately (though unconsciously) sabotaging my life. I’ve been in this new city for a month, and haven’t applied for any jobs. If I can’t make rent in three months I honestly don’t know what I’ll do, but that doesn’t seem to motivate me to actually search for a real job. I don’t know what’s wrong with me, I don’t know how to fix it, and just jumping off a bridge sometimes seems like the only option that will actually solve everything.

There are so many personal details in this that anyone who read it and knows me will immediately identify me. I feel like I should care, that I should hide my issues and keep pretending, but maybe it’s just that self-destructive side of me coming out again and pressing send.

Sign me,
I don’t have issues, I have subscriptions

Dear Issues,

Would you mind letting me know (confidentially) what city you’re in, maybe I can look up some mental health services there and at least get you started.

Dear Captain:

I’m in [MAJOR CITY]- I feel sure that if there’s anywhere in the country that would have free mental health care it would be here, but I’m 31, straight, white, cis and otherwise average. I also have the problem that my mother took me to a shrink when I was a kid and having issues with lying and stealing. The shrink who was supposed to help me was useless, and as a result I have absolutely no faith in the mental health establishment. There’s also kind of this stigma — I may be crazy, but at least I’m not *going to a shrink* crazy, you know? (Even though clearly I am going to a shrink crazy.)

I have this feeling that if I just did one thing right, everything else would fall into place. Like, if I met that perfect boy I would magically get an awesome job and have an apartment where I don’t have 5 roommates and my hair would cooperate. But boys ignore me and my resumes are apparently sent into space and I still have five roommates and frizzy hair. There’s got to be more than this, right? Being an kid sucked ass, but I moved out and away…but it still sucks. I can’t move out of my head, I guess.

Dear Issues,

I don’t want to practice unlicensed psychiatric care over the internet, but I feel pretty sure that the the feelings you describe (meaninglessness, feeling lost, self-sabotaging behavior, feeling unmotivated, mentioning suicide, having a family history of bipolar disorder) are in the DSM somewhere and I feel comfortable saying that if you did seek out some care that you would tick a lot of boxes on those ticky-box forms they use at intake.

I know this not because I’m a mental health professional (DISCLAIMER:  NOT A MENTAL HEALTH PROFESSIONAL) but because I’ve been alone and new in a strange city where I moved more to flee something than to seek something new, sending my resume into a void, living with sketchy assholes including a man who wore so much cologne that it caused my cat to pee defensively on his things and a dominatrix who used to re-arrange my furniture whenever I went out of town, watching my savings dwindle while I slept with a grotesque series of The Wrong People, including one who I refer to as “A Three-Dimensional Interactive Display Of How Bad I Was Feeling About Myself At The Time” and who old friends reading this will remember by his 1) luxurious ponytail 2) “helpful,” “friendly” offers to have them come over so he could massage their feet. Also, for the record, HE dumped ME for someone else (and if I said something different at the time it was a lie to save face).

I don’t want to one-up you on the whole Miss Hot Mess 2011 thing you’ve got going on, or be all patronizing and “Oh honey, don’t worry, it will get better!  I’ve been there!” because my dark period lasted close to two years before I pulled out of it. I take prescription medication so I can do things like Show Up To My Job Consistently And On Time (Every Single Day!) and do more waving than drowning.   I tick a lot of those ticky-boxes, is what I’m saying, and just like you I had to get past some barriers to accept that oh yeah, even though I have a lot of privilege (white, straight, educated, able-bodied, cis) and just because I’m from a Nice Family Where We Don’t Talk About Our Problems and We Are Definitely Not “Those People”….

I’m Those People.  You’re Those People.  We are human beings with strange bad messages that play in our heads on a constant loop.  Yours might be “no one wants me, might as well prove them right.” Mine is  “I have no idea how to have or express feelings.  Also, if I do something well that’s just the minimum I’m supposed to be doing and I can’t take credit for it, but if I fail let me explain in detail all the ways it was my fault”  It is not productive, and frankly a mix of self-hating and arrogant to assume that just because we read The Bell Jar at an impressionable age and should have seen this coming we are somehow better than mental illness or can cure it if we just pretend it’s not happening.

The good news is that when we show up at the place where they deal with the people like us, they’re ready for us.  They’ve heard it all before, including our well-bred protestations that it’s not that bad and we’d like to not put anyone to too much trouble.  And if we don’t have money (I didn’t have money) there are people to work that out too.  The first time I went to therapy here in Chicago I went to the Chicago Community Counseling Center on Clark Street and I paid $5/session.  I found them by calling my local United Way and saying “I think I might be depressed, can you refer me to some mental health services?”  They did, and I met with a nice social worker who was finishing school and putting in her clinical hours and a few months later I had my feet on some kind of path.

I can’t speak to your childhood shrink or apologize for him.  I’m sure he sucked. A lot of them do.  My most hated are the ones who just say “hmmm” and “interesting” and keep totally deadpan straight faces.  The Socratic method is fucking exhausting, and I don’t want to use it to unpack myself for some beardy dude who probably zoned out half an hour ago and is just playing a recording of noncommittal phrases, so when I was looking for the person I have now I was able to say “I want you to talk sometimes and have opinions and tell me what they are” and he said “No problem!”  and sometimes when I’m about to do something stupid I can picture him rolling his eyes at me.

So here’s what I can do for you.  I can say:

Don’t kill yourself.  Don’t kill yourself today. Don’t do it tomorrow.  Don’t do it an hour from now, or the hour after that, or during any one of those hundred and twenty minutes inside those hours.  Just keep deciding “I’m not going to kill myself.”  Give yourself a gold star for every time you successfully refrain from killing yourself.

And I can make a case for therapy.

I think every adult could benefit from a look under the emotional hood at some point in their lives.  Learning better communication skills, how to be emotionally resilient, how to be honest and fearless in following your dreams, how to deal with grief, loss, failure – not everyone learns that stuff as a kid.  And often people assume that because you’re intelligent, you already know how to interact with other people and take care of your own emotions, and if that goes on for too long you don’t know how to ask the right questions because you’re so invested in being the smart person who already knows stuff that you’re afraid to look stupid or be vulnerable.

Here’s what therapy doesn’t do:  Fix you and make you a better person.

Here’s what therapy can do:  Help you readjust your coping strategies so that your past doesn’t swallow your present and your future.

You survived what sounds like an awful childhood.  It is a profound, awful, wounding, shitty, terrible thing to be abandoned and to be unwanted.  During that time, you developed certain behaviors, attitudes, habits of feelings, mental patterns, internal messages that meant that you could survive, get the fuck out of there, and go somewhere you could be okay and start over.

Those strategies that served you then are not serving you now.  But they are what you know, and in times of crisis, even when you know better, they manifest.

For example, you describe some self-destructive behaviors and feelings in your letters, and you’re able to link those behaviors and feelings to things that happened in your childhood, which is a good first step.  But as an adult, you can only go so long saying “The reason I was mean to you all stems back to this thing that happened in my childhood, I can explain!”  At a certain point, other people don’t really need to know or care why you are the way you are, they look at your actions and not your history.

Enter therapy.  Don’t start with a psychiatrist, start with someone with a title like a licensed social worker/therapist/counselor.  If necessary, they’ll refer you to a psychiatrist who can evaluate whether medication is needed and get you going with that.   Therapists are trained differently and work differently, but a good one is going to:

• Help you unpack and deal with the emotions, neglect, and abuse you suffered as a child and give you credit where credit is due for surviving it.
• Help you separate that stuff out and deal with it in a safe, structured way.  Maybe this is the placebo effect, but sometimes when things were really shitty it helped me to just know ‘On Thursday I have permission to be Not Okay about this, but right now I just need to focus on sending out one resume.”
• Begin to diagnose any illness that is present and refer you for additional treatment.
• Help you find some new coping strategies to deal with your current life in the present moment.
• Help you not be so hard on yourself, in general, but really honest with yourself when necessary and know when you’re confusing one with the other.
• Help you sort out reality from your perceptions.
• Help you craft your life into a story you can live with.

When you’re feeling depressed it’s exhausting to think about making calls and hunting down care for yourself, and to be honest, it might take a few tries before you find a place that can take you on, that can offer you sliding scale treatment, and that can match you with someone you’ll do well with.  Add the whole shame/social phobia thing and the recession (which means service cuts and waiting lists) and it’s daunting.  Here is the good news:  Therapists and mental health facilities are used to dealing with anxious depressed people with poor coping and communication skills!  They will make it easy as possible.  They will understand if you have a friend make the calls for you at first or comes to the first appointment to wait with you and hold your hand.  They will not judge you.  If you a go a few times, you can say “Hey, I feel like we’re not really gelling here, can you refer me to someone else” and they’ll say “I’m sorry to hear that, but let me see what I can do.”

There’s other stuff I could say about pulling through those two bad years.  There were many paper journals filled with Lists of Things I Am Currently Failing At And Ways I Should Be Better And Not Waste My Life And  Let Everyone Down.  There was signing up with every temp agency in the city.  There were strange projects like, “I will travel to every single CTA stop at least once.”  There was a lot of ill-advised internet dating. I learned what the inside of the plasma donation center looked like (Not Good).  Somewhere in there I found friends, and love, and love again, and shitty unsteady work followed by shitty steady work followed by better steady work followed by graduate school and an actual career, and a learned ability to say “I AM FEELING SAD RIGHT NOW AND WOULD LIKE YOUR HELP, PLEASE” and when someone compliments me I can say “THANK YOU, I AM GLAD YOU LIKED IT” instead of explaining what’s wrong with it and why I am bad.

Baby steps.

If you read this far and didn’t kill yourself, give yourself a gold star.