Tuesday, December 27, 2016

A Merry Disruption of Schedule

We traveled to Brother's house - which is no longer the same house Mom and Dad had - for Christmas. Mom woke me early on Sunday, calling upstairs, leaving me to emit a groaning sigh and rearranging my pile of pillows so I could emerge from my nest.

We prayed as we drove south, asking for peace and joy despite the Ones' moods.  Mom is getting better but remains wounded over her lack of contact with the girls.  Their mother is hateful - not in all areas, but with regard to my family - and we have only to accept that, to love despite it (not her - the Ones - we'll work on our feelings toward her as I doubt God endorses the gleeful hate that enters my heart when she crosses my mind).

We arrived safe and sound, my smile easy and genuine as Smallest raced from the house to cuddle her grandma as soon as the driver's door opened.

"I had the cat on my lap!" Little explained her her rush to the car, trailing her younger sister with a giggle.  Brother soon emerged and we formed a present-carrying train into the house, smiling over the giant teddy bears dressed in onesies and the felt Santa bags we've used since the girls were born and bags Mom found on clearance that we literally splitting at the seams.

We opened gifts.  Made crafts.  Cooked lunch.  Watched movies (Loved Finding Dory - though I cried and cried over the paths of shells; Stork was fine.  Secret Life of Pets was not my favorite.). Played games.  It was pretty lovely.

Smallest and I shared Brother's bed with her giant brown bear.  The white bear, Mom and Little slept in his only guest room while he took the couch with his faithful orange cat.  We shopped yesterday - wandering the mall and catching Pokemon (!!) and buying more things we don't need.  Lunch was followed by a re-loading of Mom's car to take the girls home and return north ourselves.

Chienne had opened her presents before we left - she wagged her tail and slowly nudged paper away from new squeakies.  A wonderful neighbor checked in on her while we were away.  Sprout batted at his new catnip banana and hid from said neighbor.  Trust No One.

Today I return to work and the gym.  I'm excited about neither but resolved to do both.  But the alteration of my schedule was very worthwhile this time.

Monday, December 19, 2016

Great!

I returned to work today, bag overflowing with coping tools (both literally and figuratively).

"Great!" I'd reply with a grin when asked how I was.  I accepted the hugs - lingering for a second longer than I normally would out of a place of pure-and-present love and gratitude for the people with whom I work.

"It was good - really good," I answered questions about my treatment.  "I am on a new medication - Zoloft - the seems to be working well.  But I feel more centered and accepting of myself.  Appreciative of myself in this moment.

"One of the lessons that struck me was that depression is for the past - sadness, regret, longing, pain - and anxiety is of the future - uncertainty, fear, stress and dread.  But we are in the present - in this moment - the one right now - and I'm OK.  I'm actually great.  I'm enjoying talking to you.  The way the sun dances sparkles off the snow.  The sounds of voices on the phone uttering impressive words.  The  pattern of the watercolor yarn as I crochet to keep myself present and focused on the teleconference.  The scent of my Twisted Peppermint lotion or the Fresh Laundry perfume I spritzed this morning.  Right now, we're all OK."

I talked about past-present-future a lot, offering that bit of wisdom rather than asking if someone wanted to pray with me.  Crochet.  Sit down, close our eyes and fully experience a Wintergreen LifeSaver.

Instead, I fully engaged in each meeting.  I made brief entries into my To Do Excel sheet (another coping strategy) and felt centered and strong.

"How perfect!" I called out, smiling widely as I strode down the hallway of the hospital - a hallway I'd walked at least twice daily for the past two weeks.  I'd returned today on lunch hour, hoping to speak to one of my fellow patients and finding her directly in my path as I moved toward the Partial Hospitalization Unit, only about halfway through my planned journey.  "I was coming to find you!"

I approached the woman - my friend - and blinked back tears as I thought of what she wrote in my good-bye journal.
You are a powerful woman of God.  And while I know you came here to receive help, I feel you were sent on a mission to help us.  To brighten rooms even before you entered them.  To listen, love and pray.
I cried over her words Friday night. I pondered them more on Saturday - after the gym and during my 90 minute massage.  I let my thoughts drift and invited God to speak.  I often don't hear Him in those times, mind eager to cling to distractions.  But that day, I waited.  And I heard.

So today, I tucked cash between the pages of my favorite devotional.  Wrote inside the cover of how much God loved her - how strongly I felt that - and how much He wanted her to be healthy and what great plans He had for her.

So I set the book gently on the meal tray she carried, patted the cover of the much-loved book I've used for years and met her eyes as we prayed, wept and embraced.  The peace I feel when doing God's work - set out for me - is profound.

And - for today - for right now - I feel worthy of His love and trust.  I feel capable of pouring out love and light.  Of doing work and being engaged with this world.

Oh, and I revised my affirmation a bit.  I am loved and worthy.  Now. Then. When.

Present.  Past.  Future in the positive sense.  I feel as though I'm walking with God - happily, fully myself and feeling great.

Wednesday, December 14, 2016

Day (Program) of Progress

I had my family meeting today in the partial hospitalization program.  Mom drove.  I had her valet the car.  And we walked side-by-side down the hallways to the elevator that descends to the program. I find this poetic somehow - I dig into my personal depths in that space and then reascend to real life.

Anyway.

Mom and I talk every day about what I think and what I've learned so there was little new there, except an overall review of what Ive done and how I plan to go forward.  And while it's been on my goals list (we make 3 goals per day according to our diagnoses - my categories are (1) depression, (2) anxiety and (3) relapse prevention) to journal, I've been distracted.  Monday I joined match.com.  Yesterday I took a bath, tried a mindfullness meditation and went to sleep.

[Side Note:  I'm having miserable pain in my right calf.  I've tried exercising through it.  I've tried different exercises.  I've tried resting.  I had a 60 minute massage focused exclusively on the backs of my legs.  I stretch.  I bought a massage stick thingie and tried rolling and just pushing the end of it into the muscle.  What the hell should I be doing to make this go away?!]

Where were we?  I had to go back and read what I'd written last week - you know most of the story so we can pick up on progress this week!  Cool.

I mentioned I'd visited a friend - and her baby - and ended up fleeing (hopefully gracefully?) when I got stressed.  I mentioned it at group - more in a 'how do I deal with this stuff at work - when someone unintentionally stresses me - and escape is not the healthy option" but then other stuff came out.

"I guess," I replied when someone asked what we'd been discussing when I got upset, "we were talking about dating.  She said she'd check with her husband to see if he knew anyone awesome enough for me."

"Oh, no," I had immediately replied, curled up on her couch and taking a sip of my water in the room decorated for Christmas and bathed in sunshine.

"OK," she offered, but cocked her head at me with supportive curiosity.  "Are you going to look online?"

"No," I smiled, appreciating the curiosity and action plans of those happily married.  "I'm not ready."

"OK," she repeated, smile slipping a bit.  "But you said you wanted someone."

"Oh, I do," I confirmed.  "But not yet.  I have to lose weight - get in better shape.  Figure out my mental health and make sure I'm fully recovered.  Be more spiritually connected.  Maybe volunteer somewhere."  I trailed off, feeling my face tug into frowning concern when she started to cry.  "What's happening?" I asked after a moment of wondering I missed while I was talking.

"You're wonderful!" She cried and I blinked at her again.  "You're beautiful now.  Smart and kind and so funny.  Now.  You love God today.  You help people all the time.  You don't need to be better to have someone love you!  It makes me so sad that you think that."

I might have rolled my eyes.  I know I thanked her, patting her hand in friendship.  And she dried her tears and we continued out conversation.  Before I reached my limit and left.

"Wow," my case manager said after I finished my story.  "So what do you take from that?"

"I thought it was weird?" I offered hesitantly, feeling uncomfortable and knowing we were uncovering something I liked being hidden.  "That her reaction was too strong when I was stating facts?"

"Are you worthy of love?" She asked and I cursed silently as I blinked back tears.

"Not really," I replied softly.  Honestly.  "I can be - I hope I will be if I try hard enough - but not yet."

"That's not true - can you recognize that as a distorted thinking?" And then the group - a wonderful group of wounded and wise people - confirmed that I was worthy - beautiful and charming and fun.  They had advice - men are never perfect, maybe I'd have to leave my comfort zone to meet someone - but I've since decided on a mantra.

I am worthy and loved.  Now.  Then.  And - romantically, sexually, wonderfully - in God's time.

Sunday, December 11, 2016

PHP Perspective

I've never considered suicide or acute self-harm.  I tell you this the same way I would tell you my pupils are larger than normal - I can see pretty well in the dark and bright light often hurts my eyes.  Neither bring me any particular pride or shame - they're just the way I happen to be formed.

Personal safety - or something like it - is marked on my treatment plan (which is in my car and it's cold in the garage or I'd quote it exactly) but it says something about understanding how to not hurt myself in the future.

"I don't," I objected when I watched the intake therapist make rapid slashes across those boxes, looking up at her with my sternest frown.

"Think of your long-term health," she insisted.  "Excessive sleep and lack of activity can cause cardiovascular issues.  Diabetes.  You aren't doing your health any favors."  I shrugged, not really having a valid argument and deciding it wasn't worth the debate.

But I read this Buzzfeed article with a sense of sickness and sadness and rage.  It was my goal to journal through my experience to not only express this for me, but also to provide a data point for anyone struggling with mental health and considering more intensive treatment.  My path took me through a great primary care doctor and then to this partial hospitalization program.  And it's useful so far - I feel like I'm doing the work and making some progress.

I'd encourage people - even (especially?) those younger than my 37 years - to consider this treatment approach.  To know thyself better, gather some strategies to better cope with all the crap involved with being an adult.  To recognize joy and actively search for it.

But.

I have been asked - many, many times by many, many people - if I have thoughts of hurting myself or anyone else.

And I can honestly (and repeatedly) answer that I do not.  And I think - maybe - that could be part of what's kept this experience so empowering and healthy for me.

I listen to many people in the program stumble over the 'suicidal ideation' pronunciation and think 'those aren't your words' and I have a habit of questioning the truth of something when a person makes an odd word choice.  It would feel more authentic to me if a person said "I tried to kill myself" or "I cut my arm when I'm feeling overwhelmed."  But robotically reporting, "I'm here because of suicide... suicidal ideation..." I feel a frown want to replace my default supportive expression.

"Hey," I poked my head in the door of the therapists' office one day, about an hour before the program was due to end, "I'm going to head out - my head hurts and we're going to play a game and it's just not for me."

The therapist laughed, nodded and made a note on a post-it.  "No problem," she confirmed.  "Just sign out on the sheet, OK?  Oh, Katie," she said, and I'd turned to face her again, "are you safe?"

Not really knowing what she meant - did I feel comfortable in the program? Was I going to relapse into bad behavior and nap my brains out when I left? - I simply nodded, smiled and departed.

I don't know what would have happened if I'd said I wasn't - that I felt fragile and had thoughts I couldn't control.  People have told stories about arriving "upstairs" where the inpatient unit is after a family member made a concerned call to police.  Or after saying something threatening at work.

Most of me is so glad they're getting help - that I get to see them joke and laugh in a program they're free to leave at any time.  But that helplessness of being somewhere they didn't like, unable to leave, strikes a scary chord with me.

But I wanted to be clear that I don't approach this experience with that particularly burden.  I don't have advice on how to authentically engage in treatment - to be open and honest - with a possible threat of losing autonomy.  I don't like to think my therapists or nurses or psychiatrists are capable of taking advantage of someone at their most vulnerable.  But I don't know - and I literally ache with regret if someone is searching for answers and faces those fears.

I will say this - there is help.  Even if you're afraid.  Even if you've had a terrible experience in the past.  You are worthy of healing and love, joy and peace. Find someone you trust and - perhaps more importantly - trust yourself.  Those of us who struggle with depression or anxiety or suicidal ideation are capable of enduring miserable challenges and great pain.  So we can totally figure this out.

And if there's anything I can do, please reach out.

Saturday, December 10, 2016

Is

Depression, one of the therapists says, exists when one dwells in the past - in sadness that has been.  Anxiety is of the future - when we are uncertain and afraid and unprepared.  So the real power is in the present - in experiencing the given moment, noting its worth and giving it due attention.

My homework is therefore mindfullness.  The click of keys on my newly-purchased keyboard that allows me to post from my friendly iPad rather than using my work computer.  The scent of chlorine that lingers on my skin from when Mom and I went to the pool.

"Push the water, push the water," I murmured quietly as I alternated between swimming (in an utterly graceful display I call "wounded dolphin") and jogging down the swim lane and doing different (yet still very elegant) movements to work out my arms.

"Look at the shade of blue in the water and the pretty reflections of those colorful flags overhead," I told myself, silently this time.  "Is that a hair floating there?  Gross."

"OK - what do I smell?  I like the chlorine.  See how the water feels soft against my skin?  The warm jets emerge into the colder pool?  The resistance when I turn at the end and try to go to the other direction?  That's neat.

"That lady swimming - more a healthy-dolphin style - splashes me when she goes by but the water doesn't hurt my eyes...  Hmmm.  That's all I got."

Mindfullness is hard for me.  I get bored.  Seems like I could play pretend or make a to-do list or agonize over some decision that's impossible to make.  But working out does recenter me - even if it's a painful reminder to really inhabit my body, there's the stretch of muscles, the warming of flesh - rather than looking at it as a foreign vessel that dutifully carries around my brain.

Today I met a baby - a friend gave birth months ago and I was sick and babies kind of freak me out so I procrasinated on saying hello.  When she learned I was out and in PHP, she sent a concerned email and I happily bought a gift and headed to her house to visit today.

I found, with this friend, I was pulled from the moment and my thoughts gripped that like a treasure. I know how to analyze past patterns, attempt to manipulate future meetings.  And so I checked my phone for the time and left feeling a bit shaky.  The personalities and politics at work offer a fascination for me - the challenge and intrigue.  But they shake the calm I'm trying to create - the stability and steadiness that I can remember when I feel myself start to disconnect again.

So I turned on NPR and learned about compassion and empathy.  Grabbed a hamburger and really tasted it as I made the trip through the back roads to my house.  Breathed and relaxed my muscles.  Wondered if my keyboard would come (it did) and if a paint-by-number kit would arrive.

I smiled when I noted that coloring - what many folks use to relax and be mindful - is not for me.  It was gently recommended - after art therapy one afternoon that turned out even worse than I feared - that perhaps a more guided approach would suit me.  So I'll open my other box and trace my fingers of the canvas.  See if I'm up for making some highly-guided art.

In the meantime, I wish us all peace in the present moment.

Thursday, December 08, 2016

PHP - Acceptance of Pain

On day 1, I tried to be fully present.  To not expect too much of myself other than to engage, be attentive to the others in the program and to understand this new place and routine.

Day 2 brought some frustration.  "I'm not engaging fully," I admitted in group therapy.  "I know I'm unwell and I want to get better but I feel like I'm not ready to expose my pain.  I'm not even sure I know what it is."

I asked to meet the chaplain on day 3.  For the Holy Spirit inside me knows what breaks through to the Katie-core I so desperately protect.  And it's those who know God - who engage with grace and mercy, faith and light.  I was both eager for and dreading the chaplain's arrival though.  My head ached.  I was tired.  I just wanted to sleep.  So I left an hour early, proud I'd attended at all when I could have let them know I wasn't feeling well and a bit gleeful that I'd escaped without really achieving my goals.

I was given a large envelope this morning and I nodded at the post-it upon it.  The chaplain had visited yesterday after my departure and would return this morning to meet me.  There were four booklets inside the envelope - their glossy pages offering soothing pictures and hopeful text encouraging prayer and perseverance.

He arrived around 10AM on Day 4, removing me from one of our sessions about community support and we sat in a small room I'd not noticed before.

"I prayed on my drive in," I confessed, "and I thought I had a different topic for you.  That it was my impatience - my tendency to be either all-in or completely-out of any given situation.  But..." I pressed my lips together, shook my head and accepted I was going to cry.  I'd known this person - whomever God had sent - would crack my wall of self-preservation but there was still a sharp pang when it happened.

"I think I'm angry.  No, disappointed.  I don't know - something..." I stopped again, pulled a Kleenex from my pocket to dab at tears while I gathered the right words.

"I'm so blessed," I started again and he nodded kindly.  "I have a great job.  More money than I need.  Colleagues who like and respect me.  My mom lives with me and she's amazing.  I have friends I don't deserve - I don't put enough energy into keeping in touch.  And I know God."

"And where is your pain?" he asked when I fell silent again.

"I've always thought - well, I used to think - that I'd find someone to love.  Romantically.  To know and be known intimately and meaningfully.  To share all of myself with someone.  And I've failed every time.  God hasn't given that to me and I'm so sad about it sometimes."

He quoted Genesis and the Psalms.  He advised that God knows my pain already - that it's my task to expose it (to myself and others in therapy), to walk with it, understand it and begin to heal it.  He reminded me that God loves me - knows me intimately and meaningfully - and that when I find my person (I was polite enough not to roll my eyes at "when") - I would meet him as my whole-hearted self.  Someone who knew pain and joy, hope and disappointment.  And who valued being the version of myself that God wanted - spiritually, mentally and physically.

I went to the bathroom and cried alone after we prayed.  I mopped myself up and then shared at group therapy - did some more crying there.  Asked if it were possible that my professional unreliability could be related to my oft-ignored romantic-failures and that the sadness over the latter became overwhelming yet unhonored, causing me to escape into sleep, hiding where no one can find me.

After group, our therapist played The Power of Vulnerability for those interested while we had lunch. I watched and took notes, retreated into knowledge rather than my messy emotions.  I asked about mindfulness and how to do it when I'm so painfully bad at it.  After the program, I went to the gym and worked out with my trainer, trying to focus on my breath as it sped up.  My muscles as they warmed and worked.

It feels significant - the progress today.  And uncomfortable and tenuous.  So I'm trying to sit with it.  Allow it to be.

"Keep a journal," the chaplain advised and I thought of my little place on the internet.  "Focus on the is-ness.  Not what was.  Not what might be or what you want to be.  But what is.  Describe it.  Honor it.  Revise it so it's authentic.  Then share it."

PHP - What to Expect

I had So Many Questions on partial hospitalization programs for mental health issues.  While I did find some useful information online - example schedules, brief descriptions of different programs - I didn't find a resource to address all my questions.

I'm going to guess that programs vary in many ways.  My program is at a local, suburban hospital, so I'm happy to disclose my experience with the knowledge that it's not going to reflect everyone's experience.  But I really wanted to read a blog as I was stressing out about my first day and I couldn't find one!

My Questions (and Answers)
1. What do I wear? The intake specialist told me to be comfortable and wear layers.  She was right - the women tend to wear sweats or thinner sleepy-pants (as I like to call them) or work-out gear.  Men also wear sweats but tend toward jeans a bit more than us ladies.  Ponytails are common.  Make-up is not.

2.  May I keep stuff with me?  Yes!  I packed my bag - my favorite one that I bought myself with a bonus - with all sorts of items.  I carry it with me all day and it sits under my feet during sessions.  Nobody has asked what's in it or if I really need it.

3.  Wait - what's in the bag?  Lip gloss and moisturizer - I don't like my face to get dry.  Tylenol for headaches and Benedryl for allergies - I think those are technically supposed to be with the nurse but nobody's enforced that.  A tennis ball that I use when traveling if my muscles knot up - I'm not sure why I take it to program.  My wallet, keys, make-up wipes, extra Kleenex, my reusable water bottle I use at the gym. A snack.  And my phone.

4. How often are phones permitted?  There's a request/rule that phones are off during sessions and it's generally followed - out of respect for each other more than respect for the rule, I think.  But there are very frequent breaks where I check email, text Mom and Friend, chase Pokemon, etc.

I think my biggest worry was how respectful they'd be - if we'd be allowed to make our own decisions, have our own items around - and it's even better than I'd hoped.

5. Food?  Hospital lunches are my least favorite part.  Both the menus that we complete a day in advance and the actual trays that are delivered make it obvious that we're in an actual hospital.  Receiving actual, serious treatment.

Otherwise, the common room has coffee and tea.  We're welcome to bring our own drinks, though alcohol is not allowed given the addictions of some, obviously.  There are a few snacks - little jello cups, crackers and peanut butter.  I've been bringing a little pack with cashews, dried fruit and little cheese cubes.  I could have it anytime but had it yesterday during break.  Today I skipped it.

6. Are we locked in?  Not at all.  I sign in an out each day at the reception desk in the unit.  I've not left our space personally but people can - and do - walk upstairs to go outside and smoke.  Or take a walk.  I can go buy something from the cafeteria.  Leave early.  And the admission process make it clear I'm welcome to leave the program completely at any time.

The one Big Rule is that you have to show up or call in.  If I'm absent without notice, they'll attempt to reach me and emergency contact.  If neither of us answer, they'll ask the police to do a safety check.  The staff take that very seriously.

7. What kinds of people are there?  We're unwell to varying degrees.  Suicidal thoughts are pretty common in my group, though it's not something I've experienced.  Depression/anxiety diagnoses are the most common, by far, but anger issues, past trauma and co-existing addition disorders are also present and accounted for.

We range in age from college (so early 20s?) to seniors (70s).  About evenly split between men and women.  Different races, economic backgrounds, educational pedigrees.

Despite being ill - or perhaps because of it? - they are intensely open and without judgment.  There are some who are heartbreakingly kind and gentle.  Others who are delightfully funny.  But everyone seems focused on recovery - not just personally but for those in group with us - which is inspiring to me.

I feel very safe - both mentally and physically.

8.  What do you do?  Everyone is given a packet upon admission that holds the schedule and a bunch of worksheets.  Each day is different but the structure is constant.  Our schedule is 8:30-4:30 though I've seen online that many programs are shorter, some offering Intensive Outpatient Programs that are only half-days.


  • Arrival - complete menu, daily rating score on various items (depression, anxiety, desire to self-harm or harm others), a form on medication taken and any issues or concerns, goals for the day.
  • Goal Group - we go around the table in a smaller group to discuss yesterday's goals, how we did and what our goals are for today.  We all focus on 3 goals per day - 1 per treatment-plan category (mine are reduce depression, manage anxiety and prevent relapse).
  • Focused Therapy - again in groups (sometimes different ones), each day is different - triggers and coping strategies, reframing negative thoughts a la cognitive behavioral therapy.
  • Group Therapy - this is unstructured and, again, therapist-lead.  Yesterday, a few people spoke for longer times.  Today we went around the circle and all spoke a little.  The group offers feedback and encouragement and the therapist will suggest new goals or encourage us to focus on how to recover.
  • Lunch
  • Expressive Therapy - in the afternoon, the work is easier (which works great for my morning-person-ness).  There's an art project (yesterday we made stones with pictures pasted to them to remind us of our safe place) or music therapy or another activity or game.  It's a different group of therapists and while I was wondering if I could just skip the afternoons and head to work instead, I'm finding it useful.  Something about the distraction or the slight shift in focus enables a different perspective which can be useful.  
  • Closing

Individual work is on an as-needed basis.  There are staff psychiatrists available to address medication questions or issues.  The therapists are also available for individual discussions during breaks for in the afternoons.  A chaplain visited today and offered to pray or talk with us whenever we'd like.  And that's where tomorrow's story begins.

Tuesday, December 06, 2016

PHP - The Referral

I've been referred to a partial hospitalization program, a less friendly name than 'day program' as it was initially presented to me.

"Oh," I replied when my doctor suggested it.  It's what I say when I'm dismayed over something but don't have an immediate argument.

"Katie," she explained gently, "we've tried four medicines.  None have helped.  Two have made you worse.  You're still missing work somewhat regularly.  I don't want you to keep suffering when there is a potential solution.  I just called and I can get you in this week."

"Oh," I said again, trying to gather my thoughts frantically as I pictured pieces of them scattered around me in shards.  I was prepared to complain - I'm trying so hard!  Going to the gym of all places! I've been tracking food and water intake!  Attempting mightily to engage at work and keep promises.
"I don't want to be this sick," I finally said, blinking at tears.  "I want to say that I can figure this out - I'll try harder or do more or be better - but I don't know how to do it.  I'm out of ideas.  And I don't want to be like this forever."

She nodded, blinking a bit faster against tears herself.  "I failed you," she admitted softly and I immediately shook my head.  "Not because I wanted to," she clarified, "but because I don't know what else to prescribe.  I can't get you into therapy any sooner and your appointments are a month away.  You can do this now and other patients have responded very well.  If I were you, I'd do it without question."

"OK," I replied, nodding continuously in an attempt to convince myself.  "Yes.  I'll go."  So with a referral submitted and a request to call in hand, I left the office I'd visited twice-thrice monthly since May or June.

I wept when I told Mom, feeling desperately ashamed.  She held my hand as I waited on hold with the mental health intake line and made encouraging expressions when I offered to come on Wednesday, two days later (as this happened Monday last week).

In the meantime, I went to work.  I cleaned up projects and made plans to be out for the two week duration of this program.  I told select colleagues and received unanimous and enthusiastic support.

The intake meeting was straightforward - she asked questions, I answered and - because I do like to talk - elaborated.  And after 40 minutes, she reviewed my worksheets and her notes and smiled.

"This program will be great for you," she said.  "I'm completely confident.  When can you start?"

"Monday?" I offered hesitantly.  "I have meetings scheduled, want to wrap up a few things...  I don't know."

"Monday," she confirmed.  "It's going to be fine.  You're going to get better."