internal conflict contributes to complex comorbidity

[S_A_D_]

Hello dear reader, 

I have a complex internal conflict which needs to be resolved. To do this I will attempt to describe  the conflict in general terms instead of specifics. 

My mother and father are very different people. They see the world different, react to it different, behave different, and have drastically different attitudes about it. When I was growing up I had these 2 polar opposite perspectives being presented to me as models of behaviour that I could choose to imitate and learn. Each model had pros and cons and each parent prefdd to see me learning their model, so I was motivated to learn both. However, due to their polarity, my behaviour became erratic and inconsistent as I switched between the models. Over the years of internal wrestling I have found myself critiquing both models as inferior to the most commonly used/learned model displayed by both parents in a nurturing, enriched developmental environment for the child to imitate, however the adoption of this model now would alienate both my parents and would be an extremely challenging long term task in behavioural modification to break habituation. 

I have long thought much of my problems originate from this inner conflict, and the unilateral adoption of one model over another would provide the consistency I crave, however I find myself unwilling to give either up. One provides a sense of protection, security and safety, but requires immoral attitudes; the other provides a sense of freedom, acceptance and closure, but requires disrespectful ideation. The third, better model, which I'm unfamiliar with, offers a sense of trust, cooperation and respect. It's better because with trust and cooperation comes safety in numbers, and with respect and cooperation comes the peer support which encourages freedom, autonomy, acceptance and closure. However I do not have a strong relationship with anyone living this model, and has sufficient time to teach me, so I lack the ability to take such a person on as my mentor to learn to apply this model. 

I have tried seeking a professional mentoring program for people with mental illnesses as severe as mine, and they do exist, but do not service my area. My psychologist charges $200/hr, being the best psychologist in the state for dealing with complex comorbid psychological cases, but asking him to mentor me would run into thousands. My treatment would also need to be flexible enough to blend in with my university studies schedule. 

Can anyone offer any suggestions?

[The_Real_David_Charles]

Dear Facey,

Is being consistant with your inconsistancies an option ?

Adios, David.

PS  Apologies for the quickie - my hot water heater packed up 3 days ago and the plumber is here.   What is more important for you - the university schedule or the complex pro mentoring ?  Bloody door bell.  Bye.

[Mel_D_1978]

As far as I know it's your psychologist job to help with these thoughts. $2oo (sorry I have food stuck under my zero button) is expensive, does he do the 10 (yeah there's my zero) session bulk billed to medicare or are you through private health insurance. I get confused with how the fees and scheduling works. What's your diagnoses? I try not to use my parents as an example of how I should behave and what morals I should have, I am an adult its up to me now to decide what I consider is right and wrong. I know its hard especially if you have been raised by people with complex problems themselves to changed that ingrained thought pattern, especially if your parents are like mine and are still repeating the same things they did to you as a child. You seem like a smart person you'll figure it out.

[S_A_D_]

David,

inconsistency makes me unpredictable. I am also ill. My illness is not recognised by doctors or family. They all agree I am ill, but don't know with what. predictability is essential to both the diagnostic process and therapeutic treatment plans. It is also essential for people who are trying to support the ill person. One of the most commonly used and effective methods of supporting an ill person is to learn about their eccentricities and compensate for them with nurturing expressions like encouragement. The inability to anticipate the circumstances under which nurturance is required results in an exponential increase in situational stress makes nurturance ineffective, forcing supportive people to skip the usual process and proceed directly to crisis/disaster management.

I can't figure this out on my own. I'm certain of that.

[Vegetarian Marshmallow]

I thought the whole point of being alive was to figure out who you are.  And it's not usually a sudden "change the channel" thing.  It's a series of small changes over time until you look back one day and think "Wow, did I really used to be like that?".  I don't like the idea of following steadfast in anyone's wake.  I prefer a pastiche of all the disparate ideas that seem like good ones to me, no matter where they came from.

Your parents are hopefully perfectly capable of interfacing with other humanoids who are not exact replicas of themselves.  If not, that speaks to the unwieldiness of their models in the universe we currently find ourselves involved with.

You don't always need a mentor.  A feedback loop with physics can be your mentor.  "Oop, that didn't taste very nice; I'll put less oregano next time.  Oop, that didn't taste very nice; I'll try to stick the landing better next time."

[The_Real_David_Charles]

Dear Facetious & Rodentdron,

"Managing your illness" doesn't really do it for me. Partly because our options seem to be limited (but at least we have options) and partly because there is a tendency with mental health to opt for a defense mechanism for our defense mechanism.  So, we are fond of saying that "No one really understands me" or "You don't know what it's like".

But, that should be a given in this area.   We could be in for a long discussion here.

Adios, David.

PS  Rodentdron - may I ask why you are eating your origami ?

[Vegetarian Marshmallow]

Well, what I had in mind was someone skateboarding, falling over, and "eating pavement".  But a good non sequitur is open to interpretation.

Adios, David.

[S_A_D_]

My biggest trigger is monotony.

If we get a long string of days with no rain, heavy rain is like the best thing EVER!

If I work in a labouring or office-work job for a year, quitting is all I can think about.

If i"m at uni and I have lots of things to do, and the whole day is running on rocket fuel, the idea of getting home, curling up in bed, and watching the idiot box seems like the world's best therapy.

If I suddenly start craving a certain food or drink, and I have that 2 or 3 times in quick succession, like 3 days in a row for lunch, having another serving is like torture.

If I consistently make plans for what to do each day for several days in a row, the act of not planning anything and just being spontaneous is like the best feeling ever.

There are two powerful opposing forces in each of us that guide decision making: safety and autonomy. On the one hand, if we choose something we know can be relied on to deliver whatever we expect it to, it is a safe option. This is where hobbies come from. The repetition of an enjoyable task that involves enough subtle differences and/or rewards to maintain motivation. On the other hand, we like to try new things, explore, experiment. This is the risky path, but has a higher potential for reward and variety. Choosing these options takes conscious effort, because there is no habituation. It becomes an expression of your independence from the safety, and a way to prove to yourself you don't need to be who you were before. This is how we grow and learn.

If I'm feeling anxious, I'm more likely to seek the safe path for guaranteed rewards. I will worry a lot about trying new, unfamiliar things, because I don't want to be hurt by making the wrong choice in a risky situation.

If I'm feeling depressed, I'm likely to go for a mix, starting with one then moving to the other. If I start with the safe option, and it doesn't satisfy, I'll switch to the risky path seeking sufficient satisfaction. If I choose the risky path first, and it doesn't satisfy, it could be because I succeeded but it wasn't enough, which means I should go even riskier, but it could also be that I failed, making me more depressed, and I should go for something safer. Sometimes I misunderstand my results, and I go riskier when I should go safer, or the reverse. Yeah, OK, more than just "sometimes."

If I'm manic, or inclining towards mania, I'll definitely be seeking the highest possible risky option. If I succeed, it will accentuate my mania and further boost confidence, and I'll go for another high stakes gamble. Can you predict where this is going? eventually I will fail on enough separate occasions, or on one occasion in a big way, to offset my "high", and bring me right back into depression, anxiety, and regret. This usually means binging on lots of safe options, until some natural phenomena is so noticeably different from the usual, and I am successful at navigating it, providing me with those big rewards, that my confidence rises back up and I begin the adventurous experimental experiences all over again.

Take note of the lag effect. If something happens to switch me between two opposing feelings, there are sometimes residual "left-overs" from the previous to keep me in that state for a bit, till the new one can get "settled in." Also, and especially with mania, there may be a chronological expiry on the feeling regardless of success or failure. It would seem the unreliable state of mind can't be relied on the be unreliable! Ha ha LOL.

A perfect example of a natural phenomena that we have no control over, and is extremely different from what we think of as a normal day is during heavy rain. It shakes us out of apathy with a type of shock we can easily identify, yet seem unable to get used to. The thunder and lightning excite emotions like fear of dangerous threats, and it doesn't matter where in the world you live or lived, because this association has been deeply ingrained into the psyche of ALL animals. We have a biological imperative to fear bright flashes and loud explosions, and especially both together, as in lightning. We also quickly learn to become desensitized to this feeling after the first 1 or 2 flashes and cracks, unless they occur very close to us. In fact, it has been proven through experiments that loud sounds are one of the only 2 fears that we have at birth. The other is a fear of falling. We're not born to fear bright lights because our eyes are one of the last physical features to develop in the womb, and I think I read somewhere that we are born blind. It's also pretty dark, like all the time, in the womb anyway LOL.

I have many other triggers too, of course, as we all do, but not only is this my biggest trigger, it's also the hardest to manage. I have this massive internal conflict telling me "go outside, try new things, meet people, break your monotony, get a life,  be active, socialise." Then the other side says "ooh, shouldn't do that, you'll probably get hurt, like last time, and even if you don't it's a lot of effort for a small chance at feeling a little better, so why bother?", but then the adventurous side comes back with "we're bored, nothing to do, we know that if we stay here we will probably continue to be bored, so if  we go out at least there is a chance we won't be bored." Then the safety side retorts "breaking our boredom is easy. There's lots of things we can do right here that we know will keep us occupied, so breaking boredom is not a strong enough reason to leave the safety of home."

This argument can go for half a second, when I realise I actually do need to go out, or I realise going out is impossible (ie hailstorm), or it can drag on for days, literally days, where I'm not sure what I should do, go or stay, go or stay, go or stay, urgh I suspect this indecision is a trigger for most of my problems.

Sometimes I go out even when I have nowhere to go, and I sit on the bus or walk around in shopping centres of parks or open bushland or stop at a cafe, as a way to churn through hours, or end up in a cinema watching a crap film, and I get home late feeling like the day was a complete waste of time and money. Other days, like today, I'm online from 10 minutes after waking up till after I fall asleep that night (and computer turns itself off). 

I have social groups i can go to, and uni, but I lack the motivational incentives to do more than the minimum. If I'm awake, I lack to incentive to go to sleep. If I'm asleep I lack the incentive to get up (except to use the toilet LOL). If I'm at home I don't want to go to school or group. If I'm at school on a regular, low pressure day, I don't want to go home, so I go to the library and study till it's dark. If I'm at my social group, they have to kick me out to get me to go home. Whatever I'm doing, I don't feel satisfied. I want more. Whatever it is, if it's delivering rewards I need it to continue. I'm not picky or impatient, I don't mind if I'm eating a burger or a bowl of salad, when it's finished I want more of the same or something better, without it getting monotonous. I don't trust that I will get what I've got again, so I binge and extend the experience as much as possible, appreciate it as fully as possible, and try to remember it, value it, be grateful for it, just in case I don't get another chance. Fortunately I don't follow this pattern of behaviour with dangerous substances like alcohol, and I'm allergic to caffeine (possibly due to binging on caffeine as a teenager).

I'm told that even among the unusual/rare/special, I'm very unusual for these reasons. Who would've thought?

[The_Real_David_Charles]

Dear Facetious,

I have those do/don't days.   More often when on a manic cycle.   Maybe the depressive reality is more don't/do.  But whatever the cycle I find it hard to manage anything without the usual patterns of anxiety, etc, spoiling the moment.

You're lucky you have outlets.   Social groups.  Uni.  Dare I say, relatives ?  Watching crap films is better than not watching crap films.    Shopping centres, bus stops, parks, all teem with life to watch or enjoy without getting overly involved.  People watching is a great way to relax.  You just need take away coffee and a bench.  Maybe a donut.

I have this one set of lights to cross with my dog, Jemima (border collie) and if I miss the sequence it's a 60 sec wait.  We used to rush to hit the Pedestrian button before the sequence rolled in our favour and somehow all this anxiety and effort to "make" the lights dominated.  Now we just mosey up any old fashion. And wait.  Sometimes the wait is long enough for my tired dog to lie down.  Sometimes another person waiting will chat (usually about how long the lights take).  

This probably won't be a gospel comparison to your ailments but with this one slight change in focus I was able to enjoy life a bit more, meet more people and let my dog sometimes take a quick rest.  We weren't hurtling along to the next thing that would require equal frenetic hurdling.   The even might be passing slower now but so what ?   It's like taking a crap, having a pee, breathing, digesting, feeling sleepy and all those other natural and essential moments - they have a pace, a rhythm, etc, and don't come off good with being rushed.  If you've ever had food poisoning you'll know it's the most painful thing ever.  You want to die.

Nowadays it's just composing and dog walking for me.  Gone are the big social events and extensive family gatherings.    That's why, for me, my own family is more central than with most family situations.  Even in your situation if you get to turn down just one thing to a more reasonable level you might be satisfied.  Some of what you described is very akin to the cravings during pregnancy.  But then if you watch small kids play, devise roles, learn a game, change the rules, etc, constantly pushing the boundaries there is a similarity in the changeover too.

I am still counting the no. of rules my niece/nephew have for playing hand ball.  Last year I wrote them down - something like 30 !  All for a game where you hit a ball against a wall in turn.  When I showed them a few days later they both cried "No, that's not right".  And further clarified the matter.

Adios, The Real David Charles

[S_A_D_]

I've had food poisoning before. It was rather painful. maybe a 8/10. My average day is a 2/10. I got to experience a 0.5 a few days ago, which was very nice. I've had many experiences that rate among the 9s and 10s, almost all involving hospitals and a noticeable lack of anaesthetic. A recent experience involved a bloated bladder, a panic attack, and a catheter that wouldn't go in for 5+ minutes of forcing. Ouch!

Most of the outlets you mention are not outlets. They are distractions. Sometimes effective. This place is an outlet. One of the in-person social groups I rarely visit because it's inconveniently located is an emergency outlet, but it's not really there for that. It's mostly a social group, not a support group. Helps me work through my social anxiety in a non-judgemental environment.

Your story with the crossing at the lights is the reason I have temporarily given up driving motor vehicles. Public transport is good enough, and walking is healthy. I'm applying the "relax" principle to the best of my ability. 

I'm not allowed animals in any of the dozen (or so) places I've lived in the last 10 years. I would like a dog, but won't give up on uni and can't afford a place of my own. One day, mate. One day. The companionship of an animal would be very therapeutic, but study is better.