Dear Bobby,

i had started a longer reply to you last night but got interrupted. now i find myself a little uninspired. i don't feel like i can say it in two words.

HOWEVER, FWIW

The same way lots of professionals do! This is not the discovery of the century, it is good clinical practice to encourage good personal hygiene. And other personal routines. As for the method of "encouragement" used, that is another kettle of fish.

I personally DO NOT think your therapist is an idiot!

I personally DO think that wearing clean clothes and showering regularly can, YES, help bipolar disorder. (once a day is a negotiable example of regularity, is how i see it.)

I am a bit irritated right now because LOTS AND LOTS of STUFF PEOPLE HAVE GONE GAGA over - links to self-help etc that have been posted on this forum - talk about how having a routine etc, getting physical exercise etc, help. We all "Thank" those articles when they get posted and give advice... take a walk, a warm bath... bla bla bla. some articles are more aggressive than others, about getting up dressing up showing up etc... putting on makeup???
Now suddenly people are flipping out here over the same things?
Aren't we throwing out the infamous baby with the dreaded bathwater here?
Consistency anyone?

Bobby,

If you were able to do those things daily/regularly, i do believe you would feel better... gradually. Self-grooming has a psychological impact. It won't make you thinner, but self-grooming is an act of love, of physical commitment to oneself... in a "body is your temple" sort of way. It could help you not hate your body as much for however much adipose tissue it might have gathered.

Getting off Zyprexa was not a matter of luck by the way. After I went up that last clothing size I told my pdoc right away, "look i keep packing on more weight, and i'm to the point of being uncomfortable with myself - I don't want to gain another ounce because then i am really going to hate my body." He took me OFF it immediately, leaving it for use only over a few days for more acute states. He got my hating my body was going to hurt my moods in the end, no matter how well the med worked otherwise.

It doesn't sound like your T expects you to make changes gradually?

What i see as the more likely problem is your being asked to do too much too fast, considering ALL of your situation. Sure i think it would help (if you could get there), but being something unreasonable (for now) it is just plain discouraging, counterproductive. In this sense, the suggestions, to this degree, in the here and now, are not helpful to you at all - i do agree with that 100%.

It's like the old Nike ad: "JUST DO IT." like the old Nike ad. I hate that ad. It so does not work with depression for me - it's like, if i could do this stuff, i wouldn't be in therapy!!! But occasionally someone else who had (BAD) depression told me it hadn't worked for them but it was working at some point. I think it depends on a lot of subtle aspects too. And I don't personally care for the word rules in this context but i don't know how that came up.

Sometimes a therapist will make a first attempt to spur the patient - then, if it doesn't work, other kinds of approaches are made. That is what could be happening.

I think it's absolutely fine for you to be angry and the fact that you feel totally misunderstood and your situation misunderstood needs to be brought to her attention very very clearly - and perhaps repeatedly. I suspect your physical difficulties are likely being under-estimated. One thing i like about this woman is that she sees potential in you and is trying to bring it out. You know, even your anger is a psychologically active and not passive response - which is good. Go with the anger... take it from there.

I had to work with my therapist on various things - and with some the confrontation was hard on me and it took several attempts. other times not so hard but was almost ready to give up when he finally got it. the thing is no relationship is going to be smooth-sailing. and if you like this person, i think it is worth sharing your anger with her.

i really think this is what it's all about right now.

It is of course always up to you if you want to change therapists at any time. All i can say is no therapist is perfect, and liking this one as a person is a good sign. I have had huge objections about my therapist, questioned his competence and all - and thought about terminating on several occasions - but usually the imperfections "matter more" when he has upset me somehow. He is good in some ways. He is not as good in others. He is a good person however and if i started with someone else everything i have "worked out" relationshipwise with him, would have to be re-established. Working on the relationship is a big part of therapy, and the better that gets, the better help you will get.

I hope i haven't upset you. i am trying to be totally frank and then of course you may not agree with what i say but i don't want to just post reactionary stuff on your therapist even if that might be a comfort right now, like a statement of being on your side and where your T is on some other side. I AM on your side, regardless what you do with your therapist.

You hang in there. Keep reading and hanging out with your kitties. I'm very glad to hear about your breakthrough with the fear of death and God - that is really huge. Good luck with the Celexa - i took it for a while you know. it was ok, i mean nothing awful with it, certainly no weight gain, and it was effective. i hope the same for you.

love

~ waves ~