I’m actually enjoying this – the Fix These Important Bugs project. Which is not a blogging project – it’s a fixing my entire life up project – with the blogging as just a way to help guide my thoughts. I’m not sure that’s what I originally envisioned but hey it’s ok.
Why do I suddenly notice I’m enjoying it? Because for the first time I’ve noticed a couple of successes. Pretty much any difficult project is going to involve some initial stumbling around not getting anywhere, and at least I stuck with it long enough to get a little reward.
But I’m still on psychosis watch.
What does this mean? It means over the last few weeks I’ve had a few very slightly out-of-the-ordinary experiences, of the kind which I’ve only otherwise experienced in the run up to my psychotic episode. It doesn’t mean that anything’s going to happen this time – and yes I do have medical help and so on – but it means I need to keep an eye on things.
One of the things I need to keep an eye on is relentlessly chasing after ideas. In the run up to my episode a few years back, the ideas I was chasing were initially CFAR-related, and then it moved onto weirder stuff. But there was a definite burst of frenetic activity in a time when I otherwise seemed to be mostly well.
Again, I don’t think this is happening this time but it’s good to take stock. An upward spiral into genuine productivity and altruistic awesomeness is going to look a lot like a downward spiral into psychosis, from the inside (and to some extent from the outside too, at least initially). So how do I make sure it’s not?
Obviously, contact with reality is key. This is a problem with the EA project as a whole, because you can’t directly go out and experience the effects of your charitable donations. All I really have to go on there is that the people I’m likely to be donating to are the same organizations I’ve grown to trust over several mostly non-psychotic years.
So, yay EA. It’s good to be critical about it, and to read what critical people have to say, but I don’t feel the need to have a full-blown crisis of faith about it right now, and neither do I need to bring the psychosis angle into it. EA seems to mostly make sense when I’m sane.
A more solid point of contact with reality is the medical system. Actually, they’re their own weird version of reality, but they deal with a lot of people with mental health problems and if I can’t at least manage to convince them that I’m sane then I very likely do have problems. So far I am passing that test.
It may not be sensitive enough though. Some kind of intuitive notion of not just “am I basically functioning” but “am I near the top of my game?” would be useful too. Feeling like I’m having lots of great ideas is not it – the great ideas need to be validated by reality as well.
So just recently I had two not great, but ok ideas. One is to notice when I’m noticing things – in particular the kind of things that are supposed to lend themselves fluidly to some kind of action. When one of these noticing events happens, I write it in a small book I’m calling a TAP journal (for Trigger Action Plan, the kind of system that it’s designed to set up). Associating actions with these triggers and then maybe also actually doing them is involved as well. I don’t have the exact system formalized yet, but the recording stage seems a useful first step.
This is pretty much how I would have described something in the run up to my psychotic episode the last time, by the way. I did say from the outside they looked similar. In particular, I would describe a system like this as if it was totally how I was going to live my life now, and then in a few days it would be forgotten. So bear with me.
Suppose in a few days the system is not forgotten?
Logically this would imply a couple of things:
- that I’m less likely to actually be psycho this time, by conservation of expected evidence
- that maybe the system is providing some real value.
Of course, I need to leave room for the fact that the system isn’t providing value after all, and I decide to abandon it for this reason. I think this would feel different from the more psychotic “yeah that was great but this new thing I’ve just thought of is TEN TIMES BETTER”, but maybe they aren’t so easy to distinguish. I at least feel I should give it long enough to give it a fair chance of working.
Generally I’m better at coming up with ideas than with implementing them and getting them to really work for me. During psychosis the lifetime of an idea might be a couple of days. When I’m well – or at least in my usual mental state – the lifetime is more like 4-5 weeks for an idea I actually choose to take seriously. This blog – and by extension the whole Fix These Bugs project – has not yet passed this hurdle.
Other techniques, such as the TAP journal, logically wouldn’t have to in order to count as part of my usual behaviour. But I don’t want my usual behaviour – I want something that actually works better, that involves techniques that really work and that I stick to (or which I tweak or replace with something that clearly delivers the same value but more efficiently).
The other technique I want to give a fair chance to is gradual exposure for scary to-do tasks. This complements a well-known technique I was pretty much doing already, which is to break up a large and vague scary task into smaller bite-sized tasks. The problem is of course that some of the bite-sized pieces – and often the first one – still maintain that scariness. Techniques like Eat That Frog might help here, but I want to stick to my chosen one for now, to avoid technique overload.
Technique overload as I mentioned above may be symptomatic of psychosis onset, for me at least. And it also suffers more mundane failure modes, such as things just not working very well if you’re trying to do too many unfamiliar things at once.
The technique is to take such a small task, imagine that it was made of spiders and that I was scared of spiders, and then think how I could expose myself to those spiders in a way that was gradual and safe.
One of these at the moment is a message left on my cellphone’s answering machine, which I suspect is going to be annoying or cause problems but which I need to listen to anyway. I’m trying to think how I can turn this one into more manageably-sized spiders, but it’s difficult. The answering machine is itself to me something of a weird void, where messages sometimes live but you can delete them by pressing arbitrary numbers and only listen to them once – or maybe not if you press some other number that doesn’t make sense? and can I even remember my password to it and so on and so on.
If there were some way I could transfer the offending message into a space where I have full control, such as my computer here, and in a way that I was sure wasn’t going to end up erasing it instead, then that would solve it. But I don’t think that one’s going to happen. Maybe when I’ve dealt with this particular message I can explore ideas for such a system in case such a thing comes up again in the future though.
See what I mean?
OK apparently I have no messages. That… wasn’t what I was expecting, but it doesn’t negate the general theme of what I was saying either.
The lesson here is that sometimes gradual exposure, in the sense of separating the act of opening the envelope from the act of taking the scary letter out, may not always be possible. In this case I was able to do a somewhat lesser thing, of at least conceptually separating it out into two separate units of scariness (the voice mail system and the actual content of the message), which I think helps. And with the first of these I was able to gain exposure to a map – albeit a somewhat inadequate one – to help guide me through what I was to expect.
In case you’re wondering, no software developers are not any better at dealing with phone menus than the average human being, unless they’re software developers who happen to use the phone a lot. There may be a sense in which I feel I ought to have a gift for using any kind of technology, but coming to terms with not being good at things I feel I should be is part of the point of this project.
I might be able to go into a more theory as to why I think phone menus are badly designed, but my actual experience using them is the same as yours.
Oh hey, I just noticed another scary aversive thing!
It’s this number, supplied by my employer but going to a third party, that I’m supposed to call if there’s something bothering me about life. It’s the Work Life Employee Assistance Program, and the idea is you phone them up with a problem – like hey I’ve been overworking and might be seeing a resurgence of a psychotic episode that I totally have a history of – and they give you the number of whoever it is you should really be talking to.
This sounds like quite a good idea, and their glossy pdf is proud to boast “Employees report saving as much as 40 hours of time researching specific issues” which given those would be hours spent doing stuff I hate, seems well worth making an extra phone call.
So why have I been putting this off for weeks?
In some sense it’s a repeat of the last story, in that it combines the phone – a medium I basically don’t like – with talking about something that society has basically decided should be really uncomfortable to talk about. They don’t seem to have an email address as an alternative way in, but they do have a website I could browse to find out more of what they’re about.
I haven’t done this yet either. Given the gradual exposure concept I’m developing here, I should do that and not maybe worry quite so much at this point why I haven’t been doing it so far.
Generally with these comfort zone expansion things I dive right in and do the thing and then write it up here afterwards. (Or perhaps I should generalise that from “comfort zone expansion” to “things that involve doing scary things”, since long-term aversion erosion is not my intention here, but rather tactical obliteration of specific aversive tasks).
This time I’m not diving in yet firstly because reading a website, especially one that’s presumably trying to be nice, isn’t that scary. I won’t start lose that burst of courage gained after deciding “yes I’m going to do that thing”.
And more to the point I want to be clearer about what my goal here is. I can browse around a website, and ok I’ll have looked at it, but did it really help clarify anything? No.
So my goals are basically:
- Do they do psychos? (already answered, in the affirmative, by the brochure)
- Do they do people who probably are not psycho this time but still want some kind of counselling or therapy anyway, because it’s not like they have a ton of actual friends willing to listen to all their crap for long enough to process it all and produce some useful support or advice?
- Do they do overworking (again almost certainly yes), in the specific case that I’m not actually sure why I’m overworking?
- Some idea if I phone this number up what are they going to ask me, so I can have some information prepared ahead of time.
OK let’s go. I don’t expect firm answers to any of these, but maybe I’ll get a clearer idea.
Point number 1 is already answered. Points number 2 and 3, on reflection, are basically just particular manifestations of “stress” which they definitely sound like they’re set up to handle.
Point number 4 was not answered, and I’m a little disappointed in that. Realising that you have a problem that requires professional help and then actually going and getting it can be a difficult step, and I might be pretty nervous right now making that call if I hadn’t been through the system once already. Knowing what I’m going to be asked and what information they want from the first phone call would be handy, to me and maybe to other people too. Perhaps, if they seem like they actually care, I can give them this as feedback afterwards?
Anyway, the primary reason my mind is presenting as to why I’m not making the call is, while they claim to be a 24/7 number, I don’t want to bother them too far outside usual work hours. I don’t know why this is such a blocker, but it has been because making the call inside work is hard as well, as it’s hard to find a private area and I get absorbed in whatever I’m doing. Maybe I’ll see if I can phone them tomorrow morning?
The second lesson here, is that I don’t need to understand all the why’s when it comes to fear and aversion. Merely recognizing that something is scary, and that it can be approached in smaller steps, helps (usually just 2 steps but maybe this time it’s 3 with website -> finding a convenient time -> making the call).
But I’m thrilled I seem to be making some progress. This gradual exposure thing seems like it’s tackling a deeper and more important problem than the TAP diary – though I want to continue with both. I really have been putting these things off for far too long, and I’ve been hating myself for it too. I know that if I just dive in and try and do all the things in one wild panic they will actually get done, but it just sets me up for continued aversion the next time around. Maybe this approach offers another way through?