Harriet M. Welch

I had an insight yesterday. First some background:

I have been on birth control pills continuously for 18 years, since my daughter was born (she will be 18 next week!). Three years ago I went off of them because my doctor said I suddenly had high blood pressure and it was probably from the b/c pills. (This now makes me angry. It’s a ridiculous conclusion. The first thing that he should have thought was that I had gained 35 pounds from being on Zoloft and Lexapro and that could raise my blood pressure. Another factor could have been the Wellbutrin, which also can raise blood pressure.) At the time I did not ask questions. I was 47 years old, I figured I didn’t even need the b/c pills anymore, so I stopped.

I immediately felt awful. Terrible depression. Horrible hot flashes, about one each hour. Not only did I get hot, but I got terribly nauseous. (I later told this to a friend and she said I was being ridiculous.) I was not functioning at all, luckily it was summer. I was a substitute teacher, so I had no job.

I had a routine visit with my pdoc (different one at the time) and I started crying hysterically in her office, telling her how awful I felt. I didn’t relate it to the discontinuation of the b/c pills though. She increased my Wellbutrin dosage, and I felt better emotionally.

Physically I continued to feel horrible. I also went to see a cardiologist and had to have a lot of tests to see if there was something more wrong with me, which there wasn’t.

Then over the next year or so I began to lose weight (on purpose and easily since I wasn’t taking the Lexapro anymore). What a surprise, my blood pressure became normal. I lost over 35 pounds. I went back on the b/c pills, not to prevent pregnancy, I wasn’t getting my period, but to have the hormones.

So everything has been fine. Oh another thing about my b/c pills. You know how you take them for three weeks and then take a week off? During that week off I would get terrible migraines, so I never took the week off. I would take my pills continuously. Therefore I never got my period (and yes this was under the guidance of my gynecologist, so please no comments about how this is bad for me.)

A few months ago I decided to start taking that week off every month. How else would I know if I am in menopause? I am now 50 and the average age for menopause is 51.

So all of a sudden I am getting my period every month. May, June, July. And I put two and two together. The dates of my menstruation = the dates I am particularly suicidal. May 12th – the week of my birthday. Remember that disaster I wrote about? June – I was in New Orleans and don’t remember being particularly down, but I was irritable (that might have been around the time I got so angry about my daughter’s mess that I threw things around, broke a bottle, and cut myself). July – Saturday I woke up in a terrible funk. I ran 11 miles, felt like crying the whole time, came home and got into bed and went to sleep until 1:30. The only reason I got up was because I promised my son I would go to a baseball game with him. Came home from the game and went back to bed. Yesterday I woke up and I had my period. Totally explains the funk and the fatigue.

Now I have some new questions. Why am I getting my period at all? Why is it causing me such emotional distress? Why hasn’t my pdoc or therapist asked me, ever, about what stage of menopause I am in – can’t hormonal changes cause extreme emotional problems? And I am at the age when that would be happening. I so often feel that doctors don’t ask the right questions.

Now I plan to make an appointment with my gynecologist to talk to him about these issues. Maybe there is a blood test for hormones. Maybe mine are inconsistent, maybe I need to go back to taking the b/c pills continuously.

Bear in mind, I have had suicidal ideation for the last 14 months or so, and this hormonal issue just began back in May, so it is not a total explanation for my condition. But it does seem to be a factor.

I wonder if any studies have been done on PMS and suicidality.

Tags: emotions, female, hormones, medical, medication

I commented on Sanity’s blog about the reasons I am not killing myself. I thought it would be good to list them here, as a reminder to myself.

1. afraid of screwing it up
2. not wanting to be seen as manipulative
3. not wanting to get a borderline PD label
4. not wanting other people to have to go through my belongings
5. knowing, from doing a lot of reading, how difficult it is to really kill oneself, despite the large number of people who successfully do it. I am too afraid of violent methods of suicide and those are the most reliable.
6. screwing up my kids (Darn, this should be #1) I’m not sure about this one, because I mainly think they would be better off without me. However seeing other people who had a parent who has committed suicide, whether or not he/she was a good parent, and seeing how that child, now adult, is screwed up, is a deterrent.

After making this list I got inspired, and went to Target today. I bought lots of storage bins and I am packing up all of my stuff – books, photos, clothing, paperwork, etc. Then I will label all of the bins and put them in the basement. It will be much easier for someone else to deal with my stuff this way. And if I don’t die, well then, at least everything I own is organized.

I began packing books today. Those storage bins look a lot bigger when they are empty. Another problem is the weight! I am going to have a problem carrying these bins from the third floor down to the basement. But it will be worth it in the end. #4 will be taken care of.

Tags: organization, suicide

I asked J about the Purell. He said his hands felt kind of dirty. I told him that every single week the minute I walk in he Purells. He asked me if I don’t want him to do it anymore, and I said, no, it’s ok. He said he is always touching stuff on the desk and the keyboard and his hands feel dirty. I think he has ocd personally.

You know what I noticed? I just realized it today. He doesn’t say, “So what are we talking about today?” anymore. And he’ll mention something we talked about the week before. These are things I’ve written about on my blog that have been bothering me, but I haven’t mentioned it to him. I wonder if he is reading my blog without showing up on the statistics. It’s easy to do that if he is using an rss reader, like Google Reader. And later on in the session he mentioned how I express myself so well on my blog and in email. Interesting…

So first he asked if I am still thinking of leaving and going to Iowa, something we talked about last week. We talked about that a while, and how I know I would never do it, it is just a fantasy. But I did tell him that I am going to beach as soon as the session is over. I told him that I packed all of my meds. The whole stash. We talked about that for a while. He said sometimes people will bring him their meds to hold for them. But he didn’t ask me for mine, and I didn’t volunteer to give them to him. He asked how I would feel if I didn’t have my stash. And he asked how often I take more than I should. I told him I never take more than I should and he scoffed. He didn’t believe me. He said that there have been times when I have emailed him and told him I took too much. I said that is not true, I emailed him once when I took some extra, but it was still less than the therapeutic dose. I take 1mg of klonopin per day right now. He asked how often I take more than the usual amount and I said never, I haven’t done that in a long time, like almost a year. And I told him that my plan does not involve overdosing, but I just like to have my stash.

Then he thought of an analogy of being trapped in my marriage, my family, my life and trapped in my thoughts of suicide. We talked again about being good enough, and he compared it to our country (the United States) and how it is a pretty good country, but it has its flaws. And he said everyone has flaws and he has flaws (hmm, I have to think of his flaws. List to follow). This is an ongoing topic for us.

We spent time discussing my guilt over going to the beach, and spending the money especially since the hospital bills are coming in from my visit to the er a few weeks ago. And that was a good chunk of cash and there wasn’t even anything wrong with me. If there had been something wrong with me it would feel better somehow. He said that there must have been times when I have saved money, so that offsets the times that I spend money. He said I have probably thrown away $2000 worth of lunch meat in my lifetime. Then he told me a story about getting his air conditioner fixed. He started to tell me, then said, never mind, but I said, no tell me. So he did.

He tried to convince me that I deserve this trip. He asked who I was going with and I said no one. That I used to go with a friend, but we aren’t friends anymore.

And we talked about how I didn’t have the discussion with my husband that I wanted to have. And the envelope that my husband didn’t open. J said I should email my husband and ask if he read that info yet that came in the envelope. He said in his experience counseling couples that he recommends some of them communicate via email, and that would be good for me (since I express myself so well in my blog and in email to him). I said, you know it’s not even so much about whether my husband read the information. I want to know why he didn’t open the envelope. J said that my husband feels that is my “department”. He said that in relationships there are precedents, and these habits become ingrained over the years and then are hard to change. I asked how a parent could be so uninterested in their child’s college education. J said maybe he is interested, just not in the paperwork. I said, “So he is interested in parents weekend and football games?” And J said maybe he is.

I said that I want him to be the kind of person who would open the envelope. And J said, “So you want him to change.” Yes, exactly. But that isn’t going to happen, is it? And discussions initiated by me aren’t likely to happen either. But we didn’t really get into why that is.
Lots of surface stuff this week, which is fine. I left afterwards and drove to the beach, which is where I am now. Staying in a very cute bed and breakfast one and a half blocks from the beach. Unpacked, changed, went to the beach for a couple hours. Sitting on the beach suddenly realizing I am alone. And I felt lonely. I read. Got some French fries. Then came back, changed and went for a long run. I ran down an interesting looking road and came to a state park right on the beach. Very desolate. Perfect place to commit suicide. I had been looking for a place like that at home. It put scary thoughts in my head.

I also ran by a cemetery and walked around in there for awhile. There were people buried there who were born in the 1800s. Then I came upon a little grave, for a baby who was 6 months old. And she was a twin. There were small rocks on the grass in front of her headstone and they were painted with sayings like “We love you Megan”. I sat and looked at that for a while.

I had been thinking suicidal thoughts prior to getting here. What it would be like to die here instead of at home. Much better. But I’m not going to kill myself. I just think about it all the time. Like all the damn time. Something needs to change here. J says I only think about the negative – of myself, of my life. Never the positive. Or I notice the positive, but it is fleeting. The negative sticks forever. Is this a choice I make, is it part of my personality, what is it? Is it something I need to get to the root of, or is there a way to change my thinking?

It seems like J loves to work on this day to day stuff, and maybe that is what I need. I’m always trying to get so abstract and that obviously hasn’t helped much.

So anyway, he told me to enjoy the beach and I deserve to be able to go and have a good time.

Tags: beach, purell, suicide, therapy

So let’s see what else we talked about. J didn’t really address the items on my lists specifically, I guess because they all come down to me finding negative things about myself. And he seems to really not bring up suicide or death at all, those issues were on the list and he just ignored them. I didn’t mention how often I think about this, how the “equipment” is in the back of my car, how I did a trial run, etc. I brought it up a couple of times in previous sessions, I have emailed him about it, we talked on the phone about it, and I guess he figures that his work in this area is done. That he has convinced me to stay alive. And since he doesn’t ask questions he doesn’t know anything unless I bring it up. And it is difficult to keep bringing it up all the time. So I guess we’re done with the suicidal ideation discussions.

He went off on the mindfulness stuff again. How my problem is anxiety and my mind thinks too much. He asked if I have ever been to the Grand Canyon, and I said yes. He asked how I felt when I saw it, and I said I was scared I would fall in. He looked dismayed and I realized that I gave the wrong answer. So I said, “It was amazing. It was big.” He talked about how a person can be in the present when they are in a situation like seeing the Grand Canyon for the first time, and I should be mindful instead of letting my mind go crazy. I said what am I supposed to do, go to the Grand Canyon every time my mind wanders? He said that wouldn’t work, he doubts the Park Rangers there are impressed after they have been working there for a while.

A while ago he had suggested I get an audio cd called “Mindfulness for Beginners” by Jon Kabat Zin. I had read his book “Full Catastrophe Living” previously and liked it. So I got the audio version and put it on my ipod and listened to it, but I haven’t listened in a while. I found that while I was being mindful and letting my mind empty itself of its never ending thoughts, that is when the bad thoughts came in. I told J that, and he said that is common for distracting thoughts to enter people’s heads when they practice mindfulness. And I told him that most people probably think things like, “Oh I better pick up the dry cleaning.” But I think really bad thoughts, and they just come into my head, and that is why I have to keep my mind working at all times. He said, “So the perseverating is a defense against bad thoughts?” Yes! Exactly!

He looked kind of baffled, like he doesn’t know what to do about that. Hopefully he is googling the answer so that he’ll be able to find the solution.

So I’ve been listening to the audio book, and I got to a part that I didn’t really understand. I wish there was a print version of this, but there doesn’t seem to be. I transcribed this:

The interesting thing really happens when you start to question who you are and where you are going. How much do we actually know with certainty who we are or are we just creating some gigantic story for ourselves and then when the story seems to be going well we’re just tremendously happy and full bore ahead into what’s next and when the story turns a corner or maybe even for one reason or another even from early childhood is a story of mayhem and disaster and abuse and neglect or not being seen then the story we tell ourselves is one of being completely imprisoned or completely unworthy or completely unintelligent or whatever it is that we tell ourselves to create this story that there is no hope for us. And what mindfulness is saying is “This is just all thinking”. It’s highly supported by all sorts of evidence that you can xxxx (couldn’t understand this word) from your past why you’re no good or why you’re the greatest thing to hit the planet since sliced rye bread, but all of those are just obsessions around self-centeredness. That when you begin to question it or look at who is doing all this talking inside my own head you realize that you don’t even know. And if you actually want to taste wholeness which is the root meaning of the word healthy, the word healing, the word holy, the irony is that it’s here in all moments; this rotation in consciousness that allows us to actually see and realize that we are seeing, to think and to know what’s on our minds, to feel, to experience emotion and to be in relationship to a new way that is actually wise and is actually self-compassionate and doesn’t saddle ourselves with stories of how great we are or stories of how horrible we are or inadequate we are that then kind of serve like cement blocks that keep us sinking in some kind of ocean or some morass of our own, to a very large extent, of our own creation. So from that point of view it’s not like meditation is saying you should know who you are, it’s much more can you question who you are and be comfortable with not knowing because when it comes right down to it people say well who are you ….

And this leads me to think: What the fuck? First of all it is insulting to anyone with a messed up childhood. They are obsessing around self-centeredness? They are making up a story? That’s basically the only thing I understand in this paragraph. What the hell is he talking about?

There are other parts that I need to transcribe and post here, that are equally as non-understandable. But basically he is saying that mindfulness is being aware. I think I’m pretty aware. So I don’t understand what I am supposed to be doing exactly. Turning off my mind I guess. And J tried to convince me that I would never do the things that my mind comes up with, that they are just thoughts not actions. And he told me I am always questioning whether I am a good or bad person, but there is no way to know. I said that was discouraging, and he said, why? If you know it is impossible to find the answer it is a relief. You don’t have to keep asking. That is totally confusing to me.

J also said something about how with some people he has to dig deeper to figure out their emotions, but that I feel too much. Is it possible to feel too much? He told me this once before, that I need to water down my feelings. This after he has told me repeatedly that I am not too sensitive.

Does he even know what he is talking about?

Tags: anxiety, mindfulness, suicide, therapy

Yesterday was J day. I had emailed him on Monday asking where we stand, because technically I “quit” therapy last Tuesday when I was hurt that he didn’t remember that I had told him my plan was to kill myself on my birthday if I didn’t feel “better” (whatever that means). And last Tuesday he didn’t mention it, which led me to believe he doesn’t care and doesn’t remember anything I tell him. So he answered my email by saying “We stand wherever you want us to stand” and “I don’t consider that you quit.”

When I walked in he said, “You’re here. You’re alive.” Yes and yes.

I asked him if he still had the list I sent him last Thursday that I emailed him in preparation of our phone conversation, and he did so he printed it out. I asked if we could talk about those things again. So we went through them one by one. Here they are again:

1. Our email exchange from Tuesday scared me, even though I started it and it was my fault.
2. I think everyone would be better off without me, including you because now you are frustrated that your work isn’t helping me.
3. Sometimes people say they care about me, mostly internet/blog friends, but I don’t believe them.
4. I want to ask you if there is a way to make this easier for me, but I don’t want you to think that I am looking for an easy way out, or that I am trying to avoid hard work. If I can’t make this easier I don’t know if I can continue.
5. I feel like I have been working hard, but maybe I’m not. Maybe I’m lazy and I procrastinate, or I focus on the wrong things.
6. My dog is really attached to me, but I think she could attach to someone else if she needed to. Do you think so?
7. Over the last year I’ve really isolated myself and disconnected from people and now I don’t think I can reconnect. On the one hand it is safer to be alone, on the other hand connections with people are what make life worth living.
8. I don’t know if I am more afraid that I will be successful in going through with my plan, or that I will totally fail and I won’t be able to do it. I can do it in my head and it seems easy, but I think the chances of actually pulling it off are really small.
9. I’m not afraid of being dead, but I am afraid of getting old and getting sick and not being able to do things I can do now and of getting even uglier than I am now. And although I’m not afraid of being dead, I think I am afraid of dying. Because what if I change my mind and it’s too late?
10. I’m afraid of no one needing me. Is it really that important to feel needed?

First, why did our email exchange scare me. I told him that I made him feel bad and angry and that was bad. He said that he did not feel angry, that his email to me was not written in anger. I said it sounded angry and he said how could it sound angry, it is just letters and words. I said that words have connotation and tone. He then read the email to me so that I could “hear” how he intended it to sound. Here is that email again:

“Among the first things I asked you this morning was what you wanted to discuss. You seemed visibly upset, so we ended up talking about the past weekend. We did address your potential plan tangentially. I will not accept responsibility for this complaint. You were in my office for 45 minutes during which you could have broached that, or any other, topic. I don’t know if you were testing to see if I would remember. If so, I don’t appreciate being tested. It would have been helpful for you to communicate your desire of what to discuss or to offer your complaint during our meeting.
If you would like to meet again this week to have the discussion you wanted to have, we can do that. If you wish to quit therapy, I will respect your decision although I do not think it is wise to do so. I can also provide you with referrals if you wish to continue therapy with another clinician. Its up to you.”

He read it in a very nice voice, totally incongruent with the words he had written. He refused to admit that he was angry, although he did say he was frustrated. He also said that he wrote it on his blackberry, and perhaps if he had been at his desktop computer and was able to use more words it would have been better. I assured him that more words would not have helped. I even said that this email was not written in his usual clinical, detached style. I’m sorry, there is emotion in this email, and he just won’t admit it. I tried to get him to say he was angry, but he would not. So I have to accept this. Even though I don’t believe it. And we talked about how I am taking all of the responsibility for this incident and saying it is all my fault, when actually no one needs to be at fault.

Regarding #2 he tried to convince me that people need me. That I have an impact on people that I meet, whether in person or on line, or whatever. He told me that suicide is frequently passed along in families, that if I kill myself one of my children has an increased chance of doing the same. Then he brought up the hurt issue – that people would be hurt if I commit suicide. I asked why would they be hurt and he said they would be hurt because they would feel I didn’t love them enough to stay alive for them. That sucks, it really does. If someone close to me commits suicide I would not feel hurt. I would feel empathy for the pain that brought them to such a drastic behavior, but they are not doing it to hurt me. I asked, “Why is it about everyone else, why isn’t it about me?”

#3 – we talked about people saying nice things about me and caring about me. I told him about the word document I started in which I copy and paste nice things people say about me, or write things that people tell me that make me feel good about myself. This caused J to smile, a really nice smile. I like when he has that spontaneous smile. I guess he thinks this is a good idea, this word document. And all of you out there who write caring things about me – I copy and paste them into this document. I still tried to explain to him that you are all just saying that to be nice, and he said even if you are all saying these things just to be nice, doesn’t that mean you care about me? I hate when I can’t come up with a good argument in return. J told me that he needs to blast me with logic, that I am stuck right now. That I can’t see things in their true light because of my feeling of low self worth.

He asked to skip #4 and #5 for now, although he did say he has some ideas.

He commented that I asked about my dog adjusting to my death, but not my children. I told him that my children can take care of themselves – my son is 20 and my daughter almost 18. My dog is 10, but totally reliant on humans. I told him about how she was trapped in the basement the other day when I didn’t realize she had followed me down there, but didn’t quite make it out when I left. She doesn’t bark when she is trapped. My whole family was leaving to go out and we couldn’t find her, finally my daughter found her behind the basement door. She was crying, not barking. And the door was cracked open, all she needed to do was push it and she could have gotten out. But she didn’t. If I wasn’t there everyone would have left and never noticed her trapped behind the door.

#7 – J told me ways that I can ease into reconnecting with people. But I told him that I don’t want to connect with anyone right now. Which is contradictory to what I said, I wrote that connections with people are what make life worth living. But I told him that it would make it harder to die if I was connected to people, so I am pulling away from everyone.

We didn’t get to anything else on the list, but he said we would continue next week. He has said this in the past and then doesn’t bring it up, but we’ll see.

Other things of importance:

I told him that I was hurt last week that he forgot it was my birthday week and he didn’t mention it. He said that I was visibly upset that day, that he thought I had gotten into a car accident or something on the way over, although that day when I arrived he said I seemed “annoyed”. He said that he didn’t know what to say in response to my assertion that he “forgot” what I had told him. I don’t know what that means.

At the end of the session he spent some time telling me that I don’t need to worry about whether I am good enough, about whether I offend people, about my behaviors and what other people will think of them. That is is ok to just live my life. I don’t know what to think about this, or how to do this.

I told him that I visited the pdoc and he wants to put me on celexa, but I don’t want to take it due to the side effects. He asked what would be the side effects of not taking the meds? Although he did say that he is not a doctor and doesn’t make diagnoses or prescribe drugs, but he doesn’t feel that depression is my main concern. He says my issues are more likely anxiety, and feelings of low self worth. I told him that I have nothing to be depressed about, that I have a great life. He asked if I feel deserving of this life, and I said that no, I do not.

He said the best thing for me would be to die, but to have my spirit live so that I can see the effect my death would have on everyone, and then to have to ability to reverse it, so that my death would never have happened. I asked how to do that, and he said it is impossible. I asked, “You can’t write me a prescription for that?”

It was a full session, and we didn’t cover all of the points. How is it possible to actually change in 45 minutes a week? And then when I was leaving he said, “Please call me if you need to.” And I told him I didn’t think I’d be doing that. And he said, “You can.”

Tags: anxiety, depression, medication, self esteem, suicide

I saw the pdoc yesterday. Told him I was having a lot of suicidal thoughts. He asked me what kind. I didn’t know the answer, I didn’t know there are different kinds. I said, “Can you make that a multiple choice question?” He asked if I was just thinking about dying in general, or if I had a plan, etc. I told him I have a plan.

He decided I’m depressed. Yay! Another DSM code to add to my mental illness resume. He decided I need medication and told me Celexa would be good. I told him I would research it, and he said that in my state of mind I shouldn’t do that. Huh? Like I just do whatever some doctor tells me to do without checking it out? He said I would know in 4 weeks if it is working, so I said I would try it. But I lied. I’m not going to.

And then, I guess because I am suicidal, he wrote me out my prescription for klonopin, but gave me twice as much as usual, and my prescription for Xanax, also twice as much as usual. Yay, those are the drugs I like.

Tags: medication, pdoc, suicide

I’m functioning, so I guess I’m not having a nervous breakdown. Thank you to everyone who answered my questions yesterday, I really appreciate the knowledge and experience that you shared.

I’ve been in NY since Friday evening with my mother and daughter, and I’m holding it together. I had a meltdown Friday night and I yelled at my daughter pretty badly and then at my mother after she told me to stop yelling at her. Thinking back on that 2 or 3 minute episode makes me feel sick to my stomach. I used to yell at my kids all the time like that, but I rarely lose it now. It causes me a lot of shame when I do.

So since then I’ve been using every ounce of energy to restrain myself when I feel like I’m going to get out of control. Everything my mother does causes irritation, even the stupidest things that I shouldn’t bat an eyelash at. I’m just trying to keep breathing.

And at night I drink, which isn’t very good. Because I’m not feeling very well when I wake up in the mornings, and I should be running on the hotel treadmill, but I feel somewhat sick.

I alternate between wanting to go home and not wanting to go home, because home is usually my safe place, but now home is where I can kill myself. The suicidal thoughts are constant. Practicing in my head over and over, planning a trial run, etc. Being dead sounds so appealing. Just being nothing, being gone. I feel like nothing, so I may as well be nothing.

I did send J the email yesterday, and he responded with this:

I was not angry. I was frustrated because I want you to benefit from my work and that did not happen yesterday. I do realize that you have difficulty speaking your mind in general (part of our discussion yesterday) so I understand why you did not say anything to me during our session.

I think it is very important to talk about your birthday and what that means. I can talk on the phone tomorrow (between 8:30 and 9:00am or between 2:30 and 3:00pm). I think that could be beneficial if you are up to it. Your birthday is significant and we should have talked about it – so we can talk about it (on the phone) on your birthday!
Let me know if you are interested.

He sure sounded angry to me, but whatever. So now I had to decide whether or not I wanted to talk to him on the phone today. I am terrible on the phone, even worse than in person. But my friend Grace was encouraging me to talk to him. So I wrote him back that I needed to think about it. Then I thought about it and wrote him this:

OK, but can we have an agreement? If I have trouble talking you won’t get frustrated or angry. And you’ll charge me for the half hour even if I have to hang up after 5 minutes? Because if your email from yesterday is just a frustration email I really don’t want to be around you when you are angry.

So 2:30? Will you call me, that would be easier.

And even though we didn’t talk about my birthday yesterday, it doesn’t mean I didn’t benefit from your work. It just takes me a while to process things, and I am thinking about what you said yesterday. Even the times when I am frustrated with my therapy I still benefit, the things you say are always swirling around in my head. Sometimes I don’t believe them, but they are in there.

Then he wrote to me:

Yes, we can approach this with a wait-and-see approach. If you feel uncomfortable, we don’t have to continue. There is no need to force a conversation (and we don’t want to mess up your birthday). I am not charging you for this call (be it 5 minutes or 30 minutes).

This morning I wrote him a list of things that are on my mind just in case I couldn’t actually talk:

I thought it would be a good idea to write all of this down before we talk, is that ok?

This is just everything on my mind, I realize it is more than 1/2 hour worth of material so maybe you can prioritize it.

1. Our email exchange from Tuesday scared me, even though I started it and it was my fault.
2. I think everyone would be better off without me, including you because now you are frustrated that your work isn’t helping me.
3. Sometimes people say they care about me, mostly internet/blog friends, but I don’t believe them.
4. I want to ask you if there is a way to make this easier for me, but I don’t want you to think that I am looking for an easy way out, or that I am trying to avoid hard work. If I can’t make this easier I don’t know if I can continue.
5. I feel like I have been working hard, but maybe I’m not. Maybe I’m lazy and I procrastinate, or I focus on the wrong things.
6. My dog is really attached to me, but I think she could attach to someone else if she needed to. Do you think so?
7. Over the last year I’ve really isolated myself and disconnected from people and now I don’t think I can reconnect. On the one hand it is safer to be alone, on the other hand connections with people are what make life worth living.
8. I don’t know if I am more afraid that I will be successful in going through with my plan, or that I will totally fail and I won’t be able to do it. I can do it in my head and it seems easy, but I think the chances of actually pulling it off are really small.
9. I’m not afraid of being dead, but I am afraid of getting old and getting sick and not being able to do things I can do now and of getting even uglier than I am now. And although I’m not afraid of being dead, I think I am afraid of dying. Because what if I change my mind and it’s too late?
10. I’m afraid of no one needing me. Is it really that important to feel needed?

A lot of things on the list. You can back out if you want, I’ll understand. But if you still want to talk I’ll be ready at 2:30. Thanks,

Today I took klonopin throughout the day. However I didn’t want to be drugged during our call so I drank a red bull at 2:15 – 15 minutes before the call. That usually gets me talking a little.

When J called he asked if I was having a happy birthday and I said no. He asked if I plan to follow through with my plan and I said I didn’t think I would be able to. I wasn’t sure. He spent a long time convincing me that no one would be better off without me, that people would miss me, that people need me. He said he would be devastated if I died. I asked him why, considering how angry I made him with my email on Tuesday. I said he would be better off without me. He said he was not angry. He explained that when he got my email he was waiting to go into court. He wanted to know what made me think he was angry and I said the tone was angry. He said there is no tone, it was an email, there is not sound. I disagree, but whatever.

He told me that yes my dog would be sad, but she would find someone else to attach to. But my daughter would be devastated, and my son would be. I said my son would be better off without me and he said he might spend the next few years doing nothing because his mother died. My daughter might not be able to go off to school because her mother died. I would never see my grandchildren.

I told him he was making me feel guilty and he said that is good. He knows I feel guilty very easily. I told him that I know this is true for everyone else, but it doesn’t apply to me. That I am not needed anymore by anyone. He told me that is simply not true.

I just didn’t know what to think after our conversation, but he said I could call any time. I could call the emergency number. I told him I didn’t know anything about the emergency number, and he said it is on his voice mail and I can call it at 3am if I want to. I don’t know what happens when I call it, like does he call me back? I would never do that.

I was visibly upset today at work I guess. After work I didn’t feel like going home, so I went to a Mexican restaurant down the street from my boss’s house. His girlfriend had left about 10 minutes earlier to go to Barnes and Noble, which is on the same block. I texted her to see if she wanted to come over to the Mexican place for a drink, which she did. We had a good time, and then I noticed a voice mail on my phone. It was from my boss and it said, “I just wanted to check and make sure everything was ok, you seemed a little down today, but then again admittedly I was running around so I’m not as observant as I should be.” This made me get tears in my eyes, and then cry, and his girlfriend asked what was going on and I told her a little (not the suicidal part) about how I’m upset about my birthday and how no one needs me anymore, etc. She is 29 years old so she totally doesn’t get it, but she was very supportive and hugged me a lot and told me I’m great.

Ironically earlier in the day she was telling me that I was the best assistant her boyfriend has had because I have no drama in my life. Ha! Little does she know.
So, I’m still alive. I didn’t do anything to even attempt to take my life, although I did buy the supplies I need just in case. I asked J how I can make my life better so that I can enjoy it and he said we’ll work on it.

But I quit therapy on Tuesday. So am I going or did I quit? Now I don’t even know where I stand.

I did tell him that I’m going to NY with my mother and daughter tomorrow and I didn’t want to go but they would have been disappointed if I cancel. He asked me to imagine how they would have felt if I died instead of just cancelling. I’m really confused right now, but trying not to think. Just taking klonopin, not a lot, just a normal therapeutic dose. I’m hoping to get a good night’s sleep and wake up with eyes that aren’t too abnormally swollen.

Today at therapy I had a very difficult time talking. I really expected J to mention something about the fact that my birthday is in two days, and how he has been holding my plan for the last 3 weeks. But no, he just asked what was going on. He said that I seemed annoyed or something. I told him that I am not annoyed. I told him that it is a really hard week for me.

It took me about 5 minutes to get this out. I was having a really hard time saying words. Finally I said it was because of mother’s day and my birthday. He asked me what went on mother’s day. So we ended up talking about mother’s day the whole time. I would have rather talked about my birthday, but I just couldn’t get the words out and once he starts on a topic it is hard for me change direction because I think he isn’t interested in what I have to say.

I told him that some people weren’t nice and were disrespectful on mother’s day and it hurt me. He wanted to know exactly what they said, but I hate that. I said that it doesn’t really matter what they said. He also said what would happen if he asked the people at the party, would they say that other people were being rude and disrespectful? I asked what difference does it make what other people say? He made a stupid comment about whether there was a food fight. I wasn’t in the mood.

In the end it came down to the fact that I believe that people are rude and disrespectful because I am not good enough or not important enough for them to be nice to. He tried to convince me that there is a problem with all of them, and not me.

Then I finally got in a word or two about the “plan”. I said that I want to punish these people and they will be sorry when I am dead. He asked when that would be. I said the plan was to be dead in 2 days. He said, “Was?” I said, “Well, was, is, whatever.”

I was sad in therapy today. I wanted to talk, I really did. But the words wouldn’t come out. And J made another stupid comment about how if I could look down at my funeral the mean people would probably still be mean (which is true, that’s not the stupid part). He said my mother-in-law would probably be pointing out future wives for my husband, and my sister would probably be late.

He did mention that I have changed in the past year, and I asked him how I have changed. He said I got a new job, I work on the hotline and I went to volunteer in Mississippi and met a great group of people. But to me, those are just things I did, not changes in me as a person. We have had this conflict before, between things people do and who people are.

When time was up he said, “See you next week.”

About 15 minutes later I sent him this email:

“You were supposed to “hold” my plan for me but you obviously lost it. I know I’m not important enough for you to remember things I’ve told you.

I don’t want to do this anymore.

I’m sorry.”

I suppose some people would consider that “acting out”. I don’t usually act out. But it’s a hard week for me.

J sent me this in response:

“Among the first things I asked you this morning was what you wanted to discuss. You seemed visibly upset, so we ended up talking about the past weekend. We did address your potential plan tangentially. I will not accept responsibility for this complaint. You were in my office for 45 minutes during which you could have broached that, or any other, topic. I don’t know if you were testing to see if I would remember. If so, I don’t appreciate being tested. It would have been helpful for you to communicate your desire of what to discuss or to offer your complaint during our meeting.

If you would like to meet again this week to have the discussion you wanted to have, we can do that. If you wish to quit therapy, I will respect your decision although I do not think it is wise to do so. I can also provide you with referrals if you wish to continue therapy with another clinician. Its up to you.”

Now I guess I know what makes him angry. Acting out.

I guess I owe him a response, but I’m not sure what to say yet. I really want to be dead, but I really do. But, and this is going to sound so stupid, I think the reason I want to be dead is to see how people react to my death. And of course I won’t get to see that if I am dead. I wonder what this means?

My head is spinning, I’m sinking down a long tunnel/hole. This is a hard week for me.

I’m trying hard to think of all of the people who might care about me. I know that all of you who read my blog and comment and tell me really nice things care about me. One of the people I met on the trip last week has been emailing with me. I was telling her that I didn’t tell anyone besides my husband and kids that I went on the trip. She said, “You didn’t tell your mom and sister?” I don’t even remember talking to her about my family, but she remembers that I have a mom and sister somehow. That makes me feel like she cares. My boss, when watching the slideshow I sent him and expressing such an interest in what I was doing, seems to care.

Of course, I always say to myself, “If they really knew me, really knew how screwed up I am, they would run away.”

And then there is J, my therapist. It’s so hard for me to believe that he cares about me, and it’s important to me that he does care because I tell him a lot of things that make me feel vulnerable. So I have a need for him to care about me. But at my session Tuesday a couple things bothered me. First of all two weeks ago I told him I have a suicide plan that I was thinking about using when my birthday comes around. And he asked me when my birthday is, so he knows it is next week. But at my session he didn’t bring it up at all.

And then, in passing, I mentioned that while I was on the trip I was emailing my husband a picture everyday from the work site, and my husband would never even respond. J didn’t say a word. Nothing. Isn’t that something that he might inquire about? A typical therapist question, “How did that make you feel?” seems like it would have been appropriate right there. And it’s so ironic, because it is the exact response I would expect from my husband. There have been a multitude of times during the 21 years of our marriage when I have brought concerns, rants and raves, complaints, worries, to my husband, and he says ABSOLUTELY nothing. I don’t mean a metaphorical nothing. I mean no words at all. And that is what J did when I mentioned this issue of emailing my husband and not receiving any response. Funny, huh?

So it is hard to believe that he cares about me. Even though he left me a voice mail when I asked him to, and he answers my emails when I send them. He never asks about things I’ve brought up in the past. Is that typical? For example, the issue with my son. That is a big deal in my life, and we haven’t talked about it in many weeks. But he never says, “What’s going on with your son?” Do therapists just wait for us to mention things? I find it hard to bring things up when he doesn’t ask about them because I take that to mean he doesn’t care about that issue.

I need him to care and I don’t think he does.