Archive of Mental Health

Desiring Confidence

They say “we are what we eat” but in these modern times we need to pay attention to what we see. I’ve been trying my best to control what I watch each day in regards to my mental health and by extension body image. Growing up I was taught that advertisements are bad and the continual stream of television and video games was rotting our brains. We’ve now basically traded those hulking TVs for a different screen. My guilty pleasure is to rip open Instagram every morning to smiling men with hot bodies. It use to be I got down on myself for not being as fit or glamorous, but then I questioned that, no that can’t be, how could I aspire to images that don’t look like me? So I started adding fitness models in Taiwan and actors in Mexico. Increasing diversity was merely trading places between faces and bodies. Then I think I realized what it was about, I was trying to seek a reflection of the confidence I wanted in my own life.

Of course I’m not saying the people in those pictures are real, in the sense that, one could actually portray their true selves in all their messy glory. I don’t want them per se, I want their visual body language. My therapist distilled this once, in that humans desire a reflection of themselves. We only know our own ego’s experience so when we see six pack abs, we are actually saying we personally want six pack abs. Certainly there is an element of lust or desire for that person specifically, but in most cases we are seeing echos of our imagined self.

This contradiction of desire always surprises me when attractive people split so easily. You can pair any two Instagram models but a visual match of “everything you ever wanted” isn’t a guarantee of success. Relationships exist in the mind, not in the body. Confidence got people to the bedroom but not to the aisle. At the end of the day what is important is to find out as individuals what we want and seek.

The advice might be to just stop cold turkey. The thing about bad habits is that the more you think of them as taboo, the more you unintentionally become hitched to it. What has been helpful is intentionally looking. For me, putting on a neutral observer lens and just being like what do these pictures do for me. Where do they resonate in the mind and body. Yeah I know, a little uncomfortable to think about, but really mindfulness can happen anywhere, why not in front of your Instagram feed.

Avoiding grasping is important. Something that curiously has been working is listening to affirmation videos. The YouTube algorithm pointed me to this goofy “Alpha Affirmations” channel that has hilarious titles like “Hyperborean Warrior and “Lift for Glory.” What really struck me was his optimism videos, which are literally just him speaking “to you” but really “as you” with simple phrases like “I am strong, I am confident, I am bold, I see myself at the highest peaks.”

The mind really is powerful at projecting an image onto your body. A question therapists often jab with is “what happens when you actually achieve your goals?” Imagining I am on the beach with six-pack abs, then what? Maybe the aspiring identity is far more nuanced. For example I see a greater context of the beach as a social stage and the body as merely part of that community.

I don’t think these strategies have necessarily stopped me from consuming these apps but it has opened up some ideas about why I respond to them and where it leads my life. For now, I’m not actually aspiring to be a fitness model, which is never too late, but I am seeking some kind of vibe for myself. Having confidence of my own body in the presence of others might be one way to put it. Defining the details of what that is exactly is the next step, so whatever that vision is can last a long time.

Waking Up in the ICU

Eight years ago I woke up in the ICU after three days of being sedated in a coma on a ventilator. The only memory I have was going to sleep on the surgery table, darkness, and a few seconds of the tube being extracted. In reality this story should be about how my adrenalectomy went terribly wrong and I could have died, but because I have no memory of any of that, all I have is my ICU experience. When the stories of COVID patients emerging from ventilators started hitting news feeds, I couldn’t help but pay attention. I had gone through all this so long ago and yet it still felt fresh in my mind. Last year in the midst of therapy I finally obtained the San Francisco General Hospital report, finally putting two and two together.

I remember the kind nurse who kept vigil over me. She had been recording each day, no change and good oxygen levels. From her point of view I had been under her care for three days now. She immediately shared what happened, eager to answer my questions and give me perspective. “Do you know what happened?” Of course! I had an adrenalectomy and I should be able to go home soon. The laparascopic had become open surgery. The right side of my abdomen ached, I opened my gown to see a large slash across my body from front to back. Metallic stitches precariously clung at the thick folds of skin.

She showed me a blood infusion bag, I had received nine packets or up to five liters of blood replacement. That would have been bad.

The strange thing is after this horrific revelation, I was calm. Somehow I reasoned that I couldn’t do anything about it. Getting angry would be pointless especially toward the nurse who had nothing to do with it. The strong IV drip of painkillers helped. I think I remember the surgeon checking in but not really exchanging words with me. I don’t think that would have been a good idea.

I probably got high off the oxygen cannula in my nose. It was so soothing and nice. I really wanted to adjust the bed and find a better position but keeping the wound steady was my main priority. The day went by, no hunger, just irritability. My family visited shortly in the ICU but quickly reasoned it was better to wait until I was a little better.

Then I was transferred to SF General’s “triage” basement because there weren’t rooms available for me to move to. I remember helping out maneuver the large ICU bed and the attendants being surprised how much strength I had. The many patients in triage were in various states of being on their way in and out. The hospital was under massive renovation at the time, so I figure the main room might be offline. Curtains were pulled and reconfigured depending on who was there.

I soon found out this triage room was chaotic. Here I am aching “in pain” and men and women were screaming about a wound or on drugs. The noise got so intense I thought I was being intentionally tortured and I cried out to the attending doctor to silence it. The ICU room was a luxury hotel compared to triage. I got ear plugs but listening to myself breathe ironically got to be too much. I became depressed and stopped trying to train my lungs to breathe again. The doctor turned the oxygen back up but warned me to keep breathing.

Being hooked up for days to an IV drip made me feel like a cyborg.

If anyone ever asks what it’s like to not be able to breathe, basically take a 1 second in and out breath through the chest only.

For the longest time the voices were droned out by a Cantonese auntie being prepared for surgery. I could see the doctor attending to her was also Chinese but she only spoke Mandarin. These were the early days of the Hong Kong anti-Mainland movement and I was incensed that she didn’t speak our language living in the Bay Area. The doctor called in the translator service, holding an iPhone on speaker phone between her, the auntie and two other doctors. It was kind of hilarious because the auntie asked why she didn’t speak Chinese. The doctor spoke to the translator and the translator tried her best to communicate medical speak. But it’s not the same! So much was kind of just inferred that this surgery is risky and just deal with it. After a while the auntie got tired of it and I laughed.

I remember having to re-explain my situation when new doctors came into take rounds. It was frustrating, isn’t there a record of all this? I guess medicine protects the patient by continually re-interpreting the situation so that the grapevine doesn’t dilute the information. By that time it was doctor number five, who knows what the previous ones wrote down.

Eventually I was moved to my “home” room where I spent two more days. This was a proper hospital room, shared with someone. My roommate was a middle-aged guy who wasn’t spending much time there, I think he had a wound or something. Eventually he was replaced by an elderly man who didn’t talk at all.

I was much more lucid by now and self-administering painkillers with the push of a button. The surgeon finally visited and basically talked over me. I didn’t have the energy to engage him the way I wanted to but I recognize he was trying to avoid a confrontation. I never actually called him up and regret that today. He’s still around but he hasn’t responded to emails. My endocrinologist who had been following the whole ordeal in real-time paid a great visit. He said he watched it go down and was terribly sorry. Really I owe the “cure” to him, getting surgery approved was difficult, regardless of the outcome.

My family again visited and this time it was everyone, mom, aunts, uncles, cousins, my sister. I don’t really remember what anyone said. Then my close SF friend came to say hi, the only one, and she was very brief but it was so endearing. She really didn’t need to come by. I’ll never forget that.

I learned to be humble in that room. As a 29 year old who thought he was was strong and intelligent, I could barely lift myself out of bed. After finally having my first meal, which tasted like nothing, I had a bowel movement all over the sheets. I was given a bed pan. Later the nurse who came to clean that out made a shrieking noise at the smell. I was so embarrassed and yet there was nothing I could do. I felt shamed and helpless. A very eccentric housekeeping staffer came to clean and wipe the walls down which added to the bizarre situation.

Yes the Bay Area has its own brand of milk.

Eventually I was given the go ahead to return home. I remember the moment I got into the wheelchair it was like the life was sucked out of me. I was exhausted and breathless. My heart raced every time I had a major change in position, causing me to worry if I was going to have a heart attack. The crammed construction catwalk was unpleasant but finally I was wheeled free into the pick-up roundabout. The feeling of the fogged over sun and wind was nourishing on my skin.

That was the end of my ICU and hospital stay journey. Of course it was the beginning of recovery which is another story. To this day really all I feel that summarizes the experience was the kindness of the ICU nurse, the first human I saw after what seemed like eternity. My stay was short, really a blip compared to coronavirus patients and I can only imagine the months to years it will take to get back to baseline. For a month I literally did not have proper breathing, and the muscles were all unbalanced for months after. I hope sharing this story gives someone peace of mind that they are not the only knows who have suffered and know that healing is a lifetime journey.

Why I Started a GoFundMe for Mental Health

I decided to create a GoFundMe out of exasperation. It’s been five months of back to back EMDR and neurofeedback sessions and I was tired of AETNA rejecting my claims on trivial matters every time. In the midst of another rejection due to simple errors, I was sick of it and appealed to the community of The Internet for support.

I slapped it together by detailing my recent journey and describing how I came close to losing it. I was up front that I had paid for it already out of my emergency fund and essentially was asking for a reimbursement. Many are not lucky to be in this situation, but I could easily have been in the situation of putting it on credit and now being chased by debt collectors. The picture I chose to represent me was ominous. It was taken in the fall of 2019 near the end of the cherry blossom blooms when I was just barely holding it together between talk therapy and panic attacks.

I was planning on going through neurofeedback but on my own time, not pandemic time.

After I launched it and was surprised by donations from close friends on Facebook, I was immediately embarrassed. I regretted it in many ways as someone in a privileged position. The pandemic has already roared through and destroyed countless lives financially. But I also knew I needed to tell the world, look this is what happened.

Anyone seeking more intensive therapy options should know this: Have a financial decision maker by your side. This is someone who’s only guidance for you is whether the treatment is outweighing the cost. I knew the costs going in but my state of mind changed radically as we progressed into treatment. My decision making abilities were compromised and I wanted more treatment but wasn’t sure when I felt done.

At $300 a session, it was already pricey than the typical $200-250. We did a total of 30 sessions which is not unusual especially for being in crisis. In retrospect we could have stopped earlier after we had achieved some milestones. I don’t regret any of it and it’s treatment of additional past trauma I would have done anyway. Did it have to happen all in the Year of Hell (2020)? Probably not.

In any case, being zapped in the brain, as I liked to describe the treatment, is far cheaper alternative than entering myself into a in-patient facility or hospital. Even that emergency parachute was a more hellish option as the only mental health facilities in the city were overrun with COVID outbreaks and by most accounts are not places functional people would want to be. I was shocked actually that the available services and facilities for the public in D.C. were quite limited, given it’s the home of NIH and the national leader of mental health treatment for veterans. I suppose to deal with living in D.C. one might just be really medicated.

My hope for the GoFundMe is to keep myself accountable. Exposing my story is both important societally to encourage an open discussion of this before you hit rock bottom, and to remind myself to stop bottling it all in until it’s too late. I’m encouraged by those who have donated and hope to honor these gifts by continuing to share.

How COVID Tipped My Mental Health Over the Edge

The news of 1 in 5 people being diagnosed with a mental disorder after testing positive for COVID-19 really shouldn’t be shocking. Disease itself is a traumatic event for anyone. Broken legs and flus are easily stored memories by your mind so that you may try to avoid them in the future. But having a precise event that caused your mental health condition is a blessing compared to those of us who have been unraveling mysterious old demons for years. Hopefully many will never see COVID in their lives but we are all living the effects of it whether we have it or not. Lockdowns, masks, avoidance, fear of others, it is all adding up day-to-day and I fear many will reach a breaking point as I did.

The first feeling I remember back in February to March was basically denial. I sensed that things could get out of control but my logical self reasoned that our highly advanced country would contain any spread. I remember weeks of coverage around Ebola, a really seriously infectious deadly disease, and how everyone thought it was overblown in the media. My mind comforted itself in past experience. How I was wrong.

Once it was clear a lockdown was going to happen and the shelves started emptying, my reactions went on autopilot. Every time I walked into a grocery store, I felt fight or flight kick in with goosebumps and sweating. Everything and everyone was deadly. It was a serious disease we wanted to stop and I accepted this situation. I didn’t realize how this fear of everything was quietly reactivating along a deeper anxiety.

Certainly when we’re children we learn to overcome fear and find assurance from our parents. My childhood was different, marked by alcoholism and family politics. Weekly reminders of chaos in the seeming normalcy of suburban life. With the COVID lockdown, suddenly chaos was every day, morning and night. I laid awake at night listening to pop music from the 90s, not realizing my soul was reminding me of the last time I experienced turmoil.

The feedback cycle intensified as the months went on. I was gripped in a cycle of fear and loathing of the situation. Even though from the outside all I was doing was living comfortably in a large apartment with access to any take-out cuisine in a foodie city, I was reeling inside. My constant checking of social media was hurtful and harmful and yet I continued to do so believing I needed the information to protect myself. My emergency-only Ativan pills became merely bandages to the next day.

I basically mapped my dysfunctional childhood into my adult life without realizing it.

The panic attacks started on a steady drum. First monthly, I blew them off. Then weekly, I thought I could handle it by buying anxiety workbooks and scheduling more calls with a therapist. Before I knew it, it was daily. Hypochondria was my usual go-to and so I thought this was actually a heart condition. Frantic messages to my Doctor came back with reassurances that all was fine. My therapist offered that I had the power to control the situation with CBT techniques.

During this time, I engaged my friends on a near daily basis. Zoom calls were terribly stressful sessions recounting our woes. They helped and yet offered no hope. Everyone was in the same boat, but only I had the power to change my situation. I wasn’t able to get real help or intervention from anyone.

Come June, lockdown lifted. I thought I had the situation under control even though literally a day wouldn’t go by without my body automatically flying off the handle. I gave myself a vacation week for July 4th weekend. But instead of proceeding to rent a car and drive out to the beach on the first day, I had my biggest panic attack of all during a supposedly relaxing run. I felt some pain and thought I was about to die on the sidewalk from a heart attack. Nearby a construction crew looked on oddly.

For the remaining “vacation” I was reeling between reality and unreality. I Googled everything under the sun to find a cause for the pain. Finally on a quiet Sunday night where I had essentially trained my body to prepare for anything, and feeling the claustrophobia of my four walls as night set in, I had a rolling panic attack that resulted in calling 911.

At a bit after midnight, in hospital ready clothes, I was sitting on the cold floor of my apartment lobby with the phone to my head (the waiting room furniture had been removed for COVID). Thankfully, the triage nurse on the other line knew what was up and instead of sending an ambulance, kept me on for a bit, asking a rotating group of questions of whether I was “in pain now” or how I felt. It talked me down and with a reassuring voice that touched me deep down she said “you sound fine.” It broke the spell. I went for a long walk outside after I felt like I had just sobered up from a true reality break.

The next day I reached out to a neurofeedback specialist I had been talking to before COVID set in. The nurse on the phone opened a window of clarity for me and allowed me to realize what had been going on. I knew I needed to take drastic action or I would relapse again and end up in a psych ward.

I’m grateful the story of a broken, lost me ends there for now. You can read more about my journey through EMDR and neurofeedback on this blog. For me, COVID was the catalyst that blew things up but also forced me to immediately confront everything and get the right help. I encourage everyone to find your path to healing. You’ll never know when the world changes on a dime.

Curing My Soul with EMDR

I can’t even begin to describe what has happened to me in just the past few months. The stress of Covid, lockdowns, social isolation, and being stuck in a place I didn’t quite desire culminated in daily panic attacks. Certainly I always had a high baseline of generalized anxiety, but I knew something was different deep down. The thought of Covid floating all around me, entrapping me in a dimly lit apartment brought me back to two critical incidents in my life: my near-death experience on a surgical table ten years ago, and a sexual assault three years ago.

Friends did their best to initially intervene, from a simple hour in a park, to taking me out to eat in precarious indoor seating situations. I always returned home with fear and separation anxiety. Daily walks and exercise only helped exacerbate the symptoms because I wasn’t ready to face this. Nights wore on me, moments with my heart racing as if the assault was happening all over again as I sat calmly on my couch.

The scales had tipped. I realized something was wrong and if I didn’t take action I would end up in a hospital, the kind you don’t want to be in.

Fortunately I had already reached out to this Neurofeedback specialist last year, but I didn’t go through with it due to high session cost. At the time, I thought I could just wait until I felt unburdened from work to begin. Well, the world moved fast.

We connected fast and after the first conversation we hit the ground running with two sessions a week. I almost felt like I needed three. I was living literally to the edge of each day, as if waiting for the day light of the next.

We started with EMDR because so many active memories and thoughts presented road blocks and conflicts to simple Neurofeedback training. I wasn’t like myself in late 2019, I was in a high fight or flight state.

EMDR was a sledgehammer that smashed through everything right to the core of my being. I felt a laser beam to my amygdala, awakening it to tell us what it stored, what it saw from that scary night, and from all the fearful nights before it. A little bit of a child, a teenager, a young adult, all their experiences coming together to inform and shape the narrative that struck me three years ago.

Nothing really made sense even though it made perfect sense. Why would the child’s screaming parents relate to the frozen man on a stranger’s bed. The magical part of EMDR, is that the pieces do not even need to have any logic or truth, it is just the medium of the English language that we describe how the body has kept the score. Concepts like assault are meaningless to the body, the body only knows what it has seen.

I saw truly how EMDR was so powerful in immediately forcing the body, the mind, the nervous system, to come to terms with what it locked away. My two years spent meticulously crafting CBT defensive logic and coping skills had evaporated in a series of months. I knew then that CBT could have never addressed the “real problem.” It was too complex, too many fingers in different memories, too many triggers to be resolved in an easy breathing exercise or a dysfunctional thoughts log.

After about ten sessions and several follow-ups to tie loose ends, I felt completely absolved of the misery that had plagued me deep down all these years. I couldn’t believe that I had not done this sooner. I felt cheated, robbed, years of my life taken both from the original incident and from not knowing what to do about it. So many relationships and interactions that could have gone better, ruined by a broken mind.

With neurofeedback, we’re now reinforcing those revelations and clearings by finally asking the brain to change. EMDR can be sufficient to let the mind heal over time but I knew that just as easily I could relapse. I wanted complete healing now. I finally know what it’s like to just sit and just be, to be conscientious of others deep down. I can shift my fears, re-assure myself, and for once my body will respond. Not all days are bliss but for the first time my soul feels at peace.

Anxiously Ambivalent Lover

Reading The Body Keeps The Score by Bessel A. van der Kolk

The established study on attachment theory distribution shows 9% of children in typical middle class families developed anxious-ambivalent attachment, while the majority 62% were the normal secure type. I’m alarmed my parents might have made me a dysfunctional outlier. I was a little reassured by this slightly whimsical Washington Post article about dating and how the author is an anxious type. The article references Attached which states for adults, 20% are anxious while 50% are secure. Makes me feel a little better! One out of five adults are anxious, no wonder the drug companies make so much money.

It would be interesting to see a study that compares attachment types to income and residence. Maybe more anxious types live in the city and while the rest of the country feels calm and collected, we’re here bumping heads. This German study didn’t really see a big attachment difference in distribution of single people (who generally live in cities). The more damning observation was simply the inability to maintain relationships:

The anxiously-ambivalent attached individuals are unable to distance themselves from disappointing and conflictual relationships just as they are incapable of detaching themselves from overwhelming inner stress.

Ouch! Such is true when high emotions are involved, but the research says the emotions are involuntary, they are bound to happen because your parents didn’t coo you enough as a baby. It seems kind of ridiculous that simple actions could have a profound effect throughout my life.

But that is just talking about basic brain wiring, it’s what you fall back on. So talking with friends, learning from past experiences, one can build up a set of strategies of dealing with these fallouts and recognizing them as real but not true. I don’t have to stay glued to a former mate just because my brain-body is yearning so.

Another aspect of anxious-ambivalent I found annoying was the penchant to be super communicative and overshare, while actually being bored. I always have a need to perform, to wow, and afterwards still leaves me feeling hollow.

Individuals with a secure attachment style show positive beliefs about themselves (e.g., self-worth, social competence, sense of control) and about their partner or others (e.g., trustworthy, dependable, and altruistic). On the other hand, individuals with an anxious/ambivalent attachment style can be characterized by negative beliefs about themselves but positive views of the partner or others as well as an obsessive preoccupation with their partner. Individuals with an avoidant attachment style have a positive view of themselves and a negative view of their partner and others. They show a fear of intimacy and a lack of acceptance of the partner as well as distrust of others.

I can only imagine my last avoidant type would have taken any of my faults and used them to justify ghosting. Of course I have ghosted as well, an equally anxious type who I allowed to abuse my goodwill and wallet and never delivered much in return.

The Next Runner Up

I’m curious how I will bridge this knowledge with the next person to enter my life. On one hand I want to immediately spill this information in order to be transparent, but doing so is exactly fulfilling the destiny of an anxious-ambivalent to burden the partner with conflict before you’ve even gone on a second date. Of course encountering fellow anxious or avoidants are easy to spot.

The best way to see it is that people are social creatures with a complex background that affect how they appear and act. So it’s probably weird to start talking about innate compatibility when it’s clear someone who wants to be in your presence is interested.

For me, it’ll be good information to address my inner voice and the distortions created when I think there are problems. It also gives me pause to needing to “perform” in front of others. Authentic presence is performance itself.