I normally have most of this day to myself. I made choices, shifted boundaries – partially out of true clinical need, partially because I was anxious. I am self-employed; if I am not working, I am not making money. Patients cancel and/or reschedule more in the summer due to weddings, vacations, concerts, baseball games, etc. I regressed in my temporal boundaries and scheduled patients beyond what is normal today: two became five. It is what it is. However, my self-care – a manicure – now is a to do, something to fit in between sessions. [sigh] I put myself here. I know it.
This is accumulative, I tell myself. The result of three weeks of patients’ acuity. I know this and that if I had not been sleeping well, abstaining from ETOH and eating better than average that I too would be facing my feeling stressed as well as depleted. I am not stressed. The clinical decisions that I am making are sound.
However, I have not been reaching all of my goals. I love to meditate, and it has become a “when I have time … ” thing. I always plan on doing it first thing in the morning, but it has not been happening. The sugar thing. Fucking sugar. One serving, and I crave it the rest of the day. Crash, crave. Crash, crave. I know this, but I don’t.
My bicycle is at my office. My goal is to walk the dogs, shower and then walk the four miles to work. I see my first patient 90 minutes earlier than typical today. As my grandmother would have said, “There is no time to dilly dally.” But isn’t life there in the dilly dally?
As I walked the dogs, I deeply considered that last question, letting our middle-age dog sniff and decide whether or not to leave her scent as well. My grandmother was wrong: there is time to dilly dally. I just have to make better intentions.
Switching the focus from the rings on my Apple Watch, I surrender the notion of walking to work and give myself enough time to meditate. I am on day two (for the third day) of the Anxiety pack in Headspace. The young dog plays at my feet, giving me enough distraction to practice reorienting my attention.
I feel better, more present. Today I will go at half speed and put on flip flops instead of trainers or oxfords. I will be present for my life.
Fuuuccckkk. One of my patients is severely depressed. What is happening is fucking awful – there are no ifs, ands or buts about it. They are facing awful, awful choices. People sometimes believe that psychotherapy is just being coddled. Hells to the “no”. My patients today truly are examining their lives and, in doing so, are facing gut-wrenching losses. Recently, many of my patients mentioned the book, The Subtle Art of Not Giving a Fuck, so I read it. Manson basically rebrands the Buddhist concept of detachment in more secular, “bro-like” terms. While vast parts of the book were not eye-opening to me, one part did stick with me. Manson states that when we think about what we want (e.g., “a perfect body”), we think about the benefits but not what we would have to sacrifice (e.g., “hours in the gym”). Perhaps it is the way that I work, but my patients are facing deep losses in attempts to create better, more meaningful lives for themselves.
I leave work exhausted and sad with zero fucks to give. Again, I don’t bicycle home, knowing that I will have to close the last Apple Watch ring some other way. I arrive home, plant myself on the sofa and turn on something I never intended on watching. I know, but I don’t care.
There is a ring to close on my Apple Watch. I really want to earn a “medal” that I never have: closing all three rings for one solid month, and it is 2 August. I would have to sit with my “loss” for 29 fucking days. After 21:00, I begrudgingly hunt down the missing athletic sock that my young dog stole. Everything feels harder.
Outside, the rain is light, normally the type of weather in which I cherished a run – like running through a gentle sprinkler on a hot summer day. I feel nothing. I just want this over with. So, I set a goal of one mile on my watch. I have not run a mile in 21 months; it has been 18 months since my first orthopedic surgery, seven months since my last. Here goes nothing.
I run, and my body feels more balanced. It’s more of a jog, but my right gastrocnemius feels stronger – less atrophied – and I am not having to push off so hard with my left knee. I am grateful for K and F, my Pilates instructors who have had me on the jump board. Progress is slow, but I never, ever thought that I would run again. I think of the tendon in my right ankle and wonder about the donor, how they died, what their family’s pain is like from the loss. I am grateful for them.
The mile is slow-going, but I finish. I feel no pain. No tightness or the historical “fuck you” from my right ankle. I have healed. My left knee and hip remind me that all is not balanced, but everything is okay. Everything is good. I run another one-third of a mile, and my left IT band says, “Easy there, ranchero.” I stop running and walk the remainder of the way home.
I feel nothing. This is anhedonia.