“Leaving out” the nuclear option

I’m pretty determined to wean myself off all my psych meds – and my fairly holistic, progressive PA “psychiatrist” is willing to work with me on doing this in a gradual-enough manner.

At our monthly meeting two weeks ago, I told Janet that I wanted to reduce my Lithium one more time.  I have a friend who is going to help me take psilocybin “trips” or “micro-doses” – which are becoming a very respected, if in most states still illegal, alternative for “treatment-resistant” depression.  (Michael Pollan, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence.)Michael Pollan - How to Change Your Mind

This friend is a very grounded and experienced psychotherapist who is also open to trying new things.  The anecdotal and major research data about “magic mushrooms” and depression is convincing her that there is something here worth exploring – and she wants to coach me through one or more “trips”.   I have for the last four months no longer seemed depressed, but we are both still interested in me going through with this “experiment”. Doing some research on the internet, we discovered that the Lamictal I am still taking (for 15 years) is not seen as a problem to mix with psilocybin – but Lithium is more problematic.

I said to Janet: “I want to drop to the next lower dose of Lithium.”

Janet: “I think it’s really too soon to lower it again.”  

I’m absolutely sure that this four-month good stretch (four times longer than a mania has ever lasted for me) is not mania but a genuine spiritual breakthrough – partly because I see myself to committed to grounding, especially by “leaving things out”.  Sometimes in the past I have been too expanded (I’m trying to wean myself also off psychiatric words like “manic”).  For me, “too expanded” means “expanded beyond what I have any support to help me integrate”.  But my psychiatrist and my psychotherapist – who seems especially open to the possibility that my new energy is not a psychiatric symptom – each in their own way feel a need to check hard if I have fallen into a “manic episode”.

I was aware of a little defensive reaction when Janet basically said “No” to something that I did very much want.  But really only a little reaction.  I had expected her to say basically this – in her medical role, she pretty much had to.  But – given the relatively open and flexible and collaborative person she is and our relationship being as free-spoken and genuinely trusting as it has been – I did not expect this position to be her final offer, but rather the beginning of a negotiation.

I said to myself, “You know that you have in your hip pocket the ‘nuclear option’ – and you know that you are prepared to use it before you will agree to stand pat on the Lithium.  ‘If you don’t help me to lower the Lithium, I’ll do it myself the best I can.‘  But we are nowhere near needing the ‘nuclear option’ yet.  In fact, even though you are noticing a little bit of defensiveness inside yourself, don’t do anything with the defensiveness – leave it out.  Just stay quiet and let her say what she needs to say in order to be a ‘good psychiatrist’.”

And, sure enough, after Janet had carefully laid out for me all the hazards of so soon lowering my Lithium again, she wound to a close.  She got quiet – and I could feel the whole magnetic field shift.  Having said what she was supposed to say, she was now free to do what she really wanted.

She said, “If – after hearing all that – you still want to lower the Lithium, we could drop from the 300 mg. capsule to 150, still taken once a day.”  Trying hard not to look like the cat that had swallowed the canary, I just gave her a nice little smile – no hi-fives, no end-zone dances – and a soft “Thanks, I think that will be great.”

Published by Majo

These days all of my identities are converging: whether I am offering a blessing in the grocery store checkout line, offering a prayer in a poem or experiencing the kinship with all life while walking my or a client's dog - it's all the same. It's all Life.

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