Couch 239: Cape Coral Couch

At work, I often use this circle of influence with my students as a way of helping them manage their anxiety and take control. It's very interesting to me how many students are reluctant to accept that they have control over any aspect of their lives. Maybe this is part of our modern, disenfranchised experience (of living with patriarchy, capitalism, and so on), but it worries me. It seems that people (myself included often times) are afraid of claiming control - even if it is small and unassuming ways.

For me, the idea is that you *can't* control away your emotions (you can't simply tell yourself to not feel sad or angry, etc), but you can control the stuff around the emotion. You can control what you do when you feel sad, for example. It's complicated when addiction, mental illness, poverty, etc are at play, but it is sometimes possible to find some small seed of control which is the thing to focus on.

So, your emotions themselves can be the subject of a circle. You can't control if you feel sad. You can influence the factors which might lead to sadness (not drinking alcohol or socially isolating, etc). You have control over what you do when you feel sad - you can journal, walk, sleep, cook, swim, and so on.

It's a pretty crude model and is definitely limited.

But how do we access and understand our core self if not through our thoughts? We might have somatic or spiritual experiences of our self which don't fit into thoughts, but I don't see how we can integrate these experiences without some translation into thought. I am not sure about the good and bad distinction, but if our thoughts (good or bad) are ours, then this gives us information about our core self. And doesn't our core self shift? At one time, I would have described my sexuality as being an important part of my core self. But now, ugh, whatever, who cares. Maybe I don't understand what core self really means.

T says talk to Pdoc. I call pdoc's office. Talk to the receptionist. Try to find out if I should make an earlier appointment (I have one on August 31). I can't answer her questions because I don't know. She eventually says let me know how you feel next week and I can squeeze you in if you need it.

T telling me to go to Pdoc makes me feel like I'm too much for her. That she can't help me. And that makes me feel hopeless and helpless.


It's hard being at work right now. Everyone is being a pain with me. (I am probably being over sensitive.) And stuff just keeps getting piled up. I got through what I had missed while being away but people keep coming to me with headaches and problems and stuff. (I am HR as well as accountant.) I can't deal with this BS right now.


I am not sick enough where I need to be back in the hospital but I am not well enough that I can cope effectively and positively with everything.

It also doesn't tell me how to let go of the stuff that is out of my control. But, it's something that feels like a good place to start. She said something like it's not the event itself that causes the anxiety, it's my interpretation of it. And that my interpretation is not the reality. I'm not so sure I buy that bit, but it DID get me thinking in a different direction from the spiral I'd been in, so in that respect it is helpful.

eta thank you i like the idea of making my emotions themselves the subject of a circle.

When she said I have more power over my thoughts that I think I do I said um no I don't! I guess we'll talk more about that next week.

Hugs, Kit. I'm sorry you're still having a rough go.

Hugs, Kit. Is it possible to take another day off? Or a half day?

I understand why you feel that way with your T telling you to talk to pdoc. But I think it's a sign that she cares about you, that she thinks it could be partly about your medications, which she can't help with--they just changed those a bunch in the hospital right? I'd see if you can get in to see your pdoc next week--the 31st is pretty far away. If they took you off a couple meds, then you could be adjusting to that (possible withdrawal, if they stopped cold turkey), and maybe it's also not the right combination for you? Or not the right dosage? So I'd see about a sooner appointment.

Also, do you have some sort of IOP or PHP program to help transition from IP to outside life?

I was kind of wondering the same thing about actions. I get that people can do things that don't necessarily reflect who they are inside. But where do you draw the line. Sometimes people's actions *are* a direct reflection of who they are. I guess I'm thinking of my ex here and wondering how his words and actions reflect on who he really is. I like the idea behind this concept but it seems to have some limitations to me.

UGH. There was a fly in my office today, buzzing in my face every time I was on the phone. All day I tried to smash that little (profanity here). Also I said the profanity loudly while I banged on the window trying to smash the (profanity) thing. I hope the next door office was empty.

I got home ten minutes ago. A fly just buzzed by my head. I felt actual rage. Just for a moment, but seriously, my head exploded. (Um, not literally though. Obvs.) I hate flies.

Do you have jelly on your chin? Thats often my problem!

I would say it’s not about who the person is inside...it’s about whether you can accept their actions, whether or not they reflect the person inside.

Stupid brain! I have been doing fine, getting on with things and then bam! My brain goes rememebr the time you made an idiot of yourself 32 years ago then goes on to list all the other times i felt like an idot at random times in the day.

I am sorry i havent been around much and dont have time to catch up but thinking of you all and hugs if people need them.

Daf, you know your my hero. You raised a family under trying circumstances and you're an artist, and you are one of the cleverest, funniest people on the couch.

There's no bigger idiot than me. Cringe was my middle name. But i still did a lot of darn good things that i am now proud of myself for. Its like an accounting ledger, credits in one column, debits in another. You dont keep a running total added up. You keep your assets.

Hahahaha! You make me laugh, una.

Here I am wide awake again at 4:30 in the morning. Been awake for an hour or so, have already showered for the day and puttered around the house straightening things. Temporarily anyway we aren't on overtime at work, so I have another hour or so before I can log on and start working. We were doing OT last week, but not this week, they're saying probably next week again. I suppose I could cook myself a nice breakfast, too bad taco bell's not open this early or I'd go down there and get a breakfast burrito or something. I have a one-on-one with my Sup later this morning so of course I am anxious about that on top of everything else. We have them every month, so I don't know why I get all keyed up about them every.single.time.

Hugs/head nods all around as appropriate/wanted/needed.

Well I went ahead and made some scrambled eggs with onion & avocado which is yummy. And now it's almost time to log on to work....

Hugs, if wanted Kit.

If I might comment on your Dear T posts,

I honestly wonder if one of the reasons you struggle so much is because you haven't had a therapist familiar with dissociation and trauma, along with your schizoaffective.

I'm wondering because clinical research has found that a significant subset of folks with psychosis/schizo-spectrum who have experienced trauma when younger also dissociate. Same for some chronically depressed and anxious folks. And unless the dissociation is targeted, therapy + meds aren't so effective.

I can't remember the studies right now. I waa fortunate to have had a lovely conversation last year with a clinical researcher investigating trauma in folks with major depression or dysthymia and we also talked about related stuff like psychosis and dissociation.

My dysthymia is somewhat treatment resistant partly due to my dissociation even though I've not self harmed in a long time. Medication is only partly effective for me.

Just my theory, I might not be right on you.

I'm nervous and scared! Today is my assessment for the IOP. I don't know what they could possibly want to know for 1.5-2 hours. I just have no clue what I'm walking into.

Good luck, Scarlet. I hope it goes well.

Hi LT,

I'm not sure it is a good idea to take another day off or a half day off....we are a small team and there's been a lot going on, like random stuff that is urgent and can't wait. I'm hoping I adjust soon.

They didn't offer me PHP or IOP so they just sort of let me go. I still have Aftercare from when I did IOP last year so I am going to do that.

I messaged my pdoc through the portal and he said it would be a good idea to wait the three weeks to see him to see how the medicine is doing.

Yes, they stopped me cold turkey on THREE medications! Yikes! I could be having withdraws maybe.

I'm just trying to suck it up and do my best. Don't know how that is going to work out.

HUGS kit

Thanks, Quietmind2

I do dissociate. T has brought it up before so I guess she is at least aware of it. I'm just so broken down from the struggle and I really have no other thing that I can think of to help. So I just have to keep pressing forward and hope that whatever resources I have is enough.

HUGS Kit

I hope it goes well, Scarlet! They likely have a set of standard questions they ask that take up a lot of time.

For me, the less I try to control these things, the better I feel. It's not about trying to change my thoughts or feelings but to accept that they exist and that they're trying to tell me something (maybe useful, maybe not) and it's my job to accept the feelings, validate them, and have compassion for myself. Like if I'm getting into an anxiety spiral, I can (only sometimes!) stop and think, "Yes, I really am anxious about how that will go because it's important to me. There really isn't anything I can do about that at the moment, so maybe I can [do distracting, soothing thing] or [focus on task at hand that I can feel accomplished about]. By giving up control, I somehow gain stability and the feelings decrease in intensity.

I hope it goes well Scarlet!

Thanks EM. I just realized something! Thanks for getting my wheels turning again! That, the stopping and looking at the feelings/thoughts/emotions is what will allow me to sort them into the proper ring of the circle - I tend to make everything my fault in some fashion or other so stopping and looking at the emotions - if they don't belong in my circle of control or circle of influence, then i move them out to the circle of concern and let them go. maybe this is just the visual I need to start doing that. I am going to go get a sheet of that posterboard stuff at the dollar store and draw the bullseye - and write stuff on post-it notes - and put them visually where they belong. I like this.

I remember something ex-T taught me a little about with ACT.

Say you're at a party and there's someone there you hate. You can obsess and be upset that the person is there, and it will ruin your experience of the party. Or you can acknowledge that the person is there and continue enjoying the party.

It's like a big pink elephant in the room. The more you try to ignore it, the bigger it gets.

I actually gave L a braclet with an miniature Amigurumi pink elephant. She wears it ever session to remind us to acknowledge the pink elephants.