I may be a bit scarce next quarter

[rachelmanija]

Zen Mind, Beginner's Mind, by Shunryu Suzuki. I had read this before, and am re-reading now. Similarly to my first read, I alternate between feeling like I kind of intuitively get what he's talking about, and feeling like the book is proof that some experiences are felt but not conveyable in words.

Trauma and Recovery: The Aftermath of Violence--from Domestic Abuse to Political Terror, by Judith Hermann. This is excellent, and readable by a lay person. I already own it, but apparently loaned it out or something, because it's sure not here now. Ordered another copy. Thankfully, it's a cheap paperback.

Compassion in Action: Setting Out on the Path of Service, by Ram Dass. Does anyone have any opinions on him? I know who he is, but that's it.

The Trauma Treatment Handbook: Protocols Across the Spectrum (Norton Professional Books)

Seeking Safety: A Treatment Manual for PTSD and Substance Abuse

Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse

Integrated Treatment for Dual Disorders: A Guide to Effective Practice. ("Dual disorders" or "dual diagnosis" means "mental illness + addiction.")

I'm not even listing all the bazillions of articles I have to read. These are just the textbooks. And it's not even all the textbooks - one professor doesn't have her book list up yet.

Comments

[rachelmanija]

Thanks. This sort of issue is exactly why I want to get a broad base of systems, techniques, and theories to draw from. A lot of bad therapy results from therapists forgetting, or not caring, that no one system will work for everyone.

PS. I had never heard of Mary Oliver before; I looked her up, and she's a poet. Is she often recommended by therapists doing mindfulness-based CBT?

[rydra_wong]

Printed on handouts. It seems to be more or less compulsory. JESUS H TAPDANCING CHRISTMAS PEOPLE, CHOSE ANOTHER POET ONCE IN A WHILE.

that no one system will work for everyone.

And that sometimes a system can be a good and appropriate choice for someone, and not work anyway. And under those circumstances, it's easy for the patient to feel they've "failed", which is hard to avoid when you're dealing with depressives, but it would be nice if that wasn't so.

(I got fired from my MBCT course. Well, told that it didn't seem to be helping me right now and perhaps I could break off and resume at some future date when I was feeling better. Which was, I agreed at the time and still agree, probably better than having me sob through all meetings and look like a bad example to the other clients, especially as I was the one who'd been working the MBCT stuff from books for months on my own prior to the course. But still. I got fired, for relapsing into depression. I am still bitter, yes.)

[rachelmanija]

How would you have liked that situation to have been handled?

I'd have been inclined to have just asked you if you wanted to continue or if you felt that the course wasn't helpful/was making things worse for you, and left the decision to you. It's okay to cry in meetings. It doesn't make anyone a bad example. In fact, if I understand the theory correctly, the concepts of "failure" and "bad example" are antithetical to the ideas of mindfulness.

[rydra_wong]

How would you have liked that situation to have been handled?

*throws hands in the air*

I don't know. I wish I did. But working with people with severe recurrent depression, even if you halve the relapse rate, that still leaves a significant number of people relapsing, and it'd be nice if it didn't feel like: go away, we can't handle you now.

(What could be done instead: not my problem to figure out, thankfully, what with me not being a therapist.)

And yes, there's the whole thing that there's no failing, but at the same time there's the implied promise -- which you can't avoid -- that if you do this right, it'll work and you won't get depressed again. Or at least it'll help.

And there was a sense both in my mind that I'd failed, and in what I was picking up (accurately or inaccurately) from the therapist that she didn't know how to handle me crashing conspicuously and still turning up to sessions, sobbing, and not being able to respond with the "proper" responses (yes, I know there aren't supposed to be any "proper" responses either) to any of the exercises because the inside of my head was a nuclear wasteland.

[rachelmanija]

Thanks. I didn't mean to pressure you - I had wondered if you did have a preference that had been ignored or never solicited.

It's hard to offer hope, which is real and necessary, without having the corollary feel like, "And if this doesn't work, it's your fault." On the flip side, too much emphasis on "not everything works for everyone," and people despair before they even begin. But the point where someone clearly feels that they've failed is probably a good time to start emphasizing that it's not their fault.

[kore]

At least in the recovery movement (here comes Moi with her good old AA background, hahaha) relapse is expected, and altho people are still very shamed and horrified when it happens, it doesn't mean "go away, never come back." In fact the more people "relapse" - i.e. the more times they try to quit - the better their chances are of quitting in the long run.

But I guess depression doesn't work like that because every time it just seems to get worse?....wow, I am....not helpful. Ugh. But yeah, the idea that people who are severely depressed over and over and over again are "causing" it somehow or are "not being serious"....gack.

[rydra_wong]

But I guess depression doesn't work like that because every time it just seems to get worse?

Yeah, the data is scary on that. The more episodes of depression you have, the more likely a recurrence is. Once you've had three episodes of depression, I believe the recurrence rate is 90%.

And I do have respect for the MBCT people, because they've got some good theories (of a non-victim-blaming nature, I should add) of how those self-perpetuating brain mechanisms work and how it might be possible to interrupt them, and solid data indicating that they can seriously cut the relapse rate (by up to 50%) in the three-or-more-episodes group.

But OTOH, the nature of working with that group is that even if you halve the relapse rate -- which is fucking awesome -- you're still going to get nearly half of your patient population relapsing regardless, because the rate is so incredibly high to begin with. And IMHO you've got to be prepared for that, and (in so far as possible) avoid creating the sense that those people have "failed".

[kore]

Wow, that fucking sucks. I got fired by a therapist once, when I was 12-13 or so, and it was devastating. I can't imagine what it must have felt like to be pushed away when you needed help so badly.

[rydra_wong]

Well, the therapist said -- and I agreed -- that I didn't seem to be getting any benefit from it at that point. Which was entirely true. And a good reason would have been hey, stop pressuring yourself to work on any new skills, just hunker down and survive. Which was what I did.

But. It still felt like being fired.

[kore]

I have never read that book but I have been given handouts of Oliver's poems (Wild Geese in particular I think) more than once. By therapists. And AA sponsors. And friends in recovery. WHAT'S WRONG WITH A LITTLE DICKINSON I ASK YOU. For some reason she's big in /Japan/ recovery, and therapy.

[coraa]

Ha. I didn't know her by name, but I vaguely wondered, "Oh, the goose poem?". And sure enough, the goose poem was by her.

It was a good thing to be exposed to once, but, uh, the repetition is a bit much! I'm amused to see it wasn't just my luck in getting it repeatedly.

[kore]

She's not....bad? but by God, one Mary Oliver poem in therapy is enough.

The other one everyone always overuses is the Sharon Olds poem that ends "Do what you are going to do, and I will write about it." Everywhere. Every writing workshop ever.

[rachelmanija]

I got that Olds poem in my Process class!

[kore]

AHAHAHA...yeah it's not _bad,_ it's just like the "Maps" of writing and narrative classes.

[coraa]

Exactly. One time it was like, "Oh, that was a mildly nice poem." The second time it was like, "That's... still a mildly nice poem, I guess." The fifth time, it was like, "Fucking geese! You just have to fly through the high clear air or whatever. You wouldn't be so happy if you had to make phone calls, huh, GEESE?"

I do wonder why those poems in particular get used so much.

[kore]

You wouldn't be so happy if you had to make phone calls, huh, GEESE?

//dies, just DIES