Chapter 11-12 Wedding Dress and Being Unsettled

Pt arrived on time. Reports doing "so-so." Had not gotten to trying on the dress for the wedding. Did get it out and look it over. Reviewed agenda for session. Started with review of notes project - collated her personal notes and writer's medical record notes for several weeks. Feels it helps tell her personal story and remember it better. Goal is to add to concept outline which organizes the material for writing projects. Moved on to review of journal prompts and how they assist with daily schedule. Reflected on process for generating them and how she plans to use them. Reviewed most recent entries which led to discussion of wedding plans/itinerary and connected concerns. Processed thoughts and associated affect - doubting self, her abilities, feeling judged. Reviewed questions related to connection to past experiences - friend's death and funeral. Challenged assumptions - current event will be different than past event - and explored data to support this - friend and family as support, this is a happy occasion. Agreed to continue to discuss wedding plans next session.

Pt arrived on time. Reports feeling "a little unsettled." Today was practicing wearing the dress she plans to wear for the wedding. Partner was helpful in getting things together. Feeling "depleted" with the entire process - a lot of choices, uncertain about what she wants/how she should look, keeping up with all the details, in addition to missing her online friend. Still has makeup and hair decisions to get through. Reviewed process for these. Discussed how to manage downtime between events. Plans to take dog to vet/kennel for the weekend. Reviewed information on boarding - worked out plan to call with remaining questions. Reviewed itinerary for the days leading to wedding and over the weekend, with the goal of defining tasks and times. Pt had several worries/negative thoughts about her abilities and potential conversations. Challenged negative assumptions and worked to reframe - used goal of the wedding (support the couple by being present, enjoy family time, keep things simple) as theme. At end of session was feeling more hopeful about the event.

Transcript

1. #2022-10-4 ## 2022-10-04 – Evidence 11A – Dress for the Wedding ### Dr. Marvin’s Notes Pt arrived on time. Reports doing "so-so." Had not gotten to trying on the dress for the wedding. Did get it out and look it over. Reviewed agenda for session. Started with review of notes project - collated her personal notes and writer's medical record notes for several weeks. Feels it helps tell her personal story and remember it better. Goal is to add to concept outline which organizes the material for writing projects. Moved on to review of journal prompts and how they assist with daily schedule. Reflected on process for generating them and how she plans to use them. Reviewed most recent entries which led to discussion of wedding plans/itinerary and connected concerns. Processed thoughts and associated affect - doubting self, her abilities, feeling judged. Reviewed questions related to connection to past experiences - friend's death and funeral. Challenged assumptions - current event will be different than past event - and explored data to support this - friend and family as support, this is a happy occasion. Agreed to continue to discuss wedding plans next session. Global Improvement (CGI-C): No change Assessment - Depression: - Moods continue to be lower to this interval. Acute stressors with upcoming wedding and change to daily schedule. Pt wrote about connections to past events in journal and was able to process/reflect in session. Worked to separate past from present and challenge negative assumptions. - Working to maintain progress with writing projects and balance with other activities. - Able to contract for safety. Assessment - DID:
2. - Current triggers ongoing with schedule change and internal reactions to son's upcoming wedding. Writing made several connections to past events and thoughts/feelings of other parts. Goal remains to assist parts to feel more confident about process. - Review of home videos ongoing. Goal remains to process smaller pieces of the video as time allows. - Continues to work to balance time online with reading/household tasks. - Returning to larger writing project (trauma narrative) - goals/product/audience. Current online writing workshops assisting with structure to writing. #2022-10-05 ## 2022-10-05 – Evidence 11B – Rich in After 11PM ### A Very Good Morning - How was sleep last night? - We did not get to sleep last night until after 11PM. Do not know the time, but Rich came in after. 11:00PM is when we last took Ginney out. Rich had some pizza when he came in - How have we been (the previous day)? - Yesterday, we remember talking to Nihit, He got some ice cream, so then we started thinking about it, and so by 4:30PM we had taco pizza, a bar treat (rice krispies and chocolate), PLUS Cookie dough ice cream. That is complete after Dr. Marvin's appointment when we take off the good dress. - We watched quite a few Trump’s news briefs, and then we watched the movie, "The Munsters." It was corny but kept us company. - We had also watched a comedy. We watched. Hasan Minhaj: The King's Jester. I enjoyed the show.
3. #2022-10-06 ## 2022-10-06 – Evidence 12A – Feeling “A Little Unsettled” ### Dr. Marvin's Notes Pt arrived on time. Reports feeling "a little unsettled." Today was practicing wearing the dress she plans to wear for the wedding. Partner was helpful in getting things together. Feeling "depleted" with the entire process - a lot of choices, uncertain about what she wants/how she should look, keeping up with all the details, in addition to missing her online friend. Still has makeup and hair decisions to get through. Reviewed process for these. Discussed how to manage downtime between events. Plans to take dog to vet/kennel for the weekend. Reviewed information on boarding - worked out plan to call with remaining questions. Reviewed itinerary for the days leading to wedding and over the weekend, with the goal of defining tasks and times. Pt had several worries/negative thoughts about her abilities and potential conversations. Challenged negative assumptions and worked to reframe - used goal of the wedding (support the couple by being present, enjoy family time, keep things simple) as theme. At end of session was feeling more hopeful about the event. Global Improvement (CGI-C): No change Assessment:
4. - Moods continue to be lower to this interval. Acute stressors with upcoming wedding and changes to daily schedule. Able to make progress with tasks but at times struggled with motivation. Able to process/reframe in session. - Working to maintain progress with writing projects and balance with other activities. - Able to contract for safety. Assessment: - Current triggers ongoing with schedule change and multiple reactions to upcoming wedding. Ongoing negative assessments of herself and the experience. Able to reframe in session. Goal remains to assist parts to feel more confident about process. - Review of home videos ongoing. Goal remains to process smaller pieces of the video as time allows. - Continues to work to balance time online with reading/household tasks. - Returning to larger writing project (trauma narrative) - goals/product/audience. Current online writing workshops assisting with structure to writing. #2022-10-07 ## 2022-10-07 – Evidence 12B – Last Night’s Sleep Was Sound ### A Very Good Morning - How was sleep last night? - Last night's sleep was sound. We usually wake up around 10:30PM, but do not recall that, or waking up later. We fell asleep as soon as Rich turned on YouTube. We did wake up with him promptly at 5AM, as if we had been doing this all along. Rich asked us if we wanted a coffee, and it was like ... well, yes! We
5. played with Ginney and entertained self on phone with email/FB. We were looking at about sixty-four gizmos to buy for a super price. Blah ... No, we did not get anything, but you know they are trying to get the early shoppers, right? - How have we been (the previous day)? - The biggest thing yesterday seems to be that we were gathering our wits about us in preparing for the wedding. We were dragging as we tried to talk through processes first thing with Rich, and then by 9:20AM, we took a shower, and then tried on the wedding dress. Things seemed to go ok, after Rich and us decided whether we should wear a shawl, and then which one. Then we managed it with both Dr. Marvin and Nihit. Both framed, helping as well. Hmm, seems like someone was getting special attention. - Rich had hooked, and I guess forgotten to unhook our dress, so that after he left, we were stuck in the dress and seemed to spend some time calming, quieting, and cooling down. We did not want to get sweaty before Rich and us could take off the dress. We tried but there was no reaching the clasps, and we refused Nihit's ideas of walking over to the neighbors. It was impossible. We did call Rich and asked him when he was coming home. He found a way to get home a couple of hours early. I guess he had also done some shopping at Kohl's and got his extra shirt, ties, and some garment bags. We were sooooo happy to see him! - We spent time together with Nihit and discussed our day and his day - particularly his problems with aunt and uncle, and then we both discussed therapy. Mine was the slowest of sessions. Dr. Marvin and us primarily had to talk about wedding. He helped us get through things like attitude, when our appointments were for today, and boarding care for Ginney. - We seemed to have picked up moods for a bit, but not fully. We were quiet during dinner and mostly through the Thursday shows. All the new season ones are on now. - One thing today about which we can get excited. - We're only one day now from leaving for the wedding. There is a lot to do today. We should wash two loads of clothes, clean-up, and pack - BEFORE we leave for makeup and Dr. Austin's. We are not looking forward to the day, but if we can get through it ... it will have been a great feat! - How would we deal with a stressful situation that could trip us up today? - We can be sure to → Time coaxed as our friend today. We have been giving up with the smallest of accomplishments. This could mean, any small thing would exhaust us. Insert here ... talked to Nihit about some embarrassing physical issue. - If we were someone looking at our life from a prominent level, what would we tell ourselves? - An Eagle's eye view → Don't you think you should start a packing list? It is time. - What else are we thinking of? (Morning Pages) - I am happy that it is now about 7:26AM and Rich has fed us and gotten in the shower. Nothing happens while he is still here. We were going to take Ginney out, but realized it was time for the kids' bus and that Duke was out. She was barking, so Rich complained that I had to put her on a leash. I would have figured
6. that out. Maybe. We get tired of it ... but then that may be a problem with that physical thing. Could be we are short of iron or red blood cells or something like that. I had been thinking the tired was emotional exhaustion with the wedding, but now it is who says what comes first. I think when we had problems with the ulcer ... another color was the problem. - One word/phrase that could describe the kind of person we want to be today? - One phrase to rule them all → You can be that kind of person who just gets things done! - Note To Next Day Self - Write a note to our "next day self!" As if encouraging Anne, what would this note say? - Just think ... by this time tomorrow, you will be on that nice four-hour long car ride. No Seriously! - What is a warm salutation for tomorrow's Anne? - You made it girl! - How could we describe our today's self in a word or phrase? - Excellent! ### Quick Capture - Today's selves - Daily Note - There are a lot of things to do today ... stay attentive! - Future selves - Weekly Note - Do you need to see a doctor yet? - Monthly Note - Remember Nihit's message of Rich being the nicest person ... Grrr, yes, but one that growls a lot! Nihit would just say, but we are cranky too. Grrr. - Quarterly Note - Hey! Christmas is over! You made another year! Doctor's appointment? - Annual Note - This is your past self - hey we were looking forward to meeting our future self too! ### Day-to-Day Balancing - Goals
7. - Do we have any riveting goals today? Should we have? - washing clothes - packing - makeup - Dr. Austin - survival - Are all today's food choices in My Fitness Pal (MFP)? How can we get through any slumps? - Who wants to put 2 nights of pizza in a row! Ok, let us be real. Today going out so do we really want to write in BK or DD? - What exercising could I commit to today? How much? - We'll be leaving the house, so just walking in and out to the locations we will be at - especially, Dr. Austin - What can you tell us about the showering experience today? - We should shower at ... let us see ... - leave the house at 11:40AM - Ginney bathroom 11:20AM - shower at 10:20AM - What could we do today, so that someone else can say, "Boldly Go! Howard Wolowitz" - Win the day task → Let us do everything on time with time in-between - ### Balance - How is our perspective of time going? Are we on track? - So far on track ... starting laundry just after 8AM - What has been going well? - Today, we have added balance by → - Being inventive - What could have been better? - Done something to make our headache go away ... just a slight bothersome type - right behind our ears - especially right (by Glasses end tip) - Check course
8. - What has been going well? - Feeling a part of the day ... tired, but steady - What could have been better? - When we realized that the noise from Aanya's TV quieted by switching the speaker from Nihit's button - at least at that point, it became only the quieter, more gentle swishing of the washing machine - We also pulled out the rack - Next time up - we should empty the dishwasher ### Connect-Consume-Cerebrate - Connect → Had a nice talk - With whom? About What? - We talked to Rich, but only a few moments in-between his moving around - mostly it was things ordered like assuring Ginney's well-meaning, or assuring his desk work became accomplished, or that my breakfast was on schedule, or medicine taken. We work as a team with various degrees of cooperation. - We talked to Nihit, but not for long. We were each coming in and out of each other's roles within our individual households. - What did we learn, and what did we contribute toward to the conversation? - That Rich works better with less of our grouchiness. He needs to hear that we are working toward group goals, without assigning him to consume all the roles - We added a balance ... We were dealing with a little meanness from one side or another. I do not recall who the meaner one between Nihit and us were. Just the word mentioned. - Consume → Run Protocol - What did we read/listen/watch this time? - The majority of our "watch/listen/read" time went to processing our notes from the journal. We are moving along ... nothing essential going on ... just processing the date - WITH a bit of a headache. They have been daily, and we are blaming this on the change of the arthritis generic Tylenol. We went from eight capsules to six. - We learned to be more attentive to self and our surroundings. - Cerebrate → My Brain is the best - What is our brain exaggerated on at this time? What triggered these thoughts? Feelings? Behaviors? - For the moment, our brain exaggerates the amount of sound coming from Aanya. Pswhoo! She is a pistol! Have they had dinner yet? Think it is almost 7:00PM, their time. About 8:30-9:00PM they will be
9. asleep. Hehe will Nihit be ready to have fallen over? His house does not have buttons like I do on my computer to lessen the sound. Good that he is younger and more patient! - Can we put out an elevator Pitch? For ourselves? For others? - Nihit told us to not make such a drama over things ... we told him - that is going to come back to bite you! ### Seriously, as a writer... - What kinds of ideas have come to mind today? Relevancy to a better life? - We've been feeling a little more encouraged in that we are moving toward our goals and still feeling we can oversee things. This last week or two have been ridiculously hard, and we have been feeling stuck in the mud. It is a good skill to keep pushing forward, especially with deadlines (real or pretend) in mind. - Stay out of the way of others. Nihit and his aunt are having a serious talk. They are speaking in Hindi and out of the way of the kids. They are both seriously trying to get across their points, but none of it is our business - move on! - What are writing cues which include writing/reading about Multiplicity, trauma, and being a better human being? - We are affecting Multiplicity by → - Perhaps Multiplicity, depression, but we have also been seeing us as working toward death like thoughts. I do not want to think this through more than we are. But it is like the feeling we are going to fall over a cliff if we can just make it so far. - To make ourselves a better human being, we could be conscious of these thought patterns, try to generalize, but then accomplish past them as an example to others. ### Note Making - Ideas Log - Are there any burning ideas to scramble down quickly? - Would you be better turning off the volume again? Damn, are you being snoopy ... we have a habit of listening for the bare slipping in English words. It is a serious talk. - Are there unanswered questions from the day? - Are things going to be ok over at Nihit's family? AHH! Finally, they both laughed. Must have been something about the kids they agreed to. I know, this is how far into it, we are. - Idea Expansion (Nick Milo) - How is this new idea (note) relevant to the question(s) I am considering? - We just want to hear that we are going to be ok and that things in general are going to be ok. Especially - NO depression.
10. - Noise and headaches seem to go together, as well as tenseness in the conversation and grouchiness - Is this idea (note) like or different from the others to which I am comparing it to? - It seems new to be considering daily headaches to regular body signs and symptoms ... - It seems familiar to add confusion to uncomfortable body feelings ... we have not checked weight for a long time. We are due. - Do my present thoughts (notes) agree or disagree with one another? - Comfortableness and lack of effort-ability seem to agree with one another and could both tie to the lack of iron - over difference in the production of red blood cells. I wonder if this is something checked with a blood test ordered by Dr. Austin. We should check in with Dr. Dorman's office. - There ... we sent Dr. Dorman's office a note ... and then had Nihit read it before he left. He was going out for an evening walk with Aanya and Vitty (Vihaan). We are eating more to stop the other feelings of comfortableness. We also switched the first load to the dryer, and the second load to the washer (at about 9:20AM) - Are there other connections that I may like to make between my ideas (notes)? - There seems to be a lot going on back and forth over at Nihit's household. We seem invested due to Nihit sharing conversations and our general interest in him. Currently, the folks are out, so Nihit is taking care of the two kids. He had been having a conversation with his aunt's sister, and not his aunt. I had not been able to make the distinction because she was sitting with her back to the camera. - The curious connection might be - could there be any tie between the stresses we are feeling over Nihit's family and our physical situation of pain. It is more due to my changes in medicine and the stress of the wedding, but could any of the poor body feelings come from something other ... - The next thought went to a back thought where we were feeling as a young girl our own poor feelings, but as well, were we taking on that stress of the family, or other things going wrong in our body? We did check earlier, and we will go back to it ... the other cue could be iron deficiency anemia. I believe we have gone through that before. - I cannot believe we are malnourished or without vitamins because we take vitamins and minerals every day. We had been taking the extra iron, but Dr. Marvin said to stop taking it because our last tests in May looked good. What happens if they were not good. The last was bone health, but we are taking calcium as well. As for other symptoms, we continue having trouble breathing, and we have been experiencing a lack of awareness, plus confusion or mental changes. BUT are these simply due to changes in our Multiplicity? Or again, too much excitability over the wedding. - The 7C's of Note Making (Nick Milo) - Create - A Note ... of some intrinsic value to us - We have been having problems due to loud noises, worry over wedding plans and getting regular things accomplished, and Multiplicity/confusion in general - Symptoms
11. - Yellow stools - Head aches - Stress - Depression - Sense of body heavy and achy - Trouble breathing - Confusion - Tiredness - Lack of strength, energy, or enthusiasm - Lack of effort toward cleanliness - Grouchiness - Difficulty balancing the day (responsibilities)