Sometimes When We Touch (signals)

 You ask me if I love you

And I choke on my reply
I'd rather hurt you, honestly
Than mislead you with a lie
And who am I to judge you
On what you say or do?
I'm only just beginning
To see the real you

And sometimes when we touch
The honesty's too much
And I have to close my eyes and hide
I wanna hold you 'til I die
'Til we both break down and cry
I wanna hold you
'Til the fear in me subsides

Romance and all its strategy
Leaves me battling with my pride
But through the insecurity
Some tenderness survives
I'm just another writer
Still trapped within my truth
A hesitant prize fighter
Still trapped within my youth

Sometimes when we touch
The honesty's too much
And I have to close my eyes and hide
I wanna hold you 'til I die
'Til we both break down and cry
I wanna hold you
'Til the fear in me subsides

At times I'd like to break you
And drive you to your knees
At times I'd like to break through
And hold you endlessly

At times I understand you
And I know how hard you've tried
I've watched while love commands you
And I've watched love pass you by
At times I think we're drifters
Still searching for a friend
A brother or a sister
But then the passion flares again

And sometimes when we touch
The honesty's too much
And I have to close my eyes and hide
I wanna hold you 'til I die
'Til we both break down and cry
I wanna hold you
'Til the fear in me subsides

Musical Diagnoses

Well, the hospital talked to the doctor talked to the internist talked to the counselor talked to the... wait? What's on the chart? Let's see...

Blood Pressure, 135/84 (Not bad!)

Pulse 68 (Great!)

Weight: gained a couple pounds back

Problem List: (This is the funny part)

Annual wellness exam (As if that is useful)

Long term use of drug (they're called prescriptions. You wrote them)

Chronic midline backpain without sciatica (as if that is unusual)

GERD (from taking clozaril and eating too much plus stress)

High risk medication use (kinda repetitive)

Severe episode of Recurrent major depressive disorder, WITHOUT psychotic features)

Sleep apnea, Obstructive (I don't sleep so good. Thanks, Clozaril weight gain plus stress)

Deviated nasal septum (from an impact)

Chronic Idiopathic constipation (gotta love this terminology)

Auditory processing Disorder (Don't hear so great)

GERD with esophagitis (As if that wasn't mentioned above)

Treatment resistant DEPRESSION (they keep inventing new types)

PTSD (Still here)

Mental Health Problem (Gotta love this one. I didn't want DID on the chart so they made one up)

Prediabetes (Another diet thing... though I'm barely in the range)

NAFLD (Nonalcoholic fatty liver... stress and clozaril)

Internal Hemorrhoids (The problem everyone wants to know)

Hyperlypidemia (This one seems new)

Weight Loss, unintentional (And here they state the obvious)

Chronic nausea (Thank you, stress and ADHD meds)

Psychosis (This one pops up from time to time)

Bipolar episode, current episode depressed, severe, with psychotic features (make up your mind)

Autism Spectrum Disorder (Here we go again)

ADHD (The first one I ever got)

BMI of 27-27.9 (shrug)

Annnnnnnnnd... down to 5 meds. 2 depression, 1 PTSD, 1 Blood pressure, one non-benzo anxiety)

Annnnnnnnnd... they're finally getting my name right.

Annnnnnnnnd... thank God no new referrals... Talk to the counselor to the internist to the GI Doc.

The one thing we decided for sure is that if I'm in the hospital again MIP will call me by the name on the chart or the guy with the name that rhymes with tent and the people above him will be hearing from me. Changed my emergency contact. Signed the new consent forms to coordinate care. So now the Psych can talk to the counselor who gets all the paperwork anyways and knows this is a bunch of bullshit that doesn't need fancy terms to describe it. I was raised by hospitals. This is the end result. Fathers were doctors and mothers were nurses. And now I'm here. With a problem list. And no ADHD meds. Cuz they suck.

Back in two weeks.

I am numero ocho.

Intrusive Thoughts (KPD)

 They started describing it alternatively as obsessions, bizarre thoughts, Hallucinations, voices... finally it drifted to intrusive thoughts and occasionally back to hallucinations, depending on the source. If it's past related, it's generally called voices, flashbacks, dissociations, or intrusive thoughts. If it's substance or medically related, it's voices or hallucinations. If it's present time related, it's the obsessions or bizarre thoughts. 

Intrusive thoughts are generally related to past experience but are triggered by things that happen in the present. Anything sensory that triggers a past association. My most common ones are seeing or hearing people from the past or seeing or hearing the same stimuli from the past. MIP. So many intrusive thoughts can come. Unfortunately, I know every square inch. It all has memories.

Now it feels like intrusive checking. The same people with the same judgments and concerns coming back for more. The Psychiatrists and relatives... the first rather reluctantly, the second rather addictively. Now I talk to a P.A. The mere fact that he does not qualify as a "psychiatrist" seems to console me. They move codes and labels around on a chart with their medications and talk about substances like it's their religion. 

The checking feels like a colonoscopy at times. Always looking for a polyp. So far, I'm signed up for weekly colonoscopies. I pass enough of those, maybe I'll get to space them out. I guess the LPCs will consult with the Psychiatrists, Social workers, nurses, MDs and others, and they'll come back to me with a plan on that. Maybe the Techs will get a break. The professionals alternate from annoyed to amused. Particularly the Internist's office. So, I space out my words. BP's remained within slightly elevated but normal limits. So, I continue the non-medical intervention: diet and mild exercise with stress management. The only Psychiatrist I can manage to take seriously at this point is the one that is/was assigned to work with the PA. That and care coordination keep him within that circle of trust. Every psychiatric guideline in my head resonates from that Psychiatrist and PA. To me, Bipolar is a rich shrink's pipe dream. It's such a vague and elastic concept that you could throw it at a wall and it just might stick. 

Maybe I'll add a dx to the DSM V. Under personality disorders. We'll call it Knowitall Personality Disorder (KPD).

Diagnostic criteria:

1. Habitual need for checking

2. Extensive knowledgebase

3. Inability to quit

4. Does not qualify for an obsessive disorder

5. Extreme need for categorization

6. Excessive attention to detail

7. Inability to shut mouth

8. Robotic communication

9. Excessive recordkeeping

10. Fails to take vacations

11. Maintains licensure when it makes no sense to do so

12. Condescending demeanor, with or without obnoxiousness

13. Intolerance for lesser beings

14. Lack of Hobbies

Exclusion criteria:

1. No four degree or higher or equivalent.

2. Has attended counseling voluntarily

3. Attends religious services regularly

4. Does not have a history of substance use

Trust Concepts

I've been thinking about trust a lot lately. I've got my categories.

Community

I can see and hear you. You are animate... living and breathing.

Person

    I've met you. I may know your name. You're not an animal. I don't treat you like one.

Acquaintance

    I've met you. We've interacted on multiple occasions. I know your name. I may not always remember it. Favors are limited based on need and give and take.

Friend

    I interact with you regularly or repeatedly over a long period of time. I know your name. I almost always remember it. Favors are limited based more on need then give and take.

Relative

    You have a biological or contractual connection to me or someone with that connection.

Family

    You live with me. You may be a cat, dog, or other domestic animal.

Professional/Client

    I interact with you only when you are under a contract to do so or are being paid to do so and vice versa. If you/I are not being paid, then you/I are on vacation.

Anchor

    Whether you are present or not, I tend to remember you, and I will aid or protect you within my abilities and within the letter of the law. But I am human. I can only do so much. You also fall another category.

If I don't say something, it is not appropriate or necessary for me to comment or I'm not sure about the answer. If I ask a question you don't want/need to answer, then don't answer or decline to answer. 

Boundary statements

I need you to XYZ (violation)

You are XYZ (violation)

I know your name and don't use it or use other names instead (violation)

You need to XYZ with XYZ person or in XYZ situation (violation)

I talk about you when you're not around (violation)

I use or move your things without asking or not under a contract of some sort (violation)

I touch, look at you, think about you, talk about you, or listen to what you're saying without permission that is implied or direct (violation)

He/she is... (violation)

Can I...? (No "you"... ok)

Would you (No "I"s... ok)

I contact you without permission or legitimate authority within the law. (violation)

Most obviously, I treat you differently based on a category related to personal characteristics. Violation.

My personal space is part of my person. That includes my living area. Don't violate it.

If you need something and it is implied, don't expect to get it. If you need something, and ask by using a lot of implied feelings, don't expect to get it. If you are being appropriate about the size of the request and the relationship and simply ask for what you want from me without referencing someone or being too personal, you just might get it.

From time to time, I need to remind myself of these things. If a relationship becomes too poisoned, I take a vacation or a permanent break. If you receive a warning (some people will call them threats even if they are not specific) or I stop responding or block your communications, you are on an involuntary vacation from all categories and interaction. The "Don't contact me again unless I contact you" is implied. DSS, FBI's ICD, SCDHEC, BBB and the local police are a click or phone call away. ICD and BBB are the only ones that tend to hear from me. I prefer not to put people behind locked doors.

If you say, "quit it", "give it up", "let it go" or something nonspecific, you are wasting your breath and energy. I'll have no idea what you are talking about, and you will gain nothing. Generally, it's not your business anyways. Develop some common sense.