being kind to myself


Some of my oldest memories are of lying in bed, late at night, wishing I was asleep: sleep-onset insomnia. I’m happy to say that I have largely overcome this malady. I have a sizeable bag of tricks to help me out with it (read about them here), the most important of which is having gotten over my fear of insomnia, which had become the primary source of sleeplessness. For the last several years I’ve had trouble getting to sleep just a few times a year.

For the last couple months, though, I’ve been experiencing “terminal insomnia,” AKA waking up too early and failing to fall back asleep. Most of my tricks don’t apply here. It sometimes helps to stay in bed until my alarm goes off–occasionally I will fall back asleep. Sometimes cuddling helps, too, but I’ve found nothing consistent so far. It’s become a problem: I’m getting married next week and sleep debt tends to make me clumsy, grouchy, and stupid–not the way I’d like to show up for this event!

So I complained about it to my therapist today and he gave me his hypothesis: I am chronically and habitually productive. Productivity is a way of life  for me and it’s infiltrated my groggy, should-be-going-back-to-sleep mind. He is right. I am on the go all day. It never occurs to me to slow down, much less take a nap, and that was exactly his prescription:

“I wonder what would happen if you cultivated a habit of trying, even to a ridiculous degree, whenever you noticed being really tired , just saying, ‘OK, I’m just going to lie down. I’m just going to quit what I’m doing and lie down.’ Even if it seems indulgent or incovnenient. Just ‘F*** it. I’m lying down, I’m closing my eyes, I’m relaxing. If I sleep, I sleep–it doesn’t matter. I’m just going to relax.’ Look at your tiredness as a sort of enlightened messenger, giving you the gift of saying, “Stop it! Stop working so hard. Just lie down right now and be irresponsibly lazy. Just lay out.’

“And you’ll have to deal with the resistance in you too. The well-trained hard, hard worker in you will say “Now’s not a good time… maybe later,” and the challenge is to say “F*** you. I’m not buying it. I’m lying down. For at least five minutes I’m going to lie down, deep breath, deep relax, and invite myself to doze if it happens.

“It’s the next logical progression of getting over the fear of insomnia: The next step is getting over the fear of being tired. OK, I’m building into my lifestyle being tired and loving myself in my tiredness. If I’m tired, I lie down. Why the hell not?

“I want you to take it on as a spiritual practice. Seriously. A spiritual practice of just interrupting productivity as often as possible in order to be lazy and relaxed and tired and just let the earth hold you up. When you lay down, experience the earth holding you up and receive that kind of support. You are a very diligent, principled and hard-working fellow, Nathen, and we have noticed. We got the message. You’ve got that covered. You’ve acheived that already and can let your pendulum swing back in the other direction.”

He’s right that it won’t be easy. As I’ve been writing, I can feel the familiar tiredness in my face and arms, weighing me down, and I’m choosing to write instead of lie down. Well, maybe I will go lie down and finish this later…

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I turned 39 at 8:50 this morning. I’m on the cusp of middle age! As usual, I used my flights to and from Not Back to School Camp to brainstorm about my 40th year. Camp is a great end-of-year celebration and source of inspiration. I’m going to do a lot this year–finish my Master’s degree and see clients for at least 400 hours, for example–but I’ve decided not to put that stuff on my list. I want to concentrate on how I do it. I just watched the outgoing cohort finish up my program and they seemed really stressed out. I want to do it without overwhelming myself, in good health. I want to enjoy it. So I came up with one intention that sums it all up:

This year, I intend to take exquisitely good care of myself.

To me, that means that I think about myself like I do my best friends, with affection and optimism, with care. I am not a slave to being productive.

When I touch myself, I do so gently, with attention, not mechanically or absent-mindedly. Like I would someone I love.

I don’t eat crap.

I meditate 30 minutes every day.

I exercise 45 minutes every day.

I do my physiotherapy daily and get health care whenever I need it.

I get good attention, from friends, co-counselors, or a therapist, when I need it.

I take a day off every week.

I say yes to social invitations.

I sleep a bare minimum of 8 hours a night. That means giving myself an hour to chill out with nothing electric and no reading before bed, and an hour to lie in bed before I need to be asleep, so I don’t get worried about falling asleep quickly enough.

I keep my living space looking nice.

I have some ritual (yet to be designed) which helps me stop thinking about my clients when I leave the clinic.

I’ve also put a lot of thought into how I will prioritize my commitments. They will probably often conflict with each other and I’d like to be able to make choices about what to do and what to leave out with minimal stress. That part will be a work in progress for a while

I just had my last Medical Family Therapy lecture. It was on eating disorders. My professor, Deanna Linville, is a specialist. One of the questions she recommended asking clients dealing with eating disorders was “What’s a good food day for you?” Also, “What’s a bad food day?”

I think those are good questions for anyone. Here are my answers:

A good food day is when I eat plenty and take the time to really enjoy the food. It usually means I’ve eaten real meals, not just snacked through the day. It means I wait long enough to feel hungry and then eat enough to feel full. It means I haven’t fixated on any food to the point where I ate it until I didn’t feel good.

A bad food day usually means I didn’t eat enough, or enough variety, usually because I let myself get too busy. It’s easy to eat nuts and raisins instead of a meal, or sometimes just forget to eat a meal, and I always regret it. I get weak, irritable, and stupid. If I eat too much on a bad food day, it’s most often because I fixated on a food (usually sugar, sometimes bread and/or cheese, occasionally meat at a BBQ or something) and ate it until I was uncomfortable. Sometimes it’s because I didn’t space my meals out enough and piled new food on top of old. Sometimes it’s a bad food combination, at a potluck or something, that gets me feeling uncomfortable. A random, moldy raisin made yesterday a bad food day.

How about you?

I’m back from a wonderful vacation with Reanna and my family in Joshua Tree and hunkering down for my winter term. I’ve heard that my last term had the most intense workload of the program, but now that I’ve compiled the list of reading and assignments, I wonder if that’s true, especially considering that we have our comp exams the first week of spring term, which includes writing four 6-8 page papers from memory. I’m thinking of ways to take it easier on myself this term because I lost some of my near-focus vision during fall term and I’m not cool with that. (Yes, I was taking breaks, looking up frequently etc. Reading 30 hours a week is reading 30 hours a week.) Anyway, here’s my reading and writing list for the next 10 weeks. The number codes are for the classes: 610 is my second Family Models class, 620 is my Psychopathology (read DSM and deconstruction of such) class, 621 is Professional and Ethical Issues in Family Therapy, and 632 is Medical Family Therapy. I’m excited about all of them.

620 “Remembering Masturbatory Insanity” (URL) 1/6/2010

620 “Mental Disorders are Not Diseases” (URL) 1/6/2010

620 “The Myth of the Reliability of DSM” (URL) 1/6/2010

620 “On Being Sane in Insane Places” (Blackboard) 1/6/2010

620 “Patient Autobiographies” (Blackboard) 1/6/2010

621 Corey ch 1 1/11/2010

621 Corey ch 2 1/11/2010

621 Woody ch 1 1/11/2010

621 reflection paper 1 1/11/2010

610 Nichols ch 6 1/13/2010

610 Nichols ch 9 1/13/2010

610 BB Bobrow & Ray 1/13/2010

620 Munson: Look at Visuals section. 1/13/2010

620 Munson: Read: Introduction, 1/13/2010

620 Munson: Ch. 3 (for overview), 1/13/2010

620 Munson: Ch. 4 (focus on structure of multiaxial system). 1/13/2010

620 Munson: Skim Ch. 21 1/13/2010

620 Munson: Skim Ch. 23 1/13/2010

620 DSM: Introduction, Use of the Manual, Multiaxial Assessment (through p. 37) 1/13/2010

620 Skim “APA Guidelines for Providers…” 1/13/2010

620 D’Avanzo & Geissler: Read Foreword 1/13/2010

620 D’Avanzo & Geissler: Preface 1/13/2010

620 D’Avanzo & Geissler: Appendix 1/13/2010

620 D’Avanzo & Geissler: look at index. 1/13/2010

620 D’Avanzo & Geissler: Look up people of your ethnic heritage, country(s) of origin, or with whose culture you are familiar in order to evaluate strengths and limitations of this resource 1/13/2010

632 Sapolsky ch 1 1/15/2010

632 Sapolsky ch 12 1/15/2010

632 Sapolsky ch 16 1/15/2010

632 Medical Family Therapy ch 3 1/15/2010

632 Medical Family Therapy ch 6 1/15/2010

610 BB Shields & McDaniel 1/20/2010

610 Tomm part 2 1/20/2010

610 reflection paper 1 1/20/2010

620 Munson: Ch. 19, 11 1/20/2010

620 DSM: Adjustment DOs (p. 679-683), Anxiety DOs (p. 429-484) 1/20/2010

620 Kessler 1/20/2010

620 Barrett 1/20/2010

620 Ung 1/20/2010

620 Burroughs 1/20/2010

620 Munson 14 1/20/2010

620 DSM: Dissociative DOs (p. 519-33), 1/20/2010

620 DSM: Eating DOs (p. 583-595) 1/20/2010

620 Schreiber 1/20/2010

620 Knapp 1/20/2010

632 Rolland part I 1/22/2010

632 Rolland part II 1/22/2010

621 Corey ch 3 1/25/2010

621 Corey ch 4 1/25/2010

621 Woody ch 8 1/25/2010

621 reflection paper 2 1/25/2010

621 reflection paper 3 1/25/2010

610 BB Tomm part 1 1/27/2010

620 Munson: Ch. 10 1/27/2010

620 DSM Bipolar DOs (p. 382-401) 1/27/2010

620 DSM: Mood DOs (p. 345-382 1/27/2010

620 Styron 1/27/2010

620 Jamison 1/27/2010

632 Rolland part III 1/29/2010

621 Corey ch 5 2/1/2010

610 Nichols ch 13 2/3/2010

610 BB carr 1998 2/3/2010

620 reading to be assigned 2/3/2010

620 quiz 2/3/2010

620 summary of small group discussion 2/3/2010

632 Gawande 2/5/2010

632 Patients from different cultures ch 2 2/5/2010

632 Patients from Different cultures ch 4 2/5/2010

621 Corey ch 6 2/8/2010

621 Woody ch 7 2/8/2010

621 reflection paper 4 2/8/2010

621 professional disclosure statement 2/8/2010

610 BB Gergen 1985 2/10/2010

610 quiz 1 2/10/2010

620 Munson 9 2/10/2010

620 Munson 16 2/10/2010

620 DSM: Schizophrenic spectrum DOs (p. 297-338) 2/10/2010

620 Alda mother 2/10/2010

620 Love mother 2/10/2010

620 Steele 2/10/2010

620 Hunt 2/10/2010

620 “lobotomies” coleman 2/10/2010

620 Dully and Fleming 2/10/2010

620 El-Hai 2/10/2010

620 Grand Rounds 2/10/2010

632 Shared experience ch 1 2/12/2010

632 Shared experience ch 14 2/12/2010

632 Shared experience ch 15 2/12/2010

632 Medical family therapy ch 4 2/12/2010

632 Medical family therapy ch 11 2/12/2010

632 Sherret 2/12/2010

632 health genogram due 2/12/2010

621Corey ch 7 2/15/2010

621 Woody ch 3 2/15/2010

621 reflection paper 5 2/15/2010

610 Nichols 12 2/17/2010

610 BB Molnar & DeShazer 1987 2/17/2010

620 Munson 20 2/17/2010

620 Munson 16 2/17/2010

620 DSM: Personality DOs (p. 685-729) 2/17/2010

620 Wurtzel 2/17/2010

620 Levine 2/17/2010

620 Miller 2/17/2010

620 Crimmins 2/17/2010

620 DSM: Alzheimer’s (p. 147-158) 2/17/2010

632 psychotherapist’s guide to psychoparmacology 2/19/2010

621 Corey ch 8 2/22/2010

621 Corey ch 9 2/22/2010

621 Woody ch 4 2/22/2010

621 reflection paper 6 2/22/2010

610 reflection 2 2/24/2010

620 review readings 2/24/2010

620 Exam 2/25/2010

632 LBL chapter 1 2/26/2010

632 LBL chapter 3 2/26/2010

632 LBL chapter 7 2/26/2010

632 Candib 2/26/2010

621 Corey ch 11 3/1/2010

621 Corey ch 12 3/1/2010

621 reflection paper 7 3/1/2010

621 legal statutes and rules summary 3/1/2010

610 Nichols 11 3/3/2010

610 BB Goldner 1992 or so 3/3/2010

610 OSCR reflection 3/3/2010

620 trans readings TBA 3/3/2010

632 LBL chapter 8 3/5/2010

632 LBL chapter 9 3/5/2010

632 Becvar 3/5/2010

621 Corey ch 10 3/8/2010

621 Corey ch 13 3/8/2010

621 reflection paper 8 3/8/2010

621 Take home final due 3/8/2010

610 Nichols 14 3/10/2010

610 quiz 2 3/10/2010

632 interview project due 3/12/2010

610 final paper due 10 am 3/15/2010

I have a bunch of papers due in the next couple weeks. About 50 pages worth, give or take a page or two.

Tonight I spent a little time with my friend Grace, watching Alseny Yansane drum and dance on campus, and catching up with each other on the drive there and back. I told her about the paper I’m working on right now, a critique of a journal article on some quantitative research. I said I was expecting some  late nights coming up. “I think I could get with a passing grade by turning in some crappy writing…”

She said, “That’s just not the Nathen Lester way,” and we laughed for a while. No, it isn’t. I just can’t bring myself to do it.

Inspired by my brother Damian and by the book My Year of Living Biblically, I’ve been taking a weekly sabbath this term. I am not religious but the idea of a day in which I was not allowed to work fascinated me. It seemed like a good way to take care of myself. It has been great. It is a radical lifestyle change for me, almost shocking. I have four rules for the day:

1. No school or business related work at all.

2. No fretting.

3. No counting, timing, or keeping track of anything.

4. No planning.

It’s a work in progress. Some grey areas I’m wondering about are reading and writing. So far I haven’t been doing them, except some brainstorming… which can verge on planning, now that I think of it… well, that’s why it’s a work in progress. The key elements are that it is restful and rejuvenating, and that I only do things for the pleasure of doing them, not for some future result.

I almost called this post “My Fledgeling, Faltering Sabbath,” because after three good weeks, I worked straight through last weekend, ten hour days, just like old times, and it’s looking like I’ll do the same this weekend. I have a draft of my thesis due on Tuesday (actually it was due tomorrow, but I renegotiated) and I will need at least every coherent hour until then to pull that off. I wonder if I can get back on track. Often I find that I only stick with things as long as I have a “no exceptions” rule. “Trying to do such and such a little more” is rarely effective. And I don’t have a religious community to keep me on the straight and narrow. Hmm. It seems like breaking my sabbath to worry about my breaking my sabbath.

I watched a training video for recognizing post-traumatic stress disorder in psychopathology yesterday. Part of it was a Vietnam veteran describing his stress cues—he had to monitor and manage his stress level carefully so that he wouldn’t become scary or dangerous to those around him. He said something like “If I find myself scanning the bushes for gooks, or deciding which person in the room I would need to kill first, if it came down to it, I know that I need to lower my stress level.” The man’s story was moving and I cried quietly throughout it, but at that moment I was surprised to find myself a little jealous of him. My thought was “It must be nice to have such obvious stress cues.” It wouldn’t be nice at all, of course, but the sneakiness of my stress cues does make it difficult to manage my stress, which is a big part of my ongoing project to master being kind to myself. I was inspired to come up with a list of stress cues that I could try monitoring, to see if it’s helpful. Here it is so far:

I can feel tension in my solar plexus and between my shoulder blades

I am craving sweets

I am having trouble with focus or motivation

I am grinding my teeth, usually along with a drum beat in my head

I am biting my lip or picking at my skin

I am in the grip of an unpleasant emotion

I am experiencing intrusive thoughts

My writing or typing gets sloppy

I am easily frustrated

I am feeling jumpy

Sitting up straight seems out of the question

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