Couch 231: Live Long and Prosper!

There can be a scene in my Lego Colosseum.

Teaching online or to empty classrooms for over a year has left me with few nice but comfortable shoe options. Had to go shoe shopping this afternoon.

I’m also in one of those phases where my body suddenly just drops 25 lbs. and I might need to go pants-that-fit shopping too.

I know I can just google this, but what exactly is an e-bike?

Congrats!! I haven't seen a pay raise in a long time.
I'd be stressed too, Kit. I'll be thinking of you on Friday!

An e-bike is a bicycle with electric power assist. An electric moped.

Woohoo! You deserve it!

Maybe they might want to do a semi-structured / structured clinical interview(s) during intake? Eg, SCID-5? Those can apparently take anywhere between 30 to 120 minutes. Lengthy but accurate, apparently.

SD and her power tools! Riding her ebike, jauntily puffing her epipe...

Doing my overtime in the morning is better than at the end of the day, I guess because I'm not totally awake yet? hahaha well better get logged onto work. later couchies

[QUOTE=velcro003;7117357]I know I can just google this, but what exactly is an e-bike?

It is a bike with a battery pedal assist. Mine is not a moped -it has no throttle and one must pedal. Mine is like this one ( mine is not this brand)
Gazelle Ultimate C8 HMB | eBike | Gazellebikes.com/usa

Electric Bike vs Electric Moped – Urban eBikes
Electric Bikes VS. Electric Moped Bikes and Motorcycles | KBO Bike
Ebikes VS Mopeds

I'm so confused right now. My BF "laughed" at a serious comment I made about trauma over text message. It felt to me like another instance of him not understanding things that are psychologically complicated (this sort of thing has happened before). BF and I talked about it calmly and respectfully.

I brought this to my T, and he said it was another instance of me being narcissistic -- prematurely certain, overly judgmental of others. He was getting increasingly riled up, and when I asked him why he appeared so angry, he said he was "offended by [my] arrogance" regarding my belief that my BF doesn't always understand psychologically complex things (even though my T has said himself that my BF is "emotionally stunted" -- T's words, not mine). T said it seemed like I was just arguing with him instead of trying to understand what he was saying. (I felt like I was trying hard to understand what T was saying and was verbally working through how his perspective differed from mine in order to achieve understanding... in part, because I spent some time thinking silently and T asked me to tell him what I was thinking so I freaking did.)

He said that being mad at my program director for not giving me my schedule is another example of this behaviour. I just do not understand -- I think it's fair to want my schedule more than 24h in advance, and that my PD failing to do that is wrong (especially since she spends all this time saying how great she is and how much she cares about us fellows). He said that it's possible that I'm right that the PD is being inconsiderate; the problem is my certainty or level of judgement or something. But, like, I am right here?!?? Most housestaff unions require 30 day notice of any schedule changes (unfortunately, we're not a part of a union, but I'm just saying that's the industry standard). She's not doing that, and her not doing that is making my life worse. I believe that's evidence of her being a crappy person, not to mention a hypocrite b/c she's always telling us how much she cares about us and how good she is at her job. I think it's fair to conclude, based on this instance and many others, that she's a crappy human in some domains of her life. I'm not saying there aren't aspects of my life in which I am a crappy human, because there are.

I just don't get what he's saying (v I don't agree), and I'm annoyed that my T is getting pissy with me for not getting it/agreeing with him, *especially* since he is so adamant that I am not only BPD but also narcissistic and this purported inability to see others' perspective is a hallmark of the damn disease he insists I have.

(If he knew I was posting this, he'd say I was being narcissistic/overly certain/judgmental again, and seeking outside perspectives for validation again, instead of trying to really understand what he was saying.)

"He said that it's possible that I'm right that the PD is being inconsiderate; the problem is my certainty or level of judgement or something. But, like, I am right here?!?? Most housestaff unions require 30 day notice of any schedule changes (unfortunately, we're not a part of a union, but I'm just saying that's the industry standard). She's not doing that, and her not doing that is making my life worse. I believe that's evidence of her being a crappy person, not to mention a hypocrite b/c she's always telling us how much she cares about us and how good she is at her job. I think it's fair to conclude, based on this instance and many others, that she's a crappy human in some domains of her life. "

I think your logic has some leaps in it and your reactions and conclusions are extreme. Your director might not be great at scheduling, but there is a giant leap in being not good at an aspect of her job to crappy human being. That is a tad extreme - I assumed the extreme reaction from you was because of your focus on your boyfriend and that you haven't wanted to be at this job at this facility from the very beginning when you found out that you didn't get your other choice. I believe she can care about fellows and still be bad at scheduling. She might be good at parts of scheduling and not good at others if that is her only job. I am really good at some parts of teaching and less good at others - I really don't think it has any bearing on whatever level of general crappy human being-ness that I am at any given moment. I am not saying she is not possibly being inconsiderate - she may be or there may be other things going on that prevent her from doing things on your timeline.

This is not to say that you shouldn't feel frustrated or sad about not making plane reservations or whatever, but I think there are other aspects of this that add into the frustration (you don't want to be at this facility in general, you are upset with your apartment, and you want to be back with your boyfriend and so on).

Thank you for this perspective, SD — I’m extremely perplexed and I very much appreciate your insight here.

I remain somewhat confused, though. 5/5 former fellows thought she was a bad program director (they said as much). 5/5 current fellows think she’s a bad program director (we’re on a group text chain). Reasons for fellows believing this include things like this scheduling issue (this is just one example, there are many similar instances), being careless with patients and families, communicating poorly with fellows and administrative staff, coming up with ideas and then not following through. The collective understanding is that she is like this because her primary job is as a Big Important Researcher, and this program director job is something she likes to do on the side bc it makes her look good, but she does not actually approach that role with the care and attention it deserves. As such, fellows are unhappy. I think that her doing this (taking a job because it makes her look good, and then doing the job poorly, resulting in other people’s’ unhappiness) makes her a crappy person. I agree that I am more upset about this issue because of the second-choice situation and the BF situation.

Is the failure in my logic about whether or not she is bad at the job or whether or not she is a crappy person? Or something else?

You seem mostly upset because she is not doing what you want when you want it. You really don't seem to take into account all that the director might be contending with. I have no idea whether she is a good or bad director (and I wouldn't put much stock in what the group of fellows thinks as being external truth) but I do believe even if she were -that would not make her a crappy human. Second - some students think I am a horrible professor and some think I am the best they have ever had (according to evals) - I don't take the general horrible to heart (or the ones who say I am the best either both are extremes)
and if they say something specific - I might think -ah I did not explain the purpose behind that well or depending - I might think well that is how law operates so I hope the student reconciles themselves to it. Students often attribute motive to me that has nothing at all to do with me (all humans do this -it seems to be a part of human nature). Students often have no idea what is going on in the background to make certain decisions the ones we have to put in place - all they go to is King Baby thinking. It is fine but it really doesn't change what I do or how I do it. It is possible that mds (if she is one) like most attorneys - are not trained in being administrators -so often they are not as good as they could be (the attributes that make a good trial attorney are absolutely not those that make a good manager). The end result -whether you like this director or not - is that it doesn't really matter. You can choose to be reactive to her or you can keep your eye on the end. Your choice. But you have not liked any director that I remember -you hated your last boss too because that one did not do what you wanted -and then you said everyone else thought that one was terrible too. It is possible that all the others at your level are going to feel put upon and mistreated etc. Almost all privates hate the drill sarge (except gomer pyle). I have had several md friends who despised their medical programs/post residency programs - it seems to be the nature of the position - and then they have become program directors who complain about the whiny fellows.

I have a pdoc appointment at 12 today. I'll take it from work and just shut my door. It was at 4 PM and then I thought I was going to get into the first IOP so I changed it and then I didn't get into the first IOP and it could have stayed at 4!!! Ugh. Oh well. Maybe this will give me a chance to shower after work and before meeting my friend for dinner and before going to Church tonight. I need to talk to pdoc about the frequency of the suicidal thoughts and the drop in mood in general. Maybe some of my meds need tweaking. I also have to tell him about the relapse in July. Sigh. I love my pdoc but I'm not looking forward to this particular appointment. I guess I need to tell him that I am applying to IOP's too. Too much to say! Not enough time!

I'm still anxious about my intake appointment on Friday. I emailed Pastor T (since I can't get ahold of my regular T) and asked him what they would possibly be talking to me about for 90 minutes. (That just seems like a really long time but maybe it will go by fast!) Maybe Pastor T can relieve some of my anxiety. Hmmm. Distress tolerance.....I think I need to learn about this so I can handle it better. Hello IOP. I did order a workbook from Amazon that had DBT exercises in it and some of them are on distress tolerance and emotional regulation which is where I think I need help at. So I am looking forward to getting that. I think I should get it today in the mail.

Though L and I haven't finished the conversation (Friday will be the third session about this...), I'm beginning to understand that she is not going to reduce her fee and I will have no choice but to reduce frequency. Even though I know this is my problem that ultimately I have to take care of, it sucks. I was hoping she would reduce her rate. She keeps saying how twice a week is ideal for me. I wish I never went twice a week with her. Part of me is regretting our relationship entirely. I shouldn't have followed her down this path. I shouldn't have allowed myself to be so dependent on her. She's hinted that if she reduces her rate, she'll reduce out of session contact. This whole scenario sucks! I'm not doing good at all. I wish she would just "rip off the bandaid" and tell it like it is. No more discussions. My frequency will depend on if she can lower her fee at all. And you know, the only reason I thought she might be willing to reduce her fee is because she's said multiple times that I'm already on a sliding scale slot, and that she would work with me when the time came. Guess she meant when I become homeless...?

Chihiro, I'd be upset about those things (BF laughing at a trauma thing and your boss not giving schedule) as well. I'm puzzled by your T characterizing them as narcissistic responses though. Granted, I don't know all that much about narcissism. But I think it's natural to be upset or bothered if something affects you emotionally and your partner/friend/relative doesn't seem to understand. I don't get the sense you're expecting him to have the knowledge of a psychologist or someone who had personally experienced it. I don't see it as "arrogance" (your T's word) to want someone else to be respectful and understanding of your pain. I'm glad you and BF were able to have a good talk about it.

I also don't see it as arrogant or anything like that to expect your boss to have your schedule. However, similar to what SD said, I don't think it extends to her being a bad person in general. Someone can be a generally good person and an awful boss. Or someone could be a great friend but a pretty bad partner or spouse (please note that I'm not referring to your BF here, I'm just making a general comparison). Or a great employee or employer but awful in any relationship unrelated to work. I'm still not sure how it's "narcissism" to think that way though? I feel that would be more if you were like, "I could do that job so much better than her." But even more than that.

So I don't see you as being either a narcissist or arrogant. But I'd also caution you against assuming that because she's a bad boss in your eyes, she's also a bad person. And I don't think that will help you in dealing with her, because she may be able to read that coming from you. So, maybe try reframing that as just "she's not that good at her job." I have no idea if any of this is helpful, just throwing my thoughts out there!

One last thing: Your T seems really hung up on labels here (narcissism, arrogant), and I'm not sure how that's helpful?

HUGS @chihirochild

Hugs Scarlet

Hugs chihirochild, scarlet, kit, and whoever else needs/wants.

i started playing this game on my phone in the evenings when i'm bored and don't feel like doing anything else, it's called gold & goblins. I don't know why it's so addicting!

Hugs, Scarlet. Money is such a difficult issue to address with T's. I forget, have you been seeing L 2 or 3 times a week lately? Just wondering because of her comment that twice a week is ideal.

Have you directly asked if she could reduce your fee? Including saying how much you could do? And maybe you could ask if she could do the reduced fee for, say, 2 months, then reassess after that? That's what I did with Dr. T when I asked for a reduced fee at one point (then I got a few extensions). It seemed like it was easier for him to agree to it if I asked for a set time period (and then potentially ask for an extension).

Another option, which I know wouldn't be good for continuity, would be if you could see her twice one week, once the next, then twice, etc. Would that be enough of a reduction to work with your financial situation maybe? Assuming L might be willing to work with something like that. Just trying to throw out a few ideas...

My pdoc appointment went well. He didn't really seem to understand about IOP's so I explained it the best I could, also not having experience with it myself, he said, "good luck" but in a sincere way, not a sarcastic way. He is increasing one of my antipsychotic medications so we'll see if that reduces the voice in my head and it also I guess has some antidepressant properties so he will see if it will work on that also. I'll see him in 3 months.

I've been seeing her twice a week with the occasional third in an emergency. I have asked if she can reduce her fee. Basically, from what I'm understanding, is that if she reduces her fee, she won't do things like emails or emergency phone calls.

Right now we're going under $3k a month. If I quit smoking and reduce sessions to once a week, I'll save around $1k. Just sucks that the burden is on me. Another example is that I have to cook dinners almost every night and make H his lunches to lower our food costs. Everything is on my shoulders.

And it sucks because I know I'm in the middle of a depression.

I called the crisis line and she told me I need a new therapist. /sigh

I do feel regret that I even agreed to twice a week. It's going to be so hard adjusting.

First, let me say that I don't approve of what your T is doing here.

However, for what it's worth, he seems to be saying "You are right in the wrong way." That you are dismissing other people's points of view without first making any attempt to understand them.

I had something similar with Madame T. She said I went straight from stimulus to response without ever waiting to see what I felt.

The point is, I skipped a step and maybe that's what your T means here.

P.S. Maybe T should try to see things from your point of view before leaping to judgement.

P.P.S. I would not have written what Stopdog wrote.

P.P.P.S. As one of my bosses said, "It's tough all over." Even if you accept that other people have their own problems, it is still legitimate to expect them to do their jobs properly.

P.P.P.P.S. Of course your T sees more of you than I do, but I never thought you were unreasonable.

The funny (not in a ha-ha way) thing about your therapist, chihiro, is that whenever he criticizes anything in you it always seems to me that he could just as well criticize himself for the same thing.