Sunday, August 18, 2019

The Best Worst Thing



I have been feeling lots of guilt and shame about not writing more about our experiences this summer.  I keep using the excuse that I’m going to school and any free time should be used on assignments, or preparing for my job teaching music this year, and it IS those things.  But also, I feel daunted by the thoughts of trying to sum up what we have been through this summer into blog entries.  I know I can’t ever explain it in words or do this experience justice, and so I have avoided even trying.   But so many people continually encourage me to write, which I appreciate.  So, I guess if I were to try and describe this experience of Chloe’s relapse and our second round through Intensive Outpatient Therapy at the OCD and Anxiety Center, I would say it has honestly been the best worst thing that has happened to us. 

You wonder how I can say this?  Can the words best and worst even exist in the same sentence describing the same thing at the same time?  After weeks and weeks of DBT (Dialectic Behavioral Therapy) in our group skills class, our family knows well that YES , two realities CAN exist at the same time and the term is: middle path.   Along with “middle path” we’ve learned all kinds of new skills and terms that once made no sense to us and now we, along with our friends at the Clinic, use them in our daily vernacular.  Strange and power packed phrases such as “ride the wave”, “hook statement”, “quick and reckless”, “opposite action,” “radical acceptance” is the strange language of our own little elite OCD and Anxiety club where forever friendships have been made with the patients and their support people, therapists, and CA’s (Clinical Assistants) who are the small sliver of people in the universe who truly understand what we are going through.   I marvel at the ability to feel uplifted, hopeful, and empowered at this place where truly heartbreaking, gut-wrenching hard things exist and happen every day, but I did. 

Case in point, this picture I took of some letters that hang on the wall at the clinic.  Patients and support people have written letters to OCD and anxiety such as this one:




I think these letters do a good job of highlighting both realities that exist at the clinic:  the cruelty of these disorders and how much they destroy people’s and family’s lives and rob them of joy, but also the hope that exists when you have tools to fight and make progress.  Here’s one I liked from a support person, which is my role so I could really relate to this mom:





This one is my favorite:




One thing I notice is that each letter has a middle path concept – you can suffer and still find joy. 

That concept sums up our summer:  we found joy, humor, learning, growth, friendships, love and more in the midst of a really crappy situation.  Actually, it was BECAUSE of the crappy situation.  Of course, being a spiritual person I attribute this to God because I have learned that if you look for Him, you will find Him in even the worst of situations.  And I’ve learned that this is what God does.  He brings about good things from bad things. 



Something new we all develop at the clinic is a deeper sense of empathy for others.  You can’t help but come away without feeling for others when you learn of their experiences and struggles, and you can’t help but feel an extreme sense of bonding and comradery knowing that we are all in this together.  Someone, somewhere has always got it worse than you do and it puts your problems into perspective really fast. 

We’ve learned more about people’s struggles with all kinds of anxiety and ocd disorders we had never even heard of including:

misophonia – a disorder where even small noises sound huge and cause a stabbing pain in the person’s head to the point that they fill with rage at the simplest thing like eating dinner at the dinner table with clinking silverware. 

Body Dysmorphia – when a beautiful girl looks in the mirror and her brain interprets that image as an ugly troll so that she is ashamed to even go out in public and hates herself.

OCD fear of harming others – when a person has intrusive thoughts that tell them they are going to harm the people they love and they live in constant agony and fear.

Scrupulosity OCD that is so bad a person can’t live life without feeling so bad and unworthy and afraid that they are compelled to pray for forgiveness every few minutes. 

This is hard stuff, guys.  I had no idea the kind of suffering these disorders can cause people and families and I will NEVER AGAIN trivially refer to OCD as “I’m just OCD-ing about this” or “I’m just OCD about how I like my kitchen” etc.  Doing so would downplay the very real, intense suffering that true OCD has caused my young friends. 

But back to the best worst thing concept…

This is a trivial example, but I used to complain about the time/gas/driving distance/family sacrifice it took each day to drive from South Weber to Centerville and back.  Once I got to the clinic, I realized that of all the patients there, we lived the closest to the clinic.  One family was from Cedar City, and had relocated to Provo where they were living in their RV so they could drive the hour to the clinic every day.  Another mom had to uproot her family from Idaho Falls and live in a VRBO condo with her small children during the week so that her daughter could receive treatment at the clinic.  Others drove from Park City or Logan.  EVERY DANG DAY.  Monday through Friday.  You can’t even miss a day or they charge you. 

Us moms got to know the Centerville Target VERY well and when Chloe graduated, one mom friend even gave me a Target gift card to use for shopping “therapy” to help with my “emotional regulation” (another clinic phrase). 

So you see how this happened so many times. Instead of daily treatment feeling like a heavy burden that had overthrown our lives, I thought “How lucky are we that if our family has to deal with this crappy thing, the only effective treatment available in the state happens to be a half an hour away?”  If I ever started feeling sorry for myself or discouraged, I couldn’t help but quickly change perspective. 

Another example, when we first arrived at the clinic again and sat down on Kate’s couch with Chloe, I was barely hanging on to hope.  I felt so much shame as a mom that I hadn’t picked up on any warning signs that Chloe was relapsing, and we were still so broken hearted from the trauma of losing my nephew Jake just three weeks prior.  Needless to say, I wasn’t in a good place.

Kate opened with, “How are you?” 

Me: “I’m both grateful for the clinic as a resource and horrified that we are here again under these circumstances,”  I managed to squeak out.  It took a lot of energy not to burst into tears during those days.    

“Totally valid,” she said.  (Kate is so good at validating and this skill ended up being the biggest gift she could give our family. )  “In fact, I would be a little concerned if you DIDN’T feel that way.” 

I appreciated the validation, but it didn’t pull me out of my self pity.  I mean, as a mother, what is the thing you pray for the most?  For me, it’s that my kids will be SAFE.  That my children will be protected, and that they will be okay. 

Here, my child was not okay.  She wasn’t safe….she could have died, and it wasn’t by some evil stranger who tried to harm her from outside our home.  It was from a terrible disorder that was INSIDE her brain, that I can’t see, that I don’t totally understand, that we thought we had beat and was gone forever like a bad dream…and it happened on my watch, right under my nose.   

It didn’t matter that we had tried to be good parents, good Christians, good Latter-day Saints, good citizens; it didn’t matter that I had been a stay at home mom who had sacrificed a career and financial abundance in order to dedicate her life to giving her kids a stable, happy upbringing.  It didn’t matter that we tried to do those things experts advised would help our kids grow up to be healthy and happy like making them take vitamins, or eating dinner together as a family, doing wholesome family activities, going to church, saying our family prayers and reading our scriptures and doing everything we are “supposed” to do. 

I had done everything right and this bad thing still happened.  And even though lots of people were kind and supportive, I still felt judged and ashamed and wondered if it was my fault. 

Which is why I am so amazed at how quickly I was able to transform from that lowly state into feeling hopeful.  Kate and the clinic made me feel hopeful that Chloe would get better, but it was really the parent support group that pulled me from the depths of discouragement in regards to my role as a mother and support person.  Parent support group was every Friday and I came to look forward to this hour more than any other part of the treatment process.  Words cannot describe how good it feels to listen to, cry with, and share with people that truly understand.  I’ll never forget that first day that we were asked to introduce ourselves and I shared that it was our second time through IOP, feeling a little bit ashamed and like a failure as a mom that I had not seen the warning signs and let it get so bad we were back in IOP.   Someone said, “So, you’re a veteran” in a tone that was kind of admiring sounding and something clicked within me.  My perspective changed from feeling sorry for myself to feeling so grateful that I had the ability and experience to give hope to these first-timers because I had experienced this process before.  And although it sucks that this is a family issue, I actually have learned  A LOT because OCD and Anxiety have been such a big part of our lives.

Nothing can turn me around from feeling discouraged faster than being able to comfort a crying mother  by giving them words of hope that I’ve earned through sheer suffering.  For example, I know not to freak out the first three weeks of treatment because I’ve already learned the hard way that when your kid starts treatment it ALWAYS gets worse before it gets better.  One of the CA’s likened the first part of treatment like this:

Imagine you’re on a lifeboat in the middle of the Pacific Ocean paddling furiously towards Japan only you don’t see any land in sight.  You’re wondering why you’re doing this, is it even working?  Paddling is so hard and exhausting and you hate it and you don’t want to do it today but you still have to.  This is what it feels like for our kids when they start treatment.  And us support people aren’t even sure it’s working either but we still have to make them paddle on the yucky lifeboat every day and tell them it will be okay. But then one day, you see land.  And you are rejuvenated because you realize you have been making progress and you are encouraged by the fact that you are getting closer and closer with each stroke. 

I was able to give many people a little hope in these meetings because I had already been through this roller coaster and I was able to tell the other parents that the process REALLY DOES work, and that after a while, they WOULD be able to see land. 

I was able to assure people from what I have learned that it is NOT their fault that their child has this disorder.  So many parents wonder if it is because of their parenting or something they did to cause this.  This incorrect belief is often aggravated by well meaning people who make dumb comments and assumptions.  Being a parent of a kid who struggles with a mental illness is hard, and sadly this is almost always compounded by the false and uninformed perceptions of others.  It’s REALLY HARD not to let other’s judgments get to you.  Validating someone else in this experience can provide so much hope and comfort and in our support group I not only received it but was also able to give that validation. 

Being able to give someone else hope and comfort while you are suffering feels REALLY GOOD. 

What also felt good was watching Chloe do the same thing – use her previous experience to uplift, encourage and inspire other participants.  I could tell it made her feel good too, and we would sometimes drive home in awe of what just happened that day at the clinic because feeling that special kind of good just wasn’t something either of us expected to gain from yucky treatment. 

I can say for a surety that because of this awful relapse our family is stronger.  I am a better person.  I have gained skills to be a better spouse, parent, friend and teacher.  We have new friends we love dearly, that we never would have met otherwise.  We have learned so much and have grown so much.  I wouldn’t trade this experience for the world. 

What’s going to be interesting moving forward is how we are able to improve on our new skills in managing this disorder and the ups and downs that accompany living with OCD and Anxiety, and how many others we will be able to help because of it.  It’s especially scary starting the school year again and watching Chloe face those triggers while trusting that she will use those skills she’s learned.   But thankfully, I have a support group  in family, the people at the clinic,  and alumni that will always be a part of our inner circle so I know we won’t have to do it alone. 
So after a tear-filled graduation day, Chloe and our family were sent off to wobble on our own two feet with the weekly instead of daily support of the clinic heroes, which will later taper off to two weeks and then monthly etc.  I feel a bit like I did when I was a new mom taking my newborn baby home from the hospital, knowing that I won't have the trusty and capable nurses by my side at a moment's notice, but also knowing that they are only a call away.   I feel a bit nervous but mostly confident because Chloe's got this!  I couldn't be more proud of her, honestly.  She is a remarkable young woman and I love her so much.  

I'll close with a few more pictures from the clinic:

 This daily reminder loomed over us support people every day in the group skills room, reminding us that we not only get to learn Parenting 101 in this lifetime, 
but being the support person to a child with an anxiety disorder we also get an extra bonus set of parenting guidelines: 

Chloe's graduation spread, churro chips with ice cream courtesy of  the Dickson family.

 Another wall in the group skills room.  Each participant had a llama that climbed through the different stages of the mountains each week until eventually reaching "Maybe" heaven.  
Maybe is a hook statement for people with OCD because it reminds us of the possibility of uncertainty and being okay with that.  

 Chloe's Llama
 An example of stuff we learned about in group skills.  This was a whiteboard example on the week we learned about Opposite Action.  


Another letter




A really popular quote used ALL the time at the clinic.  






Sunday, July 7, 2019

Thinking Errors

Many people have been asking about us and I wanted to tell you that we feel your love and concern and really appreciate it!  
Great news: 
Chloe is set to graduate from the clinic on July 18thand we couldn’t be more proud of her.  She has truly been an inspiration in how hard she has been working to get better.  We know that these trials are helping her to help others some day and I can't wait to watch her soar!
 Carter has also been going to the clinic once a week for social anxiety, but will begin IOP on a daily basis as soon as Chloe is done.  This means we will still be spending our days at the clinic which can be a bit disruptive to life but I don’t care because I love it!  

I can truly say that we are all doing better than ever.  How could we not be with a place where kids and parents can learn together, cry on each others’ shoulders, support each other and even laugh at our crappy lot in life?  We have family therapy, individual therapy, support groups and most importantly we are being trained and drilled in how to handle all kinds of mental health issues and it is glorious.  If I have an ocd question or situation, a parenting question, a marriage or relationship question…there is a professional at my beck and call every single day to hold my hand and walk me through the issue.  

 I know it sounds crazy, but I keep telling people that this is the 

“BEST worst thing that has happened to us.”
 And I truly mean it.  

We have had access to some of the best mental health care and tools around and our newfound understanding has given us the world. Our family, our happiness, our relationships, our parenting have all improved because of these tools.  What makes me sad is that it took something so bad (a breakdown/suicide attempt) to get us into the position to really learn and practice these things.  

EVERYONE should have these tools.  We ALL need them so badly!  Why aren’t these things more available to us?  They should have been taught to us when we were children. Our children should be learning these things while they are young and so many lives and families could benefit.  
I demand an improvement!

What is our society’s problem?
I don’t think it’s a new idea that total health includes mind, body and spirit is it?

When I look at our country, I see that we get the importance of physical health.  There is a big push on teaching children about physical health.  There are PE classes in school.  There are gyms and personal trainers, nutrition advice and so many diets and workouts available.  Heck, you can’t graduate from high school without Physical Education credits and without taking health class.  It’s MANDATORY.  We get that physical health is important.

Our country also seems to get the need for spiritual nourishment.  For those who chose to embrace spirituality, there are also many options and tools for building spiritual strength.  Churches, temples and seminaries of all kinds exist.  People practice meditation, yoga, praying and religious rituals.  In my church we have many programs including Young Mens and Young Womens, Sunday School, and the Come Follow Me program which provide opportunities to build and maintain spiritual health.  You don’t need to look far to find access to all kinds of physical or spiritual health resources.  

So WHY then, 

 when it comes to building and maintaining mental health and wellness, are resources so limited?   What kinds of easy access to resources do parents have to teach these things?  
Hardly anything!  
Not okay!

I will say that our wonderful school counselor tried this year to teach the kids some mental health practices, and it was a start.  But it's not nearly enough.  I also see some teachers are trying to introduce some mental health skills in their classrooms as well and bless them for doing it.  But as a society in general why do we seem to place such little value on mental and emotional wellness?  Where is my mental health fitness center?  Where are the mandatory or free mental health education classes in the schools or for the general public?  

The more I think about this the more infuriated I become.  I was curious about WHY this is… so I did a little reading.  I found that it’s not only an issue in our country, but WORLDWIDE. 
One article had some theories that made sense. Here’s a bit of what it said:

Patel, a psychiatrist at the London School of Hygiene and Tropical Medicine, said,“Given its contribution to the global burden of disease, mental illness receives nowhere near the kind of attention and resources it deserves."

Why is mental health largely ignored on the global health agenda?


“Frankly, I don’t know,” said Patel. “The level if disinterest and apathy surrounding this massive problem is mysterious to me.”



Some of it clearly has to do with the stigma that still surrounds mental health, he said. Many people still tend to view mental illness as a character flaw, Patel said, as something that an individual is somehow personally responsible for having and for not being able to control their behavior.



Because of this misunderstanding, he said, many people with mental illness in poor communities (and not-so-poor, but ignorant, communities) suffer severe abuse.



“In developing countries, it is not uncommon to find people with serious mental illness chained up, locked away or subjected to regular, outright abuse, even in health care institutions,” Patel said. “If any of us saw even one individual with HIV/AIDS treated like that, there would be global outrage … But you don’t see the same outrage when it is people with mental illness.”




Something must be done and I’m all fired up about it.  FIRED UP!!!   But wait, I need to check myself.  First, I need to focus my energy on getting my kids better, but mark my words, when they are doing well I am going to fight to fix this problem…even if it just means teaching what I’m learning on this blog, or applying these tools in my future classroom.  Or maybe I’ll eventually rally on a bigger scale, who knows?  

Until then, I want to share for others.  There are so many things we have learned.  I want to start with a topic that has been life changing for my family and me: THINKING ERRORS.  


Thinking errors are thinking traps that influence our happiness and can push us into depression or anxiety.    We all do them.  Our mental well-being depends on our ability to manage our thoughts, regulate our emotions, and behave productively and responsibly despite our circumstances. This can be a challenging task for all of us at one point or another. But learning to recognize and manage our thinking errors will go a long way in helping us build mental strength.

According to a Webmd article, thinking errors “can skew your judgment and make it hard to appraise your situation realistically." (2002)
We as a family are practicing and working daily to identify these thinking errors and correct them.  As you read these, I challenge you to recognize which thinking errors you or your children may be using and how they are negatively affecting your life.    
THINKING ERRORS  (Also called cognitive distortions)
  • All or nothing thinking:  You don't see middle ground. You assume if you don't get the promotion, the company wants to ease you out the door. 

  • Overgeneralization:You extrapolate your future based on a single event. You figure that if you failed the bar exam on the first try, you're just not cut out to be a lawyer. 

·      Mental Filter:  Only paying attention to certain types of evidence. Noticing our failures but not seeing our successes.  

·      Disqualifying the positive:  Discounting the good things that have happened or that you have done for some reason or another.  That doesn’t count.

·      Jumping to conclusions:  There are two types:
Mind reading: Imagining we know what others are thinking.

Fortune-telling: You predict that things will turn out badly, no matter what you say or do. Your new boyfriend does not call you as promised before a business trip, and you spend the week convinced he's breaking up with you. 

·       Magnification:(Catastrophising and miminalization)  Blowing things out of proportion or inappropriately shrinking something to make it seem less important. 
  • Emotional reasoning:You get lost in your emotions. You spill food on yourself at a restaurant and feel like a jerk, so you assume other people see you that way, too. 

  • Shoulds and oughts:You focus on other people's expectations of you, instead of on your own needs. You feel you ought to help a co-worker with his project -- even though it will make you fall behind in your work. 

·       Labelling:  Assigning labels to ourselves or other people.  I’m a loser.  I’m completely useless.  They’re such an idiot.  

·       Personalization:  Blaming yourself or taking responsibility for something that wasn’t completely your fault. Conversely, blaming other people for something that was your fault.  


For children especially, thinking errors are a destructive habit to get into, because they prevent them from learning the important skills that lead to success in life.

As I have been learning about thinking errors, I have two major questions:  
1.  How can we change them?  and
 2.  Why do they happen, or how do they form?

At the OCD and Anxiety Clinic, they work with clients on how to overcome these within the scope of their diagnoses.  I’m just curious in general, as a whole, how would someone like me help my kids or help myself change these thinking errors?  

Here’s what I’ve found:

1.     Identify your thinking errors as you use them.  Practice distinguishing between negative and accurate thoughts.    At the clinic, they have a form that you are supposed to fill out when you find yourself feeling anxiety.  As your SUDS levels go up, you write down the thoughts you are having in the first column of the form and more often than not they are thinking errors.  In the second column you identify at least two thinking errors that could go along with those thoughts you are having.  In the last column you challenge the thinking error by collecting evidence to support or negate the thought, challenge it, and brainstorm an accurate thought to replace it.    The repetition of doing this really helps to change the way you think.  
 Here's an example

Anxious thought:  "I can't speak in front of a crowd because everyone will judge me and think I'm stupid if I make a mistake or sound dumb."

At least two thinking errors in that thought would be:  Mind reading, and overgeneralizing

Challenge the thought:  What is the likelihood of EVERY single person judging me?  What is the likelihood of NO ONE judging me?  We can rule those two out as not realistic.  What's left is that maybe one or two people might judge me.  Maybe they will or won't think I'm stupid but I at least know that ____ knows I'm not stupid.  I know I'm not stupid.  My teacher knows I'm not stupid.  etc.  

Hopefully, anxiety about the situation will decrease after this exercise.  


2.    Cultivating optimism
Parents can play the “Unfortunately, Fortunately” game with their kids. Together with your child, come up with “five sticky situations,” which you write down on cards and put in a hat. Each person then pulls out a card and says the unfortunate situation (Chansky uses the example: “Unfortunately, the movie I wanted to see was sold out”). The other person responds with a fortunate perspective (“But fortunately, I went to see another movie”). Then you go back and forth, each mentioning unfortunate and fortunate circumstances.
The next time your child is going through a difficult situation, you might say, according to Chansky, “There are a lot of ‘unfortunatelys’ stacking up. Can we see if there are any ‘fortunatelys’ in this situation?”
3.    Building distance from negative thoughts.  Teach your child to be a thought detective.  Avoid saying they are being negative, instead blame the “negative brain”. (This also makes you an ally in helping defend your child against this ‘troublesome third party).  This relabeling “begins to demote the validity of negative thinking, encouraging the child not to trust it as the truth but  According to Chansky, this relabeling “begins to demote the validity of negative thinking, encouraging the child to not trust it as the ‘truth,’ but as the annoying, upsetting, overprotective or just sort of ill-informed voice that it is.” You can brainstorm ways to talk back to that negative brain: “You’re not the boss of me; you make me feel bad; I’m not listening to you!”  
Other helps:  If you have a child with anxiety, you MUST READ  THIS ARTICLE they gave us at the clinic!!!
On to causes:
What the heck causes people to form thinking errors?:  
Biochemical or physiological conditions:  We sure get this one.  Sadly, my kids don’t stand a chance with the crappy genetic combination my husband and my genes created.  Being genetically predisposed to anxiety and OCD automatically predisposes them to forming thinking errors.  
Cultural and social factors:  We can pick up thinking errors and cultural biases from society. This includes the fast-paced nature of our society.  People need time to examine, question and test their thinking.  If people are placed in a fast-paced environment they are forced to use oversimplified thinking and therefore will have more thinking errors.  Slow down everyone!  
Habits and attribution bias:  If a person thinks a certain way for a long time, it can make it more likely to keep thinking that way.  
Fear, anger and conflict:  Being overly exposed to any of these things can create thinking errors.   
Other articles I’ve found about this subject:

Isn’t it fascinating?  If anyone has any success using any of these suggestions, I’d love to hear about it.  And I LOVE all of your comments.  Thank you so much for taking the time to reach out, even if it’s just a line or two. It lifts me more than you know!  
Love you all,
Molly

References: 
Arnquist, Sarah.  (2011). Why is Mental Health Largely Ignored on the Global Health Agenda? Retrieved from:  https://www.ghdonline.org/ncd/discussion/why-is-mental-health-largely-ignored-on-the-global/
Tartakovsky, Margarita.  (2018) 3 Handy ways to help your child overcome negative thinking.   Retrieved from https://psychcentral.com/blog/3-handy-ways-to-help-your-child-overcome-negative-thinking/

WebMD  (2002).  Fixing Common Thinking Errors.  Retrieved from https://www.webmd.com/balance/features/common-thinking-errors.