lack of compassion

I was telling my therapist last week how I have no self-esteem and a very poor sense of self-worth. I define my worth by what others see in me, and I project my negative thoughts onto them. I assume they see the worst in me, and my inner critic reinforces those mistaken assumptions.

My inner critic has voices; sometimes it is my own voice, sometimes it is the voice of peers or strangers from my past, but most often it is the voice of my abusers who told me repeatedly how little value I have and how ashamed I should be. Several years ago I wrote that my anger had lost its hold over me, but that is not true for the voices of the past.

The therapist asked me if I could be more compassionate toward myself, and I told him truthfully that I have no idea how to do that. I don’t know how to give myself a pass for being an imperfect, fallible human without thinking of myself as defective and broken. What about others, he said; for example, how would I comfort my wife if she were feeling bad and was hurting emotionally? I told him honestly that other than an uncomfortable hug, I don’t really know.

My wife is very likely to lose an uncle to COVID in the upcoming days, and maybe her aunt as well. She wasn’t really close to them for the past 25 years, but I know she will be sad about it, and she might have some tears. I have no clue what I will do when that happens. I care about the feelings of loved ones and strangers, and I sympathize with their sadness, but I feel like awkwardly comforting people close to me is a duty I have to do.

It doesn’t seem very compassionate to say that her aunt and uncle brought this risk on themselves by choosing to listen to the Orange Cult Leader, and they are suffering the natural consequences of dismissing the danger caused from being anti-maskers and anti-vaxxers. She knows that of course, and we share the same opinion, but that won’t stop her from being sad. I will feel like I have to comfort her because it’s my job as her husband, but I don’t feel comfortable doing so.

The inner critic is right: I am emotionally defective. My therapist better bring his A-game.

tics

I’m not talking about blood-sucking arthropods, but the little movements and rituals that are the major symptom of OCD or maybe Tourette’s. I’ve had little tics and quirks since I can remember, but usually they were only present during stressful times. The rest of the time, they didn’t have control over me and I could ignore them.

During the most recent manic episode brought on by taking Latuda, I started having uncontrollable “tic seizures” where I would be lost for seconds to minutes at a time, then only by force of will could I stop them for a few moments. I could maintain calm stillness if I really concentrated (which is the opposite of being calm), but eventually I would surrender to the urge.

I tap or flick things repeatedly with my fingers. I blink my eyes forcefully, way more than necessary. I blow air on my fingers. I tap my mouse on the desk over and over. I click my teeth. I scratch my chin or my head. I wiggle my feet or my toes. All of this is fueled by the need to “get it right” – the right sound, the right amount of force, the right number of times, or the right rhythm. If I don’t get it right, I feel like I have to keep doing it until I succeed, and I never do. These rituals are not involuntary, I’m doing them purposefully and I’m fully aware I’m doing them.

I quit taking Latuda two weeks ago, and my psychiatrist tells me it should take no more than a week for the drug to wash out of my system, but the tics remain worse than ever before. I find them in control much of the day, every day, and only when my brain is fully occupied can I really prevent them from happening. I have had difficulty with concentration and focus over the past year or so, and when my mind is spinning or drifting, the tics are more difficult to control. They get worse with stress, and my anxiety is feeding them. They get worse with caffeine, which is bad because I need my coffee in the morning.

Between the manic episode and the increasing control of the tics, It has been mentally exhausting for the past three weeks or so. My work is suffering, and because I am working remotely it is too easy to take time away from the computer to try to relax. It has been difficult to work a full day every day, I am taking too long on projects, and I am struggling to meet deadlines. After work I just want to drink myself to sleep, but I have (mostly) avoided that so far.

My p-doc wants to put me on Klonopin or Ativan to calm down a little and hopefully reduce the tics, but my employer’s safety requirements and drug policy might be a problem. We are randomly tested to federal standards for opioids, marijuana, PCP, cocaine, and heroin. In addition, I’m not supposed to take any drug which might affect my “ability to perform” safety-related tasks. Klonopin is on that list, so if I do take it, I have to demonstrate to the safety police that it doesn’t affect me during work hours. Hopefully I can work with the company on this problem. I won’t ask my p-doc to be untruthful, but I wonder what will happen when they find out I have bipolar and anxiety disorders.

I don’t know if the manic episode or the Latuda triggered something in my defective brain, but something has changed, and I hope the effects are not permanent. I’m actually concerned for my future because of this. I am worried that my mental health problems will cost me the best job I’ve ever had, and send me into an uncertain future of trying to find a new job at my age. I’m not that old, and I can do good work when things are under control, but age discrimination still exists. I hope I’m just overthinking everything.

In the meantime, I’m exhausted, and I’m struggling.