DBT - Helping Me to Victory

Karen Prive

3 Jul, 2023

I’ve mentioned before that one of the therapeutic tools I find helpful is DBT – Dialectical Behavioral Therapy. DBT is an offshoot of cognitive behavioral therapy. It began as a treatment for borderline personality disorder (BPD) and today is also used to treat other mental health challenges – particularly when intense emotions impede someone’s progress. Taught in groups as well as in individual therapy, DBT teaches skills in four modules – core mindfulness, distress tolerance, interpersonal effectiveness and emotional regulation.

Central to DBT is dialectics – the fact that two opposites can be true at the same time. There are many examples of dialectical truths in all aspects of life. It sometimes rains when the sun is out (and we are rewarded with a rainbow). Some of us have love/hate relationships with a family member. There’s also the classic DBT standard – I can be doing the best I can, but still need to learn to do better.

Dialectics tend to throw many of us, and this is especially true of people with BPD. I have BPD in addition to PTSD and depression, and am no exception to this rule. When two opposites seem true, I feel confused and overwhelmed – it’s almost as if something inside snaps. I like my reality to fit neatly into a box, and when it doesn’t, I have strong emotional reactions, DBT or not.

I had one of those reactions last week.

I would like to find a new part-time job in the field for which I’m trained and am seeking some assistance in that area. Vocational Rehabilitation (VR) helps people with disabilities who want to work. I know I qualify. My mental illness alone makes it hard to function in the world, but I also have mobility issues related to an accident I had many years ago. Still, VR had to assess my disability in order to prove I qualified for their services.

When I received the letter, I did qualify for services. Yay, right? Except they stuck me in the category “Most Significantly Disabled,” which was an emotional blow even if it prioritized my case. Who wants to be disabled, no less, most significantly so?

I recognize that I’m disabled but I work so hard to do everything I can do. I work as much as I’m able (sometimes more so – that always gets me in trouble). I do the things around my house that I’m able. I refuse to use my disability as an excuse. I don’t think of myself as “most significantly disabled.”

I was happy VR was granting me services, but I felt hopeless about being so categorized. That’s a dialectic. I was very confused because the letter was good news, but the label didn’t fit neatly in the good news box. My emotions swirled!

This is where DBT helped. I used my skills. I recognized all my feelings and gave them a little room to be. My natural inkling is to shut down when I have intense emotions, and then behave in ways I regret. I was mindful instead – taking a step back and observing. Then I called a trusted friend, telling her I was having mixed feelings over the letter. She helped me accept that my reaction was valid. I did nothing I regret and am now more focused on moving forward with my VR plan. Victory!

Divine Love and Healing

Karen Prive

19 Jun, 2023

When I was very little we went to church every Sunday. I wore my pink dress and carried my wicker pocketbook full of little toys to keep me occupied during the service. The Church of the Wildwood was a tiny Methodist congregation on a dirt road in a tiny town in Vermont. Reverend Marceau – dressed in blue jeans, a plaid shirt and cowboy boots – led us in song while strumming his guitar. He was gentle and kind, and it seemed the churchgoers followed suit.

When I was about five, we abruptly stopped going to church. My father announced there was no god, and from that point I was raised atheist. Any mention of God was met with rage – if there was a god, tragedies wouldn’t strike. I cannot know for sure, but upon reflection I suspect that his anger at the idea of God stemmed from the death of his mother, lost to cancer.

Dad could try to raise me atheist, but some of the ideas from church had already been planted in my head. I believed in an all-powerful God in charge of all things, and that we were all put on earth for a purpose. In my little mind and with no one to talk to about it, I looked around at my ugly life – full of violence, abuse and pain – and determined that God put me with my family because he hated my guts and wanted me to suffer.

If I could discover my purpose and complete my task, I could die and maybe go to heaven. Maybe my purpose was to hold the door open for a woman carrying her groceries, give directions to a lost sightseer, or share my lunch money with one of the less fortunate students at school. I kept trying to do nice things, hoping I’d achieve my task and be relieved of hell on earth.

Years later, when I went to rehab and got into 12-step recovery, I was utterly lost with Step Three: Made a decision to turn our will and our lives over to the care of God, as we understood Him. The counselors insisted God was some kind of benevolent being, but I knew he hated me, and the idea of turning to such an entity was terrifying. I’d rejected Christianity, as multiple tragedies and atheist speak had shaded my view of things. God seemed evil.

In treatment we had a couple hours of school every day. I resented this – I’d just graduated high school – but the state insisted all residents of adolescent facilities have study time even in the summer. The teacher met with my team and determined that I would study eastern philosophy. I was presented with material on Buddhism, Hinduism, and even the I Ching. I began to read of different takes on divine thought.

When I left treatment, my mind was just barely opening to the idea of a loving Higher Power, but I still clung to the idea that God himself hated my guts. My 12-Step sponsor suggested I find a new God. What a strange concept! I very slowly started to believe in something I called HP – this sounded hip, like a cool friend – and was separate from that hateful God.

Time has changed the way I think. Somewhere along the line I came to believe that there is some kind of loving energy in the Universe, that loves me and loves you too. I’m not sure what to call it. Sometimes I shorten it to God. I also no longer believe God is all-powerful and in charge of all things. Not all things are God-made. Many are man-made, and God cries at some of what we do to each other.

I still don’t consider myself Christian, although I was baptized Methodist all those years ago, and study the Bible today. I don’t consider myself a Buddhist, although meditation is an important part of my daily routine and mindfulness is central to my healing journey. I draw on many sources, and am quick to see where many religions have so much in common. I am not religious, but I deeply believe I am not alone.

Whatever you believe in – or don’t – is ok. But for me, spirituality is as central to my ongoing recovery as therapy. At the juncture where therapy and spirituality meet, healing happens. Whatever that energy might be – the Universe, HP, or God – it works its love on my heart, if I remain open. There is incredible comfort in that divine love. I think Reverend Marceau would approve.

A Love Letter to Myself

Karen Prive

13 Jun, 2023

I spend a lot of time talking about hope and healing, but like many child abuse survivors, my inner child still thinks she did something wrong to cause all of what happened. If there are no mistakes in God’s world then little Karen concluded God must have hated my guts for something awful I had done.

It’s not true.

My therapist suggested I write a letter from my adult self to that little one, to comfort her and explain that it wasn’t her fault. My letter to myself was so gentle, compared to the critical voice I hear so loudly in my head.

We should all write love letters to ourselves, to counter the inner critic so many of us have. What would it take for you to find kind words for yourself? How about taking some time today to treat yourself with the love you deserve?

Here are some excerpts from my letter.

Hey there little one –

I know you’re hurting. I see you. You’ve been through so much and I wish I could take a lot of that away, but we cannot change the past.

It’s ok to be angry, but kiddo, you’re angry at yourself and you don’t need to be. Trust me. All that crud that happened was not on you. It wasn’t because you were bad or even because God hated you. (God didn’t, by the way. God cried even when you couldn’t, because none of this was part of his plan either.)

Crap happened because there were some awful adults in your life. You were a little kid who was in the midst of a lot of trouble, and you acted like a little kid who had experienced a lot of bad stuff. You didn’t fight because you were bad. You fought because you were in a hopeless situation, and there was no other way to get through it.

…

I know you felt lost, and worthless. You have never actually been worthless. You are a child of the Universe and deserve all the love and glory available to anyone! So much was taken from you before you had words to describe any of it.

…

When we told about the abuse, the world tried to circle around you, but by then it was too late to have any idea how to let people help. You’d already had a lifetime of being alone. Not knowing what to do – and yet, you did the bravest thing possible at that point. You did whatever you had to do to protect your brother.

…

I have to say, I’m really proud of who you were, and who you are. You took a really awful situation and became the kind of adult you needed back then. We’re gentle and loving, for the most part, but fiercely protective when that needs to happen.

I love you sweetie. – Momma Karen

On My Street, Hope is Invincible

Karen Prive

5 Jun, 2023

I’ve experienced a lot of trauma in my life – childhood abuse, struggles with mental illness, alcoholism and drug addiction, homelessness, a bad car accident, hospital stays.

Yet there’s a lot of good stuff too! I am clean and sober. I went to college and got my degree, summa cum laude. I married a wonderful man and became stepmom to four great kids – who made me Grammy many times over. I’ve worked jobs that make me feel proud of my capabilities. My brother and I healed our relationship. I have a blog, with loyal readers.

In other words, my trauma isn’t my whole story. Rather, I share the hope that I don’t have to live in that misery for eternity. I live with joy. When I slip into the darkness – which is human, and inevitable – I can make my way back into the light. Sometimes I need help to get there, but I know deep down that it’s possible.

This is what Invincible Hope is all about.

As a teenager I was stuck in sheer hopelessness, and desperately suicidal. I saw a counselor as demanded by the state, but I didn’t think it could make a difference. I challenged my poor therapist, who later declared me the best education she ever got. I was quiet and unreactive. But she got to me. She connected with me when I didn’t want to share anything with anybody. She offered me a hand to help me climb out of the hole.

The hole.

The poem “Autobiography in Five Short Chapters” by Portia Nelson well describes my journey from trauma to healing – a journey that continues.

You can find the poem here: https://palousemindfulness.com/docs/autobio_5chapters.pdf

Sometimes I take the same street, despite the risk of the giant hole of hopelessness. It is comfortable and familiar, and I am used to the darkness. Sometimes I dance around the hole, tauntingly. Sometimes I trip over myself and land in the hole.

But on my best days, I turn down a different street – one that is well-lit, without a giant hole, and full of joy.

What street are you taking today?

Seven Self-Care Tools for Everyone

Karen Prive

29 May, 2023

For Mental Health Awareness month I’ve detailed different aspects of my mental health journey – an overview, therapy, advocacy, and inpatient care – but this week I want to talk about tools YOU can use to care for yourself, whether you have mental illness or not.

We all have a mental health story, and will experience symptoms of depression, anxiety or even psychosis at some point in our lives. It’s part of the human condition. Situational depression or social anxiety are two of the most common forms of angst, and while they do not necessarily require professional treatment, they still deserve self-care.

What can we do? Here are seven of my favorite self-care tools.

STOP – literally stop, take a step back, observe the situation, and proceed mindfully. When a situation elicits an emotional reaction, resist the urge to jump in. Take a deep breath. Think about what you want for an outcome, and how you might get there gracefully. Take time to calm down before choosing your path. Your pause could be for a moment, or for a day or more. Try not to react from that emotional position.

Breathe deeply. Our automatic breaths are often shallow, and from our upper chest. A few conscious breaths deeper into our diaphragm (in the belly) can soothe anxiety. Inhale through your nose for a count of 4, pause briefly, then exhale through your mouth for a count of 7. This pattern not only engages both sides of your brain, but the longer exhale can slow down your thoughts.

Exercise. This one comes hard to me, but is one of the most effective tools in my toolbox. A walk can increase my endorphins and give me energy when depression is taking over. If I’m anxious or angry, an upper body strengthening workout helps dispel the energy. Dancing wildly around my living room to upbeat music is another way to get my blood pumping and shift how I feel.

Talk to a trusted friend. They say a problem shared is a problem halved. For me, when I hang onto the stuff that bothers me, my brain makes it even bigger. I feel alone, overwhelmed and often ashamed. Sharing mitigates those feelings, and my friends often help me laugh about my situations.

Take a bath. I don’t do this often enough, but crawling in a tub of hot water and soaking quietly for a while soothes my spirit. I often light candles too and play soft music. Water is very healing.

Observe nature. I live in a neighborhood where wildlife abounds, so I can sit in my yard listening to the birds, watching the deer or breathing deeply of the clean air. Maybe your surroundings aren’t as idyllic, but perhaps you can go to your local park or a nearby waterfall. Treat yourself to twenty minutes in a natural setting.

Download and use a self-care app on your phone. Right now I’m a huge fan of Finch, an app that gamifies self-care. Finch encourages you to practice breathing exercises, journal about your life, set and meet goals, and check in about your mood and motivation levels. These activities are linked to points that you can use to take care of a virtual pet birb (bird). You can send your birb on adventures, decorate their home and change your birb’s appearance.

Of course, these activities will not cure mental illness, but they can mitigate the effects of all sorts of forms of distress.

If your symptoms continue for more than two weeks or are especially intense, you may wish to seek professional intervention. Reach out to your regular medical provider for assistance in locating help. If you have thoughts of suicide or are in some other kind of mental health crisis, call or text 988 for immediate connection with a clinical provider.

Hope - My Inpatient Journey

Karen Prive

22 May, 2023

I’ve struggled with my mental health for as long as I can remember. I attempted suicide several times as a teenager. During that time I avoided inpatient treatment, always insisting I wouldn’t do it again. My parents didn’t look kindly on mental health care in general and wouldn’t commit me.

In fact, when I was eighteen and inpatient alcohol and drug treatment was suggested, my father noted that if I went to “that place” I would not be welcome home again. I still chose to go. I had been trying to get a handle on my drinking for two years at that point, and my use was pouring gas on a fire. I couldn’t stop. I was sick from an overdose and my kidneys couldn’t recover because of the amount of alcohol I was pouring into my body. When I had started drinking it was a useful tool in controlling my anger; now I was just mad and drunk, a combination that led to trouble.

When I checked into rehab I was suicidal, and the team debated whether I should instead be transferred to the state hospital. Could the treatment center keep me safe? They hatched a plan where I would have constant supervision and kept me at the facility.

I haven’t had a drink or a questionable drug since I accepted help and went to rehab. I continue to be involved in Twelve-Step fellowships and give back as much as possible. I love being sober.

But my sobriety is just part of my story. The Twelve Steps – as central as they are to my continued recovery – have not cured my mental illness. I still struggle with PTSD, depression, episodes of psychotic symptoms, and near-daily suicidal thoughts. But the tools I’ve learned in sobriety have proved useful on my mental health journey too – especially, to ask for help. I don’t have to do it alone.

Eight years ago I appeared to be on top of my game. I was working a professional job at an Ivy League school, serving on two government commissions, and was an officer for a non-profit organization. On the outside, things looked pretty good. Inside, though, things were falling apart, and the worse things got the more I threw myself into work, desperate to prove that I was ok.

I wasn’t, and things continued to unravel, in part due to hormonal shifts from perimenopause. Finally, I wasn’t sure I could keep myself safe one more minute. I called my psychiatrist and was admitted to my first inpatient psychiatric unit.

Of course I was terrified. This was a new situation, and I had no idea what to expect. The nurses and counselors were kind, though, and the patients were friendly. Days consisted of therapy, art, educational sessions, medication distribution, and recreational time.

In that first hospitalization I did not respond well to medications, and we finally opted to try electro-convulsive therapy (ECT, aka shock therapy). I had the power to choose whether to try ECT – it wasn’t forced on me. It was explained that I would be under anesthesia and not remember the procedures. I might have a headache after, and perhaps have some memory issues.

At this point I was so low. Medications were not helping, and after weeks of being inpatient I was in worse condition than when I arrived. Why not try ECT? So I did.

My first round of ECT treatments (some inpatient, and later outpatient) absolutely saved my life. They stopped my fall into hopelessness, and started moving me in a different direction. I started feeling better. Within months, I was back to work, but without the additional volunteer commitments.

And then things began to unravel yet again. I found myself inpatient a second time, with more ECT treatments. I wasn’t as responsive this time, and found myself cycling in and out of various inpatient wards.

On one unit I was reintroduced to Dialectical Behavioral Therapy (DBT) – a form of cognitive behavioral therapy that was created primarily for patients with borderline personality disorder (BPD). DBT is a skills-based therapy that helps with emotional regulation, interpersonal effectiveness, and distress tolerance. It was suggested that I access DBT through my local community mental health center, and I threw myself into it. I still go to a DBT alumni group therapy that helps me keep applying the skills that I learned.

Another hospitalization gave me time to focus seriously on completing a Wellness Recovery Action Plan (WRAP) – a plan that addresses what I can personally do to improve my mental health in various stages of wellness. This includes everyday activities (for me this includes meditation and other forms of self-care), what to do when things start to come undone or when I am in crisis, and what interventions I want to use or to avoid. I went from cycling in and out of inpatient care to a three-year period of relative stability once I completed (and used) my WRAP.

Whether it is medication, ECT, DBT, or other treatment, therapy does not mean I don’t need hospitalization on occasion. Last year I reacted to a medication and required inpatient stabilization. Most voluntary stays are very short (my last one was less that a week) and designed on coping better upon release.

I’ve learned that inpatient care is not the end of the line – for me, it’s a measure that allows me to remain safe when I can’t manage my mental health in the moment. Inpatient care offers me a chance to get back on my feet moving in a better direction.

Hospitalization is nothing to be ashamed of. It takes courage to ask for help, and can be a life-saving proposition.

If you or a loved one is having suicidal thoughts and needs help, call or text the National Suicide and Crisis Lifeline at 9-8-8. Clinical providers are available 24/7, and can help you manage a crisis or seek additional interventions.

This is the fourth of a four-part series celebrating Mental Health Awareness Month.

Hope - My Mental Health Advocacy Journey

Karen Prive

16 May, 2023

In the mid-1990s I was enjoying relative stability in my life. Medications and therapy made a huge difference in my mental health, so I was able to support myself in a stable job. Ed and I were seeing each other, and I was growing in leaps and bounds. Life was good.

But I had two very different silos in my life. I attended various twelve-step groups, and at their meetings we talked about substance use and recovery. I attended some therapy groups as well, where we talked about recovery from trauma and mental illness. Everything seemed to be covered, but what about where the two intersected? I only talked openly about dual-diagnosis issues with my individual therapist and my twelve-step sponsor.

Around this time a friend came into my life who was also dually-diagnosed, and she voiced her longing for more friends who understood both sides of her story. I thought about my own similar desires, and decided to do something about it.

Soon I hosted the first of monthly potlucks for women in 12-step recovery who also had mental illness – with the motto, “Bring a Friend, Bring a Dish.” Relief washed over me when I could openly talk with other women about what it was like to be in recovery and also struggle with my mental health. Others expressed their joy in such a stigma-free zone.

Merriam-Webster defines advocacy as the act or process of supporting a cause or proposal. In creating Bring a Friend, Bring a Dish, I was supporting the cause of women in our community who needed connection with similar women who struggled with dual-diagnosis. I’d always been an advocate for the underdog – oh how I love a fight fueled by social consciousness – but I’d been shy about declaring to anyone that I had mental illness.

My next mental health advocacy move came a few years later, when I was appointed to the New Hampshire Governor’s Commission on Disability, where I tried to carry the voice of people with mental illness. For years I did this quietly, trying not to reveal too much about my own mental health. It’s hard to fight stigma when you’re hiding your own story.

In 2017 I became much more open about my mental health journey. I had posted a picture of a mask of myself I’d created while on an inpatient psychiatric unit, changing my profile picture on Facebook. My phone immediately started pinging. “Are you OK?” the texts asked. “Do you need help?” I saw two paths forward – one was to remove the picture, and the other was to explain publicly why the mask was so important to me. I chose the latter.

More texts started coming in, now with people sharing their own mental health stories. I was not nearly as alone as I thought I was.

Then I wrote an op-ed about the emergency room boarding crisis. I shared my own experience of having a psychiatric crisis – suicidal and hallucinating – and having to wait three days without treatment in a tiny room in the ER, waiting for an inpatient bed to become available. The Union Leader ran the article, and more people shared their stories with me.

I began publicly speaking about my own story with NAMI New Hampshire’s In Our Own Voice speaker bureau, too. I had spent years being afraid of judgment and ostracism if I opened up about what I experience, but with only a couple of exceptions, people have responded with love, support, and/or their own stories.

When it was suggested that I start a blog, I resisted. I didn’t know how to create a blog! My mentor said, “Why don’t you google it?” Those words stunned me into realizing that my barrier was surmountable. Two years later Invincible Hope stands strong. I think of my weekly posts as just one way I practice advocacy.

I’ve done so much more, but it all started with Bring a Friend, Bring a Dish. I’ve learned that if I see a need, I can create something to improve the situation. That is not just advocacy – it is empowerment.

This is the third in a four-part series for Mental Health Awareness Month. Continue reading earlier segments at https://karenprive.com/blog/

Hope - My Therapy Journey

Karen Prive

9 May, 2023

When I was sixteen, Vermont’s Social & Rehabilitative Services (SRS, as it was called then) ordered my parents to find counselors for my brother and me. We had just reported my uncle to the authorities for sexual abuse. Not surprisingly, I was exhibiting behaviors that were concerning – I was drinking heavily, self-harming, and setting fires, for example.

My parents wouldn’t have allowed me to see a counselor – what happened at home stayed at home. But at the SRS worker’s insistence, my mother grudgingly made an appointment for me to start therapy with a woman also named Karen.

My first therapist had her hands full. I would occasionally complain at length about the crazy violence in my family situation, but more often I would sit quietly. While mental health professionals are taught to wait out a pregnant pause in session, these were stubborn silences, in which I was waiting for our hour to be over. But I kept going – mainly because my parents didn’t want me to. Being in therapy was an act of rebellion, even if I didn’t want to talk about myself.

Then I started writing. It began in a blackout, when I followed up a session with a lot of rum and putting pen to paper. I put that letter in the mail, and the next week Karen had me read it to her in session. I poured out the pain I’d previously been afraid to speak, that alcohol had loosened. While not typical therapy, it became our way – fear to say aloud what was inside of me, followed by somehow finding the courage to put the words on the page and mailing the letter, only to read those words allowed the following week.

It was Karen I called when I was finally ready to accept help for my alcoholism, and who made the arrangements for me to go to rehab. She actually worked in two cities, so when I left rehab and started college I was still able to work with her.

By then I’d started talking, and we started working on expressing my anger. Oh baby, did I have a lot of that. One day she helped me roll a newspaper lengthwise and wrap it in duct tape, creating a bat that made a satisfying “THWOMP!” when you banged it on the floor. I thwomped a lot, with and without loud curse words The bat helped me get that anger out without resulting in assault charges, of which I’d had a little experience.

After a decade in the Burlington area, Ed and I moved to New Hampshire. At first I thought I could do without therapy, but inside things began to unravel. I found myself again contemplating suicide. After a few different therapists, I settled with Carol, who I saw for seventeen years. She had a long history of working with trauma survivors, and introduced me to energy psychology, including Emotional Freedom Technique (EFT), aka tapping.

In EFT you tap a series of your meridian points while speaking aloud an affirmation, including acknowledging your resistance or fears. Part of it might sound like this, “Even though I feel shame and think this is pointless, I deeply and completely love and accept myself.” Tapping is a powerful way of letting go of some of my emotional blocks. Of course, I don’t do particularly well with emotions, so I found it best to do the heaviest work in session with Carol as my guide.

However, when my depression worsened I needed more support than I could get out of our weekly therapy. I had been reintroduced to Dialectical Behavioral Therapy (DBT) and was finding it helpful. Carol was not a DBT provider; for that, I needed to go to my local community mental health center. So I made the leap. For the last four years I’ve seen therapists there and been part of a DBT class. DBT is a skills-based therapy, originally created for patients with borderline personality disorder (BPD). Along with C-PTSD and major depression, I also am diagnosed with BPD.

I was familiar with many of the DBT concepts, such as wise mind (the place where rational and emotional minds overlap, helping one make good decisions), many of the skills (mindfulness, interpersonal, emotional regulation and distress tolerance), and daily diary cards. Yet I didn’t have much practice in applying those concepts. Today I do, and the difference has been dramatic. I’m much more stable than I was five years ago.

I’ve skipped over a lot of therapeutic experiences – group therapy, CBT, art therapy, music therapy – there are so many things that have helped me over the years. Therapy has been lifesaving. Learning to trust, learning to open up about things I don’t like talking about – these experiences have helped me grow, and I’m grateful to everyone who has helped me along the way.

This post is part 2 of a four-part series on my mental health journey. May is Mental Health Awareness Month. If you or someone you know is struggling, it is ok to seek help. We don’t have to do it alone.

Hope - My Mental Health Journey

Karen Prive

1 May, 2023

I have struggled with my mental health for my entire life. I don’t remember a time I didn’t think about suicide, and first attempted when I was just six years old.

My mental illness finds its roots in childhood trauma – ongoing physical and sexual abuse from the time I was a baby. I was sixteen when I realized my brother needed protection and I turned my family into the authorities. The state insisted I see a therapist, who quickly diagnosed me with post-traumatic stress disorder (PTSD) and major depression.

I have stayed in therapy ever since, but was resistant to the suggestion that I also see a psychiatrist and go on medication for my depression – in spite of the severity of my symptoms. I was suicidal, hallucinating, and unable to function. I dropped out of college for financial reasons, but basically, I found myself unable to go to class many days and consequently my grades stunk.

If it weren’t for the compassion of a friend who let me crash on her couch, after I left school I would have been on the streets. As it was, I often wandered them aimlessly. I couldn’t work. Inanimate objects were speaking to me. I refused to go to the soup kitchen or accept other help. I was sober by then, but my mind was a really bad neighborhood. After being given an ultimatum by a mentor, I finally saw a psychiatrist.

The first medication wasn’t helpful, but the second prescription moved me in a new direction. I wasn’t without symptoms, but they helped enough so that I could begin to function in life. I found a job, and excelled at my new position. I was soon able to move into a roommate situation and get off the couch. My life began to change. I started taking therapy seriously, too, instead of using it as a place to just complain about my life. I also started making friends.

Treatment didn’t cure my mental illness – to this day I meet the criteria for Complex-PTSD and major depression. Still, medication and therapy help keep the ups and downs more manageable.

Around 2015 my depression again became severe. Perimenopause changed my chemistry so the medications used to help me no longer were effective. My doctor and I changed my medications several times but eventually I was admitted to a psychiatric ward, suicidal and desperate for help.

This was the first time I had been on an inpatient unit, but would not be the last. I had several electro-convulsive therapy (ECT) treatments. It’s not like the movies – rather, I was given a little anesthesia and lots of encouragement. The first round of treatments were helpful – I began to feel better, and less obsessed with suicide.

I also go to a lot of peer support groups – many National Alliance on Mental Illness (NAMI) Connection meetings, but also those offered by the Depression and Bipolar Support Alliance (DBSA) and the Hearing Voices Network. Peer support groups have taught me that I am not alone. My mental illness can shame me into believing I’m unique and hopeless, but my peers share their stories and I fit right in. More importantly, they welcome me.

There is no shame in having a mental health struggle. In our lifetime, most of us will have some degree of depression, anxiety or psychosis. I’m grateful I finally learned to accept help for my issues. I felt like I didn’t deserve the air that I breathed, but today I know I’m just as worthy as anyone else.

May is Mental Health Awareness Month. Consider sharing your story – sit down with a friend or trusted family member. If you want to share more publicly, NAMI offers training to learn to share your story of hope– reach out to your local affiliate or your state organization and ask about In Our Own Voice.

You’re not alone.

Find your local NAMI at https://nami.org/Home.

Creativity and "Human's Block"

Karen Prive

24 Apr, 2023

When I was in kindergarten I rewrote The Three Little Pigs, and in my version the wolf was treated to bacon. For my ninth birthday I received my first typewriter (long before the age of laptops), and by fourth grade I started a business, selling made-to-order stories to my classmates for snack bar money. My story about a lonely weasel appeared in a magazine when I was in high school, and I directed a student-run creative writing program when I went to college.

Being a writer is part of who I am. I write not as a career, but because something inside of me often only comes out on the page.

Not always, though. Sometimes every phrase I type I then delete (or the ones I put on paper are crossed out) because they don’t express things correctly. Perhaps I can’t find any words.

Writer’s block is real. For me it is rarely a lack of ideas. Instead, it is like a clogged pipe – I can feel the ideas trying to push through the muck, but I can’t quite touch them.

Every writer has their own way of dealing with writer’s block. Some despair, others distract. I find it helpful to create in some other way.

I am not a painter, but I do use watercolors. I do not draw, but I sketch once in awhile. I am no longer a musician, but I pick my guitar or hesitantly play my keyboard. I don’t need to excel at these activities, but as I participate in these endeavors words start to trickle through. Creativity is my magic word roto rooter.

Creativity is part of the human experience

I just finished Big Magic by Elizabeth Gilbert, where she insists that to be creative is inherently human – that we all are born as creative beings. This may be expressed through traditional arts, but there are many other ways of being creative. When I tutored students with learning disabilities, I found my creativity especially useful, as I would sometimes need to approach a topic from several different angles before the pupil caught on.

Perhaps you’re insisting that you’re not creative. I’d like to challenge you to think outside of the box. You are the CREATOR of your life, at the very least. Have you decorated your home? Managed a busy schedule? Made up an excuse for not doing something? How about finding ways to stretch a dollar? And if you’ve given birth, you’ve created life! These are all ways we think or act creatively in our daily lives.

Just as I sometimes can’t find the words to put on the page, we sometimes can’t find the inspiration to approach problems in our lives. Let’s call that human’s block. Maybe you just found out you owe money to the IRS (I sure did this year!) and aren’t sure where the money is going to come from. Perhaps your child is exhibiting a behavior you want to challenge, but you aren’t sure how to do so compassionately. Problem-solving in our daily lives is inherently creative, but sometimes we get stuck.

So how do we solve human’s block?

The answer, my friend, is within you. Just as every writer has their own approach in dealing with writer’s block, each of us has our own way of approaching human’s block. Maybe you take a long walk in the woods, giving yourself the quiet time for the answers to come. I prefer to talk it over with a close friend (or two) and get someone else’s take on things – even if I don’t take their suggestions, they usually help me form my own ideas. And sometimes I bake bread – as I knead the dough, my answers might form inside of me just as the loaf forms in front of me.

Human life itself is a creative process. Every choice we make is an expression of an idea we had inside of us. You ARE indeed creative. Go ahead and express some of that today.

We All Need Community

Karen Prive

17 Apr, 2023

Trauma survivors often experience a sense of disconnectedness; I sure do. It is easy for me to connect with others on their behalf – to offer love, reassurance, compassion – but nearly impossible to speak to my own needs for community.

Of course, my early experience created a barrier. When I was a child and should have been able to trust the adults in my life, I could not. My father was consistently brutal, with occasional acts of kindness. My mother was most often loving, with random forays into drunken violence. I was confused and scared. My sense of human connection was distorted by a sense of unpredictability and distrust. I didn’t learn to trust others, and relied on a impenetrable wall of steel surrounding my soul. I could give, but could not bare my soul to others. I remained hidden.

I also remained hidden from myself. I find it hard to identify my emotions, wants and needs in one-way communication. I need feedback from others to help me out of my shell.

I can try to think to myself about who I really am, but for me, this is like thinking in a vacuum. Much of my thought process is tied to actual communication. Assigning words to inner processes is a communication step. Expressing them is another. Experiencing someone else’s reaction is yet another step. Adjusting my words to better reflect what I’m trying to state is also part of the process.

As I write I am trying to find those words for you, my reader. I’m much more invested in the process of identification when it is in the context of communication. I think this is one reason (among many) that twelve step programs include sharing with others as part of Step Five.

Step Five – Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
The Twelve Steps of Alcoholics Anonymous

I find it very hard to be honest with myself about myself, by myself. I desperately need connection with others in order to more fully understand who I am and what drives me.

Which means I need community.

I need people with whom I can be open and honest about me, not just to practice love of others. I was building an intimate community in which there was truly give and take, when COVID-19 struck and social interactions changed dramatically.

Like most of us, I found ways to interact with people through the last few years. Video-conferencing, while not ideal, provided a chance to communicate with others. One of my 12-step groups held outdoor meetings in a park. I started Invincible Hope, blogging my words online.

Still, I missed the hugs, and the fully body presence of my trusted friends. I found it harder to be intimate – not in a sexual way, but with emotional connection. My newly established network became smaller and I trusted less.

COVID is not over, but slowly the world is resuming its prior forms of interactive relations, and I find myself hesitant and somewhat distrustful again. I am scared.

It’s time to tear down this brick COVID wall, much like I had to tear down that steel wall I built so many years ago. It feels scary to have lunch with my friends – not because I’m scared of getting sick, but because I’m out of practice and have reverted to my old sense of distance.

It’s easy to think that this fight is because I’m a survivor of child abuse – and in a sense, it is. My natural desire is always going to be to protect myself. But I also think that as a world, we’re all poking our heads out, wondering if it’s safe to be with one another again. COVID is a trauma the world has collectively experienced, each in our own way.

Let’s hold hands and do this together.

Finding Love in the Right Place

Karen Prive

10 Apr, 2023

When my uncle died, my emotions confused me.

It seemed fairly straight-forward – this man had molested me over many years, had abused my brother as well, and in spite of being prosecuted and convicted, had managed to pretty much get away with his crimes. He’d served the equivalent of just eight days in jail before being released back into the community, in spite of a much harsher sentence imposed by the judge.

I should be angry, right?

I was angry, but not like some in the family who planned to celebrate his passing. I couldn’t put my feelings into words, exactly, but knew I wasn’t going to this party, nor would I attend his funeral.

Instead, I was quiet, confused and lost. It took a lot of time and therapy to even begin to name what was going on inside of me.

As it turned out, when this man died I suffered a loss. I didn’t care so much that I lost him; I cared that he died without ever acknowledging the damage he’d done. I was still waiting for an apology.

It’s kind of ironic, for a couple of reasons.

One, even if he’d said he was sorry, I never would have believed him. In court, this man had actually asked what the big deal was. He didn’t deny what he’d done – he just couldn’t fathom why anyone cared. He was incapable of understanding his actions had damaged anyone.

Two, apologies are empty if not tied to corrective action. Even if he’d understood the ways he’d hurt me and sincerely wanted to make amends, he could not repair those damages.

My uncle was responsible for his actions, but not for my ongoing pain. I am the only one who can pursue my healing. I can’t do it alone – for me, I have needed friends, therapists (including the four-legged kind), meds, and the love of my Creator, for example. I did not need my uncle to be part of that journey.

Still, I honor that part of myself that still wanted him to say he was sorry. Those feelings are legitimate. That desire will be forever unmet. Allowing myself to grieve – and not going to the party – was a courageous act of self-love.

And self-love is the greatest healing gift we can give ourselves.