#i'm sure cbt works for some people but i am not one of them this is a waste of both of our times

[silenthillmutual]

cbt doesn't do jack shit for my mental illnesses either, yet therapists insist on using it for me, so i've got that in common w people who have chronical illnesses

[cemeterym]

i am a cbt hater FOR LIFE

[leebrontide]

OK!

So I am tired to death of people learning a bulletpoint definition of CBT writen by some influencer trying to sell them a tracking app, on fucking Instagram, and deciding that therapy is useless.

What CBT is NOT: Talking yourself out of having negative feelings because all your problems are made up and in your head.

What CBT IS: checking your thoughts to make sure that the negative emotion you're having is the one that best applies to the situation, so it can motivate appropriate behavior!

If someone treats me shitty, and I try to do the first approach, I am going to conclude that their shitty behavior doesn't matter and I'm going to keep tolerating it. If I do the second one, I can make sure that I'm not shaming myself for someone else's shitty behavior, so I can get appropriately mad, and correct or remove the person pissing me off! The anger is useful and she shame was not!

What CBT is NOT: taking solo responsibility for every stressor in your life, like trying to therapy your way out of the very real stressors of poverty.

What CBT IS: working to connect you to useful feelings that can make you more resilient against those stressors (by, for example, letting go of being ashamed of not having money, so you don't go get the food stamps that would help you) AND by helping you to connect to your feelings about WHY you are in poverty, which can connect you to things like collective action to address large scale issues!

What CBT is NOT: removing all your feelings in place of "rational" thought.

What CBT IS: making your feelings a useful source of information about your needs, so you can see all of them and not get sucked in to tunnel vision, and find more and better ways to improve your life. Like yeah - maybe right now you are stuck at a garbage job that is making you miserable! Maybe that's your reality at this moment! But maybe you are also lonely and when you take stock of that feeling you can recognize that seeing a friend would help you feel better, even while this other problem is not resolved yet!

Is CBT the solution to everything? NO! Is it an approachable way to debug some of your feelings and take some internal pressure off? Yes! Everyone has some thoughts that are not 100% true. Our brains are basically a power-aide jello full of electricity it's amazing they work as well as they even do. But it's useful to audit that shit now and then. That's what CBT is. It's just auditing your thoughts so your feelings work better to actually address or survive your real life problems.

I know not everybody can access therapy but PLEASE stop making therapy look fucking useless so that when people can access help they have already been told that change is impossible and getting help is useless.

Know what therapy is so you can get it if you need it when you can, and also so that if you have a garbage therapist you can recognize them as such and replace them.

[willow-schmillow]

The Is and Isn'ts of Fusion

(copied from my reddit post x3)

Hiya. I'm someone undergoing fusion-focused therapy to treat DID. Every day I open this app to some new and fascinating misconception about fusion, so I wanted to clear things up.

Please note that I am not a student of psychology or mental health practitioner. The advice I share comes from my personal experience of fusion, as well as my therapist's - who has multiple clients with DID - understanding of fusion-centered therapy. I have also done talk therapy, parts work, cognitive processing therapy (a modified form of CBT to treat PTSD), and DBT.

Fusion isn't...

- **A convenient way to get rid of alters.** I can speak for myself, and other fusions within the system have said the same, that we carry on our personhoods and identities and memories, and even relationships within the system. I was V and M, and now I'm both of them.

- **A loss.** As said above, my personhoods carried over when the parts of me that make up me fused. If anything, I view it as a gain - Ariadne has everything V and M had, plus a bit more because I am a calmer, more controlled, and more mentally equipped person.

- **The death of an alter.** In a literal sense, alters cannot die. And, also, as said above, my personhoods carried over.

- **The end of the involved alters' relationships.** This isn't a problem for us with other people, because we operate as a package deal in our relationships with others. But also, within the system, some of our insys relationships carry over. Gabriel was Monika's best friend, and he's still mine. Some of our insys relationships are different, too (Fray and Cal are no longer romantically involved,) but like all changes we can adapt to it.

- **Purposely killing an alter.** Shut up.

- **The same thing as integration.** Integration is any type of processing and work that results in the system "running better" - smoother communication, greater continuity of memory or experience, more willingness to work together, and fusion are all some examples of integration.

- **The only choice to get better.** Some people with DID find that functional multiplicity suits their recovery goals more.

Fusion is

- **Healthy.** I'm happier fused than I was apart, for sure, even though it was a difficult adjustment at first. I've had to overcome knowing a fuller picture of my childhood. It's difficult, but I know this is what I want and I'm doing better.

- **Stable.** Lots of fearmongering happens in DID spaces, with the idea that once you fully fuse you're prone to splitting apart again. While that is possible, fusion does not happen without *significant* healing and trauma processing. By virtue of being able to fuse, work has been done. New, healthier coping skills have been learned.

- **A fluid experience.** Within our own system, we experience fusion in different ways. Fray is one alter who holds many experiences. I'm Ariadne, but Monika and Val are still two distinct parts within me. There's absolute continuity of experience, consciousness, and emotion, so I don't consider us separate the same way our alters are. But, I'm one and two at the same time.

- **Achievable.** With sufficient trauma-processing, many people are capable of fusing.

- **The right choice for some people.** Functional multiplicity works for many. I'm not devastated by the thought of remaining multiple for the rest of my life, but I'd also like to work towards fusion because I know that's what would make me happiest.

[caffeinatedopossum]

I need your theories… do you think the way people think affects how therapy would work/how they would express things/express it in a manner that is recognizable? I know some people think with words as a narrator and some dont, and Im sure theres even more ways, so how would that impact the way you communicate especially in situations that rely on things that arent literal?

Just curious because I was trying to think about how I go through a phase of strongly disliking something when it comes in my life at like month 3 until honestly up to a year, and Id express that as actually believing them to be an imposter or dangerous or something and this is an issue Ive had for a long time but I have never put it in so many words, instead of just an emotional sense when Im confronted with it. But I realize that is how it is for most things and Im never experiencing in words except when I am enacting a conversation I want to have. Hmm. Confuddles me.

Absolutely, it does effect it. There's an obvious advantage to people who think primarily in words and have the ability to visualize.

I personally think almost exclusively in words but perhaps in a way that isn't the most usual. For me it's almost like having a constant conversation (or even multiple conversations) with myself.

It can be really frustrating when therapies like cbt focus on changing thoughts to change feelings though since my thoughts seem to not effect my feelings as much as the other way around- like changing my feelings 100% impacts my thoughts but changing my thoughts does not change my feelings. Which is unfortunate since I only have control over one of those lol

I've heard of therapists using primarily visualization for people without internal monolouges- like saying to imagine their feeling as a red hot metal ball and then imagine it slowly cooling and going back to a cooler color- but it sounds like such a foreign concept to me that I can't imagine it being super effective. Really hope I'm wrong though!

[lilflowerpot]

ok, I have the most important question of all: How are you? Hope life is going well for you right now?

((rambly personal post incoming, you have been warned))

I am,,,,,,,,, learning, I suppose. You know how people tell you that life is less a steady curve of progress, and more a wiggly-woggly mess of ups and downs and tight little knots that no one—least of all you—can make sense of? I think I am in the process of unraveling one of those knots.

Those of you who've been around for a while (or have been very dedicated in combing back through both this blog and my ao3 author notes) may recall that I've had a somewhat contentious relationship with my health for several years now; the short of it is that burnout is no joke, and I've come to accept that due to various life circumstances and the extreme stress caused by them c.2014–2018, the ramifications my body suffered in the years following will... likely never go away completely. My physical health is not what it was, and possibly never will be again, but with the divine combination of medication & love, I'm learning to live with it, so aside from one small scare that saw me rushed off to A&E for an utterly //thrilling// overnight adventure back in july, I am greatly improved from where I was a few years ago.

On a more positive note, I started therapy! Though it's not something I advertise irl due to being quite a private person (and having someone in particular in my life who,,, shall we say struggles with respecting boundaries?) I want to be open about the experience on here, because mental health is absolutely something that should be destigmatised, and I think that my younger self might have reached out sooner had she had more people tell her that it was okay to do so? I started CBT in early 2022, which really didn't work for me because it felt very... focused in the moment? Like "go on a walk! set yourself tasks! simply Do Better :)" and the therapist I was working with did not, to put it delicately, make me feel particularly listened to—by which I mean he would repeatedly cut me off to ask questions......that I tended to be already halfway through answering.

I've now moved on to Psychodynamic therapy, for which I've only had a couple of sessions thus far, but have found infinitely more helpful and suited to the issues I personally need to address; I'm sure you've seen people saying things of this vein before, but I cannot emphasise enough the importance of finding a therapist that works for (and more importantly with) you! So if anyone reading this has perhaps toyed with the idea of therapy, but lost heart (darling, I've been there) then please allow me to encourage you to seek help if you are able. I won't lie to you, it's emotionally taxing—exhausting, even—and already I've cried about things I didn't even know I was still struggling with, but it's also been i n c r e d i b l y cathartic to have a professional with no emotional stake in my life (ie. I don't fear judgement or personal ramification) walk me through the process of untangling it all.

What else... oh, I'm taking up lifedrawing again! It's something I greatly enjoyed during university, and I've managed to find a class nearby that starts up next week, so I'm very much looking forward to that. There are also several additional (and entirely free!) short courses offered by my local college that I'm looking into, in the hopes that I might find some passion and direction for myself beyond where I am rn. As a final note, I've got an exciting personal project in the works that—all being well—I'll hopefully be able to reveal to you all in the coming spring, so stay tuned for that!

So yes, I'm learning, things are looking up, and I'm working my way toward building a modest future for myself, even if it's not at all what I might have expected it to be a decade ago. Life is funny like that.

[creepycrawliesinyourwalls]

rambling; online diary

i truely believe i can do heroin and not be addicted. i've been on dilaudid before, ive gotten high off my ass on weed, i took some vyvanse to see how itd go, and ultimately it was boring. being high is kinda boring. i complain about not having my cart, sure. but being so fr rn i do it for show. no one would ever believe me in a million years, but it is genuinely for show.

i have a hard time defining myself as a person, given the disorders i have. anything and everything that i could add to myself to humanize myself is a positive, never a negative. humanity is by definition flawed and faulty, if i have a flaw im more easily humanized.

im also incapable of being perfect, though if i wasn't abused to the point of my brain never fully forming a cohesive personality, i'm sure id be a prodigy. if my brain genetically disabled, i'd be top of my class, 4.0 gpa with honors.

with dissociative identity disorder, autism, adhd, bipolar 1, ptsd, clinical depression, arfid, and probably some sort of personality disorder, its hard to care about anything at all. these are only the mental and neurological disorders and defects, too.

inherently i was given the worst hand i could have gotten in birth. my potential is wasted, trapped inside this failure of a body. i could have been so much more. my face is somewhat conventionally attractive, so theres a win.

im confident that without my memory issues, joint pain, and depression i could be a full blown doctor. i have to settle for marketing, because my gpa currently is too low to get into engineering. i wanted to do mathematics for awhile to get into finance or something. i wanted to do geology bc my special interest is rocks, but i don't want to work for an oil company.

if i am not constantly improving with my life in any aspects, if i am stagnant for a stretch of time, i consider it a failure.

i do not have a personality, at least nothing coherent and consistent. some people say im loud, some say im shy. sweet, mean, smart, dumb, its all contradictory traits.

i consider myself better then most of the people i choose to be friends with. a good lot of them (danny, chloe, viktor) will probably never go to college. kaden might go, but im sure she'd just party the whole time. alix is maybe the only one who i'd even consider on my level, since he's aiming for law and finds debates enjoyable. he has the drive and determination to do well in life, and is at the very least takes steps to get where he wanted to get.

chloe wanted to get into medicine and be a doctor. she is chronically disabled and was failing half of he classes. from disabled to disabled person, there is no way in hell you are making it that far. id be surprised if she made it past 25, honestly. she viewed mental hospitals as a vacation, even excluding the morals on that view, its incorrect. she believed she wasn't addicted to her medication, and that it actually helped her. she never even tried.

i am beginning to become fond of alix, though. i hope my headmates realize how much better his is compared to others. taylor and vee are already fond of him, which is a good sign.

we seem to be improving our depression symptoms and dissociative amnesia, and we joined a cbt program to further along process after being voluntarily admitted to a psychiatric facility. (yes, we did ask to go. we were going to kill ourselves as soon as we were alone, we needed immediate help.) i want to work on breaking down our gatekeepers resolve, and get us to a place where we can work on final fusion. i would also like to address our npd traits, but our therapist wouldnt believe us, so ill have to work on that myself.

we haven't been practicing our religion as much as we used too, its kind of sad. we send a prayer up to apollo occasionally, and he usually answers. but otherwise we havent done any spell work. its sucks to admit it, and god to i want to delete this paragraph but i need to work on vulnerability to create and foster friendships that are mutually beneficial.

ive never seen the point of online friends, i think the concept is pointless. i've tried doing it, and everytime we ended up ghosting them. the effort did not match the spoils. if im going to have friends, i need them to invest in me before i invest in them. it can be materially, emotionally, or physically. as long as i gain benefits, you will too.

[happymusicwhispers]

Walking Through Memories Part 3

By the time I was 16 years old I was living in a house with 5 - 6 others and my son. We partied at night and then I tried to stay awake and above the curve in high school. It was a crazy time filled with pot, pills and different men in and out because we were all so emotionally damaged that we self sabotaged every relationship we had.

We started rescuing the young ones; who like us had been dumped out on the streets by parents, foster parents and adopted parents. We just couldn't let them go through what we had.

We thought we had finally gotten free of that life. We were only fooling ourselves.

The night terrors came often and we learned to cope with them by self medicating ourselves. Crystal to stay up to work, go to school and to party. Valium, ludes and codeine to come down and sleep without the terrors.

We never considered that we were running from a past we would never be able to leave behind. It showed it's damage in so many ways, unwillingness to get close t o other people. Self sabotaging relationships when we did. Drug and alcohol dependency. When we did get in a serious relationship it was always with someone as broken and damaged we were.

I was married 3 times; the first to a drug and gunrunner who was hooked up with some very dangerous people. It lasted 7 years and gave me a daughter I couldn't bond with. My son was 12 when she was born and I let him move to a friend's in KY so he could go to an elite science academy. I thought I would die when I drove away but I pledged when he was born that he'd have a better life than I did and this was the way.

The marriage lasted about 5 years and I remarried in less than 6 months. This one was a gambler and a cheat. I had another son with him who I loved more than life itself. He had some serious health issues. a stroke at 3 days old and another at almost 4 months. The stress from that and me pushing him away constantly ended that relationship. The last one lasted less than 6 months. He got addicted to crack and the stripper across the street. No fixing him or that relationship.

As I'm writing this I am now 60 and still in therapy. I just started getting my life together at 45. The fear of the unknown as opposed to the fear of known kept me stuck for a long time. I am now taking CBT therapy and my therapist is wonderful. (Always has a full box of Kleenex) I am beginning to accept some things but still have a ways to go. There were so many things in my life I wasn't responsible for happening. Although I've always took all the shame, blame and guilt on myself regardless

That's a lot for a 60 year old to live with. It was unbearable for a 6 year old,

I stopped self medicating years ago but this is one of those things you learn as a throwaway. It numbs the pain and just for those few hours you forget where you've been and how you grew up but never the faces of your rapists. They will stay in your subconscious forever. The pushing people away that I learned; I'm an expert at it now. It seems to be the hardest habit to break. I have my sons and my one friend an then there is by daughter and grandsons. I haven't seen them in years now. I was fantastic with the grandsons but not so good with my daughter. My therapist says it's because I feared abandoning her...I'm not sure on that but I do know we never bonded.

This is the 3rd and last part of my story this far. I don't know what the rest of my life will bring me but it will be better than my earlier years.

So please parents, adopted parents and foster parents think about my story before you decide to abandon your own child. The streets are no place for a child to grow up. It is a good place for them to be tortured, raped and abused in more ways than you could ever imagine . I don't believe any parent could do this knowing what their child's fate would be .

[wikipedie]

Ok so this might be absolutely bonkers and/or I might take the show too seriously but as someone fascinated by therapy/therapeutic methods and trauma i need to talk about OFMD or I'll explode or catch fire or something

For starters, Stede is one of the best therapists I've seen on screen and he's not even a therapist (god the amount of ramblings I do about media portrayals of therapists). He genuinely truly cares about the crew and wants to help them grow. He sees them, sees their trauma and he recognizes the system that made them be pirates, doesn't blame them for it. ("Traditionally piracy is a culture of abuse, floggins, keelhauligns. And my thought is "Why?" and also "what if it weren't like that" "). Also, the quote about how "every captain pirate captains pirates differently" really made me think about how every therapist has their own unique approach of dealing and connecting with the people who come to them.

He builds amenities for the crew. He creates a session of feedback after his raid and gives attention to the positives (even if I laughed at him basically applauding himself on his own speech). When Wee John complains about his way of doing things, he says

reframing thoughts being a technique in CBT. Not quite the same thing, but reframing criticism is stemming from that. When Wee John brings up the very valid point that they don't have a flag, he agrees with it and creates a session of art therapy, for them to express themselves by creating flags!

When Black Pete complains that it's 'women's work', Stede doesn't simply tell him he's wrong. He turns to the crew immediately and he asks them "How many of you sew?". He uses positive reinforcement with Roach! (Roach has sewn his own arm up and that's difficult, I'm sure you'll also be able to!). He genuinely believes that the crew is good and they are traumatized people capable of doing good (and he is right of course)

sThe whole scene is absolutely precious. The way Stede goes around, checks in with everybody and actively listens to them and encourages their ideas. He supports Wee John who used to make dresses with his mum! (and now he's a pirate). And again, he acknowledges their trauma and teaches them skills of interrelationships (true, basic ones such as sharing but still).

Speaking of trauma....

I was and am absolutely delighted at the way this show deals with trauma. We see Stede's trauma with his father from the pilot (having an abusive and neglectful parent) and the trauma of being bullied in school and we see how these affect him.

We see then in turn how the trauma influences his actions (as trauma does). We see how killing Badminton is traumatic for him (because killing people is traumatic for him - and I guess traumatic in general - but we also see how killing is connected to his father and the idea of 'being strong') as Badminton literally haunts him.

Then there is his guilt of leaving his family, which is briefly addressed in episode 2 as he goes on his own 'therapy session' (a lot of therapists do go to therapy). (Holy shit I rewatched a bit of that scene and the old man says "until you resolve that guilt, you'll continue to be haunted" which ties up with Stede leaving Ed. He could never be fully happy with Ed if he didn't come to a resolution about the family he left behind. Anyways that's for another post.) And that one is also a fantastic therapy session! "Everything is coming from within you." "Why does he keep insulting me? -> Do you feel inadequate in some way?"

And then, of course, there is Ed's trauma, which becomes clearer and clearer the closer he gets to Stede and the more he opens up: The violent and abusive ways of being a pirate, that still echo through Izzy, the trauma of having to murder his own father, to be Kraken, the trauma of killing and the pressures of being Blackbeard. All of them being activated and manifesting in most harmful ways when he feels abandoned by Stede.

And lastly beloved Jim. We see how even Jim has lost their family and how they deal with that. They deserve much more space than I am giving them right now, but my brain is turning mushy. But I am thinking about giving them their own post. (or maybe I'll do an individual post for each character I don't know). One important thing to note is that Jim is the first person that breaks out of their harmful pattern. They return to it when they meet with their old Nana, but they listen to Spanish Jackie and they're the first one to actively try to...let it go. Return to Oluwande, build a life with him.

Anyways I love this show and I love these characters and all I can say now is

(and this is probably not the last I'll talk about this because I love this subject and I love analyzing it. also i kinda want a therapist!stede fic now.)

[free--therapy]

What are some concrete ways to increase your self worth? How do you change long held beliefs about yourself?

Hey Anon,

Increasing your self-worth begins with challenging the negative core beliefs you've developed over time. In order to do that, you need to first figure out what those core beliefs are. Cognitive Behavioral Therapy (CBT) helps specifically with doing this.

Once you've identified your core beliefs, you begin to challenge all of the thoughts that are associated with them. An example of a core belief can be something like "I'm not good enough". How to challenge that? When the thoughts arise, you have to convince your mind that what it's saying is not true. Our thoughts are not facts and it's important to remember that, even when we feel like they are. You have to rationalize your emotional mind. Some things you could say to challenge those specific thoughts can be something along the lines of: "I am enough," "I am perfect just the way I am," "I am complete and worthy," etc.

While challenging your thoughts can be difficult and feel hopeless at times, repetition works. You have to remember that it's taken you x number of years of repeating the same negative thoughts to develop the thinking you currently have, so it's going to take some time to rewire your brain to think more positively instead. It takes a lot of self-love, -compassion, -kindness, and -forgiveness to develop these new habits. One thing I like to tell people when they're trying to be forgiving to themselves is to think of yourself like you would with a baby or a pet. There are certain things you can't get upset or mad at them for because you know they don't know any better. We are the same. We often believe we should know better in certain situations, but we really don't. We know better by doing and making mistakes. We can't beat ourselves up into thinking better or more positively. We have to make sure we're always doing something different instead of repeating our same negative thinking patterns/cycles and being encouraging and loving to ourselves in the process. No one else can make us love ourselves.

Please let me know if you need any further explanations or more examples, I'm always happy to help :)

[the-sappho-of-lesbos]

op could it be that because you're so conflicted about your lesbianism, when you don't get your other social needs met, it feels like the easy-to-blame candidate for your problems? bc i mean realistically--and i mean this respectfully--your orientation is only likely to come up in your pursuit of romantic & sexual relationships (are you, love interest, into lesbians or aren't you?) and/or figuring out who your people are, but even then, that's just checking a box on the "are you cool with gay people or not?" box so you can know youre safe with them. it sounds to me like youre conflating two different stressful issues. also, are you actually making progress with your therapist/psychologist? have you considered doing DBT or CBT to manage your social anxieties? both are very "building skills" focused, whether it be coping skills or learning how to manage your relationships & start new ones. would highly recommend it. as a person who used to have near rapid c-ptsd, hella anxiety, depression, OCD, etc., learning how-tos essentially on how to do people things was a HUGE relief for my brain, helped me feel more normal and adequately assess what was going on in the social realm and then correct behavior or assess more accurately dynamics. i am also another lesbian, if that helps you contextualize what i'm saying.

(Sorry in advance of these weren’t all your asks - they just sounded like they were from the same question to me)

Thank you for taking the time to reach out and write this out for me. Your concern is really appreciated and you have a wonderfully kind heart 💕 I’ll try to answer each of these in parts. But I have to apologise in advance because while you bring up some wonderful points and ask a lot of good questions I’m worried I won’t be able to answer them properly- so I’m really sorry.

1) I think I conflate the two because in my personal experience they go hand in hand. Be it people I’ve tried to date, the lgbt community as a whole, or just friends (straight or lgbt) I’ve run into problems with my sexuality. It probably has made me paranoid and I’m definitely trying to work on it. But in all types of relationships in my life I have met a lot of hostility towards my sexuality. Or if not hostility then just loneliness or lack of people in that role.

2) I don’t know if I’m making progress. I would like to think I am but I guess this blog within itself is reason enough to point that maybe I haven’t. I think I have a lot of different things to unpack and while I’m trying the best that I can I’m probably not making as much progress as I should at this point. But I’ll try as hard as I can to communicate this with the mental health professionals in my life and hopefully we can work something out. ☺️🌻

3) I think you are very right! I’m very on edge and triggered and stressed lately so I’m sure that’s contributing to the whole spiral down. Thank you very much for the suggestion! Once I’m done answering things on here I’ll splash myself with some cold water. Hopefully that calms my brain down a bit

4) I feel like I don’t know what to say here other then agree ahaha. I have a horribly small window of tolerance. I’ve been trying to work on it for years with my psychologists but I don’t think it’s gotten much better. It’s like I’m waiting for proof that it’s okay to open up. I think in some areas I’ve improved (like with food) but sexuality is such a raw nerve for me a lot of the time that I don’t really know how to deal with that yet. But I really hope to get there one day :)

5) I feel like I genuinely can’t apologise enough to those of you who have been affected by my venting posts. It was wholeheartedly never my intention to trigger anyone or upset anyone or make anyone unhappy with their sexuality. I don’t have people I feel like I can talk to about this stuff irl - and even if I did I wouldn’t want to be dumping this on them all the time. But I can see it’s affecting a lot of people on here two. I would recommend for those who are hurt to unfollow me , or for me to just say it’s okay to unfollow me and walk away , it’s okay to prioritise yourself. But I need to take accountability for the pain I’ve caused too. I might just hop off tumblr for a couple of days so I’m not posting anything that’s upsetting anyone. I think it was ignorant of me to expect my TW to be enough and I should have been more aware of the larger number of people following me and not put those types of vents on their feed. So I am truly sorry for anyone I have upset and triggered. I promise to try better.

I would put my posts under the read more thing but I’m on my phone via the app when I use tumblr and I genuinely cannot figure out how to do it. I’ll look into it more though and try to work it out so I can make it a safer place for people.

Thank you again so so so much for taking the time to write this all out for me and give me your support and guidance. It really means an awful lot. I hope you have a really lovely day 💕💕💕🌻

[supportivespaceforsurvivors]

Hey,

I need advice please, I get really angry at small things like someone ignoring or not giving me something back in time or something small or sometimes for no reason at all,

I say mean things to them or ignore them, or glare at them but I'm worried that I might hurt someone and I don't want to hurt someone

whenever I get angry I have this urge to harm myself or someone like smashing their head or mine.

sometimes I get angry at myself and smash my head against something,

I don't want to be like this I want to change please help,

Hey,

Most of my system has struggled with this same experience for years. We're finally at a point where this is improving for us and we're able to go back to mistakes we've made and try to make amends for them. I'm glad to be able to answer this one for you.

I ended up writing a lot out, so I'm going to toss it under a read more.

I want to start with reassurance. If you hurt someone, that won't be the end of the world. While hurting people is never okay and you should do what you can to avoid it, people are messy. Sometimes we hurt each other. Sometimes our emotions get the best of us. If it happens, do your best to come back to the person/people and apologize and make a point to do better from there. I know it's scary, but mistakes happen while we're growing. It sounds like you've been doing a great job of not hurting anyone so far. I'm proud of you.

Also, I want you to know that you're not bad for your anger. Your rage doesn't make you bad. Anger is an emotion and it almost always comes from being hurt in the past. When you're in a healthy place with yourself, your anger is a signal that something is wrong or painful. It's a reminder from yourself that you don't deserve to be hurt.

I also want you to know that having thoughts about hurting yourself or others doesn't make you bad or dangerous either. Intrusive thoughts are really common. Having those thoughts doesn't mean that you will act on them. Thoughts are just thoughts. They can be scary and distressing, but they're only thoughts. You control your actions, you get to choose.

Now, for my advice. I think the first thing is to try to find something to channel your destructive energy into.

Buy some magazines at the store and when you get angry, tear or cut them into shreds. (Better yet, take a moment to physically write out what you're angry about and then tear or cut that up.)

Go out to a nearby stream or river and throw rocks into it, as hard and as far as you can.

When you're driving alone (if you drive), just yell, scream, be loud.

If you work out, go for a run or see if there's a gym nearby where you could learn to box.

If you can, call a friend and rant to them about what's going on.

Get some painting supplies and create something. It can be splatters, it can be highly detailed, it can just be shapes and colors. It will be yours.

Find something that's going to be able to vent the energy behind your anger, because after you have something to help you release that energy, it's going to be easier. And knowing that you have a vent will also help you stay calm in the moment because you'll know that you have tools to work through it later.

The second thing I recommend is to try to start recognizing thought distortions. (I'll link an article that goes into this better than I'll be able to at the end of this post.) A lot of the time when I get into that rage mode, I have to stop myself in the moment and try to figure out where my thinking is distorted. I think a lot of my anger triggers fall into the categories of control fallacies and fallacies of fairness, but in general, I also have issues with blaming [others for my emotions], overgeneralization, and catastrophizing.

I have to slow down and figure out which thought distortion is happening so that I can try to ground myself in the reality of the situation instead of getting lost in my anger. I used Woebot (an app that I believe is available and free on both ios and Android) to start to build up some basic CBT skills before I was able to access therapy. It was very helpful for me to start to check and identify which thought distortions I was experiencing in the moment. (I think DBT is exceptionally helpful for what you're experiencing. If you're not able to access DBT therapy currently, though, this is a good place to try to start!)

As a subpoint to that, when I'm already too angry to be able to calmly recognize and challenge my thoughts, I simply tell myself: "It's okay for me to be mad. I'm entitled to my emotions. I'm allowed to be angry. But I am not allowed to take my anger out on others, make my anger someone else's problem, or make others uncomfortable because I'm angry. My anger is not an excuse to be hurtful to other people." And it might read/feel harsh, but when I am having a rage response, it is the reminder that I personally need to hear. It might help to try to adapt it. After telling myself this, I stop to breathe for a moment and then correct what thoughts I can. This is my flashing red light for myself to control my anger.

Third, try to reflect on why the things that trigger you do. Why does being ignored trigger your anger? For me, it triggers my anger because it triggers my fears of abandonment and neglect that stem from childhood trauma. So I spend time working through the underlying fears to indirectly cause the anger to lessen. It also helps me be able to catch myself in the moment and recognize that I'm not necessarily angry at the person who's doing something, but afraid of being hurt again and angry at my abusers for hurting me when I was a child. Does that make sense? I highly recommend journaling to help you keep track of this and to give you a safe place to vent about all of it.

And my final piece of advice is to consider medication, if you can. I'm on a mood stabilizer right now and it helps to basically "cap off" my heightened responses (especially my rage responses) as well as helping me to keep moving through my mood drops. You would have to consult your doctor about this, though, and see what works for you. And it's okay if it's not possible right now or you just don't want to medicate- there's plenty of skills to build up instead.

Please make sure that you're taking care of yourself after you hurt your head or any other part of your body ❤ Try to redirect that energy into one of the things I listed earlier on in the post.

And remember that you are capable of growing past this. I'm so proud of you for reaching out for help with this. You're on the right track.

Mod L

[goosegoblin]

I hope you don't feel like you've been getting too many ED questions lately, feel free to ignore this if you do!

I just don't really know what to do. I always used to be told when I was younger that I couldn't have an ED because I wasn't thin enough. It's taken me years (and CBT) to get to the point where I can actually just eat and not constantly be anxious about eating in front of people. But I've been putting on weight recently (turns out pandemics are stressful) and my family have started going on about me looking fat etc. I don't want to be fat, but I'm worried that if I try to diet now I'll just go back to my old ways and undo all that work.

I guess what I want to ask is how do you find a midpoint? Is it normal to struggle so much?

Also thank you for replying to other people with such compassion when they ask you similar things.

Thank you for taking the time to reach out to me- I love you. You did a good thing in writing this message and I am proud of you.

Honestly, the thing is that eating disorders- and recovery- don’t occur in a vacuum. If I turn on the television, I’ll see diet ads. If I go on Facebook, I’ll see statuses about weight gain and weight loss. If I go on Reddit and there’s a gif or a video of a woman who dares to be overweight, half the comments will be about it. We are all affected by the society we live in, and the society we live in is one that glorifies thinness and undereating as signs of goodness. I’ll tuck the rest under a read more to keep this from being too long. 

I will give you an example with some details fudged for the sake of anonymity. At my last work place, myself and several other people all consider ourselves to be recovered from our EDs.  There was a strong culture of diet and weight loss talk among other staff, however, to the point when I had to start actively shutting it down on shift because of how much it was affecting some of the recovered people. Even if the people making comments didn’t mean to cause harm, they were causing harm- both to themselves and to others.

Your family clearly do not ‘get’ it. I will try not to read too much into what you said, but I will say that ‘going on about you looking fat’ does not seem like a healthy or supportive environment, and that I am genuinely sorry they speak to you so dismissively and unkindly. Much like my recovered friends, it is no surprise that when plunged into an environment that takes the toxic elements of diet culture and turns it up to eleven, you start to struggle more than usual.

Pandemics are, indeed, stressful! They also alter many parts of normal life. Turns out staying indoors all day with no routine and lots of anxiety/ panic can cause people to eat more and gain weight- who knew, right? If you want to try and make some changes to feel a little more healthy, that’s absolutely fine. I would recommend trying to get in some daily exercise if you can- most lockdowns still allow a daily walk, for example, and there’s literally countless yoga and stretching videos on the internet. You could look into stocking the house with healthier snacks, getting more involved with cooking, or using CBT tools to combat binge eating if that’s something you struggle with (the HALT tool being one that comes to mind). But at the same time, I would not say you need to diet, and I would especially say you should NOT diet in a toxic and damaging environment where the chance of relapse is especially high.

And you know what? It is better and healthier to be overweight and happy than it is to be an average weight with an eating disorder. If it helps, though, feel free to think of it this way- the pandemic will not last forever. You will not be in this place forever. Losing weight, even if it feels important, is not urgent. There is no need to take drastic action immediately. Your mental health will always be more important.

Oh, and I’m sure you know this, but weight is not the defining symptom of an ED. You can have any eating disorder, including (atypical) anorexia nervosa, at any weight. The people who told you you weighed too much to have an ED were incorrect, and also, I hate them.

You do not need to be less to be good enough. Reach out to me any time you want to chat.

I love you xx

[dxmedstudent]

Hi dx, I'm starting med school this fall and moving to Ireland to do so! Ive got chronic fatigue though and Im worried about being able to manage the workload. Im on meds so I'm doing pretty well, working 10 hour days rn with a 2 hour commute, but im pretty drained at the end of it. Have you or any of your followers got any suggestions for handling med school when youre just so tired all the time?

And another ask:Hi, following on from the anon asking about studying, do you have any specific tips for studying medicine with chronic fatigue? I find sitting in lectures (and the journey to and from) drains me even more than I am usually. Thanks and have a great day!            Hey, peeps! So I have someone important in my life who has gone through a chronic fatigue condition in med school. I’ve seen a lot through what they went through, but I wanted to be able to give a more useful answer. I took a little time to think, and to ask them what advice they would give.  They gave me permission to share an edited version with you.

It is possible to get through medical school with chronic health problems. Don’t let other people tell you otherwise. You may encounter people who doubt you, but never let them get to you. Remember that many people with chronic illness have achieved great things and it doesn’t have to be a barrier to  success. 

There is usually a way to get through whatever obstacle comes up. The key is to take everything literally one day at a time, and do not get overwhelmed by thinking about all the demands for the year at once. Focus on what needs to be done right now. Next week is another     week. 

Let  yourself have setbacks, and don���t give up when you have worse periods of health. There will be times when you’re more tired and stressed, but you have to give yourself space to recover back from that. Remember that everyone, whatever their health status, has bad times, and that usually they will pass. If things aren’t getting better, talk to your family, friends, personal tutor at university.  Seek help with clincians.

Keep in touch with your fatigue clinicians and be open about new obstacles and your fears about things. They can help with a lot of problem-solving aspects and support you during times of difficulty. They are also useful to rant to when you are stressed out as they know a lot about the problems of people with CFS who they’ve seen in clinical practice. 

Consider reading books on CBT and acceptance commitment therapy (ACT) - these have really helped me through psychologically difficult situations and build resilience when medical school has thrown difficult things at me. In the hardest year of medical school it really helped to have written advice to look at when various situations came up. 

Tell the university (occupational health, senior tutor, personal tutor etc.) - I cannot stress this enough. It is confidential, and they have to   accommodate you because it is a disability. This can become really important if you have issues completing sign-offs/assignments on time, getting hospital placements closer to home, getting extra time in exams etc. It can also be useful if you have problems with exams (not being well enough to do a sitting) for the university to know what is going on and how best they can help you. If they do not know what is going on, then they cannot help you. This is one of the best things I did at medical school in terms of having a safety net for when things were more difficult. 

Do not feel you have to attend 100% of everything. If you are feeling very   fatigued and not gaining much by that point in the day, it is usually     better to go home and do some quality studying at home. So many students who have no health problems will go home early, so do not feel guilty for doing so when you feel fatigued and like you’re not having a good day. Just remember to catch up what you’ve missed. 

Talk to the students in the year above about what the demands of the coming year are like, what the exams are like, what textbooks/resources to use,  and other *off the record* tips which the university would never tell you. This will help you out in planning how to approach the work for that year. It is very important to know what you’re preparing for and the best way in which to do it. 

On placement, talk to the teaching fellow/head of the placement if you have any issues completing tasks or sign-offs etc. They can help you and give you advice about how to get things done. This has been of great comfort to me during placements where sign-offs have been very tricky and I’ve worried about whether or not I will complete everything. Also ask how previous students did it - you’re not the first cohort who’s gone through the system. 

Let yourself adjust the intensity of your concentration when attending     lectures/seminars. Some days you’ll be able to be at your highest level of     functioning, and other days you may feel less functional.  Your levels might look something like:

Highest  level: concentrate/listen, participate/answer questions, write down notes.

Medium: concentrate/listen, no writing or participating.

Low: zoning out some of the time (5 mins etc), prioritising more important slides or mentally checking in again when possible. 

Use breaks during lecture days to really give yourself a breather. It is best to physically leave the space where the lecture took place, ideally go to a canteen and have a snack (food and drink are very important for boosts), or go outside (fresh air is important). Let your brain truly wonder and do  something not related to university or teaching. Don’t hang around with peers unless they talk about things which are less brain intensive or   non-university topics. 

Take on a reasonable workload during group assignments, and don’t let other students foist extra work or their work on you. Be strict about your role and that you will not do their work for them. 

E-books (textbooks) - either download pdfs and upload on google drive etc. or buy on kindle etc. This is VERY useful for reading and studying whilst out and  about for medical school, and fitting in revision during parts of the day which are empty/less busy. There are often quite a few times where you will be waiting around between teaching/clinics/hospital activities and if you use your time wisely you can really get a lot done. You can also read on public transport when commuting which is a good use of that time too.This becomes especially important close to exams where time management is key. This is one of the best things I did. 

Pacing - plan for deadlines in advance. If you have sign offs/essays/histories to do, space them out and plan everything in advance. Make a plan and stick to it, but be flexible enough to change things around if you don’t feel up to doing a particular task on that day. Make sure it is realistic personal timetable, and has time for you to attend university, study and complete assignments/sign-offs, as well as relaxation/social time.

 If you feel you are doing too much, cut back and do the bare minimum of what you need to do. Whilst it is nice to aim high and everyone at medical school is crazy competitive, the aim is to pass and go into the next year, and complete the degree. Scraping passes = still a doctor. Many people forget this, but the priority is to get by and become a competent doctor. You are doing what you can do, and you don’t need to get a Distinction in all your exams to be a good doctor. 

Do  not feel guilty for not being able to work as hard necessarily as other   students can all the time. Be proud of yourself for being there and for     doing something so difficult as medical school in the first place. Medical     school is very hard even for people who do not have any problems with     their health. There is really nothing wrong with coasting along and doing    just what needs to be done. It can be frustrating to not be able to do     more, but tell yourself that you’ve done your 100% which is all you can     give at this current time. Sometimes you’ll be able to do more, and     sometimes you’ll be able to do less. But don’t feel guilty about it. Know     that you are doing your best and that’s all that you can do. 

Similarly, everyone feels they are not doing enough/like they don’t know enough. Doctors on placements will also occasionally have a go at you, not  realising that actually for your level you do know enough. You may feel you like you’re not enough, but the truth is that everyone feels like     that. Many people at med school act like everything’s fine but underneath  the surface, we’re all working very hard and tired. 

You     are not alone - many people at med school have either physical or mental     health problems. They are all also battling through the challenges and you     are not alone in your difficulties. Remind yourself of that and know that     everyone is on their own journey/battle. 

Believe in the work-life balance Pie chart - Everyone should ideally have equal time in their day dedicated to 1/3  cognitive, 1/3 self care and 1/3 social activity. In med school, the latter two may fall back a bit even for students with no health problems, but it is very important for these things to be done consistently during med school. “If you can’t look after yourself, you won’t be able to look after other people”. The only way you can achieve your goals and look after patients etc is by looking after yourself (with the pie chart) and keeping yourself in the best health possible. 

Cognitive:studying, reading, academic extracurriculars, any activity where the mind is actively involved. 

Self care: pampering yourself, hobbies, leisure activities, exercise/yoga,     playing with pets, praying/worship etc. 

Social: going out with family or friends. Relationships. Support groups.     Societies/clubs etc. 

Join  support groups either in real life or on Facebook - it is really useful to have somewhere to rant about issues which specifically affect people with  CFS/ME, and to have their support when you have a hard day. Family and friends will not always understand everything you’re going through, even with the best of intentions, so it’s important to have peers with CFS/ME on those occasions. 

Don’t be afraid to turn down going out or doing extra things in the day if     you’re really not up to it. Better to keep yourself at a functioning level     than overdoing it because you feel you *should* be doing something. It’s    best to be honest with yourself about what you can do today. 

Learn to say no - if other people ask you to do things and you are feeling   overwhelmed at the time from work/personal life, do not feel bad about     saying no if you have reached your limit of how much you can cope. Do not  feel guilty about this, and realise that it is crucial to not take on too     much at once, in looking after your health for your ability to get through     medical school. People can and will ask you to do things either not     realising that it’s over your coping limits or not caring. You have to learn to put yourself first and forward and know your limits - it is not worth the payback which can inevitably happen when we overdo our limits.     Medical school does not give you a lot of time to rest or recover, so you     really have to make sure you keep yourself functional and within your     limits. 

Work  steadily during the year - if you have fatigue then you cannot leave   things last minute and cope with the physical and mental stress of this.     Make sure you are making notes and keeping up during the year, and     increase your revision before exams to a comfortable level. Be careful not  to overdo it in terms of number it hours a day, as most likely you will     lose your concentration and not absorb the information anyway. Best to do revision in chunks, with breaks and other things to break up the day. If the next day you get payback, it’s a sign to dial back the number of hours of revision. Even if you’re doing less hours of revision than you planned, if you’re better focused and rested you will pick up more information.     “Quality not quantity”. 

I hope this helps! Good luck with your studies, and I hope that things go well for you in the coming year.

[finsterhund]

Doctor appointment.

Was asked details about my childhood trauma.

Made the mistake of mentioning my pre-existing conditions on my paperwork and now they're making everything more complicated. I guess that's better than to just lie and say I'm fine.

I gotta do blood work again.

But...

I am getting a family doctor!

AND a psychiatrist!

AND a dentist!

AND at least one specialist!

(I say that because they're debating getting me a specialist for nutrition and dietary health on top of what I'm seeing them for as well as some other ones potentially)

But they want to "stabilize" my mental and physical health. And since I have six thousand conditions that means treating a whole bunch of issues on top of the main three which means more time spent. Which I mean is fine. Being covered under Canada's health care means I'm not spending money, just time. But I feel I don't have much time left. I wish they could just do the things that would help me the most as soon as possible.

They showed me this paper that was all "what's your functionality" to determine my stability and I said I was a 70-61 because I'm not usually a danger to myself and because I can maintain friendships but they kept telling me that I'm lower because I have "serious impairments" like not being able to sleep without medicine and not being able to operate hot kitchen elements very well and not being able to go to the store without supervision and I didn't think that was fair. I'm still stable. I'm just differently abled. I was told that me having trouble sleeping isn't normal because "people are supposed to just immediately go to sleep" and that just sounds so fake. I don't even think the people who say that they do that are even telling the truth. It's supposed to take three hours I KNOW THIS.

Then I remember that yes, I am disabled, and yes, these people do think it's serious. I've normalized how much of a dumbass supreme™ I am but this poor doctor was all "this isn't normal" and I'm like:

In the beginning she's just like "you don't feel comfortable in my office" and I have to explain that it's my fight or flight instinct and my pediatric psychiatrist had stuffed animals and toys in her office and that made me feel safer. This doctor had a frog statue so I kept staring at it. I also brought my winged doggo for moral support. Romero is my wingman hahaha

I just wish I was able to hide my mental issues so at least they wouldn't concern themselves so much with them. Fixing my physical issues is more prominently important to me.

I go in being like "body doesn't make the bone and muscle grow juice. Bone and muscle stop growing" and it ends up turning into "how old were you when your father did those things and how did he do them?" Like????? This is why I fear doctors. I mean it's good to deal with all my issues eventually, but when I seek out specific specialists it's because I thought that was a priority. They're asking me if I want to press charges against my father and I'm just like "I just want the bone grow juice for right now plz"

The vast majority of my issues have little to do with my motor function and neurological damage and mental health but they're VERY interested in it. I'm pretty sure it can't be fixed. They want me to do CBT which makes a lot of sense but I want to focus on physical health right now and they are very interested in mental health. I would like some physiotherapy so maybe their interest in my neurological problems will lead to that.

So now I have to fast for bloodwork at some point and have another appointment in a week and need to fill out more paperwork. It's all very complicated.

They seem to think I am capable of fully getting better and it's like "Yay! More people to disappoint!"

I feel stupid for letting them immediately know my mental health is a mess. I know I omitted some information to my pediatric psychiatrist to hide some of my more serious trauma symptoms because that wasn't what I wanted to deal with then, but this time around I really did let them know I'm poorly functioning like lmao why did I do that? I just went to them to fix my physical issues. I suppose once they got my record that wouldn't have mattered because they'd have been able to see it anyways but dang it. Why do I keep trusting the establishment when I know I shouldn't.

TLDR: I want surgery and bone growing juice please gibe dem to meee

[ope-scuseme]

Dear Kiwi, I guess I'm ok. Maybe one or two breakdowns a day, but mostly less dramatic than before. This was supposed to be the year when everything went ok. The year after the year I got better. But now it seems like the year I'm getting worse again. I just wish I could stay in my room on my laptop forever, away from school and stress and expectations. Birom Ace Anon

Dear Kiwi, I’m probably going to write to you a lot, but here goes: the girl I amy or may not have a weensy little crush on who always goes out of her way to ask who I am usually seems pretty upbeat but recently she’s seemed a little down. I don’t know if I even have a right to worry, since we’re not that close, and no one else seems to worry. My mum is looking into me starting CBT, so good news there. -Birom Ace Anon

hi birom ace anon!! 😄💞 yeah hun keep on writing to me!! i got a little behind here with your asks and it sounds like things are starting to look up ( yes!!!! ) but i’m gonna respond to both for ya anyways 😊 and who knows? maybe someone else thinks your asks are helpful, too ❤️

for your first one, i wasn’t really sure what to say. now that i’ve been out of school for a little bit it’s kind of mind-boggling to me how much stress i was under, especially back in high school. like i look back at all the sleep i lost and all the breakdowns i had over things that aren’t really important to me anymore and i’m like…dude why 😅 lol because i had to, right? but, like…i think most of that stress piled up because i valued other people’s expectations of me more than my own wellbeing. or if you wanna get a little deeper with it, i valued what i thought other people expected of me more than my own wellbeing.

that’s pretty messed up, right? but people don’t really talk about that with you when you’re a student ( mayyybe if you go to a counselor ) and i know i had way too much on my plate to figure it out for myself 😅 and the wildest part of this? it’s totally ok for you to prioritize your wellbeing ❤️ it’s totally, completely ok for you to talk to a counselor and/or your teachers and be like “hey. i’ve got a lot going on in my brain and all this work is just too much for me right now. i know you’re here to help me so please tell me what we can do about this.” they might not understand, but i promise that there’s a much bigger chance that people are gonna want to help you find a solution ❤️

and you know what? it’s totally, completely, absolutely ok that you’re not feeling better as soon as you expected to. i know it’s disappointing and frustrating, and i really really hope that CBT helps 😊💖 but mental and emotional health aren’t always about consistent, constant healing, and there’s absolutely no need to put extra pressure on yourself by expecting them to be ❤️❤️❤️ and if other people are putting that expectation on you? welp they’re wrong 😆

but your plans to start CBT?? THAT’S SO EXCITING OMG!!!! especially because your mom’s helping you with that!!!!! honestly i am so happy to hear about that and i really truly hope it’s a good fit for you 😭💞💗💖

and ooh la la—a crush?? 😉 i’m sorry she seems like she’s feeling down, but you know what? if she always makes that extra effort to ask you how you’re doing, then now’s your time to shine!! you may not be close now, but if you show her that you’re there to listen and support her and maybe cheer her up a little when she’s down, then i bet she’ll want to get closer 😄😄😄 it might take some time, but i say show her you care right on back and see what happens! lol that’s a little bit like what happened with us, right? 😆 and who cares if no one else seems concerned about her—you’re tuned in to her mood because you’re going through your own stuff, right? you empathize with that. and if your gut is saying that something’s off, i say go with your gut. it can’t ever hurt to be a little extra caring 😊💖

well…hope you enjoyed my novel 😂 it honestly brightens my day to hear from you and share what little advice i can! i hope it’s helpful, or even just comforting to read all this stuff ❤️ keep me updated, yo!! i’m invested in this story!! sending you love 💖