Psycho-Babble Psychology Thread 847432

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OT rhinitis Dinah

Posted by Partlycloudy on August 21, 2008, at 12:49:49

In reply to :-), posted by Dinah on August 21, 2008, at 9:24:06


> I was looking up vascular rhinitis, and found out any number of interesting things - including a link to migraines. I wrote about it on the meds board.
>
> http://www.dr-bob.org/babble/20080814/msgs/847504.html
>
>

Huh. One of the things I've been diagnosed with is vasomotor rhinitis. Basically I present with allergic nasal symptoms, but don't test positive for any allergens. I've been treating it with Nasonex (it works very well).

But - depression. Anxiety. Migraine. Rhinitis. Do you see dots where I'm seeing dots, Dinah? I can't connect them, but I can see them...

PartlyCloudy


 

Re: OT rhinitis

Posted by Dinah on August 21, 2008, at 13:24:24

In reply to OT rhinitis Dinah, posted by Partlycloudy on August 21, 2008, at 12:49:49

I'm sure it has something to do with the autonomic nervous system. The thing I keep coming across in my google searches is acetylcholine. I think it's part of the adrenergic-cholinergic neurotransmitter axis. But I really don't know what any of it means, and I really don't know what can be done about it.

There also seems to be some hormonal connections.

What I do find rather sad is that all the health problems associated with this were once written off as psychosomatic, because practitioners couldn't find anything that looked wrong, and because they noticed that the patients tended to be anxious or depressed. Then they got the sophistication to do the tests and saw the physiological parts of the migraine, then discovered the neurochemical cascade that happens. And yet still they're slow at coming to the conclusion that the mental health portion might also have physiological underpinnings.

I know there are people who have mental health issues, perhaps because of childhood trauma, that can be resolved with therapy. I think for me it's important to accept I have a poorly regulated nervous system, and unless something changes at menopause, this is something that I'll have to work at controlling. I need to be careful about controlling stress, I need to do all those good healthy things that I don't always do, I need to continue therapy. And even then, who knows? If a migraine can be caused by a change in barometric pressure or flickering lights, who is to say what odd and apparently unconnected things can cause an upsurge in anxiety or depression?

It might make more sense than some more traditional cycle pattern. And as you've probably heard me say too often, I've thought all along that my proper diagnosis was "nervous system of an overly inbred cocker spaniel".

My therapist thinks I shouldn't think of it as exclusively negative. That there are advantages to it too. And while I do see the advantages, I see them a bit better when I'm not having one migraine after another.

However, I'm really not good with all this neurotransmitter stuff, so it's entirely possible that I'm misunderstanding everything.

 

Re: OT rhinitis

Posted by Nadezda on August 21, 2008, at 13:56:47

In reply to Re: OT rhinitis, posted by Dinah on August 21, 2008, at 13:24:24

I'm delighted that your therapy is going so well. Hope it keeps up-- but you'll work through the momentary disturbances. It's great to know that you can, I imagine. That seems to be one of the big accomplishments of the recent times.

I don't know much about migraines-- but I'm very sorry that they're bothering you.

As for being defended-- and upcoming deadlines-- mmm... maybe, but maybe you're just enjoying the time-- and the good things you've achieved.

I hope I don't seem relentlessly upbeat today; I'm not sure why I would be. I'm utterly worn out by this trip and a cold that I've been suppressing. I'm afraid I'll feel compelled to take a hike or go to the beach when I feel like getting back into bed and watching television and doing crosswords (although there's nothing-- absolutely-- on) all day.

Nadezda

 

Re: OT rhinitis Dinah

Posted by Partlycloudy on August 21, 2008, at 13:57:27

In reply to Re: OT rhinitis, posted by Dinah on August 21, 2008, at 13:24:24

All I've been able to gather is that the reason the Nasonex works in controlling my rhinitis symptoms is because it suppresses the acetylcholine receptors - which makes sense. I would suppose that's also what the triptine type of migraine treatments had been doing - though I'm now on a preventative regime of Zonegran, an anticonvulsant. We just increased the dosage on that because I've been getting a LOT more headaches.

But I definitely see a connection between these issues being present in myself in these particular combination. I might bring it up with my allergist the next time I see him (he's the most broad-minded and engaging of my current specialists) and get his take on what the connections might be.

PC

 

Re: OT rhinitis Partlycloudy

Posted by Dinah on August 21, 2008, at 14:16:49

In reply to Re: OT rhinitis Dinah, posted by Partlycloudy on August 21, 2008, at 13:57:27

I'd love to hear what he has to say.

I bookmarked some of the sites I found, but I started bookmarking rather late into the search so it's mostly variations on the top two. I don't have a lot on the migraine or IBS or GERD connections.

http://www.ncbi.nlm.nih.gov/pubmed/11081594?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

http://www.webmd.com/a-to-z-guides/nonallergic-rhinitis?page=2

http://www.biopsychiatry.com/acetph.htm

Do you think it's possible that the stormy thundery tropical weather lately could be affecting your frequency of migraines?

 

Re: OT rhinitis Nadezda

Posted by Dinah on August 21, 2008, at 14:21:33

In reply to Re: OT rhinitis, posted by Nadezda on August 21, 2008, at 13:56:47

I'm not worried enough about the deadlines. I need to worry more.

I do think the trust that he cares about me is very new. I am enjoying it. I break up my therapy into chunks of time based on trust. The first five years I learned to trust him, then there was a big leap of faith at five years. In the second five years, I learned to trust the trust, if that makes sense, and it was another big leap. Then everything got messed up because of Katrina and the delving into deeper levels we were starting was aborted, and maybe that moment will never return. Now I really really trust that he cares about me, which might not have happened without Katrina. But I recognize clearly that he still will probably terminate me some day because of something in his own life. I'm not quite sure how I reconcile all of that. Or maybe I don't need to. Maybe I've given up the need to reconcile. Which would be a big jump too.

How was your trip? Was it nice enough you'd consider repeating it? :)

 

Re: I think it's probably also true...

Posted by Jouezmoi on August 21, 2008, at 17:56:16

In reply to I think it's probably also true..., posted by Dinah on August 21, 2008, at 11:35:18

OMG ! Someone who is just like me. The rhinitis/ sinusitis, migraine (right now I have had this one coming and going for more than a month), snxiety, depression, and you can add mitral valve prolapse and prinzemetal angina (both linked to migraine) to my list.

Its all neurochemical, and I suspect that my depression/ anxiety is also. I have had the happiest childhood and most pampered life, so no one can seem to source my 'psychological' problems.

 

Re: I think it's probably also true... Jouezmoi

Posted by Dinah on August 22, 2008, at 8:23:11

In reply to Re: I think it's probably also true..., posted by Jouezmoi on August 21, 2008, at 17:56:16

My family certainly had their issues, and those things may have contributed to causing some disturbance in my neurochemicals to begin with I suppose. Although I can see some genetic links to my mother's family as well. For whatever reasons those things are messed up now.

I suppose there are still people, including doctors, who think that migraines and all the other things are problems caused by neurosis or something like that. But I'm glad that others are acknowledging that they might have a common cause but are all very real and have a biological root cause.

I wish there weren't others like us, but I suspect in the future they'll discover that an awful lot are.

 

Re: :-) Dinah

Posted by rskontos on August 22, 2008, at 11:06:02

In reply to :-), posted by Dinah on August 21, 2008, at 9:24:06

Dinah,

in doing additional research regarding migraines and allergies, I ran across this. Sometimes the only relief I have found when I do get an extremely bad headache that maybe migraine in nature or sinus or I just don't what the heck it is and I currently don't have a med from the neuro for when I do get a bad headache is I put ice in a small baggie and place it first on the back on my neck, and then on my head where the pain is the worst. So far it has always worked. I have never thought to use it as this article suggests.

here is the link I hope it works.

http://www.freepatentsonline.com/5527351.html

It even suggest doing it prior to extreme pain and as a preventive even when there is no pain.

Very interesting. Check it out.

rsk

 

Re: :-) rskontos

Posted by Dinah on August 22, 2008, at 16:38:50

In reply to Re: :-) Dinah, posted by rskontos on August 22, 2008, at 11:06:02

That does look interesting, and I can understand the theory behind it too. I'll give it a try.

I think at least part of my problem is that I wait too long to take meds because I know I've taken so many lately. Using this technique might be a good alternative to just waiting.

I'm glad you told me where it is they were describing, though. I'd have never understood what part of the body that was.

 

Nope, not this

Posted by Dinah on August 23, 2008, at 10:05:21

In reply to Therapy is going so well again, posted by Dinah on August 20, 2008, at 18:45:28

I was telling him what I wrote, about how I sometimes got bored but found therapy helpful anyway. He suggested that if I got bored, we could maybe walk to the nearby park for the session to shake things up I guess, unless I'd freak out about it.

I politely declined to go to the park, and acknowledge with equal politeness that I would indeed freak out.

He asked me why, and I found myself totally unable to explain it. I know I've talked about it here without trouble, but the most I could say to him was that I didn't think he could be my therapist/mommy outside the sacred therapy space. He acknowledged that he didn't understand.

Of course it's not as simple as that. If there was need, I could meet him just about anywhere, and recognize that he could carry the therapeutic space with him. In fact, I have experience of that. But that would be a purposeful meeting and a conscious creation of the space.

He's not the same outside his office. He's more matter of fact. He feels different. But even if he could consciously maintain his therapy self, it just wouldn't feel right... Therapy belongs in that room, or wherever the substitute is for that room, because therapy is not real life. It's a bubble, a sacred bubble.

I know other people have done this. And I'm not entirely sure why I'm not willing to even try. I even know I couldn't explain to him even as much as I've explained here. I'm way more aware of these things than he is.

 

It really doesn't matter

Posted by Dinah on August 23, 2008, at 10:23:12

In reply to Nope, not this, posted by Dinah on August 23, 2008, at 10:05:21

It's my boundary, one I've kept consistently. I don't need to justify it even to myself.

 

Re: It really doesn't matter Dinah

Posted by twinleaf on August 23, 2008, at 11:24:50

In reply to It really doesn't matter, posted by Dinah on August 23, 2008, at 10:23:12

I don't find it at all hard to understand your point of view. Your therapist's office really is a sacred space for you, and has been for a long time now. Going for a walk involves so many things that may not be therapeutic. It might start to feel like friends getting together- you might both start to talk about the weather! It also might feel suspiciously like a date that you had not planned on having!

My analyst once mentioned that during his work as chief of psychiatry at Chestnut Lodge, he would often start his work with severely ill patients by walking around the grounds with them. (apparently there were about a hundred acres of fields and meadows then with paths running through them) But he said that, as soon as a patient was able to do it, he wanted them to come to his office, because he felt that the therapy could become more real and effective there.

His office is so special to me. I love the paintings, all the books, the photo of snow-covered mountains on his open laptop- it's such a special place- where things happen which couldn't happen anywhere else.

Besides, I'd feel self-conscious about taking a walk together. I'm very tall for a woman- 6 feet, and he's only about 5'9"!

 

Re: It really doesn't matter twinleaf

Posted by Dinah on August 23, 2008, at 13:52:20

In reply to Re: It really doesn't matter Dinah, posted by twinleaf on August 23, 2008, at 11:24:50

Sometimes it makes me a bit uneasy that he doesn't *know* these things. And even more uneasy to try to point them out to him. Like maybe I'd be bringing something to his notice that he hasn't thought of, and that might have a negative impact on our relationship.

Yet I've read in books and on this board that it isn't *that* uncommon, so maybe he doesn't have a gap in his knowledge base. At least part of it has to be me. If for some reason his office was inaccessible it would be different of course.

I think we've recently reached an even deeper level of trust with each other. I casually mentioned something a while back about my reasonably good relationship with my husband probably being one reason I never felt any sexual or romantic transference towards my therapist. Since then, I've noticed he seems more relaxed about things like this, or about mentioning his wife. In turn, I'm more relaxed, and in fact mentioned something very (objectively) embarrassing of a sexual nature to him the other day without covering my face or asking him to close his eyes. I'm somehow thinking he wouldn't have suggested this if he didn't feel really really comfortable that I wouldn't get the wrong impression.

I really really like that we're comfortable with each other. But comfy or not, I value therapy far too much to want to allow any permeable barriers. Or perhaps I should say that I know which barriers would compromise the structure of therapy for me, and I don't want those barriers to be permeable.

 

Re: It really doesn't matter Dinah

Posted by twinleaf on August 23, 2008, at 14:04:09

In reply to Re: It really doesn't matter twinleaf, posted by Dinah on August 23, 2008, at 13:52:20

It's wonderful that even though your relationship together has spanned thirteen years, new, closer, deeper and more profound things are occurring between the two of you now. It's like a well which can never run dry.

 

Re: It really doesn't matter Dinah

Posted by raisinb on August 23, 2008, at 15:05:23

In reply to Re: It really doesn't matter twinleaf, posted by Dinah on August 23, 2008, at 13:52:20

I know exactly how you feel. Therapy is fragile. The boundaries are needed.

This is exactly why I didn't want my therapist talking to my new pdoc. Neither one of them understood this. My therapist and I had to process my "forgetting" to sign the release form for it for a whole session. She was happy that I identified therapy as something precious I wanted to protect. Tell your therapist he should be too.

 

Re: It really doesn't matter

Posted by Annierose on August 25, 2008, at 11:28:12

In reply to Re: It really doesn't matter twinleaf, posted by Dinah on August 23, 2008, at 13:52:20

I would be uncomfortable too ... as far as going on a walk with my therapist. The saftey of the four walls contains my emotional self. There is a fantasy (for me) of going for a walk with my therapist, casually, as friends, but the reality of actually going on a therapeutic walk would scare the daylights out of me. And the outdoor stimulation of cars honking, police sirens wailing, sunlight in my eyes ... YUCK! Give me a a cozy couch, dimmed lights and silence.

 

Re: It really doesn't matter

Posted by susan47 on August 25, 2008, at 17:03:31

In reply to Re: It really doesn't matter, posted by Annierose on August 25, 2008, at 11:28:12

A therapist in the real world? I think about my ex-T in the real world and I want to piss myself.

The fear is unbelievable. But when I see him the rest of the world disappears, and it's just him and me on my little Island of Hope ... Sarah M's songs must have been written about someone like a t .. or just by someone in love, really in love.

Falling in love means loving yourself.
Therapists can really hurts patients.
Doctors can hurt patients.
They might not be meaning exactly, to do that.
But why does it happen?

So now that we know why it happens, we can stop it, can't we? Can't we?

 

Re: It really doesn't matter twinleaf

Posted by antigua3 on August 25, 2008, at 18:09:09

In reply to Re: It really doesn't matter Dinah, posted by twinleaf on August 23, 2008, at 11:24:50

Chesnut Lodge? Now that was a great place.
antigua

 

Re: It really doesn't matter

Posted by fleeting flutterby on August 26, 2008, at 13:49:33

In reply to Re: It really doesn't matter Dinah, posted by twinleaf on August 23, 2008, at 11:24:50

Gee-- once again it seems I'm in the minority..... though...*blushing*.... I've been told I have quite severe attachment problems.(think that is rare)
I've felt much more comfortable walking in the park with T. than in the office. I get anxiety when attention is on me... in the park there is less attention on me- thus less anxiety. I fear people getting close to me. I don't care for four walls all around me... feels less safe... can't defend myself as easily and so few distractions from me.


> My analyst once mentioned that during his work as chief of psychiatry at Chestnut Lodge, he would often start his work with severely ill patients by walking around the grounds with them. (apparently there were about a hundred acres of fields and meadows then with paths running through them) But he said that, as soon as a patient was able to do it, he wanted them to come to his office, because he felt that the therapy could become more real and effective there.<< ............

--- See I can so understand this^^^^.... if they are safe walking with me then MAYBE they just might be safe to sit in an office with .... maybe.....

I think it's cool you all can feel so safe and "connected".... I dream of that.
..... but now, I MUST keep myself safe and that is what I am always vigilent about.

flutterby- mandy..
.. ps-- this has been interesting to read all the posts. thank you.

 

:-)

Posted by Dinah on August 26, 2008, at 17:11:38

In reply to Re: It really doesn't matter, posted by fleeting flutterby on August 26, 2008, at 13:49:33

I'm sorry I disappeared. :( I've been feverishly working on another deadline. I think at least this time I got a bit of insight as to why I'm always feverishly working to meet a deadline. Now to figure out if there's any way to use it.

It's interesting that different people feel differently about it. I've actually met with my therapist in nonstandard places when necessary, and it's never made a huge difference.

I think that for me it's a contextual difference, not a place difference. The bubble of the therapy room is transportable, but the context needs to stay the same. Nobody is the same with all people or in all places. That's even more true of therapists than most people, I'd think.

In that room, he's fond, indulgent, and totally focused on the relationship. In that room, I'm open and vulnerable. If there was a quiet garden at the back of his office, we could maintain that context. But this would involve going outside his office. The context would be different and so would he.

As a minor example, I forgot my purse in his office last week. I of course couldn't leave without it, so when I was nearly down to my car, I turned around and returned. By that time, his next patient was there, and he was walking around checking his mail or whatever. As I walked in, he calmly and professionally asked if he could help me. And I answered as I would if I had left my purse with my hairdresser, although I added a joke about it not being freudian. He wasn't my therapist/mommy in that exchange, and I wasn't his therapee/daughter. The context was different, the relationship was different, and we were both different. And that was as it should be.

Given enough time, I'm sure we could work out a functioning out of office relationship. I even had a bit of that today, since I wasn't at all myself, having been up all night, and working. It was more chit chat than therapy. The couple of topics we discussed brought home again how totally different we are, and how little we'd have to do with each other in the real world. That was tempered by the warm acceptance and amusement with which we greeted the reminder. But it wasn't my normal therapy, and it wasn't my normal therapist, and while it may have been an amusing interlude on a day that was pretty much shot to heck anyway, it wasn't therapy.

He's going away for two separate trips in September, but probably back to back, so that he'll be gone two weeks and I won't see him for nearly three, if it works out that way. And he doesn't see that as a problem.

Therapists!

 

Re: It really doesn't matter

Posted by Daisym on August 27, 2008, at 1:11:33

In reply to Re: It really doesn't matter, posted by fleeting flutterby on August 26, 2008, at 13:49:33

I worry that I can't be the *me* I need to be in therapy if therapy has to take place in the "real" world. I need to be able to float away as needed and you can't do that and maintain yourself in public. I think my therapist would be my therapist no matter where we met - but I'd be in polite hostess mode. Ick.

It is an interesting idea though. I've often found that sitting parallel to someone allows for a different kind of interaction. Maybe I could go for a drive with him.

 

Re: :-) Dinah

Posted by Annierose on August 27, 2008, at 1:17:10

In reply to :-), posted by Dinah on August 26, 2008, at 17:11:38

I remember a while back you wanted to play a card game with him ... a sort of question game. Did you ever buy it? and/or play it?

I am in week 3 of a 3 week absence (our vacations were back to back). I found out that I am doing better than I expected. I asked her for something to hold onto while she was away ... that has been very helpful to me.

 

Re: It really doesn't matter Daisym

Posted by Dinah on August 27, 2008, at 14:58:05

In reply to Re: It really doesn't matter, posted by Daisym on August 27, 2008, at 1:11:33

Does he have enough chairs that you can ask him to do that in his office?

My therapist used not to have "his chair" but now he does. Still he's willing to mix it up a bit sometimes. A couple of months ago I asked him if we could switch seats for a few minutes so I could see his view out the window.

It does sort of make a difference. The spacing, the position.

 

Re: :-) Annierose

Posted by Dinah on August 27, 2008, at 15:02:51

In reply to Re: :-) Dinah, posted by Annierose on August 27, 2008, at 1:17:10

We never did play the game. Instead we talked about what it meant to our therapeutic relationship that I felt the need for external props to make up for something intrinsically lacking. And we managed to deal with the lack without the games. He was willing, and I still have it around somewhere.

The funny thing was that since I was in totally rational mode, I was in favor of his leaving for that long, so that I could as he used to put it "try my wings". I reminded him how he used to "reframe things" in a terribly self serving way, and he laughed and agreed that therapists can do that at times. I figured it would be all to the good if I did just fine without him, since without therapy I could quit work.

Then I get home and there's all this talk about gustav, and I remembered that I always felt at some level that I caused Katrina by saying maybe I didn't need therapy anymore, so now I'm afraid I'll cause Gustav to come this way. Not at my logical level, but at the magical thinking level.

So I called him and took it all back formally, and now am worried it won't be enough. :(


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