Leaning into Discomfort
& the ways in which this process is changing me little by little
If you don’t know much about me, you might not know that I thrive on routines, schedules, checklists and a handful of other tools and actions to maintain this feeling of false control I have over life, over my life, to be more specific.
Living in a semi-permanent status of hypervigilence for more than two decades meant that I was always ready, always waiting for the other shoe to drop. I had my mental list of next steps, of what I would talk with me, of where I’d go. In my teenage years, while my brain was still forming, this pathway felt like the only option to safety. It also felt like it had to become the biggest secret.
I knew that if I shared this, the people around me would be significantly concerned. We were in high school, and nobody was mature or responsible enough to process things like this without an adult. I just didn’t have one. Which left me… on my own.
I knew that most, if not all, of the people in my world at that time would not have the resources necessary in order to support me. Hell, I didn’t even have them. How was I expecting other people, people who haven’t navigated anything like this, to have resources to appropriately and responsibly respond to the things I desperately needed to share?
I new that in the place I was in, I was barely equipped to hold and manage my own pain while keeping my safeguards up. This also made me believe that if others were to get involved, if I chose to let them into my metaphorical circle, they would simply amplify the magnitude of the situation, and try to “fix it”, not in the genuine how can we help way, but in the we’re going to call people dressed in white coats to take you away way.
Nope.
Not happening.
It’s been more than two decades since those moments and those choices, and I still automatically break out in a cold sweat and want to take off running rather than tell the whole truth of that chapter of my life, of this chapter of my life, to someone who might betray that trust by escalating the situation behind my back or without talking to me about it first.
As I think back on those moments from the end of my childhood and the beginning teenage chapter, it’s been nearly 26 years since I developed that skill set. While I’d say that it has served me well a lot of the time, it’s also forced my body to be semi-permanently stuck in the fight vs. flight response. And even this wasn’t a problem, until my nervous system became so keyed up after the twins died and my new therapist asked “Where does this certain series of responses came from? Like - have you always had them? I think they could be old trauma response behaviors related to something entirely different” and BAM. I was struck in the face by the reality of the things I’d done a pretty good job running from between high school and college, jobs and relationships, parenthood and self care.
My brain was literally on fire, and here I was, trying to periodically toss a glass of water at it. In truth, what it needed was a quick and dramatic blasting from a fireman’s hose. I just didn’t know that. I didn’t see it, because I was so far in it I just assumed it was like that in everyone else’s brain too. Whoops.
Staying where I’d been standing for all that time, it was never going to lead to safety or sustainability. It was a line in the sand, not permanent, and threatening to wash away every time the tide rolled in.
Losing access to that tactic really harmed me mentally as there was nothing of direct correlation available at the same time to deflect it, or replace it, or move it into a safer method of use.
That made my mind flip.
It was the first time ever that a therapist (or anyone I trusted) asked me uncomfortable questions in light of the misery I was wading through. It was also the first time (that I know of) that I was pushed farther than my word in order to dig deeper into the how and the why. And the first time that someone recognized/noticed/acknowledged a key piece or part of my personality before I did.
This really shook me.
When I started with my current therapist in the fall of 2021 just a few months after the twins died, I was coming out of an eight year relationship with my previous therapist (with whom I’d only had good experiences, but we agreed I’d reach the end of the ways in which she was equipped to support me). I was so reluctant to open up again. I swore to my new therapist for the first several months I was only meeting with her to talk about about this one tragedy, (Noah and Victoria dying), and that we’d only see each other via Telehealth, and of course, she respected all of those boundaries because she instinctively knew that was how I had kept myself “safe.” In retrospect, she knew a lot more about me than I thought she did just after those few months of virtual sessions.
[Note: I recognize the privilege that comes with a statement like that - being able to afford therapy, have insurance cover part of my therapy bill, finding a good fit therapist, and creating working relationship that feels safe and true.
I’m so sorry if and of these obstacles have prevented you from getting the mental health support you need, and I’d encourage you again to expand your resource search incase new providers become available.]
Three years later, and I’ve built a fairly strong patient/provide relationship on trust, stability, persistence, honestly and the immense value of a trauma trained, trauma informed, trauma experienced therapist - there are things she can recognize in my eyes or my tone of voice that sometimes I haven’t even identified yet, and she knew that’s where our conversation was headed next.
There’s not much, if anything, that my therapist doesn’t know about me, my history, my grueling medical journey, the chronicles of my losses, the ways I’ve previously dipped into and out of survival mode or disassociation, and the ways in which she knows whether or not I’m truly okay.
I’ve never known someone so intuitive… except, well, maybe me.
It quite literally shut me down the first time it happened - she made an observation which was 100% true, but I it wasn’t something I’d yet identified on my own. It was like she said this thing, this true thing, and I realized I was sitting on the floor metaphorically, trying to assemble the pieces to my own mind in order to reach a conclusion on my own.
I felt like she not only got into my head, but that she jumped forward a bit inside.
In retrospect, this is the work of a really really good therapist, however for a complex trauma survivor, especially one who’s relied heavily on hypervigilence for most of my life, this knocked me off guard. How was it possible that she figured out this thing about me, or my trauma, that I hadn’t even identified yet?
What my brain chose to reveal in that moment opened the door to a lot of other things for her and I. In truth, it began a series of moments and experiences that I’d kind of previously tip-toed through over the last few years. This caused me to put down my armor, and to begin to ask (and attempt to answer) questions in my own mind about what this therapist/client relationship could look like if I could be 100% open and honest? I’m talking no holds bar. Not embarrassment, shame, guilt or fear creeping in around those feelings. Just memories, stories and feelings.
I started to wonder how much could be honest with her without causing a riptide in my treatment? Or how often could I tell the whole truth, in all its vulnerability and pain, without my therapist worrying more about me than I was?
This lack of consistency and stability in my counseling caused by my own fears and insecurities to make that season of therapy much more difficult than it needed to be, and I’m just eternally grateful to have found a professional like this who continued to take one step at a time with me, put one foot in front of the other, without stopping or leaping, and establishing a mutual trust which was able to slowly reduce the anxiety and fear I had about telling her some of the things I’d never told anyone before. In session, I now can truly take down my walls and bare the unbearable until it doesn’t feel associated with as much guilt or shame or pain as it once did. That, friends, is winning at therapy. [yes obviously I’m trying to get an A]
This brings me full circle - the ability to lean into discomfort.
I’ve chosen to speak publicly about my health - physical and mental - and the unfathomable experiences I’ve navigated because I believe that stigma is stupid, and that there would be a lot more people here, a lot more people engaged with life around them if they’d felt safe enough or connected enough to someone or many ones by leaning into the discomfort.
This season, I’ve thought A LOT about leaning into the discomfort.
In December, when I was diagnosed with bacterial meningitis, I had no idea that my treatment would not only span several months, but that it would take away a lot of my cognitive functioning and verbal expression, and that those symptoms could take up to two years to resolve on its own. What a huge loss of control. What a gigantic loss of autonomy. I hated every second I wasn’t able to navigate or advocate for myself or articulate what I was feeling. It was mentally and emotionally brutal, and I’ll I could do was wait for time to pass.
The in April, after emergency surgery to remove an ectopic pregnancy, a burst fallopian tube, and about 1/5th of my body’s blood from where it had pooled in my stomach, I again recognized the truth - this wasn’t a choice. None of things have been choices. They’ve been circumstances.
They’ve been immense discomfort with no control, no safeguard, no seatbelt.
For the last 4 months, I’ve lived with severe Postpartum Depression and Postpartum Anxiety. I’ve pretended to Amanda in the outside world, but inside I’ve been beyond lost. I couldn’t even find myself (my old self, my new self, any self) when I metaphorically looked inside.
Leaning into the discomfort made me feel like I was going to fall right off a cliff, landing with a silent scream and the end of my days.
I recognize that’s dramatic, but that’s what depression does to us, or to me at least.
It makes me feel like it’s imperative to keep my walls up so other people don’t over-worry, and to compartmentalize my own thoughts in ways that allow me to keep putting one foot in front of the other and appear from the outside as a fully functional version of Amanda; while at the same time keeping private the deep, dark, shattered pieces inside I was in a sense trying desperately to reconnect.
Discomfort: slight pain. (ie: the patient complained of discomfort in their right wrist.
Discomfort: make (someone) feel uneasy, anxious or embarrassed.
It’s easy to say that the last four months (or really, the last many years) of my life have been filled with discomfort. However, that word is no longer enough.
The last four months have been filled with the darkest darkness that exists. The darkest darkness I’ve ever experienced. I’ve used every tool in my toolbox - from talk therapy to somatic therapy to the Safe and Sound Protocol, from DBT to ERP to EMDR, from medication to meditation to bilateral stimulation, nerve blocks and nasal sprays and anything else you could think of, and nothing broke the cycle. Nothing allowed me to exhale, or slow down my thoughts, or even feel like living in this body remained tenable.
Thats when I got scared.
That’s when my providers and I began looking at out of the box ideas.
Major shout out here to the short list of unbelievable friends and partners in crime who have walked similar pathways (even for much different reasons) and have paved this one with facts and and previews and warnings and comfort, who’ve answered every question and reassured me at every turn. There’s no way I’d have ended up here, in the place I needed to be, without you. I’ll forever be indebted.
After an excessive amount of research, conversations, questions, and internal searching, I decided that my best option of finding Amanda again was to try IV Ketamine, a medication initially used for anesthesia in the 1960s, and has since been administered in thousands of soldiers and veterans on the front lines to reduce PTSD and major depressive disorder symptoms.
Now, IV ketamine infusion therapy is being used in clinics around the world to treat people with medication-resistant depression - like me.
Ketamine works significantly different than an antidepressant like an SSRI (ie: Zoloft or Lexapro). Those medications increase the amount of serotonin in the brain, whereas Ketamine actually alters the neuroplasticity of your brain, repairing damage caused by excess release of cortisol and other long-term stress hormones. If I’m being honest, everyone I’ve talked to and everything I’ve read has noted that this is essentially a “last line” of treatment when anti-depressant (after anti-depressant after anti-depressant) fail. That’s how I ended up here.
This treatment was ENTIRELY outside of my comfort zone.
I was anxious and afraid of letting go of control, of surrendering control to the medication, and that alone made me very hesitant to go forward with trying this method of treatment. I had all the notes, the different methods of dosing, the different places in my area or mail order for home that administered the medication, and yet, I still wasn’t ready to pull the trigger.
Two weeks ago, I was on video chat with my psychiatrist, and he said “It’s time. We need to move forward with Ketamine therapy.” He noted that my affect was flat, I was completely devoid of dopamine, and I was unable to function in any sort of normal way. I was just barely keeping the water out of my lungs, forget keeping my head above the water. I didn’t have any other decent, feasible options on the table.
I had to make a lot of phone calls and coordinate a lot of logistics to make this experience possible, but there are a few key things that have made it as smooth as it could’ve been.
With help, I located a wonderful, very reputable clinic about 10 minutes from my house, meaning I wasn’t taking time off of work for a double commute plus the dosing appointment. It also meant my ride could save that amount of time too (Did anyone tell you you cant drive after you’ve been infused with ketamine? Here’s your FYI on that ;))
The facility itself is new, modern, aesthetically pleasing, and comfortable to be in - from the entrance way to the waiting room to the treatment rooms.
The staff is so kind and knowledgable, and multiple members of my treatment team reached out to me via phone or video chat in the week and days leading up to my first appointment in order to make sure I felt comfortable and ready, and to make sure they answered and and of the questions I might have.
Every treatment room at the clinic is private.
They integrate sensory deprivation, something that’s always been extremely helpful for me, by having patients wear eye shades and noise cancelling headphones while listening to a specific ketamine experience playlist. The recognize the “Set and Setting” are just as important as the actual medication.
And, they let my husband, my safe person, stay in the room with me for treatment. I think this has been the deal breaker - I don’t know that I’d be able to fully let go into the medication experience if he wasn’t present. This way, I know in the depths of my being that if something happens physically or mentally, or something comes up for me during a session that leads to a trauma response, he is the absolute most capable of re-regulating me, and making me feel like I’m safe. Of reminding me I’m in the present, I’m not alone, and I’ll be okay.
This past week I had my first two infusions, and while nothing seems radically different yet, there are some small and subtle differences I’ve noticed. Besides being extremely exhausted for about two days after receiving the medication, I’ve noticed that I NEED silence and alone time for at least the first few hours after getting home. The treatment makes my brain quiet(er) - just like when I do float therapy. Previously, that has been the only location or circumstances where I’ve been able to hear one single thought at a time, and realize perhaps I could pause or even close some of the other ‘tabs’ open in my mind.
My brain tends to take a little longer to come out of the haze than others, and I’m committed to doing anything and everything I can to get the absolute most out of these treatments. To me, that means keeping my brain quiet as long as it’s willing to be. My psychiatrist used the word calm, which feels foreign to the version of Amanda I’ve been for the last many years, but it’s something that I can set as an intention for each infusion going forward, and hopefully guide my brain and the medication to help continue that feeling where it’s okay to exhale, it’s okay to slow down, it’s okay to do one thing or even no things at a time.
If I’m doing something so far out of my comfort zone as IV Ketamine, and there’s not exactly a next plan if this doesn’t work, I need it to work. I want it to work. So, I’m truthfully trying my hardest to maximize any potential benefits I can get from these sessions, hoping that will be the difference between truly trying to get better and walking through the motions.
Another part of the experience - journaling.
After just two sessions, Ive noticed that I personally might not be ready to write or process directly after coming out of the medication infusion. I’ve noticed that my brain is still mostly quiet then and admittedly, I don’t remember a lot of what I saw or felt during the parts of the infusion in which I was dozing on and off. But the thing is, I know none of that stops the medication from working, which is where I feel most relieved. That I can’t “accidentally screw it up.”
Also what I’ve noticed is about 12-18 hours after my infusion, it’s much easier for me to write. Both times I’ve sat down to do my regular “morning pages” journaling, wondering if I’d even have anything to write about at all, and both days that writing has led to something significant - I didn’t think about discomfort during my infusion. I don’t remember seeing anything that led me to discomfort either. But somewhere in my subconscious something was triggered. Because I sat down at my computer two hours ago and here I am, still writing.
Just like this post about Death Calling that I wrote the other day, todays words also have come tumbling out of my mind, starting around 430 in the morning a day and a half after my ketamine dose.
I’m starting to think that maybe this is in line with what my initial hopes for treatment were - chipping away at the external ouch in order to reach the real internal ouch, and maybe to learn how to navigate it slightly better. My trauma’s won’t go away, they can’t be changed or fixed or undone. But if I can at least to see the way metaphorical way they have been stored in my body, and connect with those places again, maybe there is a possibility that my whole body will remember that there is more than just trying to breathe.
That there’s more than racing toward survival mode.
There’s living.
And then there’s thriving.
I’m not expecting to open, revisit, reprocess, or let go of any of the trauma’s I’ve experienced - Thats not why I chose this treatment. Or rather, that’s not why I agreed to try this treatment. [Also note: I recognize that whether or not thats my intention, the possibility that this happens in one way or another is real, and I am as mentally prepared for that as I can be.]
I’m just desperately trying to find a counteracting voice to live in my head alongside the depression that can fight back when I feel like it’s too hard to stay. And if Ketamine can do that for me after six sessions, or 12 sessions, or 24 sessions - I’ll take it. Because it’ll mean that staying, that watching my living daughter grow up, having a future - it’ll all still be on the table. And that’s more than I can say I’ve believed is possible in quite some time.
Even those are big expectations and intentions, and I know I’m still far from there right now, but what I do know is this: Today, I feel maybe like there’s a little less water filling up my lungs. I believe theres’s a chance that perhaps I can spend more time floating closer toward the surface of the ocean rather than repeatedly sinking to the bottom, desperately waiting for someone or something to either pin me down and leave me to let go, or someone to reach in and grab my hand to pull me out.
Here’s what I’ve learned - neither of those thing are going to happen. There is no other person, there is no other voice. 24 hours a day, 7 days a week, I am with myself. And when I live in a body as shattered and broken as mine on any given day, sometimes it’s really hard to remember that things like joy and fun and relief and life still exist, because right now happy feels like a lie and my innate response to others wins is to bury my head and cry.
I don’t want life to stay like this.
I don’t want to leave life, either.
I just hope no matter what, if you’re reading this you know that I’m doing absolutely everything in my damndest to tackle this head on. To learn, to process (slowly), to try to grow, to seek hope, to ask for help, to put one foot in front of the other.
I didn’t know that it was possible to need to leave and to want to stay so badly at the same time.
