I am beginning to hate group therapy again.Picture being trapped in a smallish room with about ten to twelve adults, all facing each other in a crowded, too-intimate little circle of a supposedly therapeutic nature. Imagine that they are messy, confused, depressive people with bona fide “Problems.” Sometimes even “Big Problems,” the kind that require a generous regimen of fat, pastel-colored pills ... or perhaps a few bilateral-hemisphere electroconvulsive therapy sessions ... or even a good lawyer on retainer.
A room where you are coerced to share, share, and share until you are practically telling people what you ate (or drank) for breakfast and what your cat’s favorite toy looks like.
An uncomfortably cozy space where you are nudged to give everybody verbal group hugs about every ten minutes or so.
That, folks, is what my existence at PHP (Partial Hospitalization Program) and now IOP (Intensive Outpatient Program) has been like.
And yes, the forced empathy is starting to strain my flaccid showing-empathy muscles.
Remember: We can only be pretend friends in here.I wish I could somehow tactfully signal to my fellow group therapy inmates:
Hey look, fellow group therapy hand holders—
I’m a manic-depressive coming down from a “natural” high that felt kind of great, actually. Not to brag, but it was pretty damn special. I am not quite ready to “feel your pain” just so intensely right now. I cannot always come up with constructive and supportive “feedback” of a nature that will help ease you through your difficult time, which seems to know no bounds at the moment.
Perhaps instead you can feel my soft psychic waves of lukewarm supportiveness radiating out toward you in lieu of actual authentic Real Friend empathy. You see, I do not know you very well, despite your intimate expressions of heartfelt sharing and very shattering displays of vulnerability. Speaking of which, I really do not have enough of an idea why you are rocking back and forth and crying convulsively like that all of a sudden to offer you truly useful feedback here.
Also, I am on medications that actually suppress my humanness and clog my natural emotional response channels. This makes me act like a vaguely empathic and life-like android, carefully rearranging my face and body every so often in an artful repertoire of sensitive expressions of support.
But, yes, I still do “care” about your problems.
“Yes, Smother.”My problem is not with my fellow group therapy sufferers. It is with these “facilitator” women who run the show at my current program. Let’s call them “Professional Empathologists.” They are really killing my fading bipolar buzz with their soft smothering chidings and constant verbal nudgings and fakey-and-flaky ersatz-empathy reflexive-reflecto-deflecto group therapy ego strokings and brain pokings.
Oh, man. In particular, I am peeved at how these group therapy leader women (who are often vaguely smug All-Natural Earth Women of the My-Body-Is-A-Temple type) jumped all over me yesterday for daring to suggest that the previous medication I was on potentially causes hormonal disruptions that could lead to long-term endocrine complications and even infertility.
I took this medication for something like seven years, which qualifies me as somewhat of an expert on it. Over those seven years it helped turn me into a depressive, crazed hag. After being a lean, mean 90-pound weakling for most of my young life, I started rapidly putting on weight. My uterus alone seemed to double in weight. There were stretches of being thirty or forty pounds overweight where I felt suicidal almost every month around *that* time (Pre-Menstrual Dysphoric Disorder). My hair fell out in thick clumps in the shower. Hearing a baby cry was like being stabbed repeatedly in the viscera with a rusty shank. I also wanted to breed like a jackrabbit, and with very little good reason.
Ahh, sweet memories of youth.
In short, I felt like I was being endocrinally hijacked from the ovaries out. For somebody who has steadfastly stayed off of oral contraception her entire life, this felt like a betrayal by my doctors, who seemed entirely unaware of these hormonal side effects. They were also almost totally ignorant about PMDD. (In fact, many of these psychiatrists spent the first ten minutes of every fifteen-minute session shuffling papers around trying to figure out exactly who I was again and thus also what particular cocktail of drugs I was carrying on about.)
These pill-pushing doctors actually made me miss the old-fashioned frigid Freudians I used to go to. At least those guys gave you an hour. Plus they reminded you of dear old Dad (i.e. remote, cold, and vaguely judgemental).
I am so thrilled that I don’t have group therapy today.
Disclaimer:If there really is not a “conclusive” link between valproate and endocrine conditions such as PCOS (Polycystic Ovarian Syndrome), then, sadly, I believe that I fall into the unlucky subset of women with noticeable hormonal disruptions on valproate.
A couple of references:“Valproate is associated with new-onset oligoamenorrhea with hyperandrogenism in women with bipolar disorder”
Biol Psychiatry. 2006 Jun 1;59(11):1078-86. Epub 2006 Jan 31.
“Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy”
N Engl J Med. 1993; 329:1383-1388.