The Burden Of Being Responsible

Two posts in two days, talk about writer's block being unblocked.  Processing my personal struggle through words yesterday, has had an important affect on my state of mind.  Who says words don't matter and talking doesn't help?  Which takes me to my next confession.  I have come to the conclusion that I am a relational therapist.  My year long course in psychoanalysis is almost over and I have traversed many concepts such as traditional psychoanalysis, contemporary psychoanalysis, conflict theory, object relations, self psychology and interpersonal therapy, to name a few, given that all of it is mostly just skimming the surface.  But the more I have read, the more I am finding myself changing on how I do therapy.  

Over the past year, I have gradually and almost without any conscious planning, moved towards intersubjectivity, relationships in therapy and my own presence in the room.  No, I don't mean that I wasn't present prior to this transition, but merely that I was trying pretty hard to be invisible, irrelevant.  But I don't anymore.  The downside being, I am very aware when I am tuning out during a session (downside because it still annoys me) and instead of turning it on to the patient (in my head), I now really question my own interference in the moment.  I have caught myself being lost in my own dilemmas and have now dared to bring myself back in he session and disclose to my patient, that I had tuned out.  And low and behold, the patient has already noticed.  They were just too nice to call me out.  Now I take responsibility!  

However, I will add a foot note, just so there is no confusion.  I don't discuss what is going on with me, nor do I disclose my personal dilemmas because even as my style has changed, the therapy is FOR the patient and I am not the guest of honor.  I have been faced with questions about why I had tuned out? and then follow up about what may be on my mind, when I confessed that I was preoccupied.  But even in the relational therapy and all the intersubjectivity, boundaries and the delicate art of disclosure, remains of utmost importance.  Hence the focus remains on the guest of honor, and not on me.  The upside, the sessions are more intimate, more fluid and I don't feel the pressure to fix everything.  I am more comfortable saying, "You tell me."or "What do you make of it?" or "I need to think about this."  That being said, I have also seen that what is going on with me, changes my sessions and today was a perfect example.  I was calmer and felt better about processing my own thoughts and was more comfortable pushing my patients to look at the reenactments and patterns (today happened to be a day of such sessions, or may be I was more tuned in).  

To make the long story short, may be today I understand why I wrote, what I wrote last night.  It was the responsible therapist in me, that felt trapped and paralyzed by my own doubts, inadequacies, battles about my roles and the stigma of children with learning needs, special needs.  I had carried that burden with me for months and certainly for last 3 weeks to this Thursday.  

Today I felt at peace.  Not only did I face my fragile ego that was bruised but I also rebelled against my super ego that kept telling me, to not talk about this so openly.  At the end of the day, I decided that I will not stigmatize my precious child, by keeping my feelings hushed about his struggle and my own struggle as his mother.  I am his advocate and I can help many more like him by talking about him out loud.  

Whether you are the therapist, who is mature enough to admit to the patient that he/she was wrong, or didn't know what was going on but can definitely work with the patient to find out, or a mother like me who finally decides to throw caution to wind and hold her head high to cheer her son on, welcome to the club.  It is intense, personal and never easy because the burden of being responsible, lies in being vulnerable and being vulnerable is the only way to expand your horizons.  

As Dr. Brene Brown Said:
"Vulnerability is the birthplace of innovation, creativity and change."

A Gift From My Son

I have been contemplating writing this post for 3 weeks now.  I don't know why I want to write this, nor do I understand why I don't?  For the most part, I have tried to keep this blog about my ups and downs in the residency and have used my children, only as examples in posts, as needed.  At least that is what I have tried.  You be the judge.

Yet, my absence here since January is for the most part, due to my children, specifically my son.  As a working mother, I have many things that make my life rich and expand my horizons beyond my home and family.  That being said, I have never been more aware of my guilt and sorrow, than in the last 3 months.  I have had days, where I have ached to not work and not be unavailable to him.  I can't say that he feels the same way because he is almost 8 years old and this is all he knows, me working.  There is no other reality for him.  His mom is a physician and she works.  I, on the other hand, have access to an alternate reality.  My daughter who is 10 years old now, knew me as a stay at home mom, for the first 2 years of her life and although I had a very rough start with her, as a new mother, I tend to romanticize the era more than I should.  Funny that I am aware of that, yet in these last 3 months, I have had bouts of nostalgia and longings for what ifs, for my son.

For the most part, what I do for a living, brings me immense joy and makes me feel good about myself.  I can't remember any days where I felt miserable.  Annoyed, frustrated, and tired, for sure, but never miserable.  It's safe to assume that I have been fairly happy with what I do, and still am.  But now I wish that I had the leeway, of being at his school for more than 30 minutes in the mornings, when it's my turn to drop them or had the freedom to go to be in the classroom, when I felt like it.  I am not sure if that would make a difference for the challenges that he faces on a daily basis with learning, or if I never worked, would he not have developed dyslexia.  The rational, scientific side of me knows that he would have because that is the reality of dyslexia.  But the emotional part of me feels the sorrow, only a mother can feel, when she feels inadequate.

I always felt a natural pull towards the mothers under my care, who struggled with special need children.  There was this connection with them that I had to be very mindful of, so that the treatment won't be compromised by confusion about their feelings or mine.  May be because I related to a mother's frustration, when her daughter couldn't read despite extra help at school and home, because after the clinic was over, I was that mother.  Or may be I felt bad for the mother, who didn't know why her son couldn't sit still and had to constantly move, and questioned whether he had ADHD?, because I knew what that felt like.  I also knew that there were no easy answers, I could give them or to myself.  Until I found out the answers to a lot of my whys, last month!!  Having a child with dyslexia and sensory integration disorder, even though unbeknownst to me until now, has given me a different perspective on things.  The simple logistics of how much work it takes to navigate the school system, is mind boggling.  I have a new appreciation for the word "overwhelmed."

But I have learned that I don't know much about learning disabilities, even being a psychiatrist, I don't.  I have started reading more and I have started asking simple questions from my patients,  When I see a struggling patient, or when patients tell me about how awful their school was, because they were stupid, and couldn't read or write, I try to get more information from them, which I wouldn't have thought to do before.  While I am aware that, I am not diagnosing people with learning disabilities after the fact, nor am I trained to do so, but now I am interested in knowing their strengths and weaknesses, to think more broadly about them.

Having a son with developmental academic delays, has opened my mind to the struggles many of my patients talked about previously and I didn't know how to navigate those.  Necessity is the mother of invention and my need to help my own son, has pushed me to invent means to educate myself, which in turn, tunes me more keenly, into my patient's childhood and even adult struggles.

I know, I can't stop working because that is not the answer, nor it will help my son but I do know that the only way to live with this, is to walk behind him and not in front of him.  He has shown me, how I am enough the way I am, by taking his diagnosis in a stride, by sitting through relentless testing and always coming out shining at the other end.  He has touched so many people who evaluated him, with his tenacity and his teachers with how willing he is to work hard.  If he has given me, one gift from our struggle over the last many years and journey over the last 5 months, it's the gift of knowledge.

What I do for a living, is not stagnant, nor does it exist in a bubble outside of my life.  What happens in my life, directly affects my work.  My wish to work, my fantasy to not work and my willingness to live somewhere in between because isn't that the elusive balance, we as women always talk about?

So here is to embracing my motherhood guilt, with my son's affirmation that I am enough the way I am and letting him be the best he can be, with what he is.  If he can love me with all of my work and for all the times that I feel like I wasn't around much, then I need to do the same for myself because there is no greater gift, than to be loved and accepted the way you are.