A Celebration of a life well lived.

Today was my friend J’s funeral.

Again, as I have written before, this is not my story, but several things came together for me this morning and I wanted to try and capture them.

  • There is the celebration of a life, cut short, but full of fun.
  • There is the recognition anew – that we come into this world with nothing , and we can take nothing with us when we leave, except the memories we have made and the imprints our actions have left on others.
  • There is the beauty, simplicity and conviction of faith
  • And there is something (or things) personal that I want to reflect upon.

In the last 10 days I have been ridiculously forgetful, basically ditsy. I have been rushing around at 200 miles an hour, unable to concentrate on anything much, forgetting things (some important – like not cancelling a £200 online shopping order after I had done the exact same shop in person, some less so) My eldest son has been looking at me quizzically and commented “This is just not like you Mum”. And its not.

My concentration and output at work has been virtually zero. Forgetting things scares me at work for pretty obvious reasons, but I have not had any clinical sessions this week, the time freed up for other important matters to be dealt with Well they haven’t been.

On Tuesday evening I was struck down with diarrhoea. Severe diarrhoea. The kind that keeps you max 30 foot from a lavatory and leaves you wrung out, fatigued and sore. I have no idea what the cause of that was, emotional stress? Maybe.

Not good really. The house looks like a bomb has hit it, the dishwasher is kaput and the fridge is stuffed with enough perishables to feed a blinking army ….

This morning I was berating myself (again) for my poor performance in life over the last week. Then I looked in the Mirror and thought “so what HAVE you been doing ?” And the answer, of course, is that to the very best of my ability I have been supporting my friend K, J (before he died) and their son through a hideous, terminal illness that has been painful, terrifying and traumatic for much of the last 3 years. That I have lost a dear friend, been brought face to face with my own mortality, organised a BBQ for 30people in the back garden at a moments notice and generally lived through the pain and heartache of death, bereavement and funeral planning.

I would not have had it any other way.

Every single thing I have done or tried to do, has been done with love and a genuine gratitude for the support that both offered to me in the past.  I have been well placed to offer support, both geographically and by virtue of my medical knowledge. But I have not shirked from it, not taken the comfortable option (not my problem), not avoided hard conversations and not left K to manage alone.

Thats ‘what I have been doing’ and I’m both proud and grateful that I could help, and very honoured to have been trusted to be that close to a family in a time of need.

A woman I have heard a lot about came to talk to me at the post funeral ‘do’. As we were talking I heard the familiar inner voice of perfectionism and self blame in her narrative. When she finished speaking, I smiled at her and said, “But others will see what you HAVE done; we are always so much harder on ourselves than we need to be, look at how hard you have worked and how much you have achieved” I could see that this reframing of recent events was a bit of a revelation to her, and she responded by thanking me. That’s when I knew that some of the lessons I have worked so hard to believe in, to trust and incorporate in to my life are actually working.

Courage, compassion and connection. All there.

The closeness and loving kindness I have been part of the the last few weeks, the genuine compassion and community spirit of J’s many, many friends … it has been humbling and profound.

I know there is much more I need to reflect on, and much more that I have leaned from this whole experience. But today I have shed tears of grief, literally sobbed as though my heart would break, and also been a big part of a moving and uplifting church service that I will never forget. I have laughed, connected, chatted, listened and hugged so many people.

no wonder I am emotionally exhausted.

May God bless you my friend, you will live on in our hearts and our memories.

 

A Good space

Im in a good place right now

Not the ‘pink cloud’ good space that I have experienced periodically over the last 2 years, not an artificial high caused by something good happening. No, this feels sold, better, calmer.

My problems have not gone away; the kids are still the kids with their challenges problems and my anxieties about them; work is still work – busy, demanding, unmanageable; and life still has its downsides.

But I feel better.

Since what I am going to call my spiritual awakening, the problems I face seems to have been placed in a more appropriate perspective leaving a big space for gratitude. Not the slightly forced gratitude of the last 833 days, but a real, deep, profound, heartfelt thankfulness for all the amazing positives in my life.

Underpinning that is a much stronger sense of self esteem, a feeling of personal control and a trust in God. A true belief that I, with all my imperfections, am not some hideous malevolent, undeserving fraud, but just a person. Just a person with good and bad traits. A person like others, worthy of love, help and support. That my Shame and self hatred has been shrunk down to its proper proportion and assumes a much smaller place in my psyche.

This is a HUGE relief, and a huge step forward for me. Associated with this feeling is compassion for others, including those who have wronged me. No longer am I so angry, resentful and fearful (even though it was largely hidden from others) resentment, anger and fear were big parts of my feelings about my ex husband and my ex partner. Although I would probably have denied it, the fear with connected with anxiety they they could in some way still hurt me. Being able to let go of the fear, trust in my own boundaries and  KNOW that I will be ok, is very freeing.

Im working my steps, bit by bit – onto Step 4 and writing my lists of resentments, fears, anger, frustration is quite cathartic. It pulls all those suppressed ‘negative’ emotions into the present –  and poking over them makes me realise they are all very boringly common. Theres nothing particularly shocking there (that I have done) nothing to horrify or scandalise. its all pretty mundane. Who knew !

So despite this period of sadness and mourning, despite the tears for J which catch me unawares sometimes, despite the inevitable struggles of my dear friend and my absolute inability to make it right for her, inside I am at peace. I have faith that it WILL all be ok.

I think of that faith as a droplet falling in to the water of life – and the ripples are felt throughout my life – in all aspects.

One more things I’m grateful for .

A letter to my higher power

This is part of my Step two / three homework. It feels very important so I thought I would write it as a blog post, that way it stays here for me to look back on.

As I have written before,  have struggled with the concept of a higher power – an internal struggle of ‘wanting to believe’ ; envying those who do ; but lacking the trust needed to make that leap … By some miracle (and I use that word deliberately because that is how I experience it) I have made that leap of faith and I now find myself embracing the faith I have searched for …

Dear God,

I have been aware of you all of my life. At times I have felt Your presence pushing at the edges of my consciousness and trying to make me see You , but in my arrogance and wilfulness I ignored the obvious signals You sent to me. I carried on alone, struggling to cope with the unmanageability and chaos of my life, trying to control every facet. I continued down my self destructive path for so many years ignoring the lifelines you threw in my path …

I feels so lucky that despite my stupidity, despite my arrogance, self will and stubborn refusal to listen eventually an enormous proverbial slap across the face woke me up to the blindingly obvious fact of Your reality. After so long agonising over something I could not control, it came right in the end, by Your Grace, You showed me that my will and planning  is irrelevant, that Your greater plan will prevail, and we will all be ok. We will all suffer, because that is a part of life, but with trust and faith we will be ok.

To turn my will and life to You, enables me to LIVE the serenity prayer. It allows me to stop fretting about what I can neither alter nor influence. Instead by trust and faith and prayer I can come to accept the futility of my attempts to manipulate the future, and learn instead to trust in You.

This may be the greatest gift my recovery has yet brought me. I have learned patience, self control, calmness, have practiced setting boundaries, learned to manage the shame that previously engulfed me, and started on the path of self love. All these are great gifts that have come to me in sobriety and the lived experience of a calmer, happier home, and greater honesty with those I love is a wonderful result.

All this however has not removed my worries about the future that have tormented me. This nascent faith, trust and deep feeling of serenity provides me with the key to a wholehearted, joyful, spiritually healthy future.

For this I am deeply grateful.

I know there are many incidents in my life that You threw into my path, trying to help me accept Your reality. Of course now I cannot remember a single one to acknowledge in this letter. But I now there were many that I ignored. This last, this amazing last, I could not ignore. Sent to me right at this time in my recovery when my mind is open and my willingness to hear Your call is at last developed.

The last barrier to my acceptance of You was ‘trust’ – and you showed me in the most obvious way possible that I could, and should, trust in You.

I humbly ask for Your help in embedding this faith deep in my soul. I understand that faith is an action, it needs nurturing and it needs time. I commit to regular practice of prayer and gratitude to build my relationship with You. I commit to honesty in my relationship with my God and to seeking help from those who have greater spiritual wisdom than I. Please strengthen and confirm my faith in my daily life.

Amen

Good enough …

My patient X has relapsed.

12 completed days of sobriety, intensive effort by a variety of people, proper supervised alcohol detox to obviate any physical withdrawal, a proper plan made with the drugs and alcohol team but she relapsed anyway. First chance she got really.

Interestingly I feel neither angry, resentful or that I need to fix it. I feel a little sad, but I’m able to shrug my shoulders, accept that this is her decision and  that she’s probably not ready yet. She may never be, and may be one of the sad statistics – young people who die from alcohol addiction. I have done what I could, I can do no more.

That realisation, that I can’t fix someone else, comes easier these days both in the recognition and in the acceptance of this as a simple truth. Reviewing the way I managed this, both medically and personally, I’m content that I acted appropriately (except in the moment that I told her I too have had alcohol problems – and I have learned from that and will not do it again)  Right now I’m more concerned about the fall out for others who tried very hard to help, and for the future welfare of her child. For the latter,  I will do what is professionally right. And that’s it, no judgement, no expectation, no emotional response, just respond professionally to whatever questions I am asked and do my job.

And it’s got me thinking about how I respond to my patients, how my personality impacts on the way that I do my job, and how my well-being is affected (as well as that of my family)

I’m trying to approach this with an open mind; in the past I have judged myself very, very harshly if my personal responses were anything less than 100% perfect, and been super critical of (almost) any emotional response I have had. I think this stems from a  belief that a good doctor should “care” about his /her patients but not allow that caring to be seen, not allow it to disrupt their emotional stability and never be affected by it. And I am a very emotional person. I care deeply about a lot of things, and a lot of people. In my personal life I am someone who has a small number of close friends rather than a large number of acquaintance, and these friends matter to me a LOT. If I can help, I want to, and I will try hard to do whatever I can.

Similarly in my professional life there have always been patients who really ‘got to’ me; the 26 year old Polish woman who arrived in A&E desperately unwell with sepsis and died 8 days later on ITU; the young woman with dreadful Crohn’s disease who I nurtured through her dangerous pregnancy; the man I diagnosed with HIV on his admission with PCP pneumonia; the astonishing 36 year old woman who was admitted to a hospice to die from her untreatable leukaemia. I have responded to these, and many more, by giving everything I have – in knowledge, emotional support, passionate attention to detail and hours of painstaking care. Early in my career I was warned, in a kind way, that my compassion could interfere with my judgement, and conversely I was often asked to ‘act up’ by Consultants who recognised that my dedication meant I would always give my best.

It’s taken almost my whole career to truly recognise the tension and balance in this characteristic. That it can be a force for good, and also result in problems.

In X there was another opportunity to go ‘above and beyond’, and to some extent I did. Few other GP’s would have taken on the risky ongoing detox of an unstable alcoholic. But I feel I have learned where to draw the line more appropriately to protect myself, not just emotionally but from the risk of practicing outside my sphere of expertise; the hazards of prioritising one persons needs over the many others, and the loss of judgement that can accompany a personal medical crusade.

I can view myself with compassion now, be thankful that I can still care about the outcome, and yet approach each case with a greater humility and recognition that I alone cannot provide the answers. And not only that I can’t, but that in trying I put myself at risk, (of intense disappointment and self blame; of not listening to others, of exhausting myself) and of disrupting the balance of my work /life.

I feel more kindly and benevolent toward my passionate intense involvement with some patients, more supportive and accepting than blaming critical and judgemental. I recognise that caring and involvement has made many patients feel listened to and as though a doctor is truly trying hard for them, and that this is a good thing. Its not wrong how I feel, it just needs soothing and containing in a kind way.

I think that’s a bit of a gift from this period of therapy and the programme I’m working now. The gift is self awareness and self compassion.

Long may it last.

 

Spirituality

My friend J died on June 8th.

I’m not going to write about that as its not my story, but I am just going to write this.

All through his illness, and K and J are like family to me, I have been very scared about the ‘end’. Not because I am afraid of death itself, but I am afraid of the process and the manifold ways in which death can be truly horrible. Afraid for J , but also for K and their son that something horrible would be their last memory, and after all the struggles there would be more traumatic experiences.

I knew this was weighing on me, and that it was largely a personal thing. I did talk to a few people about it, but it feels both ridiculous and a bit presumptive to try and explain why it was so important to me (and after all I am not family, just a close friend) . I also knew it was yet another example of me trying to control something that I really could not , and agonising about something that might not happen (not exactly keeping it in the day !)

Until he died, and it was a perfect death, insofar as such a sad, sad thing can be ‘perfect’, I had not understood the concept of ‘handing it over’, I had never seriously thought about ‘trusting’ in a ‘higher power’ as a realistic option. As I have been exploring, my trust in ‘God’ to help me, has been non existent.

In the last 48 hours this has completely changed. I want to capture it here because I hope so much that this will stick.

It seems to me that a) I was granted the strength, time and opportunity to have the conversations I wanted to b) that amongst the myriad of terrible potential scenarios in my head, something, somewhere, led J to a peaceful, dignified, pain free death with his beloved wife by his side.

And if that’s not a higher power working so that all things ‘intermingle for good’ I really don’t know what is.

I can see how I have tortured myself needlessly, made myself ill with anxiety over something I had no control over (although of course part of the issue is that I did potentially have just a little control in that I know how to administer medication) . By ‘handing it over’ and trusting that it will be ok, I could have saved myself a lot of angst.

Much more significantly I feel that I have been granted an insight. That ‘it’ WILL BE Ok … ‘all shall be well, and all manner of things shall be well’ in the words of the 14th century Christian mystic Julian of Norwich. That meddling fretting and agonising is not helpful, not productive and is unnecessary ….

That is the point of this post. I believe I have been given help, help to see a way forward to a calmer, more trusting future.

The picture is a beautiful fountain at the place J died.

May he Rest in Peace.

Sick

Yesterday I met some sick people. Spiritually sick.

And it scared me.

On the positive side I recognised them, almost straight away, and they looked deeply unhealthy and terrifying to me. despite their energy and charisma I could see right past that to something egotistical, selfish and potentially cruel.

On the negative side I felt incredibly vulnerable, like a newly hatched chick with only the nest to protect me from a whole host of predators who would gobble me up and spit out my bones without a second thought.

All the emotional energy I have put into my recovery this week, all the thinking and reading and reflecting has left me drained – I have made progress but I feel drained.

So I’m going to take this day to ask others for what I need, look for some peace and self care, and try not to overstretch myself.

I went to a quiet but powerful church service at 8am. A nice lady introduced herself and that simple, normal Interaction helped me to feel safe again.

But I’m rattled nevertheless

Step Two

“Came to believe that a Power greater than ourselves could restore us to sanity.”

Now this is a new challenge!

A “power greater than ourselves” hmmmmmm.

Traditionally of course this refers to God, and indeed the AA “Big Book’ published in 1939 has a significant emphasis on spirituality which at the time, meant belief in God. Over the years the book has been ‘updated’ and the twelve steps, the readings and traditions now refer to ‘God as we understand him’ or just “your / a higher power”

I have heard several times that all of the words of the 12 steps are very specifically chosen, and the second step doesn’t say “We came to believe in a power ….” it says “We came to believe that a power ” and the writings and reflections I have perused in the last week have suggested that this wording is important because it shifts the emphasis from what that Power is, to what that power might be able to do for us…

It seems that the key lesson /point that this step is making is that we can’t recover alone and that we need some kind of help,  The principles that are the foundation of this step are open mindedness, humility, trust, and a willingness to have faith.  Reading around  this step suggests that it doesn’t matter if we don’t know HOW this ‘power’ can help us,  just that we believe it is possible.

I wrote This in June 2016 when I had been sober just over 100 days; and when I read it back I marvel at how naive I was, and how wobbly …  I was vaguely aware that I wasn’t ready to do the ‘steps’ (although I phrased it as ‘I don’t want to’) If I’m honest today, I would rather it wasn’t necessary, but the difference is now I recognise that it IS necessary (for me) if I want a sustained and sincere recovery

I have read some inventories/ questionnaires pertaining to step two;  about coming to a place of belief; the definition of “a power greater than ourselves”; current experiences of God; questions about insanity; what a “restoration to sanity” might look like  and examining our own as well as general spiritual principles. Some of those questions that I found most illuminating, are reproduced below

  • What does “we came to believe” mean to you?

This is quite hard. Basically I would LOVE to have a true faith because I can see the comfort this can bring to people who have it. Comfort and peace. Not always, but a basic belief that God (and I’m going with God because whilst I respect other peoples different religious beliefs and indeed other peoples ‘higher power, for me, it makes sense to call that God) works for good, to redeem suffering and that ‘it will be ok’. I don’t have that, and I wish I did. I also find theology intellectually interesting, and truly spiritual people profoundly impressive. Not the tub thumping evangelical zealots, but the calm, loving, accepting, non judgemental people who radiate inner peace.

  • Do you have a problem accepting that there is a power/powers greater than yourself?

Simply put, No. I cannot believe that we are ‘just’ cells and biochemical reactions and that we do not have a soul. That this soul is much more than the scientifically rational. In fact its harder for me to believe this is NOT the case than that it is. I have seen many people die, and I have seen, with my own eyes the alteration in the body at the moment of death. As though the soul leaves at that moment, is released from the mortal body, and goes ? Somewhere … So if we have souls, there is something other than science involved …

  • What evidence have you experienced that a “higher power” is working in your life?

There is lots of evidence. Actually LOTS of evidence. Once you accept that Fate is in-fact “the will of God” . From small things, to the big things that include my miraculous and unlikely acceptance to medical school.

  • Do you have any fears about coming to believe in something greater than yourself?
  • I have a very deep fear that I won’t be able to do it ‘properly’, that I will always have a shaky faith because of my logical rational, scientific brain. The leap into ‘believing’ seems like a giant step into the unknown … and a leap away from the control I have tried to exercise over my life and it’s progress.
  • Did you make insane decisions as a result of your addictions?

Yes. Lots of them. The very definition of insanity, doing the same thing over and over again and being surprised when I got the same outcome …

  • What changes in your thinking and behaviour are necessary for your restoration to sanity?

I don’t know right now and this is a really really scary one for me, because clearly just not drinking, whilst an essential start, isn’t enough. There is a whole heap of stuff in here which is fundamentally related to the self critical and harshly self judgemental way in which I have critiqued myself all my adult life. I’m working through this with Angela, and I can feel the progress.. but it’s painfully, frustratingly slow. I used to think I would get “better” and then consider what changes I might make in my life – I’m becoming afraid that I might have to make changes in order to live a fulfilled, contented and happy life. But this would mean taking a huge risk, and challenging some of my deepest, most profound insecurities. It would mean giving up some of the drivers that have shaped my whole life ..basically, as I alluded to in my last post it would mean creating Time for myself …. which would mean changing / reducing my hours at work.

  • What fears do you have that are getting in the way of your trust /faith

One big issue is the “Why does God allow all the suffering in the world” conundrum. I struggle with this one, as to many people of all faiths. In the process of my reading around this (google really is amazing) I came across this text, and then an explaination for it which I paraphrase here.

And we know that all things work together for good for them that love God” Romans 8. 

The explanation I read about this text went along the lines that if you allow for the translation from Arameic, the phrase could be read as “all things intermingle for good” and that from this we can take that God does not will suffering, but instead the suffering of humanity whilst individually tragic, is part of a greater plan that we mortals cannot perceive or understand, but through faith can believe that God has control, or a ‘master plan’ for the world, that we cannot hope to know but which can can make personal suffering bearable.

I found this both feasible and comforting.

The other irrational fear I have goes like this. I have always sort of believed that God does not send suffering that a person cannot cope with. And I know I could not cope, as I am, with the death of one of my children. I could not. Deep inside I’m afraid that if I had faith, God might think I could cope, and visit such suffering upon me. This is totally irrational and contradictory on so many levels … I don’t need to deconstruct it; but it’s there. And it’s a barrier.

  • What do you need to do to help let go of the fears?

I don’t know. But building on the concept of neuroplasticity, and my accepted belief that repeated actions become habits and that from habits come new neural pathways I have committed to trying to pray every day and attending Church once a week when I can. Quietly. No big song and dance, no declarations of faith or expectation of spiritual awakenings, no discussions or high drama confessions. Just deliberately cultivating and nurturing my nascent spirituality in a way that seems manageable.

  • What results have you personally seen from demonstrating open mindedness in your own AA journey?

Just GOINGtoAA was a huge step in open mindedness for me, as those who have followed this blog for a while will recollect my deep aversion to doing so. And the decision has been rewarded a thousand fold with the friendship and support I have received. Attending AA gave me the courage to be open with old friends as well as new, and my life has been immeasurably enriched by the connections I have made through attending meetings, working with my sponsor and reflecting on my experiences.

It seems important to remember that step two, like all of them, is a process, not an event, and that perhaps for now, at this stage, all I need to achieve is the belief that a) there is a higher power / God and b) I was behaving in an insane way as a result of all my addictions and c) it is possible not to behave in an insane way.

Having it all

This is one of those posts that has been lingering at the back of my mind for months; every now and then I pull it up in the drafts box add a couple of lines and know its not fully ‘cooked’, and that my thoughts and feelings need more development before I can capture them accurately on “paper”.

Today I’ve rewritten most of it,  but the essence, that elusive “having it all” dream, is still the central theme thats been occupying me, and still the thing that needs examining.

Like many women brought up in the 70’s by mothers’ who had often had to settle for ‘jobs’ rather than careers, I believed the mantra of the time, that women no longer had to choose between being ‘wives and mothers’ or ‘career women’ but could instead “have it all”. 

“ALL” was a successful, lucrative career AND a husband, children and a happy family life.

This utopia was sold to my generation of young women by the feminist movement of the 1970’s and early 80’s and by the generation of women who had struggled so hard for any kind of equality in the workplace.

The equal pay act only came into force in 1970 in the UK, when I was already 5 years old. That is utterly shocking to me. But its the truth and it is the environment that those women who were influential on my adolescence had striven to be recognised within.

No wonder they were angry. And no wonder they wanted to pass their hard won “equality” on to their ‘daughters’.

However, this quixotic dream – that the career and family that every woman could have would each function perfectly well and that no sacrifices had to be made, quickly turned into a dystopian nightmare for many women. I do not propose to develop this theme further by looking at why that might be, nor to espouse on the (far too) slow evolution of the masculine brotherhood toward true equality. That might get me started on a feminist soapbox (and whilst I am proud to identify as a feminist, thats hardly the point of this post)

When I studied medicine, I always intended to work, and when I opted for a career in general practice after five years in hospital medicine, it was with the idea that I would be able to manage a family easier without night shifts to negotiate. I swallowed all the ‘research’ about how its not the quantity of time that mothers spend with their children but the quality of that time which is important… what I quite forgot in all this planning was that somewhere, somehow one also needs time for oneself.

So for the last 27 years, apart from three brief maternity leaves (no option for a year off at that time) I have always worked full time. And I have a career. I’m a joint owner of a medium sized business, and I have done quite well for myself.  Ok our primary responsibility is to deliver health care to patients registered with us, and this I am qualified and trained to do. Running a business however, means employment, governance, financial decision making, implementing guidance across practices, strategy planning and implementation, managing staff etc etc etc. And I am neither trained nor qualified to do any of these things. I’ve picked it up along the way and make a reasonable fist of most of it, most of the time, but the fact remains I’m operating way outside my comfort zone for about 1/2 my working week.

When you work 40 hours + a week, have to do all the ‘thinking’ in the house – who needs new shoes, who has to get to an appointment, what’s in the fridge, practically manage the bills, post, stuff, cooking, some of the cleaning and washing … try to spend time with the children you work so hard to provide, for I sometimes think I drank to escape from the pure stress of the merry go round. The busy brain, the inability to just switch off and do nothing, at least partly because there was NO-ONE else to rely on, no one else who would step up and take the slack and no-one else who cared.

But behind all that, the driver (one of them) was this frankly ridiculous belief that you can ‘have it all’ and nothing will suffer, and worse: if you don’t ‘have it all’, its because you are “not trying hard enough,” and are incompetent, lazy or selfish. (or all three).

And that is JUST NOT TRUE. This idea; this construct; this theory; that deep down has been one of my core beliefs is simply and intrinsically wrong.

Now I’m not saying it cannot work out. Clearly it can. In my own experience I see many relationships and families where it works out quite nicely: but in ALL of these situations there are TWO adults in the family and both take an equal and active role in the business of “the family”. For some, one partner works and the other stays home to manage the house/children etc. For others both partners work part time and during their home days, actively participate in ALL the house ‘work’ (not just cleaning the loo, but remembering to book tickets or get a birthday present) In still others both work full time but buy in help to outsource the cleaning / gardening / ironing etc and BOTH actively parent the child(ren) at weekends and holidays.

None of these scenarios was mine.

Im not playing the pity card here, but over the last 19 years I have always been the wage earner and the parent and the thinker/ organiser/planner.

WHY did I not realise sooner that what I have expected of myself was simply not possible. That NO-ONE could have done all this perfectly, that its just not feasible for one woman (or man) to manage all that with NO casualties.

The casualty has been my children’s upbringing

Too late the realisation that young children do not thrive without positive examples of how to live, being shown and taught how to do stuff, talked to, encouraged and nurtured. And that that takes time. Proper time. Quality time. That feeding, bathing and cuddling is ‘good enough’ parenting but its not fantastic, and it will have consequences. No-one can know, because life is not an experiment, what would have happened if I had realised this sooner, cut my work hours whenI got divorced and spent more time at home and less time building my business (in a world where I am respected, I know what to expect and there is much more certainly and less drudgery than being at home with 3 children under 11)

I’m getting to the point I promise. And its not about beating myself up for the past.

I wasn’t working full time because I wanted lots of money, I wasn’t working full time because I felt more comfortable in the adult world of work than in the drudgery and chaos of home life, I was working full time because I believed I should be able to do it all and have it all,  and if I did not I was a failure.

For many years now when asked for career advice by younger women, I have encouraged them to continue working once they have a family (because its extremely hard to get back to practice now after even as little as 2 years off) but to work less than full time. I have known in the deepest places of my soul that my choices were unsustainable, and I have been much kinder to others than to myself.

I have never before been able to accept that I struggle with my life, that it feels unmanageable, in part because it IS unmanageable. That all my addictions and strategies to control and manage the feelings I have so desperately tried to bury have grown in part because I have been fighting a losing battle and setting myself impossibly and ridiculously high standards.

No wonder I feel like a failure.

having t all

Reflections on Step One

This is a piece of Homework I was set by S. Its something I wanted to do, because the three weeks or so I have been looking at the Step One inventories & questions have been interesting, revealing and have, I feel, helped me toward a greater understanding of my addiction(s).

As I wrote before, I really wasn’t expecting  a lot from this step. When I deconstructed the wording, ‘We’ in respect to the admission of powerlessness seemed vaguely inclusive and comforting,  BUT I wasn’t about to give up my thought that, whilst I’m happy to admit to being powerless over alcohol after the first drink, I retain my power to decide whether or not to take that first drink. So far so good.

I’ve done some reading around the whole twelve step philosophy, about the meaning and purpose of the twelve steps  themselves, and about the science and research behind addiction. This has all been to the good, I’ve learned a lot that fits with my ‘lived reality’, and supports the total abstinence path. I have gained comfort from the stories of others in meetings, and several new friends met via AA who’s support I value so much.

BUT, In some ways I am in a worse mess (mentally) than I was before I decided to start the steps. I WAS in (quite) a good place; I have put my ex-partner out of my mind, and genuinely don’t think of him much now. I had started sharing and communicating with all the people around me, I felt quite secure in my sobriety (but definitely not complacent) , and life was looking up.

Now I have had to face a few unpleasant truths, and a few things I just don’t know how to change. Because whilst my life is significantly less chaotic and unmanageable since I stopped drinking, it’s still more tumultuous and disordered and unmanageable than I would like.

Or is it ? I have lived in chaos all my adult life with one drama after another – some good (marriage, births of my children, moving house) some not so (divorce, toxic relationship, financial stresses) and some just ongoing ‘normal’ stresses which I perhaps feel more acutely than others? I really don’t know but I’m beginning to agree with Angela’s assessment that I am ‘a highly sensitive’ person.

Since I completely accept responsibility for the way my life has been, is now and will be in the future, I’m forced to look at why – what is it about me that creates these situations and have I learned only to “thrive” in high stress environments ?

And what IS IT that I want from my life if its NOT this?

I’ve looked at the other two major ‘addictions’ in my life and I can SEE that often a huge food binge and a shopping spree is /are triggered by stress. In one way or another I have learned these responses to feeling anxious / afraid/ overwhelmed/ angry/ frustrated/ pretty much ANY emotion.

I’m holding these thoughts and connections tenuously in my brain right now, and Im writing this very early in the morning – because I feel If i don’t catch it, the connection will be washed away in the stress of the day.

The ‘problem’ is this … my life is just too busy.

For me.

Other people might be able to manage with this amount of pressure, but I cannot thrive and build the life I (THINK I )want with the current set up.

Currently I work full time, on average 40 hours a week, in a very stressful job with a lot of responsibility. Not just for my own actions, but for the running of a medium sized business (turn over about 4 million pounds a year) and the decisions of the  30 other clinical staff. I am a single parent three teenaged children who have a father who loves them but is not able to be an effective co-parent. I have a dog. I have an elderly mother who I love but with whom I have a fairly dysfunctional relationship. That’s the practical side.

I’m beginning to recognise that I find this all just overwhelming, I’m in a state of constant anxiety and tension,  and i find it virtually impossible to relax (unless I’m actually AWAY on holiday) The result of this constant background tension – say the emotional ‘tank’ is running at only about 20% availability (because 80% is taken up with stress about permanent fixtures)  , is that there is not much left for the inevitable day to day stuff – son 2 and his GCSE’s, etc.

As I look at my new yellow handbag, bought on-line earlier this week (it’s a copy of an extremely lovely Burberry tote bag – which was too expensive even for my fevered spending spree) I’m wondering how I can better manage my whole life.

boden

If I accept the twelve step theory for all my addictive type behaviour (and my logical brain tells me I must if I accept for my alcohol addiction) then the ‘answer’ is abstinence. And key  to peace, tranquility and ultimately abstinence (given that I cannot stop eating) in ALL the ‘stuff’ I have been reading, from Brene Brown to Stephanie Covington and Kristin Neff and the AA big book , is “spirituality”.

And to develop spirituality (and Im sure I don’t need to add that this is not confined to organised religious belief) you need TIME.

Time to practice meditation or prayer or reflection. Time to develop the creativity that lives in all of us. Time to nurture friendships, time to give back to the Community, time to just BE.

And I have NO TIME.

Yesterday I went to church. I was raised in the Church of England, not in an evangelical way, but church going was part of my childhood and many of my mothers friends in the local Community were also families with children who attended the local Church. Although I have considered both Catholicism and Buddhism (for very different reasons) I realise now that I feel most at home in the comforting familiarity of the English Church.  I know the words for want of a better explanation.

I was in Cambridge, and I attended the choral evensong at Kings College chapel, and I realised that although I spend a large part of that service on my knees trying to meditate, my head is just too full of ‘stuff’. One of those things was a realisation that I cannot take Communion any longer – because of the Communion wine  so I went to the alter for a blessing.

I have no answers to this. Perhaps my reflections on Step One are not exactly what I or S was expecting. But there it is.

If Im going to do this. If Im going to get there, to serenity and peace, something pretty massive is going to have to change. And only I can do that, only I can make these decisions.

And I will have to live with the consequences. Good or Bad.

And THAT is SCARY.

So for now, I will mutter the serenity prayer several times a day, try hard to keep it ‘in the day’, and try to trust that it will be ok.

 

 

Emotions

OK…. I have realised what a huge mass of seething “stuff” is going on under the surface. As they say in AA (listen to me I sound like an old timer! ) The best thing about sobriety is that you get your feelings back, the worst thing about sobriety is that you get your feelings back.

Indeed.

And I really have

In the past I have been SO shut down from my own emotions that I have struggled to call them or realise what they actually ARE Even the easy ones, such as anger, happiness, sadness, are not so easy for me to identify … and fear ? thats actually something I can now recognise a lot, but still it often takes conscious processing to evaluate what that ‘vague’ distress is all about. The less common ones , honestly I  still, ofetn really struggle to know what it is that I’m feeling. I sometimes use this mood chart to help me…

feelings-clipart-emotional-health-2

There is an even better ’emotions descriptor’ here I like this one because it allows you to think about how strongly you feel ‘something’ and roughly what category it falls into, to narrow down the correct descriptor.

I used to automatically think I was angry if I shouted (or wanted to) but the more I think about this I realise that default ‘anger’ covers so many underlying emotions for me.. fear, shame, vulnerability, embarrassment, anxiety, sadness. I’m  trying hard to look at whats underneath the ‘shouting’ urge, and have become much more honest with my kids – for example “Im sorry I seem angry, in fact I’m afraid when you do X, because of Y; can you understand”

It is sometimes quite painful for me looking at what I really feel; for example – I haven’t really given Son1’s biological father much of a thought for many years. But when I started talking about this to Angela (a long time ago) some real emotions started stirring in me and I realised I felt angry, disappointed, contemptuous, of him, and also, more difficult, sad, vulnerable, hurt and let down. Admitting this to myself was very uncomfortable. Although I don’t think any of these feelings are unreasonable given the circumstance, I find it hard to sit with that strength of feeling. (which is one reason i drank, binged or spent loads of money I didn’t have) I still do find it hard if I’m honest, and I notice a tendency to lose myself in the comforting world of work where I know what to do, how to do it, and who I am …… (Thats the subject of another blog post I am sure)

The first place I got the courage to be truly totally honest (about everything) was in the safe space of Angela’s therapy room, and I reckon it took me a year. I WAS honest with my brother, with K, with my sober sister, but not about EVERYTHING all together. I think, on reflection, thats how therapy is supposed to work –  providing a safe, non judgemental, space to practice thinking / behaving in a new way.  Since  I have felt very safe there, and since I have read Brene Browns work, I have started opening up a LOT more. The women I have met in AA have been fantastic for this. Pretty much nothing is going to shock them (well nothing I have done anyway) and the openness with which others have shared their stories and struggles with me, makes it easy to be open back.

Im not alone in this difficulty in recognising and identifying my true emotions, It seems almost universal in the addiction community (whilst actually using) some studies show that only 1 in 3 of us has the ability to correctly assess our feelings. Its important because because our emotions usually point towards deep and ingrained truths about our beliefs needs and wants. Our feelings come from our deepest desires, hopes, needs, and goals. If we don’t know what we’re feeling and why, or we deliberately drink it away (or do anyone of a number of unhealthy addict like behaviours designed to prevent us from listening to what we really feel) we will inevitably leave critical needs unmet. Then as surely as night follows day, if we can’t communicate what we need, it cannot be provided setting up a cycle of resentment, anger and unhappiness.

For me, ignoring what my soul was screaming at me that I needed, lead me to a breakdown, suicidal feelings and deeper into unhealthy addictions.

In the end, it seems to me that listening to how you really FEEL is just the first step. Being able to understand why you feel like that (sad, vulnerable, irritated) and  communicate that, in a way which someone else can hear and understand, Thats how healthy relationships (with anyone) should operate. Im practicing, baby steps, trying stuff out now. I know Im doing better than I was before, because the quality of the conversations with two out of 3 children is so much improved, and the exchange of information is clearer and less ambiguous.

I just have to keep going, keep practicing and keep communicating.

Still frustratingly slow baby steps …

.

Work in progress

I’m quite enjoying this process. Not to be mistaken with “its easy.” Its definitely not easy, but after months and months of lassitude and ennui, the feeling that I’m moving forward, and doing something positive for myself is quite enervating and encouraging.

S (for sponsor) contacted me after she read my blog post. Its interesting that I hadn’t contacted her first, and I realised that, although I talked the situation through with Angela my therapist (because I knew I needed to talk my decision making through and reflect on both my boundaries and my motivations) , I haven’t yet added S to my list of ‘supporters’ that I could call for something like this. Of course she is exactly who I SHOULD call ! Anyway, she talked it through with me and we considered the situation as it impacts on me. It was interesting and very useful to hear the thoughts of a more sober alcoholic, and her words of caution. She was also able to recognise the things that I KNOW intellectually, but don’t ‘feel’ yet.

We also talked about the stuff I have been doing for Step One. I have heard several times the adage that a ‘solid step one’ is the key to a solid sustainable recovery, and as that is what I desperately want, I’m willing to put my heart and soul into anything that will help.

As part of the “homework” I’ve been making an inventory of

  • the consequences of my drinking,
  • times when I was powerless over alcohol
  • ways in which my life became unmanageable because of alcohol.

OUCH.

Indeed ouch. The more and longer I think about the stuff, the longer the list gets, If I needed reminding why I dont drink any longer a quick whizz through this list would remind me, I think thats sort of the point.

As well as highlighting the unmanageability of my life as a result of drinking, these questions and inventories have also thrown up the other ‘addictions’ in my life – spending and eating (and ye complete unmanageability of either of these) and also the huge spectre of my codependency and /or ‘love and relationship” addiction. These last two have actually made my life a fuck of a lot more unmanageable than alcohol, spending or eating and have caused much more pain to others.I  have felt more powerless to fix the rot in my life caused by toxic relationships that I have ever felt over alcohol.

This was all quite depressing and rather overwhelming until I realised that the chaos was there whether I faced up to it or not, that acknowledging it does not make it ‘worse’ and that only by facing it, and maybe taking a kind of 12 step programme approach to all these other issues, do I have any hope of sorting myself out.

Still looks bloody daunting. And tiring. But I WANT peace, serenity and inner strength, and I will just do what I have to do to get it.

Whatever comes next, I remain certain that stopping drinking was the first step down the path, and that this journey could not have begun until I stopped drinking and got some decent sobriety under my belt. So for now, I’ll settle for being a rather fragile work in progress, keep the faith and just keep going.

 

 

PS for anyone who is interested, X is doing ok. Early days, but I took over the detox when she was discharged from hospital (because she agreed to my stringent supervision terms) and so far, she’s doing ok.

 

 

Rock Bottom

Not me. (Today)

Though this episode and the step work I am doing have helped me reflect on the ‘bottom’ parts of my drinking and my life.

This is another of those work posts, that I just have to write, because I have to get it out. It has moved me and stirred my deepest emotions, both positive and negative, and I think this kind of situation brings out both the best in me as a doctor and potentially the worst. Living on this knife edge between going the extra mile that could (literally) save someones life and falling in to the crevice which is over involvement, control and micromanagement is both stressful and requires reflection, communication and support.

So. On Monday I was the duty doctor at my surgery. This role involves talking to all the people who call up saying that they need to see the doctor that day, when we have no more appointments. Essentially I see the ones that need seeing, and others I offer advice, medication , signposting to another provider or booking an appointment later in the week.  The number varies from 6 to 60 calls a morning.

Monday was busy.

Half way down my list I saw a call from a woman who I know is an alcoholic in denial. She has a small child and social services and the local alcohol team have been involved with her over the last six months. I will call her X, although that is not her initial. X has managed to shake off social services and the alcohol support team by insisting she was abstinent, but we (and I particularly) were quite sure this was not the case. But you cant help anyone until they ask for help …I saw her name on my list, got a prickle at the back of my neck, and picked up the phone.

Not good. She was drunk and desperate. I told her to come straight in, that I didn’t care if she had been drinking that morning, but come in, and tell me the truth. I sensed an opportunity and was keen to grab it. She did. I have not seen someone in such a bad state of alcohol withdrawal since I worked in hospital (more than 20 years ago) She was hallucinating, scratching till her arms bled, tearful, incoherent and falling over. She told me everything, and then more. Her rock bottom had arrived because her partner had left with their child and she was alone at home.

Now the rant. Like I said, she was in an appalling state and acute alcohol withdrawal is a medical emergency, the risks to life are very real from fitting, aspirating your own vomit and accidents to name a few. If she had MONEY I could have got an IP alcohol detox follows by 4 weeks residential rehab (which is the least she needs) on that same day. Because she has no money there is NOTHING. The advice from the ‘drugs and alcohol team’ was to go home and drink (really !!! ) at 80% of what you were drinking and withdraw slowly. FFS this person is an alcoholic, by definition she cannot control her drinking. This made me very angry, and frustrated and scared and led to that feeling (which I hate) of total powerlessness. I have previously offered to supervise a home detox – but only if there is a responsible adult also living with the patient (to supervise the medication and call an ambulance if necessary) I gave her 20mg of valium which barely touched her symptoms and eventually by a combination of begging and medical jargon slinging managed to get an acute hospital bed to at least start the detox. A friend of hers from that amazing fellowship collected her from the surgery and took her to hospital.

48 hours later, they are going to discharge her. FFS. Some muppet again suggested that she go back to ‘controlled drinking’ (really these people need some education) but in the end one of her friends from AA has agreed that X can stay with her, she will bring her in every day, and I will supervise a home detox (to complete the process safely) Will she agree to this? I have no idea. Her parents are at their wits end, her partner has left, this is, must be, rock bottom for X – but I am also wise enough to know it may not be…

So where am I in all this? Going the extra mile, that’s for sure. Taking a chance, yes. Over involved – probably. Not bonkers – shes not staying with me, I haven’t offered to fund her rehab (!) and I won’t detox her unless she is with another adult. But I’m examining my own boundaries, and considering my own emotional response to a fellow addict in deep deep trouble. The part of me that has always always cared too much for my patients is in the driving seat of my decision making (my first choice of career was Oncology but, in a rare flash of emotional clarity years ago, I knew I was not emotionally detached enough to work solely with people who are likely to die)

However, and I think this is important, I do recognise that I can only do so much. In the end the responsibility for her recovery is with her, I can help, (I can help a LOT) but I cannot do it for her. In her desperation, humiliation and shame on Monday I told her I too was an alcoholic (and I sort of regret that now – although I am quite sure she will not remember) and by great good fortune the AA friend who came to her rescue, and has offered a place of safety is my friend D. She and I have spoken about this and I’m confident that we can support each other and talk though our feelings about this to (and this is the most important thing) keep ourselves sober and not get sucked too far into it.

Is this over-involvement with a patient a good excuse to run away from my OWN stuff ? Am I using X’s disaster to avoid facing stuff that’s very painful for me ? Possibly – I have certainly recognised that this is a tendency I have. And there is certainly a LOT of painful stuff swilling around at the moment. Completing an inventory of  incidents when my alcoholism made me behave badly, and another set where my addiction caused my life to become unmanageable … that’s hard, shaming and embarrassing. Even with 802 days sobriety (as an aside I cannot imagine doing this in the very beginning of recovery, the  intense self- loathing that comes along would have been just overwhelming for me before now). The nice feeling of being useful, important and having people think (very) well of me for helping and supporting X – is that a distraction from the other stuff where I feel so very inadequate and that I have failed in so many ways?

I will discuss this with Angela later. And I will reflect reflect reflect – I hope this will help me avoid the trap of overstepping boundaries in a destructive way.

Because boundaries are there to keep the patient safe as well as the doctor. And I need to remember that.

This morning, talking to my AA friends at coffee I confided that I often mutter the serenity prayer when I’m feeling overwhelmed… so here it is

serenity prayer

Strong

Over the last few days it is as though a Dam has burst.

Like the last key piece in a restraining wall has been removed and a HUGE flood of stuff is gushing, streaming out. All the pain I have kept locked up inside, all the struggles the attempts to control my eating, my weight, my shopping, my spending and my drinking, just spilling out in my emotions, in my talking, in my connections. Wave after wave of suppressed sentiment crashing in to my conscious psyche – its like a voice in my head is screaming at me “I’VE HAD ENOUGH, I CAN’T LIVE LIKE THIS ANY MORE”

Its useless to try and put the cork back in or re-lay the stone, the force of the pent up emotion is just far to powerful to make that a possibility, even if I wanted to.

Yesterday was one of the most emotionally painful days I can remember, ever. And that includes the day I ended my marriage or the day my father died. The sheer force of grief and hurt and hopelessness was overwhelming. Quite literally I barely knew what to do with myself, I could think of NOTHING that could take the edge of the rawness and vulnerability.

I think that’s when we are supposed to ‘lean into the discomfort’ but I could not. Partly at least because I had to go to work… I think I would have made a better fist of it if I could have either sat reading or mindlessly occupying myself, but no, I had to see 30 patients at 10 minute intervals and hold the whole thing together.

FFS.

I did it though, and then I wonder why and how I got so good at ignoring what I feel, intellectualizing and hiding it, stuffing it down with binge eating and drinking! Because that ALWAYS what I do. I just get on with what has to be done.

My conclusion from all this, right now, today, is that I am an incredibly strong woman.

My way of dealing with stuff has been totally warped and ultimately very unhealthy but I have been carrying this burden of emotional pain for years. I have coped with SO much, and  have not laid down and given up. No, (at times to my own detriment) I have kept right on going, doing the best that I can, loving my children, trying to help and support my colleagues, friends and family, giving so much emotionally to my patients. I have done all this whilst inside I have been a wreck, a lost, sad, lonely. vulnerable, insecure wreck who has been treated seriously badly by her last two male partners; bullied, abused, frightened, gas-lighted and used.

I deserve to be treated well ( we ALL deserve to be treated well) and I have tried SO hard to do my best and make everything alright. And, you know what, today I really believe it is not I who failed my ex husband or ex Partner. It is THEY who failed ME. They who failed to treat me with respect, kindness or love… They who walked all over my basic good natured kindness and compassion and dealt out disdain, cruelty and lies.

And now I’m going to bloody well sort out this food / control / insecurity / vulnerability /avoidance of feelings bullshit, tiny step by tiny step and I AM going to live the life of contentment and happiness that I freaking well deserve.

beleif

Numbing….

Dear God this is taking me a LONG time.

I sometimes feel I’m so deep in all the psychology and therapy and steps and analysis and recovery programme that I will NEVER get out. It’s all taking such a fucking LONG time … and its SO painful.

Ok.

Deep breath

Now I’ve got that out of the way,  my rational brain tells me that I was really freaking SICK in the head until not that long ago. That I lived for at least 25 years drinking excessively and for 18 years in abusive, scary, frightening and destructive relationships. I have barely had a single day in the last 37 years that I haven’t worried about my weight, lumps and bumps… That all that time I had NO IDEA how to help myself get out of the mess I was in. That this is a PROCESS, that I started it on the day I committed to stop drinking and I cannot stop now. I cannot un-know what I know and I cannot turn the clock back (nor to be honest would I wish to).

I think I began using food as a coping mechanism when I was about 16 years old  (certainly that’s when I remember starting eating and vomiting in an attempt to control my weight). Very soon I was old enough to use alcohol in the same way. Food or alcohol was my way of dissociating from feelings which would have been too overwhelming to experience – feelings such as abandonment, social anxiety, isolation, loneliness,

From the work I have been doing reading Brene Brown and in my inventory I have come to realise that the issue at the bottom of all of this shit is that I have spent my entire adult life running from my feelings. Numbing my feelings. escaping in any way I could from actually accepting what I am feeling. Through drinking, starving, binging, purging, spending, falling in love, being miserable in relationships, all of these strategies have been adopted basically to get me to avoid FEELING. Anything. but especially emotions I was taught as a child were unacceptable.

After a huge binge / purging session I know exactly what Im feeling, no more  confusing emotions. I feel sick because I’m full to the point of bursting and I’m consumed with self-loathing because I’ve “failed” yet again. When I succeed in eating NOTHING at all for a whole day I feel powerful, in control, strong and “good”. When I was drunk of course I felt exactly nothing because I was, well, drunk. Hangovers, and associated self loathing also numbs all emotions other than shame, self disgust and despair.

Why is this? why have my feelings and emotions been so shut down, that I cant bear to feel them, acknowledge them ? why does how I truly feel seem like a completely obscured vista, where all I can see are some strong shapes which represent shame, self disgust and self loathing?

Am I just extremely sensitive? A person who ‘feels things’ so intensely that they become unbearable, and as a young person I literally could not bear it?

Is it partly the societal expectation that encourages us  to show our best selves to others and to appear strong, independent, and upbeat. See the whole ‘Facebook’ horror …which goes something like this ….we look at our friends Facebook feeds and everything looks amazing; adventurous holidays, smiling happy families, perfect BBQ parties …

We then fall into the trap of comparing our real, messy, imperfect lives with “highlighted snapshots” of others , which adds to a pressure to keep up our own “everything is great” exterior. But these images we portray to others don’t show the whole picture. We might be depressed, or anxious, or alcoholic, our kids may have problems, we may be in debt etc etc . Others see that burnished shiny happy exterior and we hide reality.  This all leads to us to feel isolated from other people.

One thing I know for sure after the last 796 days. I cant do this alone. I cant be isolated. I NEED to have meaningful connection and honesty in my life. I have to be vulnerable and truthful with people I trust to have a hope in hell of surviving.

So yesterday I have  called my sober sister, I had a therapy session and I also met  with three women from AA, women I feel proud to call my friends, women who ‘get’ this whole messy addicts world. And I talked, and listened and talked and talked and talked. And I connected, and felt less afraid, less vulnerable and less lonely.

And I survived the day. Sober.

And today, later today, I will collect my beloved first born son from the airport, and tonight all three of my boys will be safe, under my roof.

wierd kids

Step One

We admitted we were powerless over alcohol and that our lives had become unmanageable

Yes.

No problem.

I have been powerless over alcohol my whole life, and I could have admitted it every day for at least the past 20 years. No big issue for me. I arrive at this day in my life with a complete certainty that I cannot drink normally. I simply cannot. I tried for many, many years, in every imaginable way, to moderate and control my drinking … and inevitably, as inevitably as the rising of the sun, I failed.

Every Single Time.

You know that phrase, that the definition of insanity is doing the same thing over and over again expecting a different outcome? This is me and alcohol.

If I drink, I will drink too much. I will be ashamed of myself, I will hate myself.

Not maybe, this will happen.

So just don’t do it. Simple. I accept that I can’t drink, I really, truly do.

Step one done.

Except that it’s not quite that simple.

Reading the stuff about step one, and absorbing the other ‘stuff’ about other addictive type behaviours – in my case issues around eating and food, love and relationships, shopping and spending …. these things are also all under the addictions spectrum and I have reluctantly been forced to accept that these things have not been ‘cured’ by my not drinking alcohol.

They are ‘better’ certainly – my issues with food have improved and I am no longer constantly starving and binging;  but its very far from normal. I swing between standing on the scales every morning and weighing up the calorific content of the (skimmed) milk in my coffee, to buying a whole vanilla cheesecake and eating the entire thing in one day. I am obsessed (and really no other word will do here) with my weight, and the value that I put on myself is directly related to my weight. The thinner the better. This is profoundly unhealthy but I have absolutely no idea how to shift this thinking. TBH just admitting it feels really really hard, harder than admitting to having no control over drinking. Ugh. SHAME, and you cant really go cold turkey on food… I know, I’ve tried.

I’ve become wiser when it comes to relationships, I know I’ve truly stuffed it up in the past so now I avoid. Completely. Although actually I don’t. I still have the fantasy in my head of a nice partner so periodically I download a dating app to my phone, spend 48 hours messaging various men, and then get terrified and delete the app. Bonkers. I don’t actually DO anything, but I’m hardly approaching the opposite sex in a calm, rational balanced way.

My financial situation is better now than when I lived with ExP. But it should be better than it actually is. Late night amazon shopping sprees are less frequent and less impulsive, but they still happen. Shoes, handbags and clothes have become an antidote to feeling horrible. The urge to ‘get away’ on holiday comes over me VERY strongly, and the urge to just spend on anything is not unknown. Sound familiar?

I feel sick. And cold. And exhausted

This is step ONE, I look at it and it looks EASY .. I’m an alcoholic, yes yes yes, Next …

Now I am not only an alcoholic I’ve got a whole fucking array of ‘holics’s’  and ‘isms’ … and I’m powerless over them all ? And my life is unmanageable because of them ? Great. Just fabulous, fantastic. hoo-bloody-ray.

Its true though.

Sigh.

Failure to address /deal with the other addictive, avoidant type compulsions  is probably whats preventing me from achieving what I desperately want. A peaceful normal life. A balanced response to stimuli (of all types)

The second part of this step “our lives had become unmanageable” I only really clocked when I started doing the ‘homework’ which involves a whole load of thinking and inventory making. Much as I disliked admitting it, and struggled to deny it, my life was completely unmanageable when I was drinking and living with exP.  By sheer force of will I held on by the skin of my teeth but in constant screaming, searing emotional pain and with little respite from gut wrenching anxiety. I can accept that my life was unmanageable with a combination of alcohol and that relationship, but both are now gone. Why do I not have serenity, peace and positivism washing around me? It IS better, life is SO much calmer, and there are moments of real joy… but, BUT despite my work with Brene Browns stuff, and my conscious efforts to ‘love myself’ – there is still far too much self blame, internal hostility and struggle … I think, and I will d/w Angela, that this is due to the unaddressed issues above. Sigh, more work, more heartache and more horrible emotions.

So, taking the whole thing ALL of it ..in what ways has my life become unmanageable ? In what was / IS my life unmanageable …

  • Emotional Consequences:  I have felt hopelessness, despair, guilt, shame, remorse, depression, paranoia, anxiety, loss of self-esteem, loneliness, emotional exhaustion, fear of going insane, feeling like two people (living a double-life), suicidal thoughts, , fear of the future.
  • Physical Consequences:  for me these include  high blood pressure, weight loss & weight gain, unintentional injuries from falls, multiple bruises I have no idea how I got, abuse by others which I allowed because I was drunk, trouble sleeping and trouble waking up, physical exhaustion, abnormal blood tests, cutting myself accidentally when cooking, burning myself when cooking,
  • Spiritual Consequences:  feeling disconnected, feeling abandoned, feeling anger toward God, emptiness, lack of faith ( I have always deeply envied people who have faith) , loss of values and morals. Living a life against what I believed to be right and the dreadful cognitive dissonance that ensued from that.
  • Family and Partnership Consequences: Lots of unhappy relationship strife, loss of respect for myself, alienation from my children esp son 1,  jeopardizing my family’s wellbeing, scaring the kids by being drunk; loss of emotional control, shouting at children, inconsistency in parenting,
  • Career and Educational Consequences: actually not much in this category. I’m in a stable job and have been since before my alcoholism was a huge problem – I was always VERY conscious of how easily it could all come tumbling down though. Ive coped quite well with the stresses and could be said to have built a successful business. Still feel like an imposter and so very tired of it at times.
  • Financial consequences  I’ve borrowed a heck of a lot of money. I’m only ok because I earn extremely well , but I have NO savings and am one salary away from disaster. Even now. I also have pretty poor pension provision due to earlier fiscal stupidity. Not great really for a 53 year old woman.

So, my step one, previously thought to be easy easy easy – not quite so much now. I feel terrified, panicked, exhausted at the thought and there is a very small nagging voice at the back of my brain that my primary addiction is not in fact alcohol (although as I said I am clearly alcoholic) but food …..

Oh shit.

eating disorder

 

 

Sponsor

Ok. so I’ve decided to go with the AA programme and work the 12 steps.

So I needed a sponsor. As many of you will know, women sponsor women so that was a good start. In the same way that I looked for a therapist with certain characteristics, I wanted (or more specifically did NOT want) certain characteristics in a sponsor….

  • I wanted a woman of roughly my age or older
  • A parent
  • kind
  • not too dogmatic about ” this being the only way” … or demanding about what I must do eg 90 meetings in 90 days ….

So, after quite a lot of thought I contacted a woman who I actually met at the second meeting I ever attended. Im going to refer to her as ‘S’ (for sponsor) on this blog, as I imagine she will appear occasionally (! ) and using this initial distinguishes her from all the other people who appear under their (real) initials…

I had absolutely NO idea how I thought this would proceed. After I sent her a message asking her if she would be prepared to sponsor me, and she accepted – what next? Fortunately she seems to know what to do, and we met at a mutually convenient time. We agreed we would do this most weeks, same time, same place for the foreseeable future ( I like this predictability so that pleased me)

She told me a little more about her background, it was very interesting to me because she grew up in an abusive home. She ‘gets’ the cycle of abuse and understands why women don’t necessarily leave. I hadn’t known that but I was grateful to her for sharing that with me.

And then we worked ! We read some stuff, and discussed what we read. We looked at a pretty terrifying ‘addiction and recovery’  graph and I was truly horrified to realise how far down the slop I had progressed. (But then cheered to see how far UP the other side I have come in the last 26 months) She asked me to buy a book , and set me some ‘homework’.

I found it quite tiring but I left feeling good. Uplifted and positive. Less apprehensive and very very determined to do this once, do it right, and  shore up my recovery. To stay long term sober and never ever relapse.

I think Im at middle recovery right now. I have successfully stopped drinking, and maintained that for a while, BUT …. there is more, I know there is more around working through other emotional issues, addictive type behaviours (food and spending) codependency and acceptance of myself.

Wish me luck

Terry-Gorski-Model-of-6-Addiction-Recovery-Stages-1

The neuroscience of recovery

As part of my commitment to working the 12 steps, my sponsor asked me to buy this book

It duly arrived from Amazon yesterday and I started reading it.

The first  pages are concerned with some of the neuroscience of dependence and recovery which has been well researched especially in the last 20 years.

Interesting stuff. My sponsor thought it would interest me with my scientific background, and she was right.

Essentially, and I’ve tried to summerise and write in non scientific jargon (when I tried to read some of the original papers by Nutt and some others my brain got scrambled, much too technical and complex)

1.Addictive behaviour can be shown to cause hundreds of changes in the brain anatomy, chemistry, and especially in cell-to-cell signalling,  We know, from many studies, that messages passed between brain nerve cells are the molecular basis for learning and memory. Neurotransmitters (chemicals that pass messages between nerve cells) are also heavily implicated in mood disorders and behaviour, Deficiency in, for example. the neurotransmitter serotonin leads to depression, which can be successfully treated by increasing serotonin levels.

2. The brain is amazingly good at adaptation.  Called “neuroplasticity” this is an umbrella term for a sequence of processes that occur in your brain over time in response to any incoming stimuli. Your experiences, behaviours, thoughts, and emotions physically change the form and function of your brain. In other words, based on life experiences and repeated behaviours, emotions, and thoughts your brain remodels itself and especially its inter-connections.  This is particularly obviously seen when for example a person who is right hand dominant loses their right hand and learns to write with the left.

Are you with me so far ? makes sense to me so far ….

3. Because of neuroplasticity, what you do habitually – both good and bad – literally gets hard-wired in to the structure of your brain. from writing with your non dominant hand, to remembering to check your mirror before you pull out in the car… we all know this yes? when you learn to drive you think about it ALL the time, but with practice it becomes instinctual. I tell this to my trainee doctors, … whilst you are worrying about HOW to examine the heart you will hear nothing abnormal. Only when you have done it thousands of times , so the actions and processes require no conscious thought, is your brain free to pick up the abnormalities. So similarly, repeatedly worrying about finances, catastrophising about mistakes at work, drinking alcohol to relax, placing a bet,  using cocaine …. all of it, is laying down hard-wired pathways in the brain.

Equally important as this creating of new neural pathways by repetitive drinking or drug taking is the role of neurotransmitters. e.g. dopamine

4. Dopamine is particularly interesting  to addictions scientists because it is the major neurotransmitter manipulated with drug / alcohol use. When something we perceive to be “good” is taken/done , that’s when dopamine is released. Different people need different pleasures and rewards to get enough dopamine. A food addict’s neurones get activated with the bite of a juicy hamburger, Similarly, an alcoholic gets that same rush of dopamine when that first drink is sipped. Dopamine surges produce a euphoric effect that rewards and reinforces the addicts behaviour. Unfortunately this dopamine high gradually becomes more difficult to achieve on the amount of the drug / stimulus they used to take, which is why the addict winds up taking more of the drug than previously to achieve that same feeling.  The addict may not realise it but they are affecting the functioning of their brain and altering its chemical structure (through neuroplasticity) to achieve that high.

5. In addition, the manipulation of serotonin, (another neurotransmitter like dopamine but which instead regulates mood)   leads to the laying down of behavioural circuits that create irritability and depression when the addict abstains from drug / alcohol / addictive behaviour. Hence the come down described by so many addicts. It’s psychological yes, but it’s also a physically motivated sensation.

6. Your nucleus accumbens (which is part of the limbic system in the brain – think emotions center and memory bank)   craves the dopamine hit that it knows goes with what it has learned to be pleasurable (see new pathways laid down that associate alcohol with a nice dopamine rush)  The thing is, the first time you do something, the dopamine rush comes after the action. In the future, the dopamine is released earlier and earlier until just thinking about something in anticipation causes a dopamine reward. So, the dopamine released before the action and along the way actually motivates you towards the behaviour, and a bad habit is born.

Every time you follow the same path, a specific pattern is activated and becomes more defined in your brain – it forms a kind of circuit, and it becomes easier to activate the circuit the next time and so on. Pretty soon, the bad habit neuronal pathway becomes the unconscious default, and your brain, wanting to be efficient, just takes the easiest, most familiar route.

By taking advantage of the brain’s plasticity, addiction remodels neural circuits to assign supreme value to cocaine or gin or gambling, at the expense of other interests such as health, work, family, or life itself

Ok. Thats the neuroscience. It makes sense to me in many ways, but It doesn’t however explain why I am an alcoholic / addict and my brother is not. Thats somethings I will need to look into further.

Now I entitled this post the ‘neuroscience of recovery’ becaue thats what I’m most interested in… and I think you can guess how this goes from reading the above …

Basically ….

1. What is learned can be unlearned. Because neuroplasticity is fundamentally present for out whole lives, the brain can make changes to support new, healthier behaviours: basically we can retrain the brain,  With intensive therapy and other holistic interventions, esepcially repeated positive behaviour thoughts and actions, we can strengthen the new “recovery” loop within the brain. The brain then learns to enjoy recovery, those things that give us pleasure in our sober lives – family, work, interpersonal interactions. We retrain the brain, by our actions we lay down new pathways that provide pleasure,  and thus we are able to make changes.

BUT, the old neural pathways, the old links between addiction and pleasure are still there. This is why  complete abstinence from drugs and alcohol is essential to addicts. It doesn’t take much to jump start the old habit. Recovery doesn’t remove the old pathways, it just allows them to fall into disuse and no longer be the ‘go to’ response.

Great, retrain the brain… But HOW ? HOW ! what are we doing to do to replace those big dopmine hits ….. There has been quite a lot of work on this, and some people seem to have studied the brains of recovering addicts in quite extrordinary detail! My research is not complete and not from Google scholar (at the moment) but there is some evidence that storytelling, which is a core tenet of 12 step programmes activates the doapmine system, giving the speaker a powerful boost.

There is evidence for mirroring being helpful in rewiring brains – basically if you hang out with clean and sober people you are more likley to be clean and sober, and that this mirroring of others behaviours also give you a dopamine boost . There is evidence that the love and care recovery communities share has a very positive effect on brain rewiring, but I couldnt really work out how.

I think the main things I came away with from having done a LOT of reading over the past few days is that addicts lay down new pathways in the brain which both cause and result from addictive behaviours. That once those pathways are there the positive hit that comes from even anticipation of the addictive behavior makes it hard to stop. That for lots of good scientific reasons only complete absitence will allow those “bad pathways” to wither away a bit. And that recovery, neuroplasticity in recovery, takes time. And it does take time. I can see that. Im 794 days sober, and my new pathways are still pretty baby.

For me the point of doing the 12 steps now (honestly i do not think I could have started before now) is because I can see that as a process it seems to work. And reading this neuroscience stuff, I kind of undertsand why it works: service, storytelling; mutuality … honesty, vulnerability, hard but laying down new pathways of beheviour that will, in time, become the default ones.

 

neuroplasticty

 

Emotional

I’ve been struggling the last few days. So much emotion and such extreme feelings.

On the positive side, my eldest is coming home 🌟🌟🌟

I’m beyond excited, and so happy. He has been away for eight months, first in Nepal and latterly in Vietnam. He’s had a option to stay away till July, but yesterday told me he’s decided to come home now. I feel a bit guilty, I think he recognised the stress in my voice, and asked me how I was. I try not to ‘lean’ on him as a sounding board, he’s only 19 after all, but the stresses of son2, of my desperately unwell friend .. I actually really want him here … so Thursday evening he will land at Heathrow – and I will be there to meet him.

Also good, I asked someone to sponsor me, and she agreed. We met on Friday and started the programme… I found it illuminating and feel positive about this decision.

Not so good.

My friend J. It’s not my story, and it’s not my pain: but it is so hard seeing him die ; inch by inch, deteriorating, his world shrinking , the pain, the fear, the breathlessness the sheer physical breakdown of a kind, fun generous person. Watching K, so strong and so brave, shouldering all the heartache, keeping things together for him, for their son, working .. my heart bleeds and I’m struggling with my emotions. Resentment, anger, frustration childish feelings of “why him, he doesn’t deserve this” : “it’s not fair” ….

Son 2. Public exams start on Tuesday. No work, no study. No effort. I’m struggling with fear, frustration, anger (because total failure will have a huge impact on me in the future) impotence, inability to understand his complete non engagement. It’s hard. Managing his simultaneously rock bottom self esteem, and huge inflated sense of importance (he thinks all my emotional stress is caused by him – which makes him feel shit about himself) it really really drains me.

And I’ve run out of my SSRI. For six days , That is a huge mistake and my first job today is to collect my prescription .

Sunshine

Its a glorious day in the SE UK; sunny, warm and calm… and its  a pretty good day for me too .

Yesterday I rewrote  a post about resentment and anger that I was going to finish today, but you know what, its such a beautiful day I thought I would write a totally spontaneous piece about the GOOD things in my life

  1. I have set up a little office /desk space in my bedroom – you can see it below. I used a table from the boys den that they don’t really need and a chair from the same place. Its not huge but its MY space and I have my laptop, some books, my candle and a desk light. In due course I might put a shelf up too. My bedroom is at the top of the house, you can see the light from one of the skylights falling in… I’m very happy with my new space.
  2. I met D this morning for a coffee. We met only last week, but I feel close to her already. She is earlier in her sobriety than I, but doing really well.

I love meetings , but I love meeting people who “get it” on a one to one basis too, and for me that’s one of the best things about AA, a room full of women who get it! I felt really happy after that coffee, accepted for just me 🙂 I hope we will see do it again.

3. A lot of my anguish about my patient has settled. Yesterday’s heart felt dump on the blog, and talking with D helped me realise that it’s mostly Shame that’s stalking me. I’m ashamed that I have done something wrong (colluding with the psychotropic medication changes) in the scheme of things it’s a little wrong, a small thing- but perfectionism is one of my big failings, and I have been less than perfect , and worse, other people know!

4. I have found myself a sponsor I think. I have met this lady a few times, and having thought about it quite a lot – about what I would like from AA, I decided that ‘doing the steps’ would be a useful and probably revealing exercise. After Anne’s recommendation I bought the ‘women’s guide to the 12 steps’ by Stephanie Covington (and the workbook) I think a sponsor to help me along would be a good idea. The woman I have asked is also a mother, works in a high pressure job and seems not TOO evangelical about the whole thing ! We will see, but I’m Comfortable with that decision so far.

5. My poor stressed anxious son2 is talking to me fractionally more. Just a little bit, but it’s progress. Yesterday evening we had 10 mins together , the three of us, playing badminton in the garden. It was fun and I’m holding on to that positive.

6. I’m having my hair cut and the Grey dyed out today !

7. Son 3 and I made a conscious decision to try and eat better – we started about 2 weeks ago. Nothing too extreme, just increasing our vegetable intake, limiting white flour and sugar and cooking together from scratch every evening. He has been really enthusiastic and positive – and has tried several things he would previously have rejected. I feel like , at last, I’m setting a good example on the nutrition front.

8. I clipped the dog ! She’s a collie and this hot weather is not much fun for a black and white fur ball .. the dog groomer we used to use has closed down, so I did it myself 🙂

9. Son1 has sorted out his visa problem in Vietnam (not the country to piss about with visa’s) I managed to send money to him via western union (his bank card was stolen / lost) and he’s now in Ho Chi Min city for a few days before leaving for Cambodia. He will be home soon which is SO exciting !

10. I am SOBER. Still bloody sober. 789 days sober. And clear headed and GETTING THERE. What a gift and a recurring joy to wake every morning with no hangover, intact memory and no messy behaviour to be ashamed off. That should be number one really !

So I hope everyone else is having a good day, that’s my gratitude list for Tuesday and right now I’m feeling optimistic, enthusiastic and positive

🌷

Manipulated

Writing about being blocked yesterday, seems to have let some stuff go and I completed, to some degree, the ‘stuck’ posts yesterday. This, and what I’m planning to post tomorrow, strike me as the two major themes right now.

This is quite a hard post to write for two reasons. Firstly because I must be careful to maintain the anonymity of my patient, and second because this episode has reinforced to me a) how fragile my sense of self is, b) how heavily I rely on my work and ‘being good at my job’ for self esteem, c) how hard I find it to self validate – feel ‘good enough’, d) and how difficult it is for me to assess what is a proportionate reaction to something ‘wrong’.

So, in a nutshell, and having changed some details to protect anonymity. I have been the GP for a patient with mental health problems for many years. About 18 years in fact. This person is a health care professional which is relevant because a) their area of specialisation means that they have greater specialist knowledge about some aspects of their illness than I, as a family practitioner, do,  and b) I think we tend to accord colleagues a higher degree of autonomy over decisions regarding their health care than we would to a member of the lay public. Over the last 18 years I have gone above and beyond in my support of and care for this person. (is this a problem in itself?) I’m going to specify gender, because I hope it makes it clear (given that I am straight) there is no hidden sexual motive in my kindness.

I think its fair to say that there have been a number of problems between this person and their treating specialists over the years. Frequent changes of Consultant and clashes with many of them. Its not easy being a patient, and I have had some sympathy with this. I have seen her very often, sometimes twice a week and tried my best to be non judgmental, collaborative and sympathetic to her difficulties. At times I have been asked to prescribe treatment slightly different to what the Consultant has recommended and I have (unfortunately in retrospect) agreed to this. Partly because the patient will do it anyway, partly to maintain a positive relationship and partly because as I said, I have tried to be the patients advocate. Nothing I have done has been strictly ‘wrong’ and no boundaries have been overtly crossed, but subtly they have been eroded; for example, she calls me by my given name ; she has my (work) email address, I have booked appointments for her myself, I almost always see her for longer than the routine 10 minute consultation – all privileges I would grant as a matter of course to a colleague, but not to a patient.

Last week she asked me for a medication to treat a (new, physical) condition for which she had been seeing a specialist. The request was for  dose considerably higher than is usually prescribed. I asked specifically if this dose of medication had been recommended by the Consultant they had seen, and was told that it had been. I prescribed. This is something we never usually do until and unless we have seen written conformation of the dosage from the treating specialist. Again I stepped outside my usual practice because this person is a “colleague”.

Unfortunately, when the hospital letter arrived I discovered the specialist had in fact recommended a different treatment regime and the patient had lied to me, to get what she wanted based on her independent research.

So, what of it?

I am beyond upset. I’m angry & agitated, I feel guilty and ashamed.  I don’t know if this is reasonable or if I am overreacting to a stimulus that has poked me where I’m vulnerable.

I’ve been wrestling with my emotions surrounding this for more than a week now. I talked about it in therapy last week, I contacted a close friend H who is a psychiatrist to share my shame, and felt supported and validated by doing so. I contacted both the treating consultants of the patient to explain what had happened and to suggest a professionals meeting to try and work out the best course of action. I ranted on a closed GP forum of which I am a member. I’ve tried to de-escalate my emotional response, but a week later I’m still agitated, not sleeping well and I can’t seem to let it go.

So, what is this about?

I’m trying to deconstruct it a bit, honestly…

  1. I feel stupid. I am a very experienced GP. I train other GPs. I’m the lead GP for governance and the medical director. Im the “go to” person for other doctors difficult situations and I’ve been manipulated like a trainee.
  2. I feel ashamed. see above, but also because I have allowed myself to undermine the specialist psychiatrist which is just not cool.
  3. I feel angry and resentful. I have tried SO hard for this person. Honestly I have gone above and beyond for years, and stressed myself by doing so. I carry the risk when she tells me she feels suicidal , but wont tell anyone else. I am angry that she has showed me up, has demonstrated that despite my care she doesn’t trust me to act in her best interests and resentful that she has exposed me to censure.
  4. I feel vulnerable not because I have done anything awful, I haven’t, but because Im now agitated, restless and thinking about drinking (I wont) because I have allowed this to get right under my skin.
  5. I feel frustrated It is my belief, backed up by the evidence of a battery of tests, that the majority of this physical illness is functional in nature. That is, it does not have a physical measurable cause like infection, or inflammation. I believe strongly in the effect of the mind on the body (you only have to think about blushing when embarrassed or palpitations when anxious about something) to recognise that emotions are frequently translated into somatic symptoms. [As an aside, for anyone who is interested in this I read a fantastic book, written by a neurologist. Its called “Its all in your Head” here subtitled “true stories of imaginary illness.” She explains it so much better than I …]  even the most gentle attempt to explore this with my patient leads to a complete shut down and refusal to engage …and this also, at least on a  subconscious level makes me angry.  She comes to see me for my advice, but doesn’t actually want my genuine opinion, in any form….

Lastly, I’m struggling to work out what is a proportionate response to this, one that another doctor would make in the same circumstances. On one hand I want to refuse to see her any more, hand the problem over, deregister her from my list, refer her to a regulatory body – (I know this last is an overreaction) on the other I think maybe its not that bad, that its not a drug of abuse, that she’s worried and maybe others would do the same.

Im trying to self care. I have reached out to people I can share this with, I’ve talked to Angela about it, and unusually I also emailed her between sessions, I’ve shared, ranted, cogitated and reflected …. and  I just can’t seem to get peace with it, or come to a point of stability.

The bottom line is of course, that the problem is not HER but ME. I’m over invested and over sensitive … and I really do NOT know why. You might theorise that I’m so fucking arrogant I can’t cope with rejection (of my ideas / my care) ; that I NEED to be right. That its devastating to my fragile but puffed up ego to be manipulated like everyone else when I have tried so fucking hard. That I believe I’m ‘better’ than everyone else – at my job- and this proves I’m not ….

GGGGGGGGRRRRRRRRRRRR and AAAAAAAAAGGGGGGGGGGHHHHHHHHHHH

All i know is that I’m bothered, agitated and not settled  and it reminds me, not in a good way, of my drinking days ….

Maybe this will help !

 

 

Writers block

I havent had this before.

Usually an idea for a post comes to me, sometimes in a flash, or as the result of an experience or conversation; other times over a few days I realise I’m musing on something and I need to write it out. There have been times when I have not written much, and this has been related to one of three things, 1. Too gloomy / flat to have a creative thought 2. Not able to catch which thought is nagging at me 3. Overwhelmed by experiences…

but generally, once I start writing, the words just drop out, via my typing fingers until the post is written. I don’t edit much (as you can see) because I find when I do, the emotion behind what I have written (and it’s ALL about emotion) gets diluted and fades.

this feels different. In the last few days I’ve started 4 posts, but none are sufficiently coherent to publish. Even on a personal blog.

I can’t write at the moment. I can’t follow a train of thought to create a short written piece. Even this feels forced and unnatural.

There is a lot. Inside there is a lot. But I’ve lost the ability to translate it into the written word.

Shit.

I have relied heavily on this ability to take stuff out of my head. To capture how I feel in a moment and put it on paper. By writing it, I have managed both to unload at the time, and provide myself with a reference to look back on. I can remember how I felt when I read my posts, and I can compare that with how I am now … this has been extremely valuable (and it’s one of the main reasons I keep this blog)

I hope this block is temporary .

 

Interactions…and boundaries

This thought occurred to me when I wrote my last post.

In my life I have literally hundreds of relationships. I am a mother, daughter, sister, Aunt, sister in law, colleague, employer, client, doctor, friend, teacher, parent, appraiser,

I interact with a vast number of people; at my children’s schools, with my patients, our employees, with my cleaner and anyone who comes to do stuff for me in the house, my colleagues senior and junior. I have never been accused of being unfair or bullying, no complaints have ever been made about my professional behavior. I have had good relationships with the staff who teach my children, the lawyers in my divorce case, the psychologist who assessed my children, my colleagues both close and more distant. I manage to negotiate with unhappy angry people pretty successfully. I don’t get walked all over at work, people respect me.

Every 5 years I have to submit a multi source 360 degree feedback for my revalidation as a doctor. I also review others 360 assessments as part of their appraisals. In my experience people are generally pretty honest on these forms because the number or required respondents (> 15) does mean anonymity is pretty good. My 360 reports have always been well above average across all the domains, with common words being approachable, kind, team player and supportive. Similarly my patient questionnaires >40 when compared against scores of other GP’s in the area deliver me a well above average rating. For a pragmatist this is evidence.

So, it really is ONLY in my intimate relationships that I have had a significant problem. There are some stresses between my mother and I, and in the (distant) past there have been a few issues between my brother and I (but that is resolved now) –

On balance given that my ex-husband barely sees his brother and family, and has few friends left; my exP has very strained relationships with his own children and no long term friends at all, (in fact the only person who likes and admires him is his mother) – I think the problem is primarily them not me.

So what is the underlying reason that I can have largely successful, healthy and satisfying associations with family, friends & colleagues and yet have such unhappy, destructive intimate relationships?

Does it in part come down to the issues of boundaries? and more than that, accountability?

At work, I don’t have a problem in holding people accountable for their actions. For example, one of my colleagues was persistently late staring work. This is a problem when they worked at our branch surgeries because the receptionists don’t like to open the door if they are alone (indeed they should not do so, for personal safety reasons), so the doctor being late means patients are left standing outside the surgery as well as being late for their appointments. It is unprofessional and discourteous to be persistently late, so armed with the evidence (log on times for the computer system) we had a conversation about it. Long story short, I made it clear this was not acceptable and needed to improve, the doctor agreed and I discussed the implications (formal disciplinary action) if the lateness continued. No problem. That’s setting a boundary, making expectations clear and holding that person accountable. Not hard.

Personally however it has been very hard for me to do this. And I think there are three reasons,

  1. I have had trouble even knowing what my boundaries are
  2. I have difficulty in believing I have a right to these opinions /needs especially if they conflict with anothers needs / wants
  3. I have been way too emotionally invested in the relationship when these issues arise so walking way seems harder than just brushing it under the carpet.

I first started thinking about this a couple of months ago Here, and have refined and developed my thinking a bit since then. The first two problems I am trying to address at the moment, through attending therapy, reading, reflecting and talking to my friends. I actually feel now as though this is bearing fruit, and that I will get there.

The third still scares the pants off me. I have a history of falling in love very, very fast. Indeed I can’t remember any relationship when I have not done so, way too quickly to have made an accurate informed assessment about the character or personality of my new partner. At times this has worked out fine, my boyfriend when I was a medical student for example was a nice chap, ultimately we were not suited but he was kind, fun and not abusive in any way. The last two times, it has not worked out so well.

I am not sure, and I guess I will not know until it happens, whether I can exercise sufficient caution and emotional restraint to avoid that pitfall again. The optimist in me says I could, armed with my new appreciation of the importance of circumspection and forethought and because I will be sober and thus not afflicted by the recklessness that(for me) accompanies inebriation.

I hope so. I don’t propose to put this to the test just yet, but I hope so, and there is a major shift in my thinking over the last few weeks… I now feel I would like to TRY…one day.

healthy boundaries

 

 

 

 

 

More connection

Oh my goodness I love this.

On Saturday I met up with my sober sister. She travelled from her home city to London and we spent the day together. We have been on this sobriety journey together almost from the beginning, and have shared a lot of the ups and downs along the way. Our paths have been different yet strikingly similar in parts. She is happily married, I (well you know about that) we both have children, we both have professional careers, we have both struggled with anxiety. Our situations are different, but at the same time, our emotional experiences have been very congruent and she was the first person I have ever met who ‘got’ the whole alcohol issue.

In a lot of ways, meeting V made me believe that I AM an alcoholic. It’s hard to explain to normal drinkers why it’s so impossible for me to “moderate”; “just have one” or “drink sensibly”. I suspect some people have trouble recognising me as an “alcoholic” because on the outside I don’t LOOK like an alcoholic. Now, I know that’s actually luck, that I hadn’t caused the whole thing to come crashing down , simply because I’d been lucky. Not yet, as they say in AA … normal drinkers don’t understand the crushing shame, self disgust and anxiety (why would they, a drink is just a drink for them). Meeting V , she doesn’t LOOK like an alcoholic either, and she too had been lucky, gave me someone to talk to who knew EXACTLY what the burdens of the alcoholic are … and could see them all in me. I didn’t have to pretend or cover up, explain or justify my decision to quit, because she had been there too.

So we went to the Tate, had some lunch and as it was a rainy and miserable afternoon, we decamped to The Connaught Hôtel bar. This is a VERY smart hotel in Mayfair, with doormen, perfumes in the ladies and a person who hands you a cloth towel after you have washed your hands. It also has a pretty extensive alcohol free cocktail list! So we lounged in the bar for the afternoon, eating the (free) olives and crackers and tasting the mock tails : they were delicious, and every bit as good as the real thing😊 see below !

Last week I met a friend for dinner. We live about 40 miles apart and met half way at a lovely small pub. I have known A for more than 30 years and we have had a enormous amount of fun together. In the last five years, despite her not living very far away, we have not met up that often. This is my fault, as I withdrew into myself, I didn’t reach out and ask for help. Even the best of friends can only offer to meet so many times. She had a bad feeling about ExP from the start I think, and he definitely didn’t want me mixing with anyone who might encourage me to question my relationship. When we met for dinner, the years just rolled away, and it was as if this gulf had never opened. The affection and staunch support, the genuine wish from us both to stay connected and support each other were balm to my battered soul. We had a wonderful evening, every bit as wonderful as the many we have washed down with Sav Blanc, or gluwein in the Alps. I felt restored, uplifted and renewed by this evening and I genuinely hope we will have many more in the weeks and months to come. And the food was just delicious 😊

Today I am meeting an AA friend for coffee. She is bringing (maybe) two other new ladies… new friendship, new connection.

I feel very, very blessed. And grateful.

Amends

This is one of those things on my mind the last few days,

Those of you who have attended AA or any 12 step programme will know that one of the steps involves making a list / remembering all the things you did that damaged others when actively addicted.

Step 4: Made a searching and fearless moral inventory of ourselves.

Step 5: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

Then you need to discuss these ‘with another human being’ (so Lola the dog doesn’t count) and make a list of those you have wronged

Step 5: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

Step 8: Made a list of all persons we had harmed, and became willing to make amends to them all.

and ‘make amends’ (step 9) as long as doing so doesn’t cause more hurt / damage.

Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others.

So far so good. I’m not particularly proud, and I already feel that in general, sober alcoholics are amongst the least judgmental people I have ever met. Admitting all the stupid, embarrassing shameful things I have done will not be that hard, they are all stored up in my brain pretty near the surface, and I know there are worse things I could have done.

One of my first experiences with this was when my ex-husband called me a few weeks after our marriage imploded. He was attending either NA or AA and had a sponsor. He was obviously ‘working the programme’ but he demanded to see me (that day) so that he could make amends to me. The dictionary definition of amends is “compensate or make up for a wrongdoing.” This clumsy demand made me furiously angry, (and pretty contemptuous of him, his sponsor and the whole 12 steps caboodle) FFS he though he could ‘make amends’ for terrorizing me and the children, abusing me and the children, trashing our marriage vows, destroying the kids family and permanently altering my life, by demanding to see me and saying ‘sorry’. I don’t think so.

I do now see that the problem was not the 12 step programme, nor (probably) his sponsor, but him – and that ‘making amends’ is not supposed to be a quick trip round your nearest and dearest with a superficial ‘sorry’ and brushing all your dreadful behaviour under the carpet. Rather, proper commitment to the steps involves a thoughtful, considered reflection on your addiction related behaviour and a genuine heartfelt apology where possible but most importantly a commitment NOT to repeat the mistakes. As above “change the behaviour” is an essential part of the process.

So, I have not yet chosen a sponsor, I’m a little reluctant to do so if I’m honest, and one of the reasons is the “amends” part.

I KNOW I damaged people, let them down, embarrassed them and myself, and upset them as a result of my drinking. I know that the underlying character traits of stubbornness, willful pursuit of MY wishes, lack of consideration for others needs and selfishness were exacerbated by the numbing effect of alcohol and that I knee jerk responded to situations in an unhelpful and sometimes hurtful way.  I have no problem in apologizing to my mother, my brother and my children for past mistakes. I think, as I have mentioned before, that knowing that sustained sobriety has increased my patience, reduced my tendency to over dramatization, and made me more sensitive, thoughtful and less self centered, makes it easier to be confident that I won’t repeat the behaviour.

No, my problem with the whole ‘amends’ things, centers around my ex-husband, and to a lesser extent my ex Partner.

To be brutally honest, I never should have married my ex-Husband. And by doing so (and yes I know he was an adult with free will, I hardly coerced him to the alter) I damaged HIM. I didn’t /couldn’t see that he was not like me. I couldn’t see that he was not driven, didn’t really care about traditional measures of success, and that due to his chronic low self esteem a highly competent, successful, professional female partner was never going to make him feel good about himself. Ignoring his part in the disaster, I met him when he was vulnerable, I saw in him a man who wanted a family (more children because I already had son 1), who came from a stable family background and who could redeem my past mistakes (unmarried mother) and give me what I wanted. (see how selfish I was) I loved him certainly, but not as I should have done (as I know I am capable of), not enough to put his needs above my own wishes. I knew that at the time, but in my arrogance I believed I could ‘fix’ it. I believed it would be ‘good enough’, essentially I settled for him, and by doing so I short changed him as well as myself. By being married to me, I emasculated him and left him feeling even more useless than he already felt. I didn’t intend to, I wasn’t consciously trying to, but through sheer capability and innate drive I demonstrated to him every day that he was not as good or capable or competent as me.

I do not believe this excuses in any way his horrible, abusive, vindictive and aggressive behaviour, it doesn’t let him off the hook for his drug taking, it doesn’t provide justification for the sheer horror of his actions when high / paranoid. All those actions belong to him and were caused largely by his inability to see that he lost all sense of decency and acceptable behaviour when using and was unable / unwilling to put in the effort required to get and stay clean. When weighing up my errors and contribution to the failure of our marriage I still believe they are massively outweighed by his. I kept my side of the bargain, I genuinely tried hard to ‘make’ it work. But I recognize that I was not blameless, and in my recognition I feel some compassion for him. This is a much more comfortable place to be than the anger and resentment that has characterised the 8 yeas since our separation.  In finding compassion I try to ‘live’ amends to him, by treating him with respect, accommodating his wishes with respect to our children and keeping him informed of any significant updates. For example I forwarded him some pictures of son1 this morning that had arrived from my friends in Vietnam.

So whats the problem? I would have no problem talking this over with my therapist. I trust her to listen and respond without judgement, to be able to place my thoughts about him into the pattern of my life and allow me to accept my part in the whole thing without making me take more blame than I am due. I’m not so sure about a potential sponsor. In the end a sponsor is just another alcoholic, sober longer than me, without training or expertise in the complex issues that surround self worth, shame, marital breakdown and relationships. To ‘make a fearless moral inventory” and admit this to another person, fine – but is it arrogant / missing the point to be a bit picky WHO I choose to admit these things to? Or is it actually sound judgement, deciding only to talk to someone who has earned the right to hear them?

I wonder if a sponsor is essential ? If I have a therapist, is it really necessary to go through all this stuff with another person? Or is that arrogance and self will talking?

Not sure, but I do l know I will take my time, and not decide to ask someone to sponsor me until I feel ready, and I know more about that person.

amends2

The gifts of imperfection

This book has changed my life.

That’s strong stuff, but that is how I feel about it.

Its a small book, (about 4 hours on audible) and its written by Brene Brown. I started trying to read it some time ago, but I found it almost overwhelming and couldn’t get past the first chapter. Now I’m in a better place I have been listening to it on audible… several times.

The basic themes are that

  • we are all imperfect and many of us struggle to be perfect
  • by trying to ‘fit in’ and be seen as perfect we don’t ask for help or allow our true selves to be seen
  • If we can have the courage to reach out and ask for help / share our struggles, we will encourage deeper connections
  • by recognizing our own struggles and being compassionate and loving to ourselves, we develop compassion for others
  • Connection, compassion and belonging (not the same as fitting in) brings us deep and meaningful contentment which we can share with others.

It’s all very obvious, but also very profound.

Falling out from this is the realisation that wholehearted living, loving and compassion are actions not a static state; that by actively striving and seeking everyday to treat ourselves with love, and nurture our own inner, imperfect selves, we are better able to overcome shame, disappointment, fear, anger and frustration; better able to parent, work and build relationships, which is, after all, the most important part of all of our lives.

This chimes with everything I have been discovering on my sobriety journey, everything that has changed and developed in the last 780 days. The courage to address so many things I have been ashamed of, to name them, share them and learn to accept them, the forgiveness of myself for all my many mistakes and the active process of developing authentic loving relationships based on honesty and compassion. The latest courageous decision – to attend AA meetings, despite my apprehension and fear, has been rewarded 100 fold by the acceptance, genuine affection and support I have received from my peers.

This is still a work in progress, there is much more practice and reflection to work through, but I do truly feel that my eyes have been opened to a new world; a world where I value myself, treat myself with the kindness I would show to others and accept my own imperfections and mistakes, not as shameful stains that make me unworthy of love and acceptance, but as knots worn into a tapestry of personality, that are as integral to the beauty of the whole as the perfect stitches that surround them.

There is a great quote in the book

” She could never go back and make some of the details pretty, all she could do was move forward and make the whole beautiful”   Terri St Cloud.

I love that, It gives me great solace, hope, and peace.

imperfection 2

 

 

Attachment

In my ongoing process of (as I put it) working out what is WRONG with me … I’ve been looking at attachment.

Before you get on my case by describing myself in this way , I don’t mean it to sound as self critical as it may come across. I look at it this way, I’m 53. I have a number of wrecked personal relationships (with partners, not anyone else) at least the last two of which were highly abusive . The common factor in these is me … so, it’s only logical to look at me; my decision making, my motivators, my experiences, to see what’s going on and what I can change / work on.

As a result of this I know I’m an addict (drug of choice alcohol but I could get addicted to anything) that I have had very poor boundaries, low self esteem with a big dollop of Shame and perfectionism contributing to my acceptance of far more from partners that I should have accepted. I know that I’ve absorbed a whole load of subliminal messages about my own self worth from both my parents and society, and that I am relentlessly hard on myself in a way that I would never be to another.

All good stuff, and all things I can and have worked on…

This week at work I have been working with a multidisciplinary team of social workers, school and health visitors to tie up the ends of a child safeguarding case. Part of my job is child safeguarding lead from my practice and it’s a role I take seriously. I will not reveal details about the case, for obvious reasons, but it’s been long, complex and heart rending. As part of our work in this case we have had access to detailed child psychological reports which evaluate the attachments of the children. We talked as professionals with the reports’ author, and her professional opinion based on research about attachment and the psychological damage associated with poor attachment was both interesting and rather frightening.

Now, I had a much more secure upbringing than the children I mention earlier, with much better basic parenting, but the theories about attachment, and the consequences of poor or disordered childhood attachment are interesting to me.

Once again, I’m not looking at this to criticise or blame my parents, they did the best they could with the resources available to them; and I’m not blaming or criticising me .. but I know the power of recognising my weaknesses .. once I accepted that I was and had been deeply and profoundly ashamed of myself for more than 30 years.. I was able to access work on Shame, and I have made enormous progress in working through this and dumping a LOT of the shame …

in its most basic form, a man called John Bowlby developed a theory that human infants arrive in the world ready to make attachments, and how their needs are met has a profound impact, especially if the primary care giver is erratic, unavailable or insensitive. Essentially, if your primary care giver is consistent, present, reliable and kind you have a good chance to form a secure attachment …if not, as a young child you are thrown back on your own resources to manage you emotions / the difficulties if your world and problems develop.(BTW; I was relieved to read that the best caregivers only get it right 50% of the time 😏)

That’s a very quick summery ! And I haven’t started reading about adult attachment theory yet …

So, a lot of this makes sense to me, as a theory… and I like the idea that there are things one can work on to improve ones attachment style …So, on line there are little “quizzes” you can do to evaluate your attachment style ….(lots of them ! Most trying to get you to sign up for this or that ) …

So I’ve done a couple of these. And actually the thing that stuck me is how differently I would have answered those questions in the past. Whilst IN my last relationship, and probably until a couple of months ago… anyway, I came out as a mishmash really, not very strongly one thing or another (I’m believing this represents the transition between the ambivalent avoidant thing below, and the development of skills to form secure attachments)but the dominant “style” for me was ambivalent ….

Anyway, this is it …

Ambivalent Attachment

Children who inconsistently had their needs met by parents or caregivers may develop Ambivalent Attachment because they lacked confidence in their parents’ ability to attune to their needs. Parents may sometimes meet their needs, but not at other times. When children are faced with this dilemma, they often develop the ability to “read” situations and cues from their caregivers, causing them to become overly attuned to others and the belief that if they behave in a certain way, they may gain their parents’ affection. Children are often left desperately wishing for and wanting more affection, acceptance, and love.

This leads to confusion and insecurity when it comes to having their needs met. Children may become clingy with caregivers and try to extract more attention and acceptance from the parent. Children can become performance-oriented, people-pleasers as a result of learning that behaving in a certain way affords them the attention they crave.

There are also times when the conditions for Ambivalent adaptation might be due to medical circumstances or when a parent is dealing with their own issues like grieving a complicated loss where the child does not receive the consistent care and love needed.

Ambivalent Attachment in Adults

Adults with Ambivalent Attachment can become preoccupied with pursuing relationships and connection. They may have feelings of being unworthy, which causes desperate behaviors and love seeking. They may look for validation in others and define their own self-worth by how others perceive them. They can often over-emphasize the opinion of others in defining their value.

This can lead to insecurity, clinging, and deep feelings of anger and resentment when their needs are not met. They are often fearful of losing their relationships and desperately beg for forgiveness after outbursts when their needs are not met. This may lead to a self-fulfilling prophecy by ending the relationship.

I How to Work Toward Secure Attachment,

By recognizing when needs were not met during childhood and acknowledging the impact on their adult relationships, adults are often able to identify patterns that are a direct result of their childhood experiences.

Surrounding yourself with trustworthy relationships and owning the behaviors that you see as detrimental to developing true Secure Attachment leads to awareness. Practicing self-regulation is helpful.

You may also begin to develop more Secure Attachment characteristics by being in a long-term relationship with a Securely Attached individual. ( ha ha, need to find one and recognise this first !!)

I don’t know what real relevance this Might have, over and above the other stuff im doing, but I thought it was interesting !

The day off: a tale of self compassion

Today I have not gone to work.

😲

This is very unlike me. I am not unwell. A meeting I was supposed to attend was cancelled and I am emotionally drained. Physically I’m tired and I have noticed that I have felt quite irritable that last couple of days.

I have no patients booked to see me, and nothing that will inconvenience anyone else if I don’t do it today; but I do have a lot of work todo.

So I got up and dressed as usual, took son 2 to school and as I was heading to work the message came that the meeting was cancelled. I went home. And I’ve stayed here.

I felt “naughty’, guilty, & ashamed … initially. And then I caught myself, and started a different thought process. Along the lines of, “I work very hard in an emotionally taxing and draining job, I have a number of very stressful emotional issues of my own (think sobriety, connection, compassion) and I’m caring for a mentally unwell teenager. Give yourself a break… others would feel compassionate toward me if I shared this, and i would definitely be compassionate to another in this situation; it’s ok to be overwhelmed, it’s ok to feel worn out and it’s ok to take a day for yourself”

So I have.

And I have done a little work at home, but mostly I have blogged, listened to Brené on audible and made burnt caramel and chocolate ice cream in my new ice cream maker

I feel calmer, more composed and better able to deal with the rest of the week.

I think that’s ok.

Leaps and Bounds

My progress on this sobriety / self compassion /growth / whatever it is, journey has not proceeded in a smooth linear fashion. If I previously thought about it at all, I would have imagined building a wall, or laying a path, with one brick being placed on top of the next deliberately, regularly and predictably to create a neatly interlocking, even wall / path. I would have imagined that slowly (I would have allowed slowly) there would have been continuous progress with less and less issues arriving from my previous alcohol abuse and more and more positive things coming into my life.

It has not been like that AT ALL.

Its been much more like the graph at the top of the screen, with periods of flatness and struggles and occasional big leaps forwards.

When I think about it, I often talk to my patients about grieving, how the process is NOT linear, and mixes up the accepted ‘stages’ of grieving in one big mixing bowl. That each person experiences it differently, emotions are unpredictable, that you never ‘get over it’ but that you do learn to “live alongside”, grief and loss. It seems to me that much the same could be said for recovery.

Of course its not ‘just’ recovery from alcohol abuse for me. Its a whole heap of things that arose from, or contributed to my alcohol addiction that need(ed) addressing. Its like a whole spiritual /emotional/psychological/ personal ‘spring clean’ of the soul; take it all part,  clean it up and then place lovingly back together. All at the same time as being a single parent to three children, running a home and being a full time doctor in a busy practice.

phew. As  part of my loving compassion toward myself I’m going to say right here that I’m proud of what I have achieved. I’m proud of getting sober, and I’m even prouder of maintaining it. I’m proud that I have not become bitter or turned into an angry person, I’m proud of my kids, and how I now parent them

What HAS surprised me is how ‘nothing’ seems to happen for MONTHS in terms of my understanding / ability to help myself or move forward,  and then suddenly its as though something clicks or drops into place, and there is a seismic change.

  • This happened in August 2016 (after 5 months sober) when I had a period of extreme clarity and ended my relationship.
  • again in July 2017 when being at a domestic abuse training day had a massive psychological effect on me (bad initially, but good in the long term) and the reality of just how abusive and toxic my relationship had been hit me like a ton of cement. Looking back at that time, I was quite unwell. I lost 18 lbs in weight, had pretty awful anxiety and was pretty shaky for several months. although nothing actually changed, all of a sudden the truth became starkly and painfully revealed.
  • Now. I think it is going to AA and making connections with other real alcoholics that has been the catalyst for a HUGE leap (forwards this time)

Its as though this small things, clicking into place and the opportunity to get and give support has opened up a whole new dimension for me. All of a sudden the “work” I have been toiling away at for months seems to not only make sense, but be applicable to me. The reading about Shame, perfectionism and poor self worth, the practices of mindfulness and compassion to myself … they seem real and achievable. No longer nice theories and unattainable goals, but genuine principles by which I can help myself and feel happier, more content and peaceful.

As an example. Yesterday I took son2 to an appointment at the Child and Adolescent mental Health service. We met with a ‘case worker’ and after I had briefly outlined the problem (at his request) I left so she could interview him. When the meeting was over, son2 was surly and silent as she outlined the next steps. I asked a couple of questions, trying to include him. When we got into the car I asked how it went, and he replied that he didn’t want to see them again as he felt he was being interrogated.

I was conscious of a surge of ‘something’ inside me. Something that made me feel cross and frustrated. Even a couple of weeks ago I think I would have opened my mouth, but yesterday I checked myself and tried to decipher what the ‘something’ was. After a few minutes I realised the feelings were

  • frustration – because he won’t /can’t do anything at all to help himself. Won’t even try
  • anger – because I’m spending a lot of time and money sourcing help for him
  • fear – because she reinforced to me that son2 feels helpless and hopeless, and that increases the risk of self harm
  • self criticism – because I ‘blame myself’ that he is unhappy.

So I took a few calming breaths, reminded myself that I am human and not perfect, that I am trying my hardest to help him and no-one can do more than their best, that struggles with life are common in teenagers and many many others have faced the same fears. Then I said ” I understand its hard being asked lots of personal questions, but let’s see what is suggested once she has had a chance to talk to other members of the team” I took the opportunity to ask him if he found the sessions with the private psychologist more helpful, given that I knew he had found it hard to talk on the last couple of occasions.

Not much back, but I’m satisfied that my response was calm, pragmatic and loving, that I recognised my own emotions and took care not to pass them on to a stressed teenager, and (perhaps most importantly) I did NOT beat myself up about it. 

Now, I’m not certain that I will be able to behave this way EVERY time, but given that I have literally never done this before, I am amazed, happy and proud that I achieved it on this occasion. Progress not perfection is the goal, and this was definitely progress.

 

new-5-sldd-stages-copy-rz

If you want to call self critisism a ‘disorder’ (not sure about that but anyway) I quite like the diagram above. It seems to me that I have spent literally months stressing and toiling and reading and reflecting and talking to my therapist and writing this blog and feeling like I am getting nowhere. The suddenly, whoosh… and I’m  at stage 4

I feel literally SO happy, and so optimistic.

And there is not a small element of relief too .. maybe I’m not destined to send the rest of my life feeling rubbish about myself !

Women friends

To move to an entirely different subject, I mentioned my brain is overful !

In my life I am happy and lucky to have 6  ( yes SIX ! ) very close women friends that I love and cherish. In general I like women; I find them (on the whole) funny, courageous, supportive, kind and honest. Most women I know are not aggressive, judgmental or critical and I so find their friendship valuable and important as well as less risky than relationships with men. Since I have been sober (or is it since I was in a relationship with that man?)  I have seen much less of some friends, which is entirely my fault because I have been silent, closed and reclusive, but in the last couple of weeks I have reconnected and made more new ‘budding friends’ in the fellowship meetings. This post is to celebrate those relationships and to remind myself why I value them all so much, how essential they are to me (I was going to write important but its more than that) and to express my gratitude for them so that I can look back when things are tough and remind myself that these attachments are valuable and I should cherish them.

I won’t name them, as I have not named other individuals in this blog, but use initials (as I have done previously) If they read this, and they all have access to it, I think they will see themselves. One of my biggest issues has been my own lack of self worth, and I do sometimes wonder why they put up with me, choose to see me or continue to support me when I am so very flawed. But for now I’m just glad that they are there, to hold my hand in the darkness, shine the spotlight of their experience and wisdom into some of the dark corners of my past and walk with me down the rocky path of sobriety, relationships parenting and life.

My friends all add something different to my life with their diverse experiences and personalities, but all are courageous, warm, generous and openhearted people. My friend K who lives in California I have known since I was about 8 years old. Through distance we don’t have the opportunity to see one another often, and life can get in the way of regular communication, but our shared history of childhood and experiences (she is also in recovery) have forged a deep, enduring attachment, and her empathy, compassion and understanding are a rare and valuable gift for me … She is visiting the UK in the Summer with her husband and children, and I am so excited to see her again.

My sober sister, V, is the newest addition to this select group. Although we have not known one another very long, and we have met face to face only a handful of times, she has had similar issues with alcohol misuse – and got sober just a few days after me. We ‘met’ over the internet and she was the first person I have ever met who really understood the struggles I had with alcohol, could empathize with the love/hate relationship that addiction brings, and with whom I did not have to feel ashamed of my ‘weakness’. Offering her support as well as receiving it provided me with my first experience of the connection, support and fierce solidarity between addicts – Its been a wonderfully enriching and valuable stanchion in our recovery journey.

The three women I first met at medical school … our friendships forged in the furnace of a University lifestyle and enduring through career development, marriage (three), (divorce – me) children (three out of 4) moving abroad (One to Australia for three years, one to Indonesia for VSO for a while) , moving away within the UK, sobriety, boyfriends, husbands, family, illness, bereavement and all of life’s vicissitudes. These three women and I are now woven into each others lives like recurring patterned threads that appear in a tapestry, not always visible, but always there. We meet when we can, sometimes together, sometimes individually, perhaps three times a year. I know they have my back, just as I have theirs and I know that, should any one of us need or ask, we would do whatever was in our power, unquestioningly, to help, support and protect one another. Yesterday evening I had an early dinner with my friend H who was in London for a training day. She could see the physical and emotional recovery I have experienced and I felt genuine, pure, uncomplicated JOY when I was with her. What a fantastic feeling to have.

Close at hand is my friend the other K. I met her through my ex husband and our friendship developed through our children and sharing our journey. She is very perceptive and thoughtful, and like all my close friends is able to listen and support without trying to ‘fix’ it, to stand beside me when things are dark and provide a reassuring hand hold. She is also very sociable, great fun and a great cook !

How lucky I am.

High on my gratitude list that I think of every morning as I come too, are these friendships. My life would be a much poorer lonelier place without them, and I am more conscious than ever before that I must nurture and consciously invest in these connections in order to live the fullest life I possibly can.

 

women friends

Self compassion

In the last few weeks I have been doing quite a lot of psychological ‘work’ with myself.

It feels like I have shaken off a lot of the grey gloom and apathy that has dogged me for much of the last 6 months, and been able to take some steps forward.

You know those women, the ones who are just full of love, empathy & wisdom? The ones who are really calm, boundaried and yet genuinely compassionate; who don’t judge or anger quickly, who are considered and deliberate in their actions ? That’s who I want to be.

I have always known that I don’t ‘like’, let alone ‘love’ myself; that I am harder on myself than I would ever be on anyone else; that I hold myself up against an image of perfection and constantly find myself wanting; that I do not feel “good enough” most of the time. And I have known for  along time, that this negative view of myself is unhelpful, probably damaging to me and that it needs to change. It’s just that I have been going about it the wrong way. I have been trying harder and harder to be perfect, to do everything right, to be more productive, exercise, stay slim, socialise, keep the house clean, manage the children perfectly. And that doesn’t work, because NO-ONE can be perfect, so when I inevitably  fail in my endeavours, I beat myself up some more.

This is NOT helpful.

Associated with the perfectionism comes a whole heap of Shame (which I have alluded to before) Again I think I have known for a long time, that things wouldn’t change until I stopped drinking, because it’s pretty hard to like yourself when you repeatedly tip bottles of Sav Blanc down your throat, and you can’t control your drinking. The fact that I have not added anything to my list of things I am ashamed of in the last 25 months is a huge thing to me, and it’s much easier to forgive yourself for past errors when you can honestly see that you are unlikely to repeat them. This is why I see my sobriety as a critical first step on this journey; as essential to maintain as it was to start, and I remain mindful of the risk of relapse.

So having removed a big hurdle in the path of self acceptance and self love, what next? I think there are a few basics which I have been musing about over the last couple of weeks.

  1. asking for help. Like many people I have a huge issues with asking for help. I feel like I ‘should’ be able to cope alone, that needing help and support is somehow a ‘weakness’; yet I am very willing to offer support, practical and emotional where I can see a need. I read something that struck a really big chord with me in Brene Browns work ‘The gifts of imperfection’. She says that when we attach judgement to receiving help we, consciously or unconsciously, attach judgement to giving help. Now I do NOT consciously attach any judgement to offering support – but I can see what she means. I believe the reluctance to ask for support comes from my internal perfectionist, (and the associated shame with being less than perfect) along with a hefty dose of subliminal messaging from my birth family . These messages went something like “Women cope with whatever is thrown at them, their needs can be ignored and they just have to get on with it, not coping or leaving is not an option. If things are hard, you just try harder”. At some later date I will pick this (especially the “women” bit) apart with my therapist.
  2. Lack of common humanity: By which I do not mean I am a horrible inhuman monster, but that (maybe through arrogance, and super inflated ego- although that doesn’t feel quite right) I often fail to see that the struggles I experience are very common. They are not unique, not special to me (and my stupidity) but shared by many many people, ordinary people who struggle with ‘stuff’, because ‘stuff’ is hard.
  3. Emotional over reaction: This is something I think is quite common with addicts, and something I have had for as long as I can remember. I am quite cyclothymic (by which I mean I experience periods when my mood noticeably shifts up and down from my baseline.) I tend to overreact to external stimuli, good and bad. I catastrophise quite a lot and take too much on myself – eg trying to ‘fix’ someone else. This is noticeably better since I have been sober – I am calmer and have less “knee jerk” reactions to things. The tendency is still there (see yesterdays post)  and its still hard for me to sit with uncomfortable emotions such as anxiety and anger, but its improving.

I recognise that the ‘big’ piece of work I need to do now, is on myself. I want to learn to accept myself as I am, flaws and imperfections and all. I want to be as compassionate to myself as I would be to another person, and I want to cultivate self respect. In looking for help in this area, along with Brene Brown I discovered the work of Dr Kristin Neff, who is an associate professor in Houston. Her website here contains a wealth of resources to help develop self compassion, including a self compassion rating scale here

I took this test … my scores are below (Scored 1-5 : 5 being the best for self kindness, common humanity and mindfulness; 1 being the best for self judgement, isolation and over identification)

Self-Kindness: 1.00
Self-Judgment: 5.00
Common Humanity: 1.25
Isolation: 4.75
Mindfulness: 2.25
Over-Identification: 3.25
Overall score: 1.58

Not great.

But I reproduce them here because I am going to do something about this. I realise now that self compassion is  something that has to be practised, and that self love doesn’t ‘just happen’ you have to cultivate it. And my initial cultivation plan is to work though some of the stuff on this website, think about things I read, and much as I practised developing serenity yesterday, I’m going to practice kindness, compassion and tolerance to myself.

In due course, maybe in six months, I will do this test again, and see where I have got to.

I would be really interested in others thoughts about this !

self-compassion