Couch 207: The spiced gingerbread couch

I don't know how honest I should or want to be with T today. I know that's the point of going to therapy, but I feel like a broken record talking about the same stuff lately. I feel like skipping today which I've never done unless I'm sick or in the hospital.

I am in a new dr's office & there are 6 seats in the tiny waiting room, 4 occupied including myself.
I think we may run out of oxygen soon.
I am usually not claustrophobic, but I am right now.
Oh no, someone else just walked in.
Oh Lord now people are talking about the weather.

Last time I tried to have one done, I ended up with so much anxiety and it was physically hurting me that the doctor couldn't finish the exam. And that was with taking a bunch of xanax which isn't possible this time because I need to be able to go to Regular T a few hours later. I'm not sure how I am going to be able to get through it. A friend offered to go with me, but that just seems weird and since in all likelihood I'm going to be discussing SH as well, that would just be awkward and unsettling.

I know, LT, I know. That's why I'm really psyching myself up, trying to tell myself I can do this. I don't actually have proof I can do this, but I feel like I need to do this at least to stop getting those reminders in the mail and on my phone that I haven't gotten it done. I'm so stressed out about it though.

I'm not sure stopdog. I think I've just tried everything besides going inpatient to try to stop self harming and this is something that I haven't tried so I am really trying to give it a go. Either that or it is some way of punishing myself. I do think he does care about me, I just don't think he really understands SH. I was educating him yesterday about hallucinations. He has a PhD in MFT. Shouldn't he know some of this stuff?!!

Thanks @JaneTennison1. He does have a PhD in Marriage and Family Therapy and has passed to licensing board, so he does have some schooling behind him. But he is definitely approaching this from a religious standpoint. Which I've never really tried to do before so I'm trying to give it a go, to see if it helps the SH because frankly, nothing has. He says he wants to trigger for Christianity I'm not sure how to do that. He wants me to and I'm really trying but I also think I'm really failing. It's complicated. I think he does care a lot about me. But I am angry with him for him unilaterally deciding that I can't SH to get through my appointment. It's not like we came together an decided it. It's just "You can't do this!" And then after my appointment last night I called a friend and I had told her about the recent SH, last weekend's and the weekend's before that, and she was like, why didn't you come to me? That hurts me. And I just felt like crap. I'm trying to be more open about my SH but this is also the same friend who says she doesn't understand it. So I'm struggling today and I want to SH and I know that I can't and it's miserable feeling. Thanks for the care and support though, Couchies, you all rock! Hugs Kit

Current recommendations are that they only need to be done every 3-5 years. It's no longer a yearly thing. So, you are actually almost pretty much on target.

I would say if it's been beyond that time, do try to get it done. I just went through having to have a repeat pap smear because of irregular cells the first time. My PCP had me repeat 6 months later to be sure it had cleared (he felt pretty certain it would and it did).

If you're able to get one done, they should be able to do an HPV test at the same time. If that comes back negative, I believe you then don't need pap smears as often (assuming you have normal pap smear results of course).

And . . . the pelvic can pick up other issues.

So, my pap is now clear, but I have a growth on my cervix (probably benign, but needs to be check out before it creates other female issues like bleeding, etc.).

As much as we hate routine physical maintenance, detecting these issues early on can be the difference between a simple fix and more serious problems requiring much higher level of medical care.

We have a high level of cancer in my family (both sisters had breast cancer; sister and mother had colon cancer). I detest colonoscopies and mammograms and pelvic exams as much or more than most because of my history, but I would detest intensive medical issues even moreso.

LT's right--per US guidelines, women over the age of 30 who have normal cells and HPV only have to get a pap smear every 5 years. If just the cells are normal and no HPV was done, you're due again in three years.

/doctoring

About 20 years ago I had a pap done by a female doctor. I was very overweight. The doctor was having trouble performing the exam and was getting visibly frustrated. It was physically painful because she kept readjusting the speculum and was also pinching me with it. The whole ordeal took forever. It seemed like 20 minutes but was probably closer to 10. At one point she body shamed me by telling my weight was why she couldn't get the exam done properly. I held it together until I got to my car and I sat there and cried for a long time. It felt like I had just been sexually assaulted by a salad tong-wielding doctor. I'm sorry if that seems dismissive of other SA, but it's how I felt. I was so humiliated by this experience. They actually called me a few days later and said I needed to come in and do the exam over because there were abnormalities and I was thinking there is no way in hell I'm doing that again. And I didn't. For over a decade. I finally met a doctor who convinced me to do one. He wrote me a prescription for xanax and I took them before the exam. I was so anxious even with the xanax, but I got through it. I'm not saying I'm eagerly lining up to do it again, and I haven't since then because, frankly, I'm still anxious about getting it done, but I got through it. Kit, you can get through this. Communicate your anxieties with the doctor and/or nurse. If you don't feel comfortable asking your friend to be in the room, maybe just having them in the waiting room to support you before and after will help. If there's a nurse you feel comfortable with, ask if they can hold your hand during the exam. I'm not saying you HAVE to do the exam, but I think you CAN get through it with the right support without feeling like you need to SH. And if you really can't do it without SH, then just don't do it. Put some supports and protective factors in place and do it another time.

I'm so sorry that happened to you, NP. I'm glad you were eventually able to encounter a doctor who wasn't an unprofessional jerk!

After watching what my person went through and having dealt with some idiot mds of my own in high school and college - I don't plan on dealing with them at all. The inevitable will simply occur sooner rather than later for me.

CPS investigator and case worker are coming out tomorrow afternoon to meet us and discuss what is involved. H is going around mockingly saying Oh, and that he shouldn't be the one it's blamed on because he didnt get them involved, it was me.

Ugh, NP, I'm sorry that happened to you. I agree about sharing your anxieties. It might help if you do sort of meditative relaxed breathing throughout, because tensing up (though often somewhat involuntary) can make it more painful. I'm not sure if it would help you if the doctor talked you through what was going on, like, "OK, I'm putting in the speculum, this will only take x amount of time, now I'm doing this, you're almost done," something like that. Or if it would help for the doctor to talk about something else as a distraction (mine tends to do that). Or, I don't know, if you could take your phone with headphones and listen to something calming while she's doing the procedure? Think about what could help and let them know. I'm sure they're used to dealing with anxious patients. And I've found it sometimes can help me in anxious situations to just say I'm really nervous or that I'm having a panic attack or something. Hugs...

Hugs, that's awful. I certainly hope he will be serious during the actual investigation. Aren't his actions toward you a big part of why they're coming to investigate?

I still haven't heard from L. I'm really worried.

Yes, that's a big reason but he denies that too.

How does one ask important people in their life for care and concern in the absence of a particular crisis? I just feel generally sad and empty and am in need of some extra love... how the heck do you say that? I don’t even know what exactly it is I want other than extra hugs.

Trying to cherish the moments of comfort that present themselves. Trying trying trying...

Student health called and said my kidney function test results are a bit off. Not really surprised since something is obviously not right. She said it could possibly be dehydration, but my electrolytes were fine. And she acknowledged drinking more water would just make the issue I'm having even worse. Kind of worried. Have to be tested again in a few weeks. I'll probably obsess about this in the meantime. It's hard not to think about it when I have to go to the bathroom all the time.

Leaving my mother’s in about 90 minutes. Do not want to go.

I have a theory that at least some of your SH is an expression of anger - and I'm not even talking about towards yourself. I think maybe you have a lot of anger towards various people that you repress and it comes out in the SH. I kind of get the impression that you don't really stand up for yourself or express anger.

Obviously, that's just a speculation on my part and could be wildly inaccurate, though.

Also, while masters level therapists are great for almost everything, I don't think they get much education on psychosis related symptoms. For example, I don't think a masters level therapist would have the diagnostic acumen to differentiate between your diagnosis of depression with psychotic features and some other diagnosis that features hallucinations.

Hi @susannahsays, actually you aren't the first person to suggest that theory to me. I really don't feel angry, but perhaps it is so far buried that I can't feel it. I don't show a lot of emotion. Pastor T said I am very good at hiding. And I am not great at standing up for myself, though I'm getting better at it. But like even though I am mad at Pastor T for telling me I can't SH for three days, I won't tell him. I'll just stuff it down and wait for it to come back to haunt me.

Well, I think you might not feel safe to feel or express anger in some situations - for example, against your mother. Iirc, she was physically abusive to you, she sounds like she's still a bit emotionally suffocating, and you are still living with her. I also think I recall you saying you didn't feel safe as a child expressing emotion because of her. So it would make sense to me that you would repress all your justified anger towards her, especially since you are still living at home. It wouldn't feel safe in that situation to feel, let alone express, anger.

ETA: And in a way, your recent SH is like an act of rebellion against Pastor T without actually confronting him for being ineffective. It says "you are not helping me and your plan sucks" without you having to say it.

Thanks @susannahsays I think you are right about not expressing anger with my Mom. Yes she was physically abusive to me and my sister when we were children and she's...well....difficult now. She was allowed to be angry but me and my sister and my dad weren't/aren't. You gave me some good stuff to ponder re: Pastor T as well. Thank you! HUGS Kit