understanding (n.)

... but that was Elizabeth Gilbert's Rome.  I should have known my Rome would be different....

As we drove through the outskirts of Rome, and then the heart of Rome, to our hotel, I knew I was going to have trouble understanding the personality of the city.  It was a little provocative, a little intimidating, a little dangerous, a little sophisticated, a little provincial ...  Some cities are in your DNA - they are your lifeblood, you take to them immediately, you feel at home.

Have you been in that spot?  Where you've traveled somewhere new and thought, "Oh, this place.  Somewhere in my spirit I've been here before," and it has been familiar and lovely and comforting?

Rome was not that place for me.  Rome was the guy you date and you're not sure if it's a good idea, but it feels right in the moment.  (and then you break up a few months later because you weren't truly a good fit but you're still left with some positive memories.)

(A few caveats?  I am still not up to date on my Roman history.  I would love to be able to put all of the following in context, but, I can't.  Also, when I say "we drove through ... Rome," in no way do I mean we drove through Rome.  Rome is a city with a magnitude of history, life and human experience crammed down into narrow Vias with suicide mission mopeds.  I mean the cab driver or the bus drove through Rome.)


Layers and layers of human life upon human artifact.  Apartment buildings next to Ristorantes next to Government Buildings next to the Spanish Steps next to Roman ruins next to the Gap (really) across the street from Vatican City.  It is so much living and so much history crammed into the here and the now; a puzzle dumped out and all of the pieces, jumbled, mixed up, lying before you -- It almost makes sense.  Almost.





Shoes and I set out on our own that evening, exhausted, jet lagged, and famished.  Our first Italian language lesson?  Although  most native speakers seemed to appreciate the effort, it was often easier for them to address us in English.  So much for those months of Duolingo ...

The next morning, still jetlagged and still confused from lack of sleep, we wandered around this confusing, hectic, slightly aggressive city.

And even though Rome was confusing, not at all familiar, and a little strange to me, I took Shoes' elbow as we walked and kept whispering, "I can't believe we're here.  I can't believe we get to do this."

(I'm still high on just the fact that we had the opportunity to do this.)

And Shoes, in his Shoes way, gently told me I needed sleep.  (and oh, how I needed sleep.)
But Shoes is the one who asked, upon seeing the following sign, what exactly Italians have against hip hop. I am certain I'm not the only one with jet lag brain.


The city was breathtakingly sexy, of course, in it's own right.









It is roped off, but it is just there.  Ghosts of other lives, laid out so intimately that one could breathe it, touch it, live it.




Shoes and I walked for four hours that first day in perfect, drizzly 55 degree weather.  We drank cappuccinos, meandered, absorbed, and attempted to avoid the extremely aggressive vendors.  Found everywhere.  I don't think vendors have an off season.  (I had never heard of a selfie stick before this day.)

In the afternoon, we took a bus loop with Shoes' mom around the city for a 2 hour everything about Rome history lesson (of which I remember nothing but it was really a very lovely city tour), ate pizza, drank wine.  And then ... we slept.  Oh, sweet, sweet sleep.

I have never been so grateful for sleep before.

And a break from the travel posts.

I know you guys aren't priests, but, this is what's on my unexplained female infertility heart this morning.

I have a really, really difficult time mustering up excitement for pregnancy announcements.  Sometimes an inordinately difficult time.  And I am having a really, really difficult time with them this morning especially.  (Before I come across as especially cold hearted and cruel, please know that I genuinely am eventually excited for all of these new babies.  Very sincerely.)

Facebook has handed me an onslaught plethora of good news announcements in the past two weeks.  And oh, dear hearts.  It is really fantastic news.  I am always so excited when babies are welcomed into the world by parents who are loving, attentive and nurturing.

But it is truly work for me to stay centered in the *absolute fact* that these pregnancy announcements have nothing to do with me and to stay grounded in the fact that my unfortunate lack of success in conceiving is absolutely unrelated to others' successes.  And I spend quite a bit of time trying to rest in that.  What's also true is that sometimes (not all the time) I spend 45 minutes weeping in the bathroom until I realize I'm engaging in the Fallacy of Fairness (it's a cognitive distortion I teach when I facilitate DBT groups.)

I won't go into detail about the specific announcement that brought this on this morning (this morning I am actually very glad that there are a few readers who would have seen the same pregnancy announcement that sent me over the edge - it is keeping me discreet and appropriate.)  But oh.  How I have thoughts.  And how, how I am trying my best to give those thoughts over to Jesus.    The mature, loving part of me knows,  I have no place to judge and our journeys are our own.  The immature, very sad part of me who really just wants to start my own family thinks, This is absolutely ridiculous.  How on earth are they expecting and I am not?  (This one is all types of complicated in all the ways and has to do with my experience in the church, my experiences with my Former Husband .... Actually, as I'm typing this out, it's becoming very apparent to me why this one is hitting me so hard.)

Fallacy of fairness, my friends.  Fallacy of fairness.

A short update on where we are with family starting right now:  (I'm not sure if I shared this before; time became a little crunched and confusing with the holidays, going to Europe and getting back to work afterwards.)  We are currently working on our adoption application and, oh dear hearts, the questions.  All the questions.  They make sense; If I was setting up an adoption I would want to ask all of those questions as well.  But let's be clear:  I'm having to go into details about my former marriage I haven't thought about in years.  And it's triggering.  And I'm also having to give a detailed account as to why there's a separation from my biological father.  Very triggering as well.

As we work on that, I consented to four rounds of Clomid.  Just to see.  That's really the subject of another post altogether, but suffice it to say Clomid is a tricky beast of a medication.  And it is really tricky when I spend all day counseling children and families -- including foster kids who have been through the worst of the worst (I really have to recognize the fallacy of fairness during those sessions.)

So there's my confession.  I'm not always a loving or a nice person.  But I'm trying.  Good sweet Jesus, how I'm trying.

A combination of delirious excitement and overt exhaustion kept causing me to gently touch Shoes' arm as we sailed over France saying, "Look at the French clouds.  Look at the sweet, puffy little French clouds."  Sweet puffy french clouds quickly gave way to getting through customs in a country that was enveloped in heightened security, though.  Soldiers with guns in the airport.  Extra scrutiny at customs.

It took us a year to get to the right terminal after touching down.  Well.  Not really a year.  More like an hour.  An hour of reorienting ourselves to an airport that was not American, finding our way, and a terminal train that was completely shut down to an "unidentified piece of baggage" found in the terminal we were trying to get to.

We stood on the train platform for several minutes while more and more people flooded the area.

Before we go further I should mention I really know nothing about French culture.  What you're getting here is my own impression of what I experiences - and that experience isn't even informed by a specific region of the United States.

I watched the French airport guards, feeling the culture differences immediately.  Oh, these French guards in their fancy reflective vests, sweetly accessorized by their stripey European scarves.  These French guards with their ... manners?  So many "Madam, sil vous plaits" and demure smiles.  (maybe it's just that "madam" sounds so much more refined than a twangy "MA'AM?"  I suppose the other thing I should mention is that I fall out of love with American culture every time I travel.)  Here, on this train platform, is where I begin to realize what deep poop I'm in when it comes to the French language.  I had spent months learning basic Italian phrases for Rome; Shoes assured me he would do the same for French.  He did not.  My mother in law assured me she spoke conversational French; simply put, that did not work out like I expected.

I have absolutely no idea what Native French speakers are saying.  At any point.  More on this later.

We did get to the appropriate terminal in plenty of time.  Situation 2319 appropriately attended to, I suppose.  We sat in the airport at Charles de Gaulle for approximately two hours, staring at each other blankly and staring at the media coverage being displayed on the terminal television, waiting for the flight to Rome.  We did not need to speak French to understand the heartbreak and fear of a country in mourning.  We knew that story ourselves.

At this point, I could see that there were many of us about to board this plane that were dead tired.   All of my thoughts had stopped making sense at that point, and I had an absurd urge to buy all of the macaroons at the little Airport stand a few feet away.  All those mint green, pink and brown circles of light deliciousness ...  My head was swimming.  My eyes were hot.  And I kept remembering the time I completely freaked out on Former Husband after working a graveyard shift because I was convinced that he took the "wrong way" home with all of the red traffic lights on purpose to make me miserable and to keep me from sleep (don't worry if that doesn't make sense.  It really makes no sense no matter how clearly I explain it.)  Oh, fatigue.  How irrational you make my brain.

On the plane, many children.  By this point, loves, you must know how much I adore children.  And I have so much empathy for families when I fly.  But way in the back of the plane, way back, way, way, back was a family with a very small Terrier in a carrier (the fact that that rhymes was extremely humorous to me in my exhausted state), two teenagers and a toddler.  There are four things I remember about that leg of the trip:

1.  The terrier did not stop yapping the entire flight.  And by yapping, I mean the most horrible, awful, high pitched yap of a dog that I have ever heard in my life (and yes, of course that  impression is completely tainted by how sapped of being we were at the time).

2.  The little one had a very, very difficult time adjusting to the altitude.  She sounded absolutely miserable - screaming,  crying, inconsolable.

3.  The French flight attendant who continued to gently plead with the mother to, "Madam, pleeze, just try to walk zee child around.  Just stand up and walk her around."

4.  I turned to Shoes and said, "I would give just about anything to have a parachute to jump out of this hell at this very moment."

Also, there was an Italian woman who continued to insist to the flight attendants that Air France carried ear plugs for its passengers.  The flight attendants continued to insist they did not.  I would have given over all of my Euros for those mythical ear plugs at that moment.
In any case, I did not jump out.
We were, in fact, fine.
We touched down at Fiumicino without incident.
Dog and Toddler survived.
(and the poor babe calmed down as soon as we touched down and her ear pressure adjusted.)

{The pictures will start soon.}

In a strange turn of events, in which the Travel Gods smiled down on us, Shoes and I had the incredible (really, incredible) opportunity to visit Paris and Rome in early January.  (Ok.  The Travel Gods were really Shoes' mom, who had 1 kajillion airline miles to use, and she so very graciously shared them with us.)  I adore traveling, you guys.  Probably the product of living in Europe until I was 9 years old, but the experience and the culture and the visual sights and the smells and the sounds ...

It is the best.

As we geared up for January, December, therefore, was a very quiet  month.  Subdued, toned down, pared back.  Because ... Europe. Quite honestly?  December was also a grief filled month.  Shoes and I have been trying to start our family for a long time now, and in early December, we thought we had it.  You know?  I  mean, we really thought we had it and my mind had skipped forward to holding my precious infant and nurturing and diaper changes and attachment and bonding and ... and then we weren't.  We weren't pregnant and all the feelings.  (I'm not suggesting it was a miscarriage; it was most likely me reading my signs incorrectly.)

But oh, dear hearts.  The grief.  I mean, The Grief.  As in, me sobbing on my bathroom floor and Shoes holding me gently by my shoulders quietly saying over and over and over and over again, "It's ok, it's ok, it's ok, it's ok."

I am ok, by the way.  That was just a hard one.

So it was easy to look forward to leaving the country.  In my concrete sequential way, I made my packing lists and my souvenir lists  and researched what to see and where to eat.  I made a complete list of phone numbers and addresses for my own mother, who watched our precious Rosie for us while we were away (Jesus Bless My Mom.  I mean, really, please.  Bless her.)

I typed out a detailed memo to the parents of my clients and ensured they had an assigned therapist covering their needs.  I was ready.  So ready.

And then, three days before we were set to leave, Charlie Hebdo was attacked and it seemed like our trip was in the air, suspended.  Of course, that wasn't the most important thing.  The most important thing was the loss of innocent, creative artistic souls.

I've been in politically unstable places before.  Did you know that?  I'm not sure if I've shared that before.  My family moved to Clark Air Base in the Philippines exactly six months after the RAM coup attempt in 1989.  That period of my middle school years was filled with armed guards, curfews and murders outside the base gates.  All of those memories were triggered as we were waiting at the airport, ready to take the first leg of the flight to Rome.

We had all the wonderments about the safety about what we were doing.  We weren't sure if we were going to be able to get to Paris after Rome.  Weren't sure what was going to happen as we took off and landed.

We went anyway.  Seattle to Chicago.  Chicago to Paris.  Paris to Rome.  22 hours of travel.  It was exhausting.  And exhilarating.   The flights went beautifully, except for the very last leg of the trip, from Paris to Rome ....

The town shuts down.   Shoes and I tried to have dinner out last night; we hit five restaurants in a row that were all closed.

And I think my body is tired of my sometimes-yoga-sometimes-not shenanigans.  

And other Rosie the Dog happenings.

You know ...
one of those fall days when all pieces fit together and it's peaceful and fulfilling and quiet.
Nothing even really happened worth note.

Shoes took The Rosie on a morning walk, in which she met a 10year old friend, who gave her loves and pets.  And then The Rosie, because she is our sweet natured Rosie, slowly closed her eyes, tipped back onto her hindquarters, smiled and gave the 10year old a hug.
Rosie gives amazing hugs.

We walked to the University for the game.
And met up with dear friends, where, I must admit, the other wife and I hugged each other and shared tears and love about the difficulty of having children and adoption possibilities.
We watched our Hot Mess of fellow Season Ticket Holder Howie (we always end up sitting in Howie's section every year) take his shirt off and almost get asked to leave the game.
Oh, Howie.

On the way home, Shoes and I walked slowly, holding each other carefully.
And spoke softly about our jobs and our dog and how much we truly love our life.
We also talked about Title IX, as we are wont to do after football games, debating good naturedly and sometimes heatedly with laughter and choice words and you know what?  I am so grateful for him.

Today, I'm trying to stay centered in today.  In this.  In right now.
What my brain would like to do is jump to tomorrow and the next day and next week (I am a little intimidated by next week's schedule and the level of crises some of my families are going through right now ...)
But that doesn't help.
And it takes away from the fact that Rosie is snoozing (and snoring) peacefully on my feet.  It takes away from the afternoon plans Shoes and I have.   It even takes away from my own small pleasure of planning our weekly meals and meandering slowly through the grocery store.

This staying present is one of the hardest things, you guys.  Turns out I am really terrible at it.
But it also turns out that I am a more gentle, loving and calm person when I'm practicing at it.
Funny how that works.

No.  It was eight days of vomiting and nausea, but only in the evening, but I did not die.

On Sunday afternoon I wore my Athleta headband directly on my forehead because the stupid thing won't stay where it's supposed to.  Shoes took one look at me and said, "What the *expletive* are you wearing?"  Instead of launching into a soliloquy as to why sports headbands for women could be the stupidest invention imaginable as none of them actually stay on my head, I said instead, "I'm Rambo!  I'm Rambo!  I'm Rambo!" and ran around the house.

Just feeling better I suppose.  Grateful the flu was gone.  Grateful I wasn't nauseous.  Grateful for energy.  I had a feeling, despite what the on call doc had said, that it wasn't the good news we are waiting for.

And it's not.  We are not expecting.

In the middle of the-only-have-the-flu-at-night, I had the first appointment with our fertility doc.  I like this doc, you guys.  A lot.  But we had to talk about some Serious Things.  Namely, I had to talk in detail about the testing Former Husband and I completed when we tried to have a baby, unsuccessfully-but-thank-the -LORD-for-that, in 2007. It brought up a flood of memories I didn't realize I still had.  (None of them all that pleasant, by the way.)

You want to know something?

Even though I knew, really, that what I had was the flu, there was still a part of me that was holding hope against hope that some miracle had happened and I had miraculously developed morning sickness ... at week 3.  (Right.  I know.)

This isn't just Shoes and I trying for 6 months at the age of 36.
THIS is added to the period before which had much more invasive fertility testing.  This is not new for me.    When confirmation came that Shoes and I were not expecting this past week, the lack of pregnancy felt different this time.  I think, due to the long conversation I had with the doc about my previous marriage, this felt ... compounded.  It felt bigger.

So much bigger.
So much deeper.

I had a little breakdown, you guys.  Shoes and I sat on the bed and talked and didn't talk and talked some more while I wept.

But here's the bottom line:  Other than one more test we could do right now, unless we wanted to skip to IUI or IVF, there's nothing more we can do (other than try conventionally.)  (We have decided that IUI and IVF are not the paths for us.)  The doc told me what the acupuncturist told me:  You're doing as much as you can do.

Something shifted this weekend.  Our hearts are still in this, deeply, but I need to make some changes in my spirit.

I know this sounds very ... therapist-y ... but I wrote myself a little love letter.  And I wept the entire gosh darned time.  In it, I gave myself permission to let go.  I told myself my life means more that constant data checking and symptom checking and symptom OVER ANALYZING.   I reminded myself that while I put all of my energy and spare time into pouring over Google Forums and threads and whatever the *&*(%$# else is on the Internet, I get almost nothing in return.  No peace of mind.  No sound advice.   Just more worry.

I am missing out on the wholeness that is my life.
Even my OB told me to quit charting.  Full disclosure:  I'm not going to do that.  But I wrote a note to myself and posted it on the computer that read, "NO FORUMS."  And I wrote myself out a little plan for when I feel tempted to over analyze and would most likely sucked into the Hell that is Google.  There's a lot of things on that list.
Worrying about this is not one of them.

And while this is all good and healthy and practices faith and trust, and loving kindness to myself, something else happens with that too.  The hurt becomes a little more protected and a little more private.  I'm not sure that's something I can explain, but I feel myself moving into a place of reluctance to talk about this when people ask outright.

After having to talk again about the full extent of this journey, ranging back to 2007, I do not want to talk about it anymore.  In person, anyway.

I used to take people's questions and (let's be honest - ridiculous) advice in love.  I'm reluctant right now, especially after some less than understanding exchanges this weekend, to talk about it with people face to face at all.  Logically, I know people don't understand what it's like to just not have this happen over and over again.  Logically, I know that *this* is not the world's biggest struggle.  However, in this moment, it is *my* struggle.  And it is scary.  And exhausting.  And the safest thing right now to me feels like to keep it, at least in regards to face to face conversations with others, to Shoes and myself.  (But the Internet offers alllllll kinds of fake anonymity, right? Suffice it to say there will be more posts about this as the Internet is not quite real life in many aspects.)

So this past week?
I did not die from the flu.
I watched too much daytime TV.
I received all the Rosie snuggles.
And I started to look fear in the eye a little bit.
And I realized, or at least started to realize, how much I have not been honoring the wholeness of this life.

(I have not read a forum or thread in three days.  It feels better.  No amount of pineapple core / bromelain is going to make me feel better about this process anyway ... it will always be something else.  I don't want to miss out on what's right here, right now as we move forward to what might be.)

I have been down for the count for 7 days.
I have no idea what's going on in this body.  I do know it's not a baby.
That just makes it a bug without a purpose, as far as I'm concerned.
Also, because this weekend is the Coug's bye weekend, Shoes and I had planned to go back to Portland for the weekend and see friends we miss dearly and visit the city we kind of maybe wish we hadn't left.
That, of course, is no longer the plan.
Stupid stomach bug without a purpose.

I've yo yo'd in between home and work this past week.    I feel good in the mornings, by mid afternoon by stomach starts hurting and by late night I'm in severe pain with other symptoms.  I thought my supervisor yesterday was going to lose it when I kept telling her I had just one more thing to do before I went home.  (Really, my work boundaries are getting much better.  I have a few families in crisis right now, though, with little coverage options, which makes not being at work a  little difficult.)

I went to Urgent Care on Tuesday, because, even though I'm 36 and we've lived here for 2 years I'm slightly juvenile and irresponsible and still haven't established care with a PCP.  The doc on call said, "Eh, you're either pregnant or you have The Bug.  You're fine to go back to work."

Extremely helpful.

I'm tired of home.  Tired of my bed.  Tired of reading.  Tired of social media.  Tired of daytime TV.  (When I watch TV, I catch myself thinking things like, "What do you mean Jwoww and Snookie and Janelle and Kim K can have babies and I can't; That makes zero sense ...."   Then I have to remind myself that those thoughts help nobody and it doesn't matter who's having babies and who isn't.)

Tired of my stomach hurting.

Not tired of the Rosie snuggles.  She's been a steady, constant companion, often choosing to lay her 75lb dog fluff directly on me, or choosing to snuggle her dog nose into my neck.   Every time I'm really not feeling well she brings me her favorite stuffed octopus, which is extremely endearing and also disgusting because that octopus is really very extremely dirty.

Not tired of Shoes, who has gone out to buy Saltines and more Saltine and Gatorade and more Gatorade and lies down next to me and continually asks me what I need.  How did I get so lucky to have him, you guys?  I look at him and I remember just two years ago when all I could think was, "Our long distance is going to end soon and then we get to have a normal relationship where we see each other every day."  He's a good one.

So today I'm at home, orders of my outpatient clinic, who are alarmed by my pasty pallor.  (look guys, it's just a product of having no food energy for several days ...)  I'm going to crack open "Play Therapy With Children in Crisis" (which I really have been wanting to read.)  I'm going to start planning next Spring's garden (when else am I going to have this kind of time?)  Shoes and I are re-arranging / redecorating the bedrooms in our house to make symbolic / spiritual / metaphorical room for a child; I'll probably start looking for paint colors.

And just continue to believe that whatever this stupid bug is it's not serious and will leave soon.
(I did schedule a real appointment with a doctor for next Tuesday to talk about the stomach issues and to establish care with a PCP.  I am a grown up, in the end.  I'm just a grown up who's tired of Super Bug.)

Sigh.

Because I'm sick.  At home.  Probably not with Ebola, but oh man.  Whatever this is has a powerful punch.  Somewhere around 8:00 I rolled out of my bed and onto my couch and thought to myself, "This would be a good morning to try to watch The Shining all the way through."  (Don't ask - I'm blaming the fever.)  I haven't yet watched it entirely, despite many years of trying, because I am truly terrible with scary movies.

It didn't work.  Eyes shielded.  I can't stand the woman in the bathtub or the last portion of the movie where Danny is silent screaming constantly.  Also, in the book, didn't the head chef LIVE?  Why would you kill off that character??

Around 10:00 my best friend texted me pictures from the pumpkin patch with my goddaughter.  That made me a little sad that we live so far away and I can't be part of those things in person.

And around 11:00, the OB's office called to remind me that my first fertility appointment is this Tuesday.

All the thoughts about that.  That phone call lead me down a spiral of thinking about the path we've taken so far to start our family and how many things we do during the month to try to make this as successful as possible.

It has taken over our lives.

It's worth it, don't get me wrong, but good night.  It's a lot.

From the charting to the 15 supplements a day to the teas to the massage therapy to the acupuncture to the eating pineapple cores to the over analyzing everything and falling down the awful hell that is Google to the limiting drinking wine to 5 specific days to the full 9 servings of fruits and vegetables a day to the keeping my feet warm always (one of my closest friends is Chinese and says I have to do this) to the fertility yoga to the daily foot soaks to open my meridians .... It doesn't really stop.

My acupuncturist fired me this week, you guys.  It was kind of a jolt to my ego and my first thought was, "Why would you fire me?  I'm like, the world's BEST PATIENT.  I DO ALL OF MY HOMEWORK!!!"  And that's basically what she said.  Actually, here's what she said:  Usually she asks fertility patients to do acupuncture and TCM for two months before trying to conceive, but she make an "exception" with me because we have been trying for awhile and charting for awhile.  Then she said, "You're doing everything right.  You need to rest in that and keep doing that and just go to your upcoming appt. with the OB.  If you want to keep coming in, we'll work on your shoulder and allergies."

So we have this upcoming appointment, and I'm nervous.  I'm nervous about what he's going to say.  Nervous about the testing.  Getting triggered from when I did this before with the Former Husband.   We're hoping for some answers and some direction in these upcoming weeks.

Also, I'm really hoping this fever goes away soon.
I'm also hoping the Cougs win tonight.
One of these things is more likely than the others.
I wish I could drink a glass of wine tonight.

... Maybe this second part should be titled, instead, "Why therapy might not be working...."

It's a sticky situation I'm about to describe.  And when I tell you this, please know that there's no judgment on part.  Things just are what they are.

Sometimes we think therapy is a good idea.  Sometimes we recognize our own distress and make that initial phone call to a counselor, complete our first session, and get started.   But therapy is a funny thing.  Therapy can be validating, affirming, life changing and challenging in all the best ways.

Therapy is also a lot of work.  We usually don't go to therapy because things are going swimmingly well.    There's discomfort.  Dis-ease.  Something isn't working.

And maybe for some people, the simple act of sitting down and talking to somebody helps.  Eases distressing thoughts and emotions.  Is enough.  That's not usually the case though.   Therapists have different views on this, but my own is that therapy is a place where we come to be validated (yes and absolutely), but it is also a place where we come to change.  Change takes work. We learn new skills.  New ways of being.  New thoughts and new ways of thinking.  New coping strategies.  Change requires we are vulnerable enough to talk about what is going well ... and what it is not.  Change requires practice during the week.  It requires therapeutic homework.  It requires being in an emotional place where you're ready to try something new ....

It is work.
(Good work, and it does work, but still work.)

I once had a very, very, very irate client tell me that this "Bullshit therapy isn't working at all."  (There were more choice words than that, but you get the idea.)  This client had come to three therapy sessions.

Change usually takes more time than three weeks, loves.

So we can say we need therapy, right?  We can make that call, come to counseling, and sit in the chair. But sometimes we're just not ready to do the work - sometimes for very understandable reasons.  (And there is no prescription for that.  That's up to clients and their providers.  It might work to keep going.  It also might work to break for awhile.  That's not my place to decide.)

Look.  A little bit of self disclosure and honesty here?  After the Big Divorce in 2007 I saw a counselor for about a year and a half.  And it helped some.  But I held back.  A lot.  I held back a lot because this counselor and I were part of the same faith community and I was having some very big faith doubts I didn't feel like I could be honest about.  It's not that counseling in that season of my life wasn't helpful, but it really was nowhere near as helpful as I could have made it.  (My own answer should have been to probably establish care with a different clinician.  I was afraid of hurting the counselor's feelings.  It wasn't a very healthy person / clinician relationship.)  All this to say, I've been there.  Counseling seemed like a good idea, but I wasn't as invested as would have been most helpful.

Also.

Your comments in the last post were lovely reminders that sometimes we need friends.  Sometimes we need people who are going to sit with us, laugh with us and cry with us.  Sometimes we don't need a professional's clinical tools .... we need somebody who, as Eliz! put it, has been where we've been.  I've been there, too.  The fluttery feeling of solidarity and recognition that happens when we find someone who really understands us ... is gold.  It's not that counselors cannot provide that, but counselors should probably not engage in high levels of self disclosure.  Right now, in this season, I am more replenished from talking to someone who has been through a divorce, or grad school, or fertility problems (my own examples.)

So.  Where does that leave us?
Counseling can be amazing.  It truly can.  I wish I could go into detail about the almost spiritual moments that have happened in my office.   I've seen it work many, many, many times (and "working" by the client's definition.)  Sometimes it really doesn't ever take off.  And that can be ok, too.

I guess my ending for these last two posts would be this:
An admonishment in love to take care of yourself.
If you take care of yourself in therapy, then fantastic.  (I love being a therapist; it can be magical; I get it.)
And if there are other ways to take care of yourself, ok.  Do coffee with your friends.  Do yoga.  Do roller derby.  Do your poetry group.  Do Crossfit.  Do it.  But do something.

(Additionally, as I'm wrapping this up, as a community outpatient mental health provider, I'm having reminder thoughts that some of us are mandated to therapy through different court systems.   As a reminder to us all, I am not giving clinical advice to anybody in this moment; rather, I am exploring thoughts on therapeutic possibilities.   If you have a court order to attend therapy, take medication, etc, or are currently in care with a clinician and these things are part of your treatment recommendation, please follow through.   Please take care of yourself in these ways.)

Part 1.

Do you  guys hear this being thrown around?:

"They / he / she need therapy."
"They / he / she just need counseling."
"I hope they get him into counseling soon."

So.  Sometimes that's true.  Sometimes there are life events, or mood disorders, or family relationships, etc. that affect a person to the point that counseling - the opportunity to receive professional help in establishing new ways of thinking and new coping strategies (That's the abridged definition) - can be extremely helpful.  

Here's what's also true.  Sometimes hard things happen and people find ways to cope without needing therapy.  In the case of bereavement, for example, feelings of loss and grief might be extremely painful, but experiencing difficult emotions does not always mean you need counseling.  Sometimes allowing ourselves to experience painful emotions is the best thing we can do ... because we're allowing ourselves to feel and to move through it.  (Am I saying that nobody experiencing bereavement should seek out counseling?  Nope.  I'm just saying it's not always an automatic.)

I just got back from my hairstylist.  Good night sometimes she drives me crazy.  I was talking to her about how uninspired I am with my hair (this is a daily feeling for me), which somehow lead to me briefly mentioning that I was grumpy today.  Grumpy with my hair.  Grumpy that I have to drive 2.5 hours to a wedding reception tonight by myself as Shoes is in Utah for the away game.  Then she asked how "working on your family's little addition" was going and I simply stated I was grumpy about that too.

Well, I am.

Then she said, "Are you in therapy?"

Dear hearts.  Please do not ask people you don't really know very well this question.
It is RUDE.  And deeply personal.  (I also think we should let go of the stigma around seeking out mental health help.  But still.)

I stated I was not, and she said, "Well, I think you should be."
For what?
For being grumpy that my hair is alternatively a greasy / frizzy mess?  I think grumpiness is an appropriate response to that.
For being grumpy that I have to go to a wedding reception where I might not know anybody?
That's normal too.
And being grumpy that we're delayed in our family plans?  HA!  Grumpy is a MUCH preferred alternative to any number of things I could meet that with.

(Now, I should be in therapy because I'm a therapist, and it's standard practice for us to be so, but turns out I'm having a hard time finding a therapist who doesn't know me or my spouse's family in this tiny rural town....)

All this to say is that counseling is not always the answer, and sometimes we can find answers within us, or in our support systems, or our friends and family.   Or Jesus or God or Allah or Nature or Art or Yoga or Marathons or ....  (We know more than we think we know and can do better than we think we can do ...)

Sometimes counseling is most definitely the answer, but here's a little nugget about that as well.

Sitting in a counselor's chair / regularly attending therapy does not mean you're going to experience relief from negative symptoms or an increase in positive symptoms.

Why?

Well, that's Part 2 of this post, which is forthcoming ...

Sometimes when people are trying to start their family, it seems like everybody around them experiences the success they so ardently hope for.

Shoes and I have decided it's time for some sort of kid to  live in our house.  Actually, we decided this awhile ago, but with the old job, the changes this year, etc., it's only been in the past few months we've really been able to focus in on what this means.

Good Lord, what does this mean??

Well.  Honestly.  We're not really sure.  As of right now, we're going about this natural way, but when you're 36, the natural way reveals things about an aging female body.  Sometimes it reveals things that are slightly worrisome and come with all sorts of connotations.  In our case, we're still optimistic that things can be leveled out, and with the force of several supplements, we're moving forward.  (Many, many thanks to my dear friend B., who has termed this season in my life "reproductive misadventures."   I love that.  It makes it workable.  To me, that might mean that I read the map upside down and my luggage got lost in baggage claim, but there's still hope I can hitchhike back to down and the airline will contact me at some point.)

But there's still that question if it will work, right?  On top of the question, Shoes and I have always held adoption closely to our hearts.   We almost started the adoption process before trying to have our own; we've both had personal circumstances and jobs in which we've seen the ardent need for children to be placed with families who are in it for the long haul.

We're in it for the long haul.

Fostering, however, we're not interested in.  I realize that might sound calloused, but in this very, very small rural town, I would prefer to not have my community partners coming by my home at a moment's notice for 30 day face to face checks.  There's too much togetherness there, and I am far too opinionated.  Sometimes I agree with the Children's Administration.  Sometimes I bluntly and unapologetically don't.  But I have to have weekly meetings with those folks.  Shoes and I have agreed this is better left alone, for the sake of working relationships.

Kids.  We think we know what that means.  I think I know what that means.  Deep down, we know we have no idea what this means.  And we're ready for that, you know?  We had to come to a place where we were able to look that question dead in the eye and answer quietly, I don't know, but we stand in a place of faith and quiet confidence.

Also, when you get ready to have a family?  Holy moly, the free advice starts flowing like thick molasses.  I have heard Everything.  EVERY magic trick that GUARANTEES success.  And while I receive the advice in love (because I choose to believe that that was the spirit from which it was intended ...  MOST of the time), it becomes very overwhelming very quickly if left unchecked.

But don't worry, I'm checking it.  And letting go of worry.  And putting aside My Ultimate Plan.  One way or the other, it will happen, and Shoes and I will grow our family.  Rosie will have a human sibling.  We'll take family vacations to cheesy resorts.  We'll stay up all night with sick kids.  All of it.  

All the Everythings.

One full month at the new job.

I am no longer waking up at 4:00 in the morning, worrying about paperwork, clients and children at risk, or how much laundry is piling up downstairs.  I am not waking up at 6:00 in the morning on weekends out of a feeling of obligation, worried that I won't get everything done.  I am not bringing paperwork home with me (although that might be temporary and due to a lull in my caseload.)

I have responded to my first crisis call in the ER with this job.  I had backup.  I had a beautifully understanding ER doc and ER nurse.  I was paid appropriately for this wee-hours-of-the-morning-overtime.

And so now, in the past couple of weeks, I have noticed my attention starting to focus on non work related items.  I read a book.  For fun.  For fun, I read a book.  It had nothing to do with kids in distress, abuse or trauma.  It was lovely.  Shoes and I harvested a healthy crop of green beans and sat around the kitchen, munching on their crisp, earthy goodness, talking about how chunky Rosie is getting.  We have taken Rosie the Retriever swimming many times (as I no longer have to worry about being within cell phone range and, let's be honest, anything 5 minutes outside of town falls out of cell phone range.)

I signed up for yoga again.  And started exercising again.  And finally scheduled a facial for which I'd been given a gift card for AGES ago.

Also, we're going to Italy (I'm still good at non sequiturs, huh?), and it is one very lovely thing to look forward to and plan. Shoes' mom had 90 bajillion airline miles that had to be used; we're all going together.  This plan came together very quickly (so quickly it made me nervous - this planner likes to move slowly) and in a week we've booked the tickets, arranged for time off, applied for passports and arranged for Rosie's house-sitter (my MOM - who offered to come up from Central Oregon!).

I've also downloaded basic language learning software and have been plugging away nightly.  I'm not sure how useful knowing the plural forms for feminine and masculine nouns will be when I'm trying to order a glass of wine (unless I'm ordering several glasses of wine?), but it's fascinating none the less.

Today, I'm not sure what's on the docket.  Cleaning up the Rosie hair from the hardwood, no doubt.  Maybe building the compost bin.  The argula needs to be weeded as well.  Or maybe not.  Maybe I'll just watch movies all day.  I'm starting to feel like *I'm* finally in charge of my time off.

I am having to learn how to be a DMHP all over again.  And it is exhausting.  (read: the person who acts as an arm of the superior court to make decisions as to involuntarily detaining patients to psychiatric beds.)

A week before my wedding in 2012,  literally the week before my wedding, I was at a DMHP week long training in the city.  And then I went back to the community in which I was working, and the coursework did not transfer over to any practical skills.  O, how I just dreaded, dreaded, dreaded crisis work in the previous community.

For propriety's sake (and o, my word, is it difficult to be in a place where I observe any propriety), I'll refrain from going into why they skills did not transfer over.  That county just did things that county's way.

So now, while I am building up my child and family caseload at the New Clinic, I am being trained again in DMHP work, because I will be expected to take crisis shifts 3 to 4 nights a month.  There is always a sliver of worry that pierces my spine when the crisis calls come - hard and sharp and automatic.

I am slowly learning that the New Clinic's way of doing crisis is so different from the Old Clinic (and we're talking the job before my last one, folks.  Two jobs ago) that it shouldn't even have the same name.  I'm learning.  Learning how to trust my clinical skills.  Learning to trust that help will actually be there.  Learning that I *can* make sound clinical decisions that serve my patients' best interests.

Slowly learning that crisis calls don't have to be spears of fear.

I'm grateful for that.  It's a slow gratefulness, but gratefulness none the less.

The head crisis worker at the New Clinic has been training me carefully.  He is a quiet, gentle, seasoned veteran, and he continually asks me quietly, "What do you make of this?"  "What do you think about (something)?" "What could this be from?"  And then when I hesitate or apologize for thoughts he quietly says, "I like your line of thinking" or "Go on with that thought a little further."

And this is where we get all Mufasa lifting Simba to the sun.

My MIL was a clinical psychologist in the area for years.  Head of mental health, retired now for a bit.  Next state over, but the same geographical region as where we all live now.  The Head Crisis Worker at the New Agency actually worked under my MIL for a long time.  (That's how it goes in small towns.)  Today Head Crisis Worker and I responded to a particularly sticky crisis call at the ICU.

As he was writing his final documentation (and we had been there for hours, my stomach grumbling and my head swimming from information), he started chuckling, looked up at me over his glasses and said,  "I find it ironic that as I'm writing this, I'm very much remembering things I learned from (my MIL)."

It's all in the family, I guess.

Look, folks.  All I really want to do is get back to providing child and family therapy.  But if this is what has to happen as part of this package deal, as long as it looks like this and has this type of support, and as long as I'm surrounded by clinicians who are in this for the patient's best interest, I think I can stick this out.  Being an Every Person with Other Duties As Assigned is part of working rural community outpatient health.  I wasn't prepared for that at first.  I think I'm getting closer to that point.

July 12, 2014 ~ Captain's exploration log.

This new clinic is a foreign, bewildering place of hot tea, water features and piped in music.  The inhabitants claim to be rural community outpatient mental health, but I continue to look for signs of proof to this claim.  Upon arrival, the presiding therapists came out of their offices and while I presumed their first, most pressing question for me would be "When are you going to take your first crisis shift?," they most confusedly instead asked me my name.  Additional observation needed; we don't appear to be speaking the same language.


Maybe it's because this clinic is actually in the town with the PAC12 University.  Maybe it's because of some vision somebody had ages ago to buck all stereotypes of rural community outpatient mental health.  Maybe I don't know why it is, but this workplace is different.

~ We have a prescriber who's there several days a week.  A prescriber!
~ We have several licensed social workers, licensed mental health counselors and clinical psychologists.
They like each other. (??)
~ The executive director attends all clinical meetings.  Quietly.  Just so he can "really know what you guys are dealing with on a daily basis."
~ Despite the fact that I am already qualified to be a DMHP in this state (read: I can involuntarily detain people to psych beds), nobody has asked me when I'm going to start taking crisis shifts.  They like doing it.  There's no rush to push it off on someone else.
~ There are *several* case managers.
~ I am actually being *trained* to do crisis on call, and with that, am receiving a ton of training on SPMI (never had that before, folks.)
~ I called my first clients and when I asked where I needed to document that, I received a concerned, but caring, look, and my co-worker stated, "Oh, you don't.  It's fine.  People trust you here."
~ We gave a "great" relationship with local law enforcement.  (? What ?)
~ The Friday Therapists (the few of us who work Fridays) asked me to lunch the first week.
~ HR actually sat down with me the first day to explain benefits, gave me a key and asked me several times if I had any questions.

Look.  I'm not saying it's perfect.  I'm not saying things aren't going to bother the crap out of me at points or that I'm going to love everything.  I'm not delusional.

What I am saying is that this clinic feels more like the clinic I left in my native Portland.  I'm saying that I'm having cross disciplinary meetings.  I'm saying that we're speaking about heteronormative and gender normative language.  I'm saying that somebody said "prodromal" this week and I literally have not used that word in two years, despite working in mental health.

I *am* saying that people are happy at this clinic.  People have worked at this clinic for 20+ years and nearly every one of the old timers has said, "Fresh eyes!  Ask questions!  Let's better this process!"  I am saying that, after two years of rural driving, the clinic is 7 minutes from my house.  I am saying that I worked 40 hours (as opposed to 55 or 60) this week.

I *am* wondering if this is going to be the switch Shoes and I needed to be able to stay in this area for a few more years.    I am cautious, but I am hopeful.