I should probably make my career decisions with the question "what do I want to do next?" as opposed to "what would open an unlimited number of doors?"

I'm loving my clinical internship. No surprises there. At the same time, i'm loving research. I would also really like to develop a career in policy.

I don't want to die without a PhD. I also don't want to die without a policy position.

I have a client with deep-seated anger because of the war zone she had been a part of. Bullets crossed her path and bombs blasted on her street.

I can't wait to introduce Narrative therapy to her and see how it works for her.

I think I should journal about her experience. That's the only way to gain more insight into her experience.



It's hard not to have heart-felt affection for your clients.

It's something when your colleagues experiences are way worse than your clients.

I can't fall asleep thinking about what my internship advisor shared with me about her life. I wouldn't know how to live if that's what I had to go through, in addition to regular life stuff.

Then a classmate shared with me a horrific childhood incident - moreso an episode. Yesterday, another one of our very senior advisors shared an extremely difficult news.

I'm concerned about what my advisor said today. I wish I had gotten up and hugged that woman. She's on my mind more than my clients.

My perfectionism is acting up again. Now it has to do with our furniture.

Both W and I are extremely particular about what we like. So far we have customized most of our furniture. We haven't bought a single "set", except for the nightstands that came with the bed.

However, as much as I love the idea of the freedom to customize exactly to my tastes, practically, it's a decision making hell!

While trying to figure out the kinds of cushions I want on our couch, I found myself on fabricland's website. There I was, thinking about sewing our own cushions. I have already toyed with the idea of making our own coffee table.

But who has the time, or the skill? Neither one of us. But the idea of having things exactly how you want them, and starting a new project that no one these days engages with, and literally making a place your home is C-O-O-L!

I am either a bored, suburban wife or a "cool", city-dwelling hipster.

Let's not forget, I have work, classes and a steeep learning-curve of a placement.
Oh, and a new marriage.

I just realized that I am way more comfortable with the term "calculated risk" than I am with "go with your gut".

I am coming across many borderline personality disorder folks. Part of the diagnostic criteria of BPD is chronic suicidality. They feel compelled to threaten suicide to get the attention, care and support they are needing. As there is often very little family and relationship support available to them, they rely heavily on their therapist and other care providers.

With the knowledge of client's diagnosis missing, I found myself with - what appeared to be - severe suicidality. I could not get clear answers from them that would help me determine how severe their suicidal intent was. They knew if they gave me answers that spell out severe risk, we would have to get them to go to the hospital. Because these clients visit the centre with suicide risk 2-3 times a week, everyone has learned to manage the risk. These clients had no previous history of an attempt which would put them at a higher risk. Again, with lack of information and only hearing the presence of suicidal thoughts, I stayed engaged with them to get to a resolution for way longer than I should, or they became antagonistic towards me. By the end of the sessions, I felt like a failure because I was not able to reach a resolution. One of the clients kept me up for much of the night. I kept worrying about what I had done and should have done.

I felt better when I got to debrief the next day. I learned of her diagnosis and how other people have had a difficult time working with her too.

I have been told that in a crisis situation, I should go with my gut about what needs to be done; if police must be involved. I have found that rather confusing. I realize I need to stay calm on a much deeper level to hear my "gut" speak - which is hard to do when you have an emotional, agitated, suicidal client.

While reading up on some publications on BPD and suicidality, I came across a suggestion for therapists to not be afraid of client's suicidality and take a "calculated risk" to determine the next steps. And that term instantly put me at ease.

I can do calculated risks. My evidence- based rationality-based education makes it impossible to justify "gut" for clinical decisions (and for everything else, really).

I think it means something when you realize you are excited it's the weekend, solely because you get to spend it with your husband.

#socheesy #buttrue

Post-wedding blues.

I don't know if there is such a thing. But I am feeling it.

The biggest event of my life is done. I am thinking about all the little mistakes that were made. The fact that I wasn't smiling when we exchanged rings, or when I walked down the aisle, I don't know if I had a smile on my face. I shouldn't have picked my wedding jewellery literally the  night before. I should have tried the dress on with the jewellery to make sure that is what I wanted to look like. I should have thought twice about getting my hair done the way it was. No one would say that I did not look good, and I do think I looked good, but I could have prepared more, instead of winging many details.

I bought the cake topper and forgot all about it. It did not make it to the cake until the cake reached the venue - and then the topper broke.

Our DJ pissed me off with his attitude and lack of effort. I did not have our entrance songs figured out. I literally chose my entrance, one I had liked many months ago, when I was getting ready on the day of the wedding. Our valima song was chosen while we were waiting at the venue, and we just went with DJ's recommendation - a song I did like. I am finding new music that I wish I had before the wedding. I would have loved to play it at the wedding.

Like this for example:

Laung Gawacha, a folk song, and it's Coke Studio rendition.

I know I was tired out of my mind before the wedding. I did not care about all those details. But I wish I had the time and the energy. Now, with  more people getting married soon after me, who have/would have the time to make their wedding way better I would feel jealous. Happy for them, but also jealous. I know I really, really shouldn't. 

Depression

In the Cognitive Behavior Therapy circle, we believe that all an individual needs to do to overcome depression is change their thought patterns. Figure out their ABCs; affect, behaviour and cognition. A and B are easier to figure out, which then help with C.

What we often forget is that often there is a natural progression from a sense of despair and hopelessness, to problem solving after accepting the truth. The length of the process differs for every individual.

We need space to express those thoughts. We need to be able to talk about the depression, and the depression-causing thoughts. Once the individual feels they have formed a good, supportive relationship, we can slowly move on to awareness and evidence finding.

Of course, all of this is only possible when the individual is motivated enough to make a change.

Now that the option of having kids is available to me, I'm reconsidering my desire for them :s.

It's not like I don't want them objectively speaking, but when that idea meets the reality of living, I'm not so sure. I'm not so sure it is that easy to bring up kids.

Kids are work. And they are expensive. And a lot of work. All those ideals about raising your kids well go out the window when you have little time and little energy.

I don't think I would actually want to go through my entire life without kids, but im not so warm to the idea right now. Also, thankfully, I have some time.

I thought Fundamentals of Caring would be a boring, cheesy movie.

By the end of it, as possibly intended, this is what I was left with:

Life is really fucking short. Years go by, a child grows to adulthood, and you grow out your prime years in no time. You have lived the productive years of your life. Nothing lets you recognize time going by like a child growing up.

Like life, marriage too is impermanent. Who has not known that. I got married with complete knowledge of the statistics. But now it hits me on another level.

We know if a couple loses their child, the chances of divorce increase exponentially. That is one of the background plots in the movie. Being newly married, it struck home. Life is short, anything can go wrong. Having a child is a huge gamble that can open you up to lifelong suffering that you (most-likely) endearingly embrace. And divorce as expensive as it may be, is not unimaginable.


Solution? Create happiness, success and love. You cannot sustain happiness, success and love without putting in the work.

I have so much adrenaline this week, I have not been able to sleep properly.

4am, first night at our place. I'm just busy setting up and organizing. W is surprized as to where this side is coming from. I know this is me when I really care about something.

As soon as the adrenaline dissipates, I will crash. I am so glad we decided to take some time to unwind post-wedding.

Valima tomorrow - today - I really should sleep.

Wedding day!

I marry an amazing person today :D. That's it. The search comes to an end :). I did not think I could have everything that I wanted in a relationship and thissssss much love allllll together.

Next chapter begins...

Wedding is in 3 days.

I'm tired out of my mind. Time off starts tomorrow. I'm completely wedding'd out. I don't want to think about any decisions and logistics. I am DONE. I just want to enjoy the wedding day

I had a lottt of fun at mehendi and I'm hoping shadi would be much the same.

I think I'm learning another constant of life.

People are annoying.

Or I am burning out. What compassion, what empathy. I just want them to not piss me off.

I really need to take time off from almost every aspect of life right now. 10 days. Ten days and I can just relax with W. He's the only person not pissing me off right now.

I have an emotional block when it comes to expressing my expertise and ability. It is difficult for me to offer help to people related to my skillset because I fear I would send the message that they are less than competent.

But I am noticing that people are quite warm to offers of help. I feel good when they accept it. I need to offer it more.

This hasn't been an issue with clients. But it can become one as I learn more, feel like a newbie and deal with imposter syndrome.

Dear Life,

Can you be a little easy? I know I have the habit of taking on too much, but what else am I to do? Things need to happen.

I will have long commutes and very little time in September. I'm going to do about 750km every single week. I'm going to dieeee.

Make the world a little bit supportive of my ambitions please.

😥

Last assignment of the semester and I cannot get it done!

I need a god damn break from everything. Can I just spend the weekend in bed with pizza and netflix? :(

No, I can't. There are things happening that I am looking forward to, but will require getting out of bed and looking good. GAH

I think I'm a jealous person or something. I've been noticing it more and more lately. I'm also feeling like I'm stuck in a system that just doesn't work for me and how I want to live my life. Im jealous because I don't have the things I don't really want. Others having them makes me want things. Whats up with me!

It is also a bit saddening because if I start to want things I never thought I'd care for, who would I be then?

As much as I hate my life on Thursdays and Fridays, on Mondays I realize how well I have been using my time - generally speaking.

More you have on your plate, more you get done... (before law of diminishing returns kicks in).

I am submitting 90% worth of assignments this week, where I would have acted the exact same way if I only had one 15% assignment due - i.e. no social life, no plans to do life-maintenance tasks.

I do wish I had finished more of my Wednesday assignment, and not wasted so much time yesterday. But I am still safe. I just would have been more impressed with myself had I gotten more done. ( :( )

 I think its time to learn to realistically allocate time to my assignments.

One of the most nerve-wracking experiences; videotaping and watching yourself conduct a counselling session. My perfectionism is deeply stirred.

I should not be complaining. I have everything going for me right now.

But I am tired out of my mind. I'm tired of not having time. I'm tired of running from one thing to another, and having every hour of my day occupied. I don't see it ending. Even though it is everything that I want.

I should probably be very happy. And I am, when I'm not so tired. End of every week is just exponentially harder.

I should be asleep, except I'm lying awake trying to determine how exactly I would combine my clinical interests with policy work and research in this program. I want to go ahead with a PhD after, and then another masters in another field of interest. Too many desires, too little time.

One.

Heels. As a woman of 5'4, if you want to be taken seriously, wear heels. I've gone from 2.5 inches to 3 inches and it makes a difference. You walk with your chin up and share the height space with most others.

You also  can't dress like a bum  in heels, so you have do dress up a little bit. Being dressed up professionally gets you taken seriously.

Two.

For someone who will probably never being extremely hard on self, it's quite a realization to know that ones perception of self, and how you carry yourself, speaks way more than ones accomplishments. Accomplishments are only important in that narrow time range when they are being tested. For the rest of the time, you must be seen as deserving of success to be successful.

I have my practicum "interview" coming up. And I just spoke with my supervisor to be. I liked her. I'm uncomfortably excited and nervous for this opportunity. I'll be doing real treatment therapy in a few months time.

She asked me if I know my Myers-Briggs. Even though that isn't really scientific, I know I will like her and have a good experience.

Ok. Deep breaths.

Yaar ko hum ne ja-baja dekha

Can't make up my mind about Abida Parveen (because of the costs). This may be once in a lifetime opportunity.

A lot of peace of mind comes from just telling the truth. Difficult, hard, vulnerable truths. No one can fight reality. Acceptance of reality fights the shame that might come with it.

I'm SO done with any social justice issues and "providing" support.

I know I need a short vacation soon. I have too much going on. I just want to sleep.

Fatigue approaches.

I didn't realize how strong of a value 'service to humanity' is to me.

While deconstructing an ethical issue, I have had to journal several times to deal with my frustration. The dilemma also makes me fearful for my long-term prospects. This situation had to do with a client with passive thoughts of suicide. I have been concerned for the level of suffering that a passively suicidal client deals with.

One drawback of dealing with suicidal clients frequently is that you develop an insensitivity to lower risks of suicide.

Along with all this, my thoughts are also laced with a fear of my lack of clinical knowledge and best practices. Am I being too idealistic about support? Do I just plain lack knowledge? Do I not have knowledge of decision making models?

Ultimately, I feel very strongly about making sure my client gets the support.

I love her.

https://www.facebook.com/theworkofthepeople/videos/10153967066765682/

"I just assumed that people were sucking on purpose just to make me mad"

It takes me a back to a power and leadership conversation I was having with classmates. I am deeply uncomfortable with telling people what to do. I am comfortable with determining a course of action and getting consensus to act on it. I am comfortable (as inherently uncomfortable that conversation is) to talk to people about life getting in the way of responsibilities. I have to respect autonomy of other people, and I can't tell them what to do - unless it's just a task and there's enough consensus reached for me to be able to express that.

A. Q. (therapist in making) said "that's because of your values."

I didn't see it as my values. I thought, and even considered that same day, that it was my weakness.


Every time I have been deeply offended  by someone, I assume they act in xyz ways because they choose not to be better, or worse, they have poor intentions towards me.


Boundaries. My (therapist) prof commented on my response to an ethical dilemma with "that's because you have boundaries."

Do I have good boundaries though?

"BIG: what Boundaries need to be in place for me to be in my Integrity and make the most Generous assumptions about you?"

I like how a lot of the research in the field is insightful because of its qualitative nature. It studies people and experiences as opposed to numbers.

It feels like I'm being crushed by the weight of deadlines and worries.

In reality, I have the flu and two assignments due that I do not have the cognitive ability to work on. It's probably being made worse because I'm worrying so much about it. Theres also how many sick days I've taken from work, and may need a couple more.

My doctor suggested I stay home for a week. But I couldn't do that. Theres guilt around not pulling my weight in both those areas of my life.

I don't quite know how to help the worry and get shit done.

I want to take my heart and wrap it up in "malmal ka kapra"

Not my strongest day today.

Things that make me feel like I am in love:

1) Poetry
2) Music/ghazals
3) Nature (water bodies, really)

I don't like the feeling of being in love with a person. I can love. It will take a lot of safety to allow myself to feel "in-love" with a person (maybe a signed contract intended to be for life). I can still think about a person first thing in the morning, and fall asleep thinking about them.

First Sunday to myself in weeks. Plan was to do school work. I am procrastinating by completing a Trauma-Focused Cognitive Behaviour Therapy module.

The nuance required to work with children dealing with sexual traumas is impressive.

I didn't realize working with children would be tougher.

I think I want to specialize in children dealing with sexual traumas.

I am growing more interested in childrens mental health. That is way more specialized. Grief and bereavement with children is another area.

Just some thoughts.