The Secondary Gains (and Losses) of Psychiatric Hospitalization

Seven years ago today, probably at roughly this time, I was being admitted to my first psychiatric hospitalization. I was in my second real appointment with my first therapist (third if you count the intake assessment), and told her that I was planning to drive several hours away the next day to purchase a gun at a gun show. Looking back on this, I don’t believe I’d have ever reached the gun show, as my driving anxiety is so bad it would probably override the most intense desire to die.

Am I sorry that I was hospitalized to prevent me from doing something that I probably would not have done anyway? That’s a very difficult question. A month prior I’d been taken to the ER by a sheriff’s deputy who was sent for a wellness check, and when I spoke with him a week later he was appalled that I was still waiting for an intake assessment. He thought I’d be on medication by then. In fact, the process required an intake assessment and at least three regular therapy appointments before a referral to a psychiatrist could even be made. Hospitalization definitely fast-tracked that process.

On the other hand, that hospitalization set a precedent. Last week my therapist and I were discussing the Dialectical Behavior Therapy (DBT) concept of secondary gains. It’s the idea that when a person behaves in a way that causes harm, there is some (possibly non-obvious) way in which that behavior benefits them. That could be someone using illegal drugs because they alleviate symptoms of untreated mental illness. That could be someone self-harming because the endorphins released by physical injury create feelings of pleasure. That could be someone acting out in class because it results in being removed from that situation, where perhaps they are being bullied or experiencing some sort of embarrassment.

While I was discharged from my final hospitalization one year, three months, and 11 days ago, the 15 or so hospitalizations in the preceding almost six years were as much an escape as anything else. Very little of the treatment that took place was beneficial. The assumption when someone is hospitalized for mental illness is that medication changes are obviously necessary, so they piled on more drugs, raised dosages, switched out meds that hadn’t even had a chance to take effect. The answer is rarely “this medication is causing problems so we’ll remove it”. Instead the answer is “we’ll give you another medication to counteract the problems this one is causing”.

I try very hard to view life experiences, pleasant or unpleasant, as a source of knowledge that I can then share with others. I try to find the humorous stories to make others laugh. However, I’d be lying if I said that I didn’t wish that first hospitalization never happened. Coming out of a hospitalization is difficult, even if it’s only for a day or two, and the more times I was hospitalized the harder I found it to not be hospitalized. Looking back, I can see many instances where I was making progress in therapy and regressed, with the secondary gain of going to a place where I could escape the demands of the outside world.

There’s no way of knowing how my treatment would have progressed if avoiding hospitalization had been the ultimate goal at that time. With my current therapist it is a significant goal, and I very much appreciate her for that. I know my life would be very different had I not followed the winding path that started with my first hospitalization. I’m not sorry about what my life is now. I do sincerely wish I’d been given a chance to reach a similar place without the experiences I had. I will admit to being selfish internally. Although I do help people whenever I can, I also wish I didn’t have those experiences to share in order to help them.

IRS Free File & Banking Tip

There are a number of things I’d like to post about, including one very long saga that has still not reached a conclusion. So today I am making just a brief post to share some useful information that I discovered.

Since the very first year I worked, I have filed my taxes using TurboTax. I am really not good with financial issues and the fact that it will walk me through every possible question with lots of explanations alleviates my anxiety. The past two years I did not have to file taxes, but in 2020 I made an attempt at returning to work in two separate part-time jobs, which only lasted a few months.

I couldn’t afford the fees for TurboTax. My mother’s helpful suggestion was that she could ask her accountant if he could do it any cheaper. (This is an obvious no, as her taxes are not particularly complicated and he charges her more than double what I’d been paying.) I printed all the forms, and today I worked up the courage to try doing more than filling in my name and social security number.

When I went to the IRS website for the instruction booklet, I discovered this information on IRS Free File. The IRS has partnered with a number of popular tax preparation sites to offer free tax filing for people with low income. It estimated that 70% of the population may qualify. The link I provided has a tool to determine which offers are available to you.

I was able to use my existing TurboTax account from years past, but pay absolutely no fee to file both my federal and state taxes. I highly recommend checking the tool to see if you qualify, as this was a million times easier than the pen and paper method I was about to embark on.

---

BONUS FINANCIAL TIP: I went to my bank to try to sort out some inexplicable service charges. A few months ago I had received a $2 charge that turned out to be because, after one year, my savings account started having a minimum balance. No one told me this when I opened it. I scrounged up the money to get over the minimum balance, and a couple of times had to grin and bear it when I needed money out of savings. Except I was getting charged the fee again even when I was over the minimum.

As it turns out, the account has to stay over the minimum balance for the entire month. By the time I knew it was under and added money to reach the minimum, it was then less than a month before the next time the fee was applied. I did get a refund for any time they deducted the fee when I was over the minimum balance, and the teller made a very helpful suggestion.

Since there is no chance I would ever have enough money in savings to earn more than a few cents in interest, we moved my savings to a second checking account, titled “savings”, with no checks or debit card. I can still move money between it and my normal checking account online. The only difference is that there are no fees.

Top Reads of 2020

[Collage made from cover photos on Amazon.com, as most of these were read through hoopla or library checkout.]

In last year’s Top Reads post, I said that I was bumping the goal up to 36 books for 2020. I made it with 3 hours to spare. I must admit that I checked at least as many books out of the library and returned them unread, due to a brief spell of being a library employee. I’d wander around shelving books, see something that looked good, use the library card barcode that I’d pasted on to my badge…and then realize I had far more books than time.

1. Shutter Island by Dennis Lehane: I saw the movie many years ago, and remembered enjoying it, but very little about the plot. When I had too many books and needed to return some, I thought I’d just read a couple of pages of each and decide if I still wanted to read them after that. This was the first one I picked up, and didn’t put it down until the final page.
2. Some Day by David Levithan: The original book, Every Day, was on my Top Reads list a couple of years ago and this one was quite possibly even better. It added depth to the strange premise that, in the first book, was primarily a teen love story.
3. How to Make Friends With the Dark by Kathleen Glasgow: Another repeat author (from last year’s pick, Girl In Pieces), although this one is not a continuation of a series. I am very impressed with her treatment of teenage characters as being complex individuals.
4. Pretty Girls by Karin Slaughter: I have a confession…I can’t even remember much about the plot of this book. It’s fairly graphic, and I don’t use the 5-star rating lightly, but I’m having some significant memory issues this year. So in all likelihood I could think, “I want to read a good book” and go grab this one, with the knowledge that I loved it but the absence of knowing what’s about to happen.
5. Unfu*k Yourself: Get Out of Your Head and Into Your Life by Gary John Bishop: I think this might be the only thing in the self-help category I read all year, and I picked it up as a joke, thinking my therapist would be amused by the title. I actually found it rather inspiring. Another case of not remembering the details, just that the overall concept was stop thinking so much (an unhelpful habit of mine).

One Year of Freedom

Today makes 1 year of me not being in a psych hospital. Technically yesterday, if you consider that this was a leap year. After having ~15 hospitalizations in 5 years, this seems somewhat implausible, and yet here I am. I have been reflecting on how I got through this year so much more smoothly, and have a few thoughts:

* I am no longer a student. I completed my BA in May 2019, and withdrew from my master’s program after only a couple of months, so I’ve been free from the pressures of school for over a year.

* Although I did try working again this year, I recognized that the job (which sounded like a dream initially) was not a good fit, the complications of working were not worth it, and that given all relevant factors I would be better off doing what I love as a volunteer rather than what I only sometimes liked as a staff member.

* On the subject of volunteering, my brief employment got my foot in the door for two different volunteer opportunities in line with one of my lifelong passions. I have had moments where I nearly threw up from excitement over things I’ve had the chance to do, and it feels amazing that there are a few people in my life who think I’m a rockstar at something that’s just plain fun for me.

* I moved into my own home. I won’t lie and say I haven’t had total breakdowns from the stress of it, but most of the time it is an improvement over having to share a space 24/7.

* I am free of toxic relationships. After 2 solid years of 2 back-to-back negative friendships, I have no contact with the first, and have had only minimal phone and online contact with the other over the past 11 months.

* Animal Crossing. I had no interest when it was released (I joked with my therapist that when GameStop only received 20 copies I considered buying one only so someone else couldn’t have it). Now I’m close to 700 hours in, and still learn something new constantly. I remember the first few days of play when it seemed like catching a fish was impossible. The next thing I knew I’d flattened my whole island and rebuilt it from scratch. That seemed impossible. Now I’m starting to use custom designs to add details…seems pretty impossible. Taking cute photos for Instagram…not totally impossible, but definitely needs improvement in my skill level. Taking cute photos for Instagram at Harv’s Island? Hahahaha, I don’t think I’m going to master that one.

This year has, of course, not been entirely smooth. My beloved psychiatrist left her position abruptly in January, and I spent countless bedtimes crying over how much I missed her. My therapy appointments have been mostly by phone, aside from a few weeks this summer when there was lovely weather for meeting outdoors. I can’t say I enjoy phone appointments by any means, but it’s definitely not bad to have therapy while lying in bed with my cat. My therapist took a new job, but in a rare stroke of good luck I am among a tiny handful of clients she still gets to work with. (If I were not, I would probably not being writing the same post at this moment.)

My health has spiraled horribly, starting in April. After many instances of being told that my sudden, severe, and unfamiliar symptoms were “just anxiety” (despite not happening when I was having full-on panic attacks) or “[my] bipolar depression” (despite not being depressed at all), I worked up the courage to seek a new doctor. I naturally feared she would not believe me or would make those same statements, but that did not occur. Tomorrow I have a brain MRI and a cardiology appointment. I feel like I should be super depressed about how lousy I feel physically, yet it’s almost a relief that it’s different from feeling lousy mentally.

This is also rather ironic, yet quarantine and social distancing have improved my mental health. I’m naturally a little lonely at times. I also usually don’t have to deal with the people I don’t enjoy dealing with, and where avoiding people at the grocery used to make me feel guilty, now it’s socially appropriate and I don’t beat myself up for the rest of the day.

The What and the How of Mindfulness

There are six core skills in the Dialectical Behavior Therapy (DBT) Mindfulness module, separated into two groups of three. The “what” skills describe what mindfulness is and the “how” skills describe how to do it.

“What” Skills

Observe: Notice what is happening around you. Notice the environment and the people. Notice what you can experience with your five senses. Observing is not putting words on the experience, just being aware.

Describe: Now is when you put words on the experience. Tell yourself what you are observing.

Participate: Throw yourself completely into the moment. Don’t hold anything back.

The “what” skills build upon one another. You cannot describe without first observing. You cannot participate without first observing and describing.

It can be difficult to separate the three skills. My therapist gives the example of being in a room. You observe when you notice that the walls are painted. You describe when you tell yourself that the paint color is beige. You participate when you remember the paint color after leaving the room.

“How” Skills

One-Mindfully: Focus on only one task or thought. If your mind drifts, bring it back. If there is an interruption, such as a phone call, switch your attention fully to the call and then return to the original task. Do not multitask. Multitasking leads to errors, and actually takes longer than completing one task before starting the next.

Effectively: Do what works in the situation. Let go of stubbornness. I am reminded of a work situation where I needed someone’s help to complete a task. There were steps I could have taken to make progress while waiting, but I behaved ineffectively and stopped all work during my long wait for a response.

Non-Judgmentally: Let go of right and wrong. Do not label things as good or bad. If you must label, use phrasing such as healthy vs. unhealthy. If you find yourself judging, don’t judge yourself for judging. It is virtually impossible not to have some judgmental thoughts. This does not mean you have failed at being non-judgmental. Reinterpret the situation in a non-judgmental way.

Applying for SSDI and SSI

This history of my application, appeal, hearing, and approval process for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) is intended to give readers a glimpse into the steps in the process and some tips for their own application. It is not a definitive guide to SSDI/SSI.

My first of three initial applications for SSDI/SSI was submitted in April 2015. I had been out of work since the beginning of December 2014, having quit my full-time warehouse job due to significant work stress leading to multiple hospitalizations. I was promptly rejected, because I did not have enough work credits for my age. The number of credits required goes up as you get older, based on the assumption that you had more opportunity for work. Unfortunately, I had spent a total of five years housebound due to severe anxiety, but had not received any sort of diagnosis or treatment, so I could not deduct that time from my eligible work years.

I needed about 6 more months of work to be eligible, so I applied for a job at a local hospital. It was less than part-time, and even if the hours had been available I could not have worked full-time. However, I assumed that working would make it impossible to get approved.

I applied again in June 2016. I was still working, but I believe my therapist at the time encouraged me to re-apply. I was scheduled for an assessment by a psychologist I had never met, which mostly consisted of him testing my memory and subtraction skills – nothing to do with the actual limitations caused by my disability! Another unfortunate event here, as I was told to bring someone with me to the appointment. My mother and I drove there separately and in the middle of my assessment she knocked at the psychologist’s office door. When he opened the door, she said, “Hospital. Now. Love you.” I freaked and was like, “What hospital? Why?” She said, “Christ. Transplant,” and rushed off.

Mom had a kidney transplant when I was 16, and after 17 years it failed. She’d been on dialysis for about 3 years at this point, and got the call that a kidney was available during my assessment. Needless to say, I was excited for her, which conveyed to the psychologist that I was not actually depressed, and distracted by my desire to get to the hospital, which prevented me from expressing how my disability affects my capacity for work. I received a rejection letter a couple of days later.

TIP: Appeal your rejection.

I did not appeal my rejection, as I had received an acceptance letter to return to college the same day as mom’s transplant and my ill-fated psychologist appointment. Again, I made the assumption that this would prevent my approval, so I dropped it.

I started college part-time. I continued my work at the hospital. In January I was hired to work at a mental health organization, and turned in my 2 weeks’ notice at the hospital. My new job lasted for 5 months before I was so desperately ill that I had to quit. I was still making the assumption that my “success” in college would prevent approval. I was maintaining a 4.0 GPA, but at great cost to my mental health. I only attended part-time and still experienced numerous hospitalizations. It was only through the grace of a very dedicated advisor that I managed to stick with it.

At some point, someone (possibly my current therapist) persuaded me to apply again. I submitted that application, again at the initial step of the process, in December 2017. I was rejected quickly. I submitted the appeal form immediately, adding any new developments since my application. I was again rejected, although a little more time passed.

In May 2018, I hired a local disability attorney. From there, the only work I had to do was to answer questions when he asked. In our initial meeting I brought him any paperwork I already had on hand, and provided him with a list of all doctors I’d seen and hospitals I’d stayed in. He requested any missing files, and submitted it all to the Social Security Administration (SSA). The lawyer stated that it was a ridiculous case, and given the paperwork I had submitted it should have been approved on the initial application.

The estimated time frame for a hearing before the judge was 18 months. I had mine almost exactly 12 months after hiring the lawyer, in May 2019. Three days after my much-awaited graduation from college. My therapist drove me to the nearest major city for the hearing. She was not allowed in the room, because my lawyer did not think it was necessary for her to testify.

In the room, aside from myself and my lawyer, were the judge, an employment expert, and a court reporter. The hearing was also audio recorded. My lawyer made a statement, I made a statement. We made sure to emphasize two factors: the difficulty with which my college degree had been obtained, and the fact that even when I was externally appearing to function at a job, I was self-harming in secret.

Tip: Talk about your worst symptoms on your worst days. It’s humiliating and degrading, but you will not win the case by sugarcoating how bad your symptoms can be.

The employment expert requested clarification on some issues pertaining to my past employment. Then the judge gave her a scenario full of legal mumbo-jumbo based on how she had interpreted my situation, and asked if there were any jobs I could do. The employment specialist stated that I could be a floor waxer or industrial cleaner. My lawyer and I managed not to laugh at the fact that those would both be a fast-track to suicide due to boredom and lack of purpose. The judge then gave her the same scenario, with the added detail of missing two days of work per month. The employment specialist stated that this would be completely incompatible with work.

The judge thanked us and stated that I would receive her decision in the mail within six weeks. I expected it to be the full six weeks and come back unfavorable. My lawyer had warned me that this judge was very careful to review all the information, and that she denied a larger percentage of his cases than he thought appropriate.

I was utterly shocked – and terrified – when her decision arrived in a mere two weeks. I was utterly shocked – and delighted – when it stated “fully favorable”. My disability date was set at the date I had left my last job in July 2017.

Back pay is calculated starting five months after the disability date, so I had accumulated back pay from the beginning of December 2017 to sometime in July 2019 when I started receiving payments. I do not recall the exact amount I had signed over to my lawyer in the contract. I believe it was 25-30%. I was okay with this, as it was still a decent chunk of money, plus the monthly payments, which I would never have received without his help.

So began a series of very confusing letters. It is now April 2020 and everything has just recently settled into predictability. So here’s the sort of things to expect after being approved:

• Back Pay: Back pay depends on the disability date the judge sets and is subject to the lawyer’s fee.
• Monthly SSDI Payment Amount: This will be set based on your work credits, and increases annually for a cost-of-living adjustment.
• SSI Approval: If approved, you will receive a separate payment monthly. I was approved, but initially given no payment as I was living with my mother and they deducted estimated housing expenses. When I purchased a home, I had to go back to the SSA office and provide documentation of all my new expenses in order to start receiving SSI.
• Loss/Reduction of Public Benefits: My monthly SNAP amount fell drastically once I was approved for SSDI.
• Transition to Medicaid: I lost my special state health insurance plan in October 2019 and it was replaced with traditional Medicaid, which has much greater restrictions on which providers I can use.
• Addition of Medicare: My Medicare coverage began in January 2020. I now have it as my primary insurance, and the 20% it does not cover then gets submitted to Medicaid as secondary insurance. Medicare is a NIGHTMARE. I was automatically enrolled in Part A (hospitalization) and Part B (doctor’s visits), with the option to decline Part B. I also had the option to sign up for Part D (prescriptions). Part A is free. Part B and D are deducted from the monthly SSDI payment, but in most cases these premiums can be covered by the state if the recipient also has Medicaid.
• Part D NIGHTMARES: The plan I chose was supposed to be paid by the state, and even if it wasn’t, I had a letter from SSA saying it was being deducted from my monthly SSDI payment. It was, and the Part D provider repeatedly tried to double-bill me for the premium and gave me incorrect information in a really nasty tone when I called multiple times to straighten it out. Also, with Medicaid I never had to pay for prescriptions, but now I have a co-pay. There is an Extra Help program that reduced the cost of the copay to no more than $3.60 per prescription, but I have repeatedly been billed more and then received a refund check in the mail.

For a very long time, I felt like the approval wasn’t worth it. I was drowning in all this new and confusing paperwork, and feeling very down on myself about being ill enough to qualify. I promise it gets better once the kinks are worked out. I hardly ever tell my therapist I’m worthless anymore (at least not for the reason of receiving SSDI).

The best part is, there are a ton of resources out there after approval. I will talk more about Vocational Rehabilitation (VR) in the future, but my VR counselor referred me for benefits counseling, where I learned a ton about my options for trying to go back to work, special savings accounts I could open (some with matching programs), and applying to have my student loans forgiven. All these steps are very much a work-in-progress, but I will happily share information as I learn more.

DBT: A Primer

Dialectical Behavior Therapy (DBT) is a therapeutic program created by Dr. Marsha Linehan. The first edition of her skills training manual and client handouts was published in 1993, with a revised edition published in 2014. DBT is based on a blend of Cognitive Behavioral Therapy (CBT) and Buddhist principles. The program was originally designed to treat Borderline Personality Disorder (BPD), but has since been expanded for a number of mental health issues. As one of my former therapists said, “Everyone needs these skills. Some people just didn’t learn them from their parents.”

In addition to Dr. Linehan’s manuals, there are many other materials available about DBT, including workbooks, skills for children, and decks of skills cards. The one I have used most is from Moonshine Consulting. It has simplified versions of some skills, as well as a few new skills not discussed by Dr. Linehan.

DBT is made up of four modules: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. This is not the order they are presented in the material, but I placed them in this order because it seems like the most logical progression for building upon earlier skills. I will be elaborating on specific skills in future posts, so here I present a brief description of each module.

Mindfulness

Mindfulness is the act of staying focused on one task in the present moment. Not multitasking, not living in the past or future. Mindfulness primarily consists of the three “what” skills and the three “how” skills.

Distress Tolerance

The purpose of Distress Tolerance is “to tolerate distress”, as I sarcastically say each time my therapist asks. Of course, I follow up with the serious answer. Distress Tolerance is a set of skills to be used to cope in difficult, painful, intense situations without making the situation worse. This module is not about fixing. It’s about damage control.

Emotion Regulation

Emotion Regulation picks up after distress has been tolerated. This module is for understanding the source and function of our emotions and learning not to let them control our actions.

Interpersonal Effectiveness

Interpersonal Effectiveness does what it says on the tin. It teaches us how to interact with others in ways that meet our needs. How to ask for help and set boundaries. How to do these things in ways that show respect for both ourselves and the other party.

That, in a tiny nutshell, is DBT. There are two main components to a DBT program: group and individual therapy. In group therapy, we learn the skills. In individual, we can have focused guidance on applying the skills and working through our trouble spots.

A feature of DBT that can bring some frustration and resistance is diary cards. Both group and individual diary cards ask the client to note which DBT skills are used throughout the week. An individual diary card also asks for information on emotions and impulses that were experienced and/or acted upon. Ideally the client would fill this in daily, but in my experience most (including me!) are going to wait until right before the appointment and frantically scribble it in to the best of their memory.

Top Reads of 2019

I know I’ve kind of vanished from blogging.  Still here, just super busy.  I did manage my GoodReads goal of 24 books this year and am bumping it up to 36 for 2020.  Here are my top reads from the past year, in no particular order:

[Not pictured: Bird Box by Josh Malerman.  Read the Kindle edition on my phone.]

1. Bird Box by Josh Malerman: I had seen exactly 5 seconds of previews for the movie and accidentally stumbled on a list of “scariest books we’ve ever read”.  This was on the list and it said it was way scarier than the movie.  Of course I would read the book first anyway, but that intrigued me, because movies have the advantage of visual effects and sounds for scare factor.  Read straight through this and was totally freaked out in a very enjoyable way.
2. All the Bright Places by Jennifer Niven: I had some Barnes & Noble gift cards and was browsing the website’s section of YA books because they are easy reads and usually pretty good.  I’d never heard of this one, but it starts out with two teens in a clock tower, potentially ready to jump, so I was curious.  This book saved my life.  I can’t go into detail without spoilers, but trust me that it was so good I ended up buying the pocket version and the Spanish version as well (reading it in Spanish is a goal for next year).  There’s also a movie coming to Netflix in February so read it now to be prepared!
3. Five Feet Apart by Rachael Lippincott: Another book from my YA kick, this one was already out as a movie when I read it.  I didn’t really know what I’d think, but I had a friend whose son has cystic fibrosis and she wasn’t sure if she could handle reading it, so I read it to give her my advice on whether to try or not.  It would have been intense for her, I think, but worth it, in the same way that I push my way through books about suicide and self-harm.
4. Girl in Pieces by Kathleen Glasgow: Aaaaaaand….here’s the book on self-harm.  I wish I could get everyone I know to read this.  There are a number of really bad books out there that include characters who self-harm and they just don’t get the motivations right.  This one does.  It should…I knew within the first chapter that the author was writing from personal experience.
5. The Mindful Mom-to-Be by Lori Bregman: I went through a long span of baby fever this year and was reading everything I could on pregnancy and childbirth.  This book had a lot of great information for those who want to get through pregnancy and childbirth using natural remedies, birthing methods, etc.
6. Miss Peregrine’s Home for Peculiar Children by Ransom Riggs: I actually saw the movie first, something I rarely do, and was terribly confused reading the book due to the movie covering the whole trilogy.  So putting that out here: if you’ve seen the movie and want to read about that, you’re committing to a trilogy.  I totally loved the inclusion of pictures of the peculiars throughout the book.
7. To Kill a Mockingbird by Harper Lee: Yes, I made it to 39-years-old without reading what is typically a high school English assignment.  You see, my school had remedial English, English, and college prep English.  Instead of reading the same material but processing it at different levels, we were assigned completely different material, so basically anything that was considered a universally assigned book by the world of my teen years?  Not assigned to me.  I really was just tired of not getting the references made in pop culture, and someone gave me this book, so I went ahead and read it and was shocked to find out it was actually GOOD unlike so many of the “classics”.

Top Reads of 2018

As usual, I’m writing a little about my favorite books that I’ve read this year.  I know the year isn’t quite over, but I’m not in a place where I can really sit down and read more.  I wanted to get an update onto the blog, because it’s been 6 months and I swear I haven’t vanished.

(Not pictured: Luckiest Girl Alive by Jessica Knoll)

In order by date read:

1. How to Be Interesting: An Instruction Manual by Jessica Hagy: A book of diagrams explaining, well, how to be interesting.  An example, not from the book:

I loved it because it was simple advice in a simple format, that really made me think about how I was living.

2. Luckiest Girl Alive by Jessica Knoll: I ran out of Gillian Flynn books to read and this had praise from Gillian Flynn.  It’s a similar style with the story unraveling slowly through present and flashbacks, and you will absolutely not expect what is coming.

3. Every Day by David Levithan: I saw a preview for the movie and whenever I get excited about a preview I go read the book instead.  Absolutely read this book.  It is simply impossible for the movie to have captured what goes on inside the character’s mind while traveling from body to body.  While the premise sounds weird (well, it is pretty weird), the author took it seriously with good results.

4. Constructive Wallowing: How to Beat Bad Feelings By Letting Yourself Have Them by Tina Gilbertson: My list is actually a little light on the self-help books this year.  This one was my favorite, because it acknowledged that emotions serve a purpose in our lives and we need to experience them in order to overcome being bound by them.  It was advice people can actually follow without feeling that they are in some way inferior.

5. The Time Traveler’s Wife by Audrey Niffenegger:  This premise may be even weirder than that in Every Day, but it is absolutely beautifully executed.  It’s a love story with real meat to it, and I promise you will be impressed just trying to wrap your mind around how the author planned out all the details in this book.

Top Reads of 2017

2017 was a light year for reading.  I had to make my way through several lengthy textbooks and that plus the struggles I had with my mental health led to not reading nearly as many books as in recent years.  Thus, I only found three to be highly recommended.

1. The Buddha and the Borderline by Kiera Van Gelder – A memoir about recovering from Borderline Personality Disorder, this book artfully describes the reality of living with the disorder and how Dialectical Behavior Therapy (and its roots in Buddhism) led the author to a more manageable life.
2. Turtles All the Way Down by John Green – This is a mystery in the vein of the author’s past book, Paper Towns, only the main character spends much of the time caught up in “invasives” – the obsessive thoughts that Obsessive Compulsive Disorder is named for.  The descriptions of her thought processes are very poetic and insightful.
3. No Mud, No Lotus by Thich Nhat Hanh – Inspired by The Buddha and the Borderline, I began reading books on Buddhism.  Among several books I read in a short span, this one on relieving suffering helped me the most.  In DBT group we often discuss how rumination turns pain into suffering, and I have a strong tendency toward rumination.