Fine. I'm the bitch.

I’ve been having some trouble lately with the local flora and fauna in my oh-so-progressive-East-Bay town.

First there was the incident of the Fu Manchu mask.

Then two weeks ago, while I was at my local and ever-so-sketchy coin laundry, I ran into “Chatty” again.

First, let me just tell you a little bit about this laundry… it’s in a very convenient location, only a few blocks from my house. And it’s large, well lit and has tons of parking. During the daytime on a weekday, it’s usually pretty empty. (Except for the pedestrians. (It’s located in the middle of a long block and people walk through the laundry to get from a main downtown street to a large parking lot on the other side.) And there’s a residence hotel on the upper floors of the building. Sometimes people congregate by the back door and smoke things that are not tobacco.

So, ok, I know this is starting to sound bad… but really, at noon on a Wednesday, it never used to be that bad. But recently, it seems like it’s become a favorite hangout for the homeless and the mentally ill. I guess it’s just a warm, well-lit place with vending machines and trash cans. It seems like almost every week now, there’s some disheveled looking person, pacing back and forth and muttering – trapped in some psychosis. I try not to let it bother me. Heck, I’m a crazy lady too right? I used to live with schizophrenics and people with anti-social personality disorder and whatnot. I feel like I generally know how to make myself look non-threatening to them. Then again, I know just how dangerous people can be in these states. (Usually not, only on rare occations.)

Anyway, back to Chatty. I’d seen her at the same time the previous week so I started to wonder if she and I were on the same schedule. I think Chatty is homeless (although she could just be rummaging around in the trash cans for fun…) but that’s beside the point. You could be the fucking QUEEN OF ENGLAND and I wouldn’t want to strike up a conversation with you at 9am on a Thursday morning in my local coin laundry! The previous week I’d managed to avoid exchanging more than a couple of words with her. But this time, I was not so lucky.

When I got up to transfer my clothes from the washing machines to the dryers, she went over to the table I’d been sitting at and started looking at my NY Times. On the page I’d turned to, there was an article about a local town, Woodside, CA.

“Do you know where Woodside is?” She asked me. “Is it near here?”

“Uh, yeah. It’s really close to Palo Alto.” I said, trying to look busy.

“Have you ever been there? It looks nice.”

“It is. Actually, I’m going down there as soon as I get finished here.”

“Well! Really!” She exclaimed. “Is it expensive there.”

“Yeah. It’s extremely expensive. I think it’s one of the most expensive towns in America actually.”

“Oh. Well. Too bad.” She said, sounding a bit… insulted? What the fuck, I thought. I’m not trying to be mean. It’s not like I can afford to live there either - I think the average home price is over a million dollars. But at that point, Chatty wandered off and left me alone. That wasn’t too bad, I thought. A few minutes later, another woman (I’m guessing also homeless) walked in and upon seeing Chatty, turned around and left. So it’s not just me, I reassured myself.

BUT THEN! Twenty minutes passed, I folded my laundry and turned to go out the door.

“Goodbye!” I heard her yell behind me. I didn’t turn around. How do I know she was talking to me, I reasoned. “GOODBYE!! Hey, Goodbye!” She yelled louder. I was out the door at this point but I heard a male voice say:

“Well that was fucking rude, wasn’t it?!”

“Yeah, I know.” Chatty said. “I don’t know what’s wrong with some people.”

Fine. It’s me. I’m the bitch.



Scene Two.

For the last couple of weeks, I’ve avoided going to this laundry because I didn’t want to run into Chatty. I told my husband about it and now he’s encouraging me to go to another laundry. But. I hate going to new places. I like getting stuck in my little ruts. If I go to a new place, I don’t know what I’m going to find and I have to psych myself up just to walk in the door.

So, this afternoon I went back. I thought, maybe it’s a Saturday so it’ll be busier. There will be other people to distract the roving conversationalists. I was right. It was busier. But there were enough open washing machines for me to do all four loads at once. As I start putting my clothes in the washers, I hear this loud creepy voice behind me talking to nobody in particular. Must be another psychotic, I thought. I looked out of the corner of my eye and there was….

Piseth (see the comments section)

I recognized him right away. He sent me his resume last year and again this year. He’s an actor and since he’s the only person who’s ever included his headshots with a resume (for a tutoring job?) – I remembered his name. Piseth. When first saw his pictures last year, I remember thinking he was a pretty attractive man. Today however, Piseth had taken it upon himself to practice his lines. (He’s auditioning to be the ghost of Hamlet’s father?) Let’s just say these are some eerie lines and he was using his best “spooky” voice.

So since I recognized him, I broke my standard I-don’t-talk-to-strangers rule.

“You know, that’s kind of creepy.” I said. (I should’ve said “You know, that’s kind of creepy, Piseth!” But I wasn’t 100% sure it was him yet.)

“Doom’d for a certain time to walk the night,
And for the day confin’d to lasting fires,
Till the foul crimes, done in my days of nature…” Piseth continued.

“Ok. Fine. Don’t answer me.” So I went about my business, put my clothes in the wash and went back to my car to wait.

Twenty-five minutes later when I came back to put my clothes in the dryer, he was still there. Fuck, I thought. As I busied myself with the dryers, he continued his recitation. And then, when I got closer to him he started with this:

“And the Oscar for best actor goes to… Piseth, in ‘Hamlet!’ Oh, thank you, thank you! What an honor, I don’t know what to say… I remember back when I was a struggling actor in the Bay Area… I used to have to practice in a coin laundry… “ At this point he breaks down in fake sobs of joy. I just wanted to hit him as hard as I can. (Which admittedly, is not very hard) But I just finished putting my clothes in the dryers and walked back to my car.

Twenty more minutes passed and when I went back to get my clothes out of the dryer, he was still there. Double fuck. And now he was talking to this woman who had just rolled in on her bike. (Do me a favor, don’t ride your bike in the laundry lady!) And as I gathered up my clothes, I listened to her go on and on about how great an actor he was.

“Oh your voice was perfect! Where are you studying? Don’t you think a British accent is just so much better suited for Shakespeare? You really had a wonderful intensity…!” Oh my lord.

FINE. I’m the bitch. All of you people just go right on doing whatever the hell you please. Just do whatever you feel like doing in the middle of public. Don’t worry if it freaks the rest of us out or you seem like a complete wing-nut doing it. Free expression, that’s the ticket.

Those of us who maybe have more robust social filters or perhaps, grew up on the east coast – we’re the bad guys. It’s wrong to be considerate of other people’s boundaries. You’ve got it right. We’re uptight and I’m the bitch.

Bitch soap available at:
http://angelicdreamz.com/store/mabels_laundromat.html

I've obviously inhaled too much cleanser...

Because I now feel that it's my duty to inform you of this:

Ocean Spray "Craisins" are actually pretty tasty.

An open letter

to any and all future houseguests.

I'm sorry.

I tried to make this crap-shack of an apartment come clean, but it just won't. Apparently, this place is constructed out of dust and the dead skin cells of the thousands of college students that came before us.

I'm so, so sorry.

I promise though. We have clean towels.

20 years - or approximately the same amount of time since "Rhythm Nation" was released

I was trying to explain to my (male) doctor this morning, why I feel so frustrated about not being pregnant yet.

“You’ve only been trying two months!” he said. “You can’t expect you body to just work on command like that!”

I know it almost always takes more than two months to get pregnant, I said. I know this sounds irrational to you – but most of my (female) friends seem to get it. (Apologies for the sweeping generalization…)

He just wasn’t getting it.

Look, I said, imagine you had a Porsche just sitting in your garage for TWENTY YEARS. For TWENTY YEARS you looked forward to driving it. You read about driving it, talked to other Porsche owners, watched your friends go out and drive theirs, but you couldn’t drive yours.

AND imagine that during that whole time, you had to maintain the car. You had to maintain it (let’s say… every month). You had to make car payments and insurance payments on it. And never, in TWENTY YEARS, could you drive it.

Then Finally. It was time to drive the thing. You went out to the garage, got in the car, turned the key and… nothing happened. The engine didn’t work. Wouldn’t you be just a little bit pissed??!!

In the back of your mind, you’d know that the car probably just needed a little tune up, a little oil to get it running – perfectly reasonable after sitting idle for so long. But still. It would feel unfair to have to wait a day longer. You already waited TWENTY YEARS.


Oddly enough, we have a friend who put just his sports car in storage. He wants to give it to his daughter when she turns 16. Right now she’s three. Can you say, recipe for disaster?

Wise-Ass Onesie Wednesday

world = oyster

Thanks for the supportive comments to last night’s post. And I agree, some of the people I went to high school with

- had special financial advantages
- were really fake
- probably have receding hair lines and bad marriages

But some…

- are really bright
- came from dysfunctional families
- have built lives around helping others

I guess I'm just constantly amazed by this group of people. It's a strange phenomenon to see so much success in such a small group of people. I think I've always been curious about the elements that brought us together. This school has a long history of famous and successful graduates too – it’s not like it’s just our class.

But now that I’m an educator, I find myself appreciating some of the things that I got from my high school… things I hope I can give to my students:


- dedicated teachers who were great role models (like Mr. Bergstrom)
- a sense of responsibility for my community
- a sense of entitlement, or at least the message that I could do whatever I wanted in life

But I wonder if they oversold it a bit. Not all of us could do whatever we wanted in life. Some of us had family responsibilities or disabilities or even, god forbid, the desire to live a smaller life.

Did you have a high school teacher who made you feel that you had limitless possibilities? Were they right or did it set you up for a fall down the road?

Update

My husband just read the previous post and groaned.

"More of your 'Tale of Woe!'" He said.

I do not mean the previous post to be another chapter in said T.O.W.

For the record, I think I've accomplished just as much (if not more) than most of my classmates. Just today, my doctor praised my improving mental health.

"You set a goal to get better and set about accomplishing it." He said. "I don't take that for granted. Not everyone does that. Some people just sit back and don't do anything to change their situation. I'm in a position to dole out praise and you deserve it."

I will admit though, I wish my achievements could be published in the alumni bulletin. Here's how it would read:

After a near-fatal suicide attempt, arrest and lengthy hospitalization in early 2003, "J" was diagnosed with Borderline Personality Disorder. Despite this grim prognosis, her health had greatly improved due to her hard work and the support of her husband and therapists. With the exception of a couple small relapses this winter, she has been sober for three and a half years and has not self injured in many months. She has built herself a new career teaching and mentoring young people which she enjoys immensely. Actively involved in numerous therapeutic support groups, she is also finishing a book based on her experiences in the mental health care system. She successfully tapered off all her medications this summer in preparation for starting a family.

I just didn't want to brag...

What I’m not doing with my life, from A to Z

For the last year, I’ve been keeping a list of what people in my high school graduating class are up to. Almost all of the information came from our glossy alumni bulletin. Some people I've kept in touch with or heard about through the grapevine. Why do I do this… masochism, humor, amazement perhaps? I don't think this represents a normal slice of the population:

“A” took a job in the Department of Homeland Security as an Assistant Director. “A” used to work in the Vice President’s office.

“B” was just appointed president of the Board of Directors of a Girls Foundation in CA.

“C” has moved to Barcelona, Spain.

“D” has a role in an off-Broadway musical with Val Kilmer. “D” will also be in the long-awaited remake of ‘Pulp Fiction’ that started shooting in August.”

“E” has two books coming out soon; a children’s book and a cultural history.

“F” just got married in Kennebunkport, Me. She’s an editor at The New Republic and he works for U. S. News & World Report.

“G” is living in Kiev, Ukraine and just completed a rather large real estate investment deal.

“H” is a reporter for The Wall Street Journal Saturday edition. “H” also has a one-year-old daughter.

“I” recently left the government to do research for a major investment house.

“J” recently climbed to the summit of Mt. Rainier. “J’s” job includes travels to India and Africa to improve water and sanitation in rural areas.

“K” recently started a new job as a portfolio manager at an investment bank.

“L” just graduated with an MBA from the University of Chicago and took a safari in Africa.

“M” is an assistant professor at Connecticut College.

“N” had twins.

“O” just finished two years as a Peace Corps Volunteer in rural Botswana and is starting medical school.

“P” had a son and is now the head of a private middle school.

“Q” an heir to one of the largest corporations in the world is living and working in Chile and just got married.

“R” is an actor doing voice-over work for “Family Guy” who produces and directs music videos and movies.

“S” is a pediatrician.

“T” is a fellow in Infectious Diseases and will spend the next 2 years doing research in Senegal, West Africa.

“U” is an artist who paints and teaches in Rhode Island.

“V” is an ensign in the US Navy.

“W” is a poet and a visiting professor at various universities.

“X” is a professor at Yale and just published a monograph on rhetorical theory.

“Y” is a lawyer.

“Z” is a New York City policewoman.

Note: not bad for Costco flowers, huh?

Sunday Book Review

Get Me Out of Here: My Recovery from Borderline Personality Disorder
by Rachel Reiland
Publisher: Hazelden (September 1, 2004)

Part of me was very happy when I read this book. It is an excellent, firsthand account of Borderline Personality Disorder, written by Reiland, (a pseudonym) a 29-year old accountant, wife, and mother of three. Another part of me was dismayed to discover that someone else had already written the book I was working on! But all competition aside, the book paints a brilliant picture of a woman who lived with and overcame this illness that many view as incurable.

Reiland’s story bore a striking resemblance to mine. Both of us survived the illness (with little therapy) well into our twenties, managing to gather college degrees and a spouse along the way. Once the illness emerged however, she and I both fought for health with the help of frequent visits to a wonderful psychiatrist. After many years of hard work and the support of her husband and doctor, Reiland emerges from the illness, whole and essentially healed. Her success confirms that if a patient can earnestly confront the stark depths of the illness, they can gain insight and even hope. It is a book that would inspire sufferers and caregivers alike.

There’s a million other things that I identified with in this book – too many to go into. Here’s a few:

- The bizarre fraternity of her first hospitalization where she regressed to become a ringleader of sorts.
- Her fear of discharge and desire to remain a dependent inpatient.
- The sadness and pain of her third hospitalization.
- Her ability to point out and expound on psych terms, becoming a prized pupil aiming to please.
- Her intense anger, outbursts and swelling, sweeping emotions.
- The impulsiveness, suicide attempts, manipulative behaviors, self-destructive episodes and often violent, and unpredictable behavior.
- Her ability to keep her relationships with her husband and kids if only out of fear and guilt. At one point she says: “I wish I never met you because now I can’t bring myself to die.”
- How she takes her violent feelings and twists them toward herself.
- Her role as the gatekeeper her father’s feelings.
- The message she gets from her parents that love is something to be earned.
- As a child, she was good at home and bad everywhere else. She was sarcastic, assuming others were laughing at her.
- Her pride at having a tough façade, assuming nobody would understand her.

A common feature of Borderline Personality Disorder is the multitude of secrets a high-functioning patient maintains. There are so many shameful urges and thoughts the patient keeps hidden – even from themselves. What most impressed me about this book was Reiland’s bravery to expose these feelings and show with astonishing honesty what this illness looks and feels like.

She writes openly about her promiscuity and masturbation; the pleasure, relief and excitement she took in feeling ashamed. She acknowledges this thrill-seeking behavior as a crude form of self-preservation. Reiland even talks about her infatuation with her psychiatrist, a common BPD issue that greatly complicates therapy. She admits to him

“I can’t need you because it hurts too much. I’ll turn into a crazed madwoman, a child.”

Her therapist deftly manages his own transference, boundaries, and self-disclosure. He points out:

“You survived by seizing every tiny drop of love you could find and milking it for all it was worth. These were tender moments and they sustained you.”

I never knew anyone else did this until I read it here.


In the interest of my own insight, I’d like to point something out to myself. I tend to try to do too many things at once and then wonder why I feel distracted. Then I get frustrated because I wind up doing a bad job. At the moment, I’m trying to:
- Write a book review
- Cook (an easy) dinner
- Clean up the house so we don’t spend the week in a pigsty
- Worry about work-related emails I’m avoiding
- Remember to read the first 35 pages of Last of the Mohicans tonight so I can keep up with one of my students
- Watch “Ebert & Roper”
- Worry because I tried on jeans at Target this afternoon and based on what I saw, I now know that I should be spending this minute and every following minute exercising.

Weekend brainteaser! (pun intended)

Match the compounds with their generic or brand name!

Since we’ve been trying to get pregnant for the last two months, I’ve been completely off all my medications. My husband, doctor and I decided that it would be better not to marinate the baby in chemicals. It’s an interesting situation to be in. I’m a little living experiment. Most of my friends have been really understanding and non-judgmental about this decision. But honestly, there seems to be an undercurrent of concern. A lot of people (including my OBGYN) have told me that it’s better to have a happy mom than a medication free mom.

I knew I needed to be off lithium because it can cause fetal heart defects although if I have to be on it, they just have to monitor my blood levels carefully. The SSRIs (anti-depressants) really don’t have a long enough track record to be certain, so we’re trying to see if I can do without. If I can’t, I can’t. My doc has said that there are some older, very tried-and-tested anti-psychotics he can give me if I’m really having a hard time.

Here’s my brief history with meds:

Before October 2002:
- Desiprimine (tricyclic) for 18 months as a teenager
- Lots of alcohol

Oct 2002 – Dec 2002:
- Paxil (SSRI)

Jan 2003 – Mar 2003
- Remeron (NaSSA)
- Valium (anti-anxiety)
- Ambien 10mg/day (sleep aid)
- Seroquel 900-200mg/day (anti-psychotic)
- Lithium 900mg/day (mood stabilizer)
- Effexor 300 mg/day (SSRI)

Mar 2003
- Tapered off Remeron & Valium
- Started Wellbutrin 400mg/day (SSRI)

Sept 2004
- Tried unsuccessfully to taper off Lithium

June 2005
- Tapered off Ambien

Nov 2005
- Tried unsuccessfully to taper off Lithium

Jan 2006
- Tapered off Seroquel

Apr 2006
- Tapered off Lithium

May & June 2006
- Tapered off Effexor

July 2006
- Tapered off Wellbutrin

But I wouldn’t be tapering off my meds if my doc and I weren’t already convinced it was time for me to try. That’s the thing with personality disorders… they’re not really treatable with medication. (classic definition: long-lasting, pervasive, rigid and inflexible patterns of thought and behavior that cause serious problems and impairment of functioning.)

With a personality disorder, the patient’s messed-up environment has caused them to cope in ways that only make things worse in the long run. All the meds do is help control moods, anxiety, and thought organization so the patient doesn’t continue to worsen. If the therapy and behavioral training can change the thought and behavior patterns, the patient can address the messed-up environment. Then the moods, anxiety, and thoughts should improve too. Have they? Tune in next time for the continuing saga…

So what do you think? Is it important for pregnancies to be off psych meds or is it better to have a drugged mom with no mood swings?

Answers to the puzzle:
Figure A - Valium or Diazepam
Figure B - Seroquel or Quetiapine
Figure C - Ambien or Zolpidem
Figure D - Remeron or Mirtazapine
Figure E – Norpramin or Desiprimine
Figure F – Wellbutrin or Bupropion
Figure G - Effexor or Venlafaxine
Figure H – Paxil or Paroxetine
Figure I - Eskalith or Lithium
Figure J - Alcohol or Ethanol

But the Fruit Loops are worth it

But Juniper, you may be asking… aren’t you helping students to game the system? Don’t you feel that you’re corrupting the value of the SAT as an accurate indicator of a student’s academic abilities? Aren’t you helping to change “the admissions process from a meritocracy into a marketplace” like they said in one of those NY Times articles you linked to?

Yes. I am doing all of those things.

BUT. I don’t feel guilty about it. After a couple of weeks, I’ve gotten to know my students pretty well and I start to feel… protective of them. Motherly (or big-sisterly) even. I don’t care if they out maneuver all the other kids out there. I WANT them to. To me, any school would be stupid not to want them. I want to do whatever I can to help them prove this.

At this point in the process, the SAT is now a giant game, a word puzzle, and a mind-teaser. It’s no more painful than the sort of crossword you’d bring on an airplane to pass the time. And I’ve the pony-tailed dork who stands on the sidelines cheering as my student knocks down one obstacles after another.

“Yes! Get that confusing f o g(x) problem! Don’t let that graph fool you! That’s it, take the middle answer, now solve, solve, solve and… score!”

“You’re better than that reading comprehension passage! Beat it into submission and reword the question! Yes, that’s right! It’s inane! You see how silly they are? Perfect answer!”

Ok, sometimes (frequently) my students are laughing AT me, not with me.

I guess I can’t wait for them to get to college. I loved it and I know they’ll love it. In between SAT questions, I’ll tell them about how they’ll get to live in a dorm, take road trips at 2am and eat Fruit Loops for lunch every day. Not to mention having your first class start at 11am… For most 17 year olds, that is the Best. News. they’ve ever heard.

Just a quick snip and you won't miss those Saturdays a bit...

I need to make a confession. I’m an SAT tutor. And I enjoy it.

I never thought this is who I’d grow up to be – how I’d pay my bills. But here we are. I took a daylong SAT prep course back in high school and I remember thinking the tutor was kind of a loser. He kept telling us how to “accrue” points. Finally, at the end of the day we admitted that we didn’t know what the word meant. This seemed to make him sad.

But SAT tutoring IS fun. I get to be the person who commiserates with the kid – the one who shepherds them through this awful process. Just last week, I was talking to my favorite junior about my plan to help her prepare for the SAT.

“So you’ll take the test for the first time this spring.” I said. “Then you’ll take it again next fall, during your senior year.”

“What!” She looked stunned. “I HAVE to take it twice? But the one this spring, isn’t that the PSAT or something?”

“No… you’ll take the PSAT this fall. And yeah, most students take it twice. That way they pick and choose their best scores.”

“But what if you do really well the first time…?” I shook my head. She sighed. “But the tests aren’t that bad, right?”

“No. They’re horrible. They start at 9am on a Saturday morning and take FOUR hours. This spring, when you take them, you’ll most likely be in the middle of your final exams. But everyone has to take them. And by this time next year, they’ll be over with. Well, at least until you want to go to graduate school.” She just looked at me in stunned silence. “You’ll hate them, just like everyone else. But I promise you this. The more practice tests you take, the better you’ll do.”

“Practice tests. You mean the one in the spring?”

“No, I mean the three or four you’re going to do on your own, at home, before this spring.” The conversation deteriorated into wails and gnashing of teeth at this point…

But seriously, being an SAT tutor is like being an ambassador from the Land of Adult Annoyances. For a lot of kids, it’s the first time they’ve been asked to do something this painful with such intangible results. But if I can put a friendly face on the process, commiserate with them and offer proof that yes, reasonable people can survive this process, then the whole thing takes on the feel of a ritual or rite of passage

Like an academic circumcision of sorts?

I was reading the Times this evening and I stumbled onto a trove of SAT related articles. Note: you may need to register at the NYTimes site to read these:

>Their Own X (Equals Y) Man To the Rescue

Harvard or Bust

The Long (and Sometimes Expensive) Road to the SAT

Show Them the Money

Skip the Test, Betray the Cause

It's only a matter of time until I complain...

I’m trying my best to keep my new job in perspective – but it’s hard. I'm never convinced I'm going a good enough job.

--- --- --- ---

I’m only supposed to be working 30 hours a week. (And for once, I’m actually doing pretty good at not working more than that.) During the afternoon hours, I’m usually out tutoring students one-on-one in their homes. I like most of my students, but there are stressful parts:

- Driving during rush hour. (The only time kids want tutoring)
- When I see the kids’ homework and realize I’m not familiar with the material. I’ve got returning students this year who need help with pre-calc, physics and chemistry. NOT my specialties. What happened to my beloved algebra?
- The quality time I have to spend with my Chemistry for Dummies and Cliff Notes when I get home so I don’t feel like a dumb ass.

In the morning hours I work on managerial tasks related to running the tutoring company I work for. Lately, I’ve been interviewing a lot of prospective tutors and managers – not the most pleasant task for me. During these interviews I have to concentrate on what I’m doing, what the other person is saying and the little voice in my head that tells me I’m doing a shitty job. Usually it sounds something like this:

“Why did you ask that question? Don’t you know what you’re doing? This person must think I’m an idiot. You don’t anything about this company yet and you’re interviewing people!? It’s only a matter of time until someone complains about your shitty performance, you realize.”

But now that a few weeks have passed, I’m starting to get my feet under me. I’m starting to feel like I know what I’m talking about a bit more. But I’ve managed to work through the backlog of resumes so… I have to take on new tasks. Tasks I haven’t mastered yet. Here comes that little voice again…

--- --- --- ---

So yesterday in DBT, the therapist asked us if we liked the three minutes of meditation at the beginning of the group with or without music.

“I hate them equally, I said.” She wanted to know why. Because, I said, any time I have to be alone with my thoughts, this is what I hear:

“Why can’t you just write the damn email? What are you procrastinating about? This isn’t rocket science, you know! I can’t believe you left such an idiotic message on that client’s voicemail. It’s only a matter of time until someone complains about your shitty performance, you realize.”

At least the voice is predictable.

Wise-Ass Onesie Wednesday

In retrospect, I think it was a mistake to use the BROWN fabric marker on this one...

Look what I discovered on Monday!




No, this is not a picture of the same chair. They make a kid-sized IKEA Poang chair! I almost bought one when I was at IKEA on Monday but then I remembered, I'm not pregnant yet. Let the monthly pity party begin... sigh.

Tag, I'm It

GirlMD tagged me with the 7 songs meme:
"Seven songs you are into right now. No matter what the genre, whether they have words or even if they’re not any good, but they must be songs you’re really enjoying now".

Uh, just for the record... I barely know what a meme is. I'm old and kinda out of touch. So I tried looking in itunes to see my most frequently played tracks like GirlMD did and that told me nothing. (I've only been using itunes since January after I got my ipod for Christmas. Like I said... Old. Boring.)

Apparently, I listen to a lot of podcasts these days. I used to listen to a lot of music in grad school, but then I discovered that radio and tv make my brain shut up. I love music, but it still leaves my brain too much space to think. Always a dangerous proposition. Usually when I'm in the car I listen to NPR or a podcast. When I'm home, the tv is frequently on. I wish it wasn't... but it's a less destructive coping mechanism than others.

So, I'm going to have to change this a bit. Here are 7 songs that I MUST sing along to when I hear them. It's not like I'm usually in public... they're a bit (ok i'll say it) old and boring.

1. "House of Cards" - Mary Chapin Carpenter
2. "A Case of You" - Joni Mitchell (ok, truthfully, anything by Joni - who I discovered long ago through girlMD!)
3. "I'll Fly Away" - Gillian Welch & Allison Krauss
4. "In Dulci Jubilo" - Cambridge Singers
5. "Closer to Fine" - Indigo Girls
6. "Under African Skies" - Paul Simon
7. "Playboy Mommy" Tori Amos

And here's one song that doesn't have words but I can listen to over and over and over: "Take Five" by Dave Brubeck.

So since i'm new to the blogosphere (sp?) I can only tag two people:

anonymous mom
perpetually waiting

Brandy

I’d like to think that I’m the perfect tutor for every kid, but every once in a while I have to give up one of my students. Today I think I found a replacement tutor for a girl I’ve been working with for the past couple of months.

“Brandy” and I met last spring when she took an SAT class I was teaching. I was really impressed that this group of disadvantaged students had given up their spring break to take this free course. But Brandy was a different story. She never looked that committed. Instead, she chatted with the other kids and acted disruptive. And she was so grossly overweight that everything seemed to exhaust her. On the last day when I proctored a practice test, she left halfway through. I figured I’d never see her again.

But over the summer, I got a call saying she wanted one-on-one SAT tutoring. Her grandparents’ house where she lives is in such a bad section of Oakland that we agreed to meet at a Starbucks downtown.

Brandy didn’t show up for our first session. At our second and third sessions Brandy left after 45 minutes to catch her bus. (A typical session is 90 minutes long) But she told me that she really wanted my help. She said needed to score at least 1000 (out of 2400) on the SAT so she could get into the college of her choice.

I asked her to get a practice ACT from her school and see if she liked it. She claimed her school didn’t have any (most schools do). Finally, I loaned her a test prep book that I never saw again. She said she took it and liked it better than the SAT. So I asked her to buy a copy of the book for her own use. She never did. Finally, I bought one from Amazon and said she could pay me back. On Monday, she told me that she signed up for the SAT instead.

“And now my college counselor said I only need a score of 850.” Brandy said. “And I already did better than that on the practice test this spring!” Why was I here?

“Well… how’s school going?” I asked.

“Oh, it’s fine. I just have to pass Algebra to graduate. I failed it last year but I didn’t like my teacher.”

“If you need to pass that class to graduate, maybe we should be doing math tutoring. It’ll probably help your SAT math score too.” Brandy agreed.

I was embarrassed, but I knew I needed to talk to my boss about the situation.

“Did she ever do the homework you assigned?” he asked.

“Well, she said she did, but then she’d forget to bring it…”

“I probably would’ve been a bit harder on her. Usually, if a student doesn’t do the homework, I say that I have to leave but still charge them for the session.”

“I know. I remember you telling us that at our training meeting… I just didn’t know how to handle this situation… Usually I meet students at home and I can tell if they’ve done the work. But since we were meeting at a café…” My boss agreed that it was a tough situation. “It’s hard when students don’t have parents to support them. It really shows.”

“You know, her grandparents aren’t even paying. Brandy’s supposed to be paying for this herself. Although… I think we’re never going to get much payment from her. Anyway, if she needs remedial math, maybe we should have another tutor help her. We don’t have a lot of tutors like you who can do test prep so we should match you with a new kid.” We agreed to reassign her to a new tutor we just hired.

So why do I feel so guilty?? I tried to help this kid, but I don’t feel like I did a very good job. I should’ve been harder on her. I shouldn’t have cancelled those two sessions when my car broke down. My boss probably doesn’t think poorly of me – I’m the one who brought the problem to his attention in the first place.

I manage to help the majority of the students I work with… but the minority… well, some of them have been minorities. Last year there was a Latina middle school student who I finally had to “fire.” She just wasn’t doing the work. There have been rich kids who haven’t done the work too… but they didn’t bother me as much.

I just hate the idea that these kids and I can’t relate to each other. I hate the idea that I see myself as some sort of savior who they need to rescue them from their lives. I really hate the idea that maybe I’m just a white, upper-class, boarding school WASP who takes it too easy on them out of some kind of misplaced racial guilt.

Still… I did manage to teach her how to take the square root of 125…

My head hurts... now yours can too.

I've been fighting a headache for the last 24 hours. I don't want to take ibuprofen (since there's a slim chance I could be medicating for two...) so i'm taking tylenol which doesn't really do much for me. So i'm a bit too tired to whip up a brand new entry.

But anonymous mom's post about the song her 3 1/2 year old daughter made up reminded me of my "youther years" when my friend and I used to write some twisted little dittys. Something about having a mental hospital in a nearby town must've inspired us. I shared them with my doctor once. He said "Uh, yeah, that's a pretty good sign that something wasn't quite right." Here's two of my favorites. Just imagine the words ccompanied by a cheap 1980's electronic keyboard.

Back to Bellevue
It was nice for a while
But all told it’s not our style.
We missed you, old Bellevue
We may roam but we are home.

We went so far
But we missed our bars.
Out there we cursed,
Behind we’d left our nurse.

We will never leave.
The world’s our pet peeve.
We’ll stay here all our years,
Drugged with you in old Bellevue.

The tale was told,
Our lives would fold.
They’d make us pay;
A life in the subway.

It was nice for a while
But all told it’s not our style.
We missed you, old Bellevue.
We may roam but we are home.

We’ll sleep well in our cell
Next to you in old Bellevue.


Playing in My Padded Cell
All the nurses wonder ‘bout me
They all wonder what I’m doing
Why is it they can’t see
That I’m where I want to be

Playing in my padded cell

They can’t seem to understand it
Why I stay here all the day
I like to have mental fits
They’ll grab the first aid kits

Playing in my padded cell

Doctors can’t make my brain work
They have tried and tried and tried
It may be just some dumb quirk
Now they say I’m just a jerk

I think we wrote these when we were twelve or thirteen years old. Far too young to be able to spell prescient...

Sunday Book Review

Transforming Madness: New Lives for People Living with Mental Illness
by Jay Neugeboren
Publisher: University of California Press, 2001)

Jay Neugeboren is an acclaimed novelist (The Stolen Jew) and short story writer who also teaches at UMass, Amherst. In his 1997 memoir, Imagining Robert, he wrote about his struggle to help his brother who suffers from schizophrenia. After decades of difficult hospitalizations and unsuccessful treatments, in this book he reflects on a mental health care system that can be more confusing than the illnesses themselves.

Not just a memoir, this book is also a study of history, economics, psychology and neurochemistry. In a clear and thoughtful manner, Neugeboren explains the complicated mental health system and offers evaluations of various treatment programs. He paints a picture of a profession divided between medication and therapeutic approaches. Most inpatient psychiatric care in the U.S. is now provided by general hospitals. In these hospitals and in pharmaceutical research, the goal is to make mental illness medically curable like any other illness. In just the last decade, medications have become more effective with fewer side effects. Although Neugeboren acknowledges the value of medication, he states: "Drugs are not enough.” Because the race for a medical cure has left psychotherapy and follow-up care under funded, he argues, mental health care now lacks the deep personal involvement of the human element. In the wake of pharmaceutical successes, both inpatient and outpatient care have been cut back by HMO’s.

But once the responsibility is placed on the chemical, then the illness becomes a mere disease. The patient or “consumer” and doctor are no longer active agents. Neugeboren explains how this lack of accountability can lead to barbarous treatment. Professionals assume the role of experts and consumers must be compliant. Even normal responses become pathologized. Coercive methods are used to force treatment, which leads to clashes of values, fear, and anger. Consumers often experience mental health services as dehumanizing and lacking reciprocity. They still encounter physical and emotional abuse, excessive meds with debilitating side effects, a lack of programming or rehabilitation services, and an incompetent, ever changing, and uncaring staff. Their families are left to cope alone with difficult doctors and the unpredictable terror and heartbreak of having a family member in a mental hospital.

Neugeboren makes the case that the stigma, low social status, low expectations, restricted choices and self-determination that consumers experience in the mental health system and society leads to chronic hospitalizations. A hospitalization can stabilize the consumer and allow them to get on with their life. But do you stop going to the doctor after the initial treatment? How do you get back, and what kind of help will you need? Will the treatment hold? What if it worsens and becomes fatal? What about the patient’s fears if they don’t have a place to live, meals, money, a job, school, or friends?

It is hard to retrieve lost hopes and feelings when large portions of life are stolen by illness. Bad residential situations, chronic unemployment, and loss of property, money, friends, self-esteem, dignity, rights, and hope only compound and intensify madness. Consumers (sometimes rightly) believe that others think they are less than human, less worthy, have fewer rights or possibilities. They become trapped by the belief that they are freaks, failures, and outcasts. Naturally, they fear that they can’t make it in the world and become captured in the system. This learned helplessness leads people right back into the system. Ironically, lower functioning consumers handle these falls from grace better than their more successful peers. In a way, their fall is shorter because they started so low.

For me, the most valuable parts of the book discussed the possibilities for life with a serious mental illness. It displays an understanding and sympathy for those who suffer and describes the day-to-day bravery it takes to live with a mental illness. The book profiles people who have recovered and built new lives, often after having been pronounced medically hopeless. He describes a slow change that is allowing the severely mentally ill to get an education, hold down jobs, and maintain relationships even without a cure. These new recovery programs offer peer support and community interaction as well as psychotherapy and medication.

Neugeboren’s brother seemed to do better long-term relationship with therapist or trusted social worker. This taught him that it is the presence of hope, love, trust and faith that helps people away from madness into a fruitful life. The greatest obstacle seems to be that most people don’t think they can recover. But most consumers show a remarkably resilient spirit and a desire to do the steady and sustained work it takes to heal. He urges consumers to see their illnesses more as disabilities rather than diseases. A person may recover although they still may have symptoms from time to time. There may never be a cure, just dedicated individuals with kindness.

The more integrated a consumer can become in “normal” life, the more beneficial it can be for their future health. He solicits suggestions from consumers about what changes would help them to integrate. These include:
- A flyer to encourage cops to be kind to mentally ill: “we tend to shoplift, piss, and annoy but jail costs more and is dangerous.”
- Medical alert bracelets.
- Hospitals could hire consumers to be companions.
- Realize that we are easily tired, hurt, confused.
- Don’t mainstream consumers. There’s shouldn’t be shame that we can’t be the same.
- Help kids to graduate so they can make it without parents.

Most strikingly, Neugeboren dispels a lot of myths that surround mental illness. Most of us know someone who has been in the mental health system and yet society understands very little about these illnesses. This book profiles consumers who aren’t violent and are making full recoveries from severe psychosis. It is clear that these consumer’s illnesses are not the fault of a weak will. Some lobby openly and freely for better care. Movies often reduce mental health success stories to personal solutions, heroes and miracles. This kind of portrayal absolves others of responsibility and isolates the ill. Neugeboren’s book offers hope and solutions that we can all participate in.

Bay Area... Rapid? Transit?

Ok, so today we decided to go to an A's game. It was a beautiful day - clear and cool. We live about five minutes from a BART stop, so we can easily hop a train to the Coliseum.

Since I’m not a regular BART rider (and I spent a portion of my life living in New York City) I’m a, shall we say, vigilant rider. I like to know what’s going on around me. I don’t really think a BART train in the middle of a Saturday afternoon is a huge terrorist target, but that’s just the kind of girl I am.

So as we’re going through the turnstiles, this guy walks up to the station wearing this rubber mask. I mean the EXACT mask pictured above. And he doesn’t take it off. Ever. To top it off, he’s pulling a wheeled suitcase that appears to be stuffed with a large bag of… something from a garden center; soil, peat moss, mulch, FERTILIZER? Perhaps the highly explosive kind? I think you have to mix fertilizer with something for it to be dangerous, but did I mention the guy was wearing this freaky-ass rubber mask?

What. The. Hell.

And nobody blinks an eye. Nobody stares or calls the cops or nothin’. I don’t want to look like the only paranoid nut in the station, after all... I'm the crazy lady, right? So what do I do? Nothin’.

I have a very good friend who used to be a New York Transit cop. She used to stop people for peeing and jumping the turnstiles and generally acting fishy. I have to believe in New York, a cop would’ve stopped this guy in about 10 seconds. But here in the Bay Area… Rapid? Transit? Nah.

So we watched him board a Richmond bound train and go off in the other direction. I didn’t hear a boom…

Just call me Queasy, the 7th Duff

I’m feeling queasy today. Actually, I’ve been feeling a bit queasy for the last couple of days… A friend of mine keeps begging me to “Just pee on a stick!” Maybe tomorrow… I’ll know more next week. This whole calculus of baby making is challenging, even for a math tutor!

Perhaps I’m just running myself a bit ragged? So in honor of Betty’s schedule I thought I’d share my own. I can never tell if I'm trying to do too much. Left to my own devices, i'll try to do too much and then I'll get burned out and crash. For example:

- Four years ago, I was an architect, working 60-70 hours a week on a $200 million project in San Francisco.
- Three years ago, I was on full disability and too sick to work.
- Two years ago, I went back in the hospital and attended a day program upon my discharge.
- One year ago, I was working 50+ hours a week, running a (different) tutoring company

So here's this year's schedule. I'm trying to keep the work to 30 hours a week.
8:00-9:00: Breakfast
9:00-2:00: varies by day:

Monday: Psychiatrist, swim, therapist
Tuesday: Office work (I manage a tutoring company)
Wednesday: Office work, Yoga class
Thursday: Laundromat, Psychiatrist, swim
Friday: Office work, Group therapy

2:00-3:00: lunch
3:00-7:00: Tutoring and driving to students' homes
7:00-8:30: Dinner (DBT group therapy on Wednesday)
8:30-9:00: Household chores
9:00-11:00: Free time!

What do you think? Am I trying to do too much?

Note: The 7 Duffs appear in episode 9F11 of The Simpsons. Just before Selma’s aunt dies, she tells her to hurry up and have a family before it’s too late. Homer promises Bart and Lisa that he’ll take them to Duff Gardens. But when he eats a spoiled sandwich he purloined from the company picnic, he gets food poisoning. Eager to parent, Selma takes Bart and Lisa to Duff Gardens.

Image found at www.lardlad.com

Wise-Ass Onesie Wednesday

We're a NY Mets family...



Mr. Met mobile available at: http://shop.mlb.com

the package even disappeared from their logo

This has been a strange and aggravating week. And now that I’m off my meds, my moods have been more prominent and unpredictable. It's a little scary, not knowing how i'm going to react from one moment to the next. And stuff like this doesn't help.

On Wednesday, I finally heard back from the Department of Managed Health Care about my grievance.

Good news: Blue Cross is going to pay!

Not so great news: They are going to pay from April to September of 2005 (during those months, they promised to pay and then changed their mind). So… Blue Cross owes me about $3500.00. The current outstanding balance I owe my doctor: $8000.00. Damn.

Bad news: Like an idiot, I called my parents to tell them this (sorta) good news and they didn’t act happy. AT ALL. In fact, they blame my doctor for not giving me a discount. “I guess he just knows that there are deep pockets there…” My mom said. Uh, well yeah…

On Thursday, my car broke down again. I tried my best not to tear my hair out and go nuts about this. I’m always worried that I’m going to say or do something too weird. Then everyone might write me off and think “Oh, she’s just a crazy lady. Let’s not listen or take her seriously.”

On Friday, I battled with UPS. I don’t want to go into all the gory details but let me just paint this picture:

It’s 10:15pm on a Friday night. I’ve been at the UPS package pickup center for almost two hours. The center is a windowless trailer at the edge of a huge distribution center in the middle of NOWHERE. Actually, it’s worse than nowhere… it’s in Richmond, one of the most dangerous towns in the Bay Area.

So all the other customers have gotten their packages and I’m the last one there. There is a security guard but he and everyone else in the building are men. Strange, middle-of-the-night, must-have-done-something-wrong-to-have-such-a-shitty-job men. Luckily, anticipating a moment just like this, I am wearing no jewelry and sporting a sweat suit and a head full of greasy hair. I may be the least attractive (and craziest looking) woman on earth.

And they can’t find one of my packages. They found the book I ordered from Amazon – the one I don’t care about. The package they can’t find contains my records from the Institute of Living (IOL).

The records I ordered from my three-month long hospitalization when I was fifteen.
The records that cost $70.72 to have photocopied.

I waited and waited, getting madder and madder. I tried telling myself: “you survived 3 months in that hell-hole of a hospital – you can survive 2 hours in a dingy UPS depot. But finally, I had to decide if I was going to go uber-bitch on them or just give up and go home. I went home.

Good news: The records finally appeared today.

Not so good news: I just spent the evening reading them and… what a downer.

Bad news: most of the records seem to focus on my “bad attitude.” According to the esteemed doctors there, I was defiant, rude and frequently surly.

For the record, these are pictures of the IOL from their website:


This is the “campus.” I spent 98% of my time locked on one hall of the Braceland Building, so… what good is a campus? Note: the map doesn’t show the spooky, tiled underground tunnels that connect each building. Did I mention that it used to be called the Hartford Asylum?


This is how they want you to think it looks. When I was there, this building contained a very creepy 1920’s era indoor swimming pool and gymnasium. For some reason, this is where they decided to give me an EKG. Twice.


This was the only thing I could see from the one window on my unit. It's the "recreation" building. And they wonder why I was surly…

Forever in our hearts (and on my fridge)

We were so far away and didn't know what to do. I was already awake, well before my alarm was set to go off. The phone rang and I leapt out of bed. Oh great, I thought, running to answer it. No one ever called this early with good news. But it was our friend, John. Relieved, I reassured him he hadn't woken me.

"Are you watching TV?" He asked. "You need to turn the TV on." I put the phone down and, as I walked quickly to the TV, I shouted:

"Hon, John's says there's something on TV. I think you should get up." I turned the TV and saw only one tower. "Oh my god, hon come out here right now! Get out of bed!" I ran back to the phone.

"They hit the pentagon too." John said. I turned to see my husband standing motionless in front of the TV in his pajama pants. His hand rested on top of his head, stuck where he had been scratching his head.

"Where's the other one!?" And as I said it, the picture changed to show the tape of the first building collapsing. Oh no. My husband sat on the couch, his eyes fixed. I know about buildings, the other one can't… As I had the thought the second tower fell. We just stared. We had just watched thousands of people die right before our eyes.

“We’re at war” my husband said.

They were trying to find all the planes. Another plane crashed in Pennsylvania and then nothing. Out the window I could see the planes lined up to land at SFO. I decided I was going to go to work. The terrorists wanted to scare us but if we kept living our lives, they wouldn't win.

I got dressed in pants and running shoes, just in case. Only a few cars were on the highway. Passing Candlestick Park, the horizon opened with the skyline of downtown San Francisco sitting in front of me. When I was little I had nightmares about nuclear bombs falling from the sky. I imagined planes streaking overhead, dive-bombing into the city like warheads.

When I got to my office, I turned the radio off and just sat in the car. Every once in a great while I pray, just in case I'm wrong about God. I squeezed my eyes tight. Dear God, please let them have no pain. All I could think of was the dusty air where the towers should be; crowded with too many souls trying to leave at the same time.

Sunday Book Re-do

Update: My husband just read the previous post and suggested that it was less of a review and more of a “rant about how I hate my parents.” He had a point (a point I would’ve taken a bit more gracefully had he not followed with this statement: “You should listen to me. I’m usually right.” His brand of humor…) So here goes:

Elan Golomb is a graduate of Bennington College who earned her Ph.D. in clinical psychology and her certificate in psychoanalysis and psychotherapy from NYU. She has been in private practice in New York since 1972. In this book, she explores the long-term damage narcissistic parents can do to their children.

Golomb argues that narcissists have a poor self-image but are in denial. Not in touch with their feelings, they inflate themselves, turning into figures of grandeur surrounded by walls, impervious to feared criticism and doubts. Behind this elaborate persona or mask there is nothing and thus the narcissist needs an appreciative audience to support their delusion.

Narcissists behave as if they are the center of the universe, imposing unrealistic standards on those around them. As a result, their families are organized to deny their negative feelings. To maintain this superiority, Golomb argues, a narcissist’s family cannot voice opposing opinions. Their mate is typically submissive and attempts to raise their low self-esteem by merging their ego with their spouse’s greatness.

The children mold themselves into whatever image the narcissist has projected on them. Sometimes the child becomes a wonderful, idealized extension. But when the child is bad, the narcissist can only see the things about themselves they hate. Trained to obediently express their parent’s values, the child is agreeable, outwardly free of malice but seething with internal rage. One case study states that she had to be on brink of insanity before family could see that there was anything wrong. Subject to such constant evaluation, the child feels they must act a certain way to be loved.

Golomb uses examples from her own life and those of her patients to illustrate how this emptiness leads to feelings of falseness that may become emotionally disabilities in adulthood. She believes that an adult child of a narcissist has no support for their inner self, no sense of substance or worth. This void paralyzes any motivation, autonomy, performance, and relationships. It can lead to physical self-hatred, self-destructive behavior and a general sense that they do not have the right to exist. Under stress, these tendencies can develop into pathology and be passed down to the next generation.

Ultimately, Golomb recommends psychoanalytic psychotherapy to combat the codependency of narcissism. She argues that therapists must gently show narcissists how their behavior effects others. For the children of narcissists, therapy can be a forum for them to acknowledge and overcome the anger they have hidden for so long.

Sunday Book Review

(alternate title: books in my library that are more than 60% underlined or highlighted and thus 10% heavier than their weight at purchase)

First in a series!



Trapped in the Mirror
by Elan Golomb
Published by Harper Paperbacks in 1995

This is the book that helped me to understand my parents.

Everyone’s parents can be annoying sometimes but I could never explain why mine bothered me so much. Dad was successful at work so surely, he couldn’t be THAT bad? I’d seen him be charming - just not at home. I’d always wanted to put my family on display. I’d quiz my friends when they slept over, hinted around to neighbors - anything to get a stranger’s point of view. Was my family bizarre, or was I blowing everything out of proportion? When I got married, I started to see their strange moral relativism through fresh eyes.

Life with my parents felt like a very long game of capture the flag. There were rules and sides to choose. You were either in the club or you were an outsider. My parents were on one side of the field and the rest of the world was on the other. In the game of capturing their love I was idealized or devalued. The only choices were to be wonderful or horrible. I had no right no make my own rules.

I knew my dad loved me but his love had an exploitative, exhibitionist quality to it. HE liked making showy gestures, oblivious to what I thought or needed. HIS needs blinded him to my boredom, exhaustion, or resentment. HE hated my autonomy and preferred manipulation, conformity and control. My talents and failures were an extension of HIM. Because we were so similar, he demanded even more. I supposed to obediently model his values and mirror him like a god. To preserve HIS self-image of perfection, entitlement, and superiority I had silently agreed that HE always knew best.

He felt unlovable and defective so he corrected me, not himself. Warning me about potential dire outcomes, he assuaged his own fears. My outside interests were attacked and demolished. Any separateness or difference was a sign of my disloyalty or insensitivity. He would become as angry as if his limb had failed. All his criticism, demands, and unsolicited advice were merely to improve me, he said. He knew what spots were sore because he created them.

The more insular I became, the more destructive the situation became. But wasn’t love always contingent on things being a certain way? Weren’t all families like that? It had to be my fault. So I controlled myself. I controlled myself so tightly that I was left with no humanity, inner self, substance, or worth. This constant focus on my faults left me paralyzed, unable to care for myself.

Warning! Becoming trapped in the mirror can lead to Borderline Personality Disorder, as described in Lost in the Mirror by Richard Moskovitz. I suggest blowing bubbles to help you determine which way is up...

stuck in park

Back in late July it was unbearably hot here in the Bay Area. I was driving in the Palo Alto hills when my car stopped running. (I was trying to find a shady place to park and have lunch while I waited between sessions with my therapists) No weird noises, it just plain stopped running. Luckily, I wasn’t going that fast so I just coasted to a pull-over place. I wasn’t super-shocked since it’s been running a bit rough lately and it was 104 degrees out which is tough on any car.

My husband called the dealership I used to go to when we lived down there and we had it towed there. I only had to wait 1 hour in the blistering heat. (Me, bitter? No… I didn’t need that $140.00) I was so discombobulated I even chatted with the tow truck driver on the way to the dealership. Which was a good thing because he warned me: “Watch out for Benny. He tends to lie. Especially to women.” So when we pulled in and one of the service reps opened the door for me, I said: “And you are…?” Benny.

He and the tow truck guy thought the timing belt broke (sounds reasonable) but they said they’d get back to me tomorrow and then I’ll know more. He said it would cost $500 just to diagnose. When I questioned this, he said it would cost $187. He said he never had loaner cars. When I asked if he could get back to me tomorrow morning, Benny sniffed and started to complain. I didn’t have an appointment and he was doing me a big favor. I didn’t want him to think he could intimidate me so I just looked at him and said: "There's no harm in asking, right?"

The tow truck guy gave me a ride to the Cal Train station. It took me 2 hours to get home on the bay area’s “public transportation system.” I had to transfer to BART at SFO, transfer again in San Francisco. Did I mention it was 104 degrees and BART doesn’t have a single soda machine in any of their stations?

The next day, Benny, the slime-ball service rep, called and told me my timing belt was broken and I needed to authorize $1000 of charges to tear the engine down to check if the valve or pistons were damaged. I thought this sounded fishy so I called the VW dealership in Oakland. They said that everything would be covered by my drive train warranty. I called Benny back and suddenly he was all sweetness and light. I told him not to work on the car; that I didn't trust him, that I didn't appreciate his attitude and told him that he had a bad reputation. Finally, Benny said he'd have car towed to another dealer FOR FREE. I was dizzy with power.

Turns out, my was car fucked. The valve shafts are bent so the whole engine needs to be rebuilt. I spent two hours gathering up my service records. My worry was that VW would decide I hadn’t taken good enough care of the car and claim I’d voided the warranty. I didn’t have $8000.00 just lying around.

Rebuilding the engine took A MONTH. I tried to be patient - It's not a big deal for us to be down a car right now since my husband works so close to home. Last week, I finally went to pick it up. When I got there, I noticed that one of the little turn-signal lights on the passenger side had been broken off. It was fine when I dropped it off, so it must have happened when it was there. Of course, they didn't have the part in stock.
"But it'll only take 5 minutes to replace!" said the service rep.
"Yeah, 5 minutes for you, but an hour for me to drive down here and drive back!" I said. I sighed dramatically and drove off. At least I'll have a new engine in a 6 year-old car, I thought.

And now it’s broken again.

Yesterday, as I was getting on the Dunbarton Bridge, all these dashboard lights came on: check engine, anti-slip, and the mysterious “EPC” light. The car was still running, but when I stepped on the gas it barely responded. I swore. A LOT. When I finally got across the bridge, I stopped the car and called the dealership. Bring it in, they said. When I got to the dealership I looked at the service rep and said: “I think it missed you.”

When my husband finishes his post-doctoral fellowship next year, we’re thinking of getting an all-wheel drive or four-wheel drive wagon - possibly a Subaru or Toyota - something that can handle the mountains when we go skiing. No more German engineering lovingly assembled in Mexico. Any suggestions?

wise-ass baby outfit Thursday

First in a series!

My best friend and her partner had their first child in February. I went to visit them right before Easter when the baby was about three month old. The baby's biological father is a buyer for Macy's so he gets a hefty discount. AND did I mention the baby has two mommies? The result: this baby has more Ralph Lauren Polo outfits than anyone I know.

One night, we stayed up late while watching King Kong. During the entire movie, my friend's partner IRONED the baby's new wardrobe. (which included two (2!) seersucker Easter suits in lovely pastels) Although my child is still theoretical, I can tell you right now, this is not the kind of parent I will be. My child will be dressed in little wise-ass onesies his mom made because she was too cheap to buy them in a store. Preferably, wrinkled.

Upon further reflection "wise-ass onesie Wednesday" has a better ring to it.

go sit in the corner and think about what you've done

My thoughts frequently need a "time-out." Like yesterday, in yoga class. It was the middle of the day and I had rushed to get there. I was preoccupied and a little tired. Suddenly, in the middle of some pretzel inspired warrior pose, I began to feel faint. Out of the blue I was sweating and seeing stars. And even more disturbingly, my hearing was muffled – like my ears were stuffed with Berkeley’s finest organic hemp.

So last night in Dialectical Behavioral Therapy group , I filled out the infamous p.162, the “Emotion Regulation Homework Sheet 1 – Observing and Describing Emotions”

Interpretation of Event: I suck. I’m fat. All the other people in class were doing fine so what’s wrong with me? Could I be pregnant? Not likely. Is it lack of sleep, too many carbohydrates? Maybe I’m dying or maybe something is really wrong with me? My husband is going to be upset about this... he worries a lot.

Body Changes: I felt leaden and hot, flushed with embarrassment.

Body Language: I didn’t want to attract any attention to myself or act any different. I wanted to move slowly like nothing was wrong.

Action Urges: My first instinct was not to do anything and just stay in the pose. When that became impossible, I wanted to hide! I wanted to run home and cry and never come back – to dig a hole and crawl in. After a few minutes I realized that I could just faint and see what happens. But that’s the Borderline talking. I didn’t need the paramedics showing up.

What I did: I walked to the back of the room and got a drink of water. Eventually, I just kneeled down. The teacher saw me and came over. I said that I just felt a little faint.
“Remember, you can always rest in child’s pose!” she said. Great, I thought. Now I’m not even resting properly.

After Effect: I was happy that I was able to get my feet back under me and finish the class. I wondered if I should tell my husband and worry him. Most of all, I wanted to go home and lie down. Either that or exercise non-stop until my ass falls off.

+ + + + + + + +

I’ve been in DBT on and off for the last three years. DBT was designed to diminish suicidal ideation and self-destructive behaviors. Developed by Marsha Linehan, it is the first therapy to successfully treat Borderline. DBT combines Zen Buddhism, behavioral science and dialectical philosophy.

+ The Zen practice of meditation opens the mind so you can become more aware of your situation.
+ The dialectical approach takes your multiple, confusing experiences and questions them. The goal is to explain and break things down until they are unbiased observations. It confronts black and white thinking by emphasizing contradictions.
+ Finally organized into clear concepts and ideas, behavioral therapy can reinforce good behaviors and suppress harmful ones.

Unlike traditional psychoanalysis, the method doesn’t deal with the unconscious processes in personality disorders. It doesn’t claim to fix the underlying problem. It merely says that as long as I’m going to have this problem, I might as well learn how to live with it. DBT is packed with behavioral techniques and acronyms to help you recall them in a chaotic moment. As a result, it can have the patina of cultish mind control. I try to focus on the primary goal, to understand my emotions so I can decrease the chaos and suffering that came with confusion.

Yet even when I manage the destructive consequences of the disorder, I’m not in touch with my emotions. I have no idea how I feel about anything. Every Monday morning, my doctor asks me how I feel and each time I have to really think. Either I feel no emotion or all of them at once. All my emotions, even the positive, motivating ones seem scary. This confusion is the catalyst for my painful, overly reactive and frightening mood swings.

In the “Emotional Regulation” part of DBT, you practice observing and becoming alert to thoughts and senses. The idea is to insert a pause; to separate emotions, thoughts, and behaviors. Slowly, you learn that there is a difference between thoughts, your interpretations of them and facts. It takes a while. But with practice, it’s like to turning on the lights. And you stop tripping on all the furniture.

+ + + + + + + +

When I saw my psychiatrist this morning, he said that I must have pinched off blood flow somehow. His expert, clinical advice?

“Don’t do that pose anymore.”

What did I learn from p162? I have to stew for about fifteen minutes before I trust my thoughts when I’m upset. So many times I’ve wanted to dash out of a room, spewing epithets and planning my own demise. Just like a toddler, fifteen minutes of sitting quietly and glaring at the corner seems to do me a world of good.

(note: believe it or not, this chair is actually available for purchase at: http://www.allkidsstuff.com)

just a dick

My husband just read the last two posts and said:

"You didn't explain why this guy is a narcissist."

"I don't know why he's a narcissist." I said. "I don't know anything about his background."

"No" he said. "You don't explain why he's a narcissist and not just a dick."

My husband is a very smart man.

Notice he doesn’t mention the bike accident…

Here’s the most recent set of emails from Hairy:

“Hi Juniper, Can you give me the names/numbers of a few families whose kid(s) you assisted in preparing for these exams. My son will have to take the exam to apply to two Catholic Schools: Bishop O'Dowd and St. Mary's. Do you know when and where the tests are given? When should prep begin? My son returns from camp on July 24, but then leaves again for a two week camp on August 6, back on August 19. As you know, his vocab and spelling are very weak. Same with grammer. If this test emphasizes this, he will have to work hard. You know my son, and you know these tests. Do you think he will do well? Can you tell me more about the content of the test? Thanks, Hairy”

This was back in June. When I didn’t email him back soon enough, he called me at 10pm one night to demand answers. (For the record, these oh, so crucial exams to get into High. School. And i've been tutoring his kid for over a year so now he needs references...) The tests are given in January. Then this email showed up yesterday:

“Hi Juniper, the phone number for the reference you gave me is disconnected. Do you have a different number? Also, let's get geared up for his practice. Do you have homework for him to do now before school heats up??? He tells us that he would like to go to Head Royce....Thanks, Hairy”

I emailed him right back this time:

“Hello Hairy, Hope you are recovering well – your wife told me you had a bad bike accident. Here is the new phone number: XXX-XXXX. In your regard to your question about homework: do you mean review for his High School entrance exams? My first step would be to order the Catholic High School Entrance Exam (HSPT) and Independent School Entrance Exam (ISEE) study guides off of Amazon and have him take a look at the sample tests to become familiar with the formats. I'll be meeting with your son next Monday and can assign him some homework from the study guides if you would like me to. Thanks, Juniper”

And then I got this one this morning:

“Which ones to get Juniper? Arco, Kaplan, Princeton, Peterson....there are many. Which is the best, ie the closest to the actual material, and comprehensive enough to cover most everything.... If you're not sure, I'll call Ivy West or some of the schools to see what they recommend. Thanks, Hairy”

Doesn’t this guy realize… I know where he lives?

Whoops.

“Professional, Expert” Narcissus

I have a problem parent.

Not my own parents (although they provide more than enough problems), I’m referring to the father of one of my tutoring clients. “Hairy” as I’ll call him is a narcissist, by which I mean that he has Narcissistic Personality Disorder. I recognized it right away – he reminds me of my dad. You might recognize the type… we currently have one for a president… everything they say sounds defensive and condescending. Narcissists are prone to extreme mood swings between self-admiration and insecurity

When admiring themselves:
• They are absorbed by fantasies of entitlement and unlimited success.
• They act in a grandiose manner with an exaggerated sense of superiority and self-importance.
• They have unrealistically inflated views of their talents and accomplishments believing that others envy them.

When insecure:
• They are extremely sensitive to criticism, failure, or defeat.
• They become enraged or seriously depressed.
• Desperate to regain attention and admiration they consider others’ viewpoints, needs or beliefs less important. They use this belief to justify exploiting the people around them.

Ironically, narcissists frequently are high achievers, and successful professionally. This dad is a professional, expert medical witness. Yup… he goes and testifies why you may or may not really be as sick as you claim to be. (perhaps the perfect profession for a narcissist – telling other people how they feel) Yet because they lack empathy and patience, narcissists rarely have long-lasting intimate relationships and often offend the people they encounter. Like me.

I used to just deal with my student’s mom and everyone was happy. But about six months ago, dad stepped in. Hairy wasn’t happy with my performance and called to let me know why.

I left his house half an hour early because the kid had NO homework. I told my student that I wouldn’t charge them for the full hour. Silly me, I thought the family might not want to waste their money on unnecessary tutoring. I was informed that it was my job to show up prepared with work their son could do if he had no homework.

I was still charging them $50/hour although I was no longer working for a tutoring company. I told the dad I probably wasn’t the right tutor for him. “Why?” he asked. Because that’s the fee I feel is commensurate with my level of experience, I said. I assured him I wasn’t some 20-something college-student and he relented. Actually, I think he loved hearing that he had a seasoned, mature employee working for him. The next time I saw him (when he wandered in, bare-chested, after a bike ride) he exclaimed “my youngest son… with my oldest tutor!” Ass. Hole.

Health Net - A Better Decision?

Sadly, the encounter I described on my last post was not the first time my insurance company and I had to “rumble.” The story began long before that…

When I first got sick again in 2002, my insurance company cooperated. At the time, my insurance company was Health Net and their behavioral health subcontractor, MHN.

• When I started to feel suicidal again, I called and asked to see a therapist. They gave me a list of providers. I called the list and found a therapist who could see me. I saw him once a week, for a few months and MHN paid for it.
• When the therapist suggested rehab, I called and they referred me to a bunch of programs that they would cover. They all looked a bit grungy – not the kind of rehab-by-the-sea you see on Dr. Phil. But they were real programs that MHN was willing to pay for.
• When the therapist suggested medication Health Net paid for that.
• When I got really sick and my husband took me to the hospital, MHN paid for it. Even though I knew Heath Net covered treatment at that hospital we waited in the lounge for four hours while they negotiated. My doctor had to battle mightily with MHN to let me stay for a month. Luckily, I was so sick, he convinced them and MHN paid for the whole visit.

When I got out of the hospital, they were hoping I’d be fixed and stop spending their money. But I was far from fixed. I kept seeing doctors and that’s when the problems began.

-----------

My doctor in the hospital said I was still too sick to go home, so he wanted me to go to a residential program nearby. When I went to visit the residential program, they offered to contact Health Net to obtain authorization for my treatment. But it would take a week or two to process all the paperwork, they warned. What could I do - I couldn’t stay in the hospital for a few more weeks and I couldn’t go home? My parents offered to pay until the insurance kicked in. Then we could try to get their money reimbursed. It would have been healthier to separate from my parents, but they are wealthy and there was no way I could afford my treatment.

A month passed and we were still waiting for Health Net’s authorization. My parents were getting anxious and wanted to know what was going on. Finally, my therapist suggested I speak with the program’s director, “Lardlad.” I knew him already since he ran my dual diagnosis group. He was a former businessman and bar owner who got sober and had become a substance abuse counselor.

When I went to meet with him at his office, he was warm and gracious. He tried to squeeze into the armchair across from me but his rotund frame wouldn’t fit. He perched on the edge of the seat. I tried to explain the situation. As long as my parents were paying they had control over me. That’s why I was so persistent, I said. His acne scarred cheeks bobbed up and down in understanding. He’d take care of Health Net, he said.

A couple more weeks passed and nothing had changed. At first, Health Net claimed that my plan had been cancelled. One minute they’d never heard of me and then suddenly, poof, there I was on their computer screen. They’d lose a claim or process it wrong. I started thinking about all the time that had passed. My parents had already paid $8000.00. What if Health Net wouldn’t reimburse us, I asked Lardlad? The program had to get payment first, Lardlad said, his grin drooping with impatience. Then they’d help me get my parent’s money back. Maybe I should have done it myself, I said, twisting my fingers into knots. Maybe I could’ve fixed it right away. The therapist said he’d handle it, I said tightly. You said you’d handle it. My throat was choking. I didn’t want to cry - I wanted him to take me seriously.

Ok, he said, looking at the floor. That’s fair. From now on, I should just pay the co-pay. The rest would be the program’s problem. I went outside to call my husband and gloat. I wasn’t going to let anyone dictate what kind of care I got. I would yell until I got what I need.

After almost a year there still was no progress. I didn’t want to ask Lardlad about it, but I had to get my parent’s money back. Frowning, he said they were giving up on the insurance. How was I going to get my parents’ money back, I wondered, sighing?

“Don’t worry though, we’re still going to talk to Health Net about your doctor’s fees.” Lardlad said. I hadn’t been reimbursed for those bills yet either. I whirled around.

“”I see my doctor in his private practice. You guys don’t have anything to do with that.” I said, trembling.
“I know, but we’re going to help you with it.”

“Help me? It’s been over a year and you guys haven’t accomplished anything! Now you’re going to screw up my doctor’s bills? Why in the world would I want you to do that? You have no authority to meddle in my finances!” He followed me out onto the front porch.

“I don’t like the implication that my staff and I haven’t been honoring our promises. I’ve called Health Net over and over and spent hours on the phone. Your accusations are not appropriate.” My trembling turned to shaking. Why was he reprimanding me? Tears were splashing off my nose like a gargoyle.

“Stop, just… please! You don’t understand. My parents are calling me every week asking what I’m doing to get their money back. It lets them control my treatment. I worked so hard… “ He tried to speak but I was hysterical. “I never get away from them! They’re never going away! They don’t think I’m doing anything. I trusted you to help and now it’s a disaster! After a few minutes my therapist came out to comfort me and Lardlad excused himself.

Finally, I contacted the California board of Insurance and asked them to audit my file. Health Net paid us almost $20,000 and admitted that they had been negligent. It had taken them over a year.

-----------

No matter how hard we fought, my care is still extremely expensive. Every week we pay almost $200 in co-pays. It takes hours just to keep track of all the bills. It doesn’t help that the insurance representatives can be rude. I try hard to be patient but sometimes we get into stressful arguments. Often, I’d hang up the phone, shaking with any number of emotions I’d restrained.

Gee, it’s like they know that mental illness compromises emotions and self-esteem, making it nearly impossible to stand up yourself…

Get the power of Blue, working for you!

I've been spending a lot of quality time on the phone with my insurance company lately. In the middle of all these battles, sometimes it seems like I might have to give up on therapy, insight, and analysis. Maybe I should give up on trying to enjoy or care about things; abandon the idea that my life deserves improvement. Does the insurance company prefer that I walk through life half-asleep? Maybe that's what everyone else does.

A recent history: Since I became a member in June 2004, Blue Cross had paid my claims for my psychiatrist. When I became a member, I was told to send my claims to Blue Cross, not United Behavioral Health (UBH). I began submitting these claims every other month. Because my doctor was out of network, approximately 70% of the charges were reimbursed. Now mind you, my doctor doesn't deal with ANY insurance plans - he feels that they're a waste of his time and energy. Some of his patients can afford to pay out of pocket and the rest of us fill out the paperwork and submit claims on our own.

After February of 2005 all my claims were denied. I called numerous times to inquire about this and each time I was told that the denial was a mistake, that the claim would be resubmitted and that Blue Cross would pay it. I submitted more claims as the months went by and all of them were denied. Finally, in September of 2005, I was notified by a customer service representative that Blue Cross should never have paid these claims - that they should have gone to United Behavioral Health.

Then they said that Blue Cross would not pay for any of the claims that were currently being processed. I complained because during the seven-month delay that they had caused, I had continued seeing my doctor. Blue Cross said that they would pay for one month because they recognized their mistake. But they would not pay for any other claims. They also added that "I should feel lucky to get that much" and any further complaints would never be addressed. I was told that a supervisor would call me but I was never contacted by anyone.

I filed an online grievance with Blue Cross in November of 2005 and was told that a decision would be made within a month. After a month had passed and I had heard nothing, I was directed to customer service representative. He informed me that they had no record of my grievance, and referred me to another customer service representative who told me that my grievance had been sent to UBH because it dealt with behavioral health services. I tried to explain to her that my grievance was with Blue Cross, and that UBH would have no ability to address my grievance, but she didn’t seem to understand. Finally, she created another grievance and forwarded my case to "a senior quality management clinician." I had to laugh when I heard the title. I asked her "whose quality is she supposed to be managing... mine or yours?" In February of 2006, I was notified that my grievance had been denied.

My chronic, major, and life-threatening depression should be covered by California’s parity laws. But because my doctor isn't "in their network" (or anyone else's) they were only willing to pay for 20 visits a year. Unfortunately, I'm already using those 20 visits to pay for my therapist (who is also "out of network"). UBH would probably pay if I switch to one of their (less expensive) providers. But I have a productive relationship with my doctor and continuity of care is essential in psychiatric treatment. Even if I could find a new doctor and therapist, they’d have to be UBH providers taking new clients. After months, I might not find the right person. I met a lot of caregivers in my time:

- The elementary school counselor at age 8
- The prep school counselor and consulting psychiatrist at age 15
- The team of doctors at the Institute of Living
- The other prep school counselor (since I couldn't stand the one that hospitalized me)
- The doctor at Cornell
- The therapist at Columbia
- The MFT in San Francisco
- The doctor at UCSF
- Three DBT therapists
- Two group therapists
- A marriage counselor
not to mention the doctors, social workers and therapists at: three hospital & one residential psychiatric program

UBH even refused to make a single case agreement. And why would I want that anyway? Once I did that, then their case manager would get to have a say in my treatment.

When Blue Cross denied my claims I was left liable for all the charges for this provider. If I pay out of pocket, my treatment would cost me over $20,000 a year. With the job I currently have, ALL of my (after tax) income would go to the bills. So I asked my parents for some of the money - the people who made me sick in the first place. I think the insurance companies really just want to make my life so difficult that i'll eventually just give up. Sometimes it feels just that personal - i've been identified as one of the sick and the weak and now it's their job to weed me out of the herd. This is the thanks I get for trying to utilize preventative and less expensive outpatient care.

Question: does it seem strange to anyone else that UBH's logo is a frown?