This week brought no major revelations or insights, but several minor realizations that are worthy of sharing. As such, I am going to enter into a rather scattered review of some of the things that happened and some of the things I learned this week, and hope that those who read this will gain something from the telling.
Last Friday--now a little over a week--I finished my lunch and coffee and returned to the office early. I laid down on the floor to rest for a bit--I cannot nap in the short time available during lunch--and began to hear what sounded like a television playing in the next room. But it was a staticky signal, not just the slight ups and downs of a regular program, but noisy, distorted. There was no television in the next room and the sounds were not the wide swings caused by Vietnamese tonalities. It sounded like English language television and I could not identify a plausible source.
This caused me concern. Great concern. I began to think it was in my head. Whether or not it actually was, I began to panic. I sought out a quiet place to listen and determine whether the noises I was hearing came from an external source or the chemical uncertainties that exist in my brain. Unfortunately, I discovered that finding a quiet place in an office building in downtown Ho Chi Minh City is nigh impossible. But as I wandered around I heard something that sounded very much like sounds I had heard in the past. It hearkened to previous psychotic episodes. This concerned me even further.
Last year I had tried to commit myself for a near-crisis but found that Vietnamese hospitals don't welcome foreign mental health patients. The provincial mental hospital required a note from the embassy before they would commit a foreigner. Anticipating that this might be required--if I was indeed hallucinating--I called the embassy. They suggested I go to a medical clinic downtown as an option that was better than the locally operated hospitals. Feeling like I needed to take care of my situation sooner rather than later, I went. There I waited to get an online appointment booked with the psychiatrist--who is apparently in Portugal--and listened as my thoughts were repeated to me in my head. I was definitely hearing things.
I eventually got an appointment and went home to wait for the scheduled Zoom call. It occurred later that night and for the first time in my experience, I was presented with a psychiatrist who not only knew what he was talking about but spoke English sufficiently well that he could explain my situation to me. What's more, he took the time to explain things to me. Over the course of forty-five minutes he took a brief history of my condition and gave me a rough diagnosis--different than what I had been told in the past by various social workers--and discussed my medication and strategies for getting through this crisis. Aside from Victo--my psychologist last year--this was the first mental health professional who I felt I could actually trust. He inspired the feeling in me. I had never had that before. Either my psychiatrists didn't speak much English, or they weren't terribly competent. To find a psychiatrist who was both gave me reassurance and a sense of safety that I haven't ever enjoyed.
After adjusting my meds and waiting a few days for the adjustments to take effect, I found myself in a much better place. Not only were the hallucinations a thing of the past, but my mood was improved. I felt like I could actually do things and accomplish and produce. I realized that for some time before the television in the next room I had been struggling with depression and other negative symptoms of what is, most likely, schizoaffective disorder. The change in meds, and the adjustment in when I took them, cured problems I didn't even know I had.
The lesson here, I suppose, is that you get what you pay for. Access to this new psychiatrist wasn't cheap--at least by Vietnamese standards--and was more than I would normally be willing to pay excepting a crisis. It was also more than I've been able to pay for a long time. So the concurrence of a sufficient salary brought about by my return to full-time employment and the need for someone more competent allowed me to access a proper doctor for the first time. And paying more money brought me a better experience. Amazing, that.
Which brings me to another point. This week I celebrated three months of waking up every morning and going to work consistently, daily. A year ago I didn't think I was capable of doing that. I had spent years struggling to show up for work, dealing with depression and meds and poor sleep. I thought I was doomed to fail at work because I couldn't wake up. This didn't stop me from trying--I had several jobs that I subsequently lost because I didn't show up. I had developed a history of getting hired, working for a week or two while the enthusiasm of novelty allowed me to show up, and then missing mornings, missing work, staying home. Within two months--the pattern showed--I would have to quit before I was fired.
Six or seven jobs passed through this route and I developed the attitude, the belief, that I simply was not destined for full-time work because I couldn't force myself to wake up. And beliefs have a way of building mental blocks that eliminate the desire to try. But my sleep schedule, and my ability to wake up, became a major goal of therapy last year. Victor helped me realize that I hadn't tried everything, nor had I given the few things I had tried the proper opportunity to work effectively. He taught me a scientific approach: think like a scientist and experiment. He taught me that one, or even two or three, attempts or methods did not equal "all" possibilities. There are countless ways to accomplish a thing and if one way doesn't work, try another. Keep testing and changing until you find the way that works.
It became a question of determination. If you really want to do the thing, then you will figure out a way to accomplish it. It was a worldview, a paradigm shift, that required an assumption of responsibility. A change in the locus of control. As I took the personal responsibility to change my situation, identified the things I could actually change, and then changed them I began to see my ability to wake up shift. At first I looked less at waking up early than at waking up regularly. And then as my anticipation of beginning work again drew nearer, I began to adjust that schedule so that I woke up early, every day. Now, for three months straight, I've been waking up at six in the morning. I sleep in slightly on the weekends, but not so much as to derail my schedule. It requires I go to bed at ten every night and execute several other small behaviors, but it happens. I wake up, and I go to work, and I've done the same for three months straight.
I can succeed if I try.
I also realized something else this week, related to my post from last week about music and racism. A long time ago I was depressed, psychotic, feeling that I was being banished to Vietnam--that I wasn't good enough to work in the United States. Not only did I not realize that I had built my education and experience to land a job in Vietnam, but I did not realize that my depression and despair paired with an attitude of imperialism that has dwelled within me below the level of consciousness. I felt, intrinsically, that Vietnam--and Asia in general--was less good than the United States. In my lack of self-esteem and struggles with competence, I was of the opinion that I wasn't capable of working in the United States, only Asia. That Asia was inferior and a downgrade from what I had hoped to do when I was younger.
Only this last week did I realize how horrible that attitude really was. While Vietnam's laws may be less developed than those of the United States, and the judiciary less developed, there are still many issues that present themselves and require competence and expertise in resolving. There is nothing inherently unequal between the two countries, one is less developed, but that does not mean it is "less good" than the other. To assume that working and living in Vietnam is an inferior option from living and working in the United States is an attitude of prejudice. It is akin to the attitudes which led to the genocide of the Native Americans in the United States and the Aboriginies in Australia. It puts me on a level with the likes of John Smith and Andrew Jackson. Neither of whom is a person I admire.
Admittedly, this attitude developed when I wasn't in full possession of my senses. It was a place of negativity and an inability to properly reason. But that it has been maintained for so long after I began taking medication is perhaps a failure on my part. Realizing my error, though, I now have the opportunity to be grateful for the chance I have to work in Vietnam. To understand that I have to work just as hard here as I would in the United States to be a professional and expert in my field. The only difference being the nature of the subject matter, not the amount of effort required.
And that leads me, finally, to gratitude, an attitude. I have had occasional glimpses of gratitude since I realized that I could be grateful for my situation. Yesterday, I wrote down a short list of the positive things that happened in the last week--a week which seemed like it couldn't be positive because of my brush with hallucination--but writing that list, and realizing that there were good things going on, helped me a great deal. Not only did it improve my mood, but it created a feeling of satisfaction, that there were good things that came along and that I was able to accomplish more than I realized despite my mental health challenges. It helped me learn that it's okay. Life sometimes happens and there are good and bad things. But there are always good things. The silver lining is there, and by developing an attitude of gratitude, it is easier to find.
With that, I conclude. Have a pleasant week filled with contentment, mindfulness, and effectiveness.