A Visit to a Therapist, Part 4
"Woah, woah, woah, hold on! This is the first post about therapist visits and you are telling me that this is part 4? Where are the previous 3 parts?" Unfortunately, for the first therapist visit, I was all over the place. According to my therapist, my stories back then were unordered [timeline-wise], which is true, because I didn't know where to start, I didn't know what my problems were, and I didn't know how to explain them. For the second and third visit, I did have a note but I forget where did I put it... so, yeah. Anyway!
I made proper preparation before visiting the therapist because I wanted to make sure that I could get answers for whatever I was feeling at that time. The sections below were things that I consulted with my therapist.
Relationship between health and stress level
In mid-October, my father teased that my rabbits [in my parent's house] were looking for me. I took that as he wanted me to visit him and my mother. At that time, I wasn't really on good terms with my mother because of the house-building stuff. I over-thought that and the day after, I didn't feel quite good in the afternoon, and by night my body temperature was 37°C. The next few weeks, yeah, I was battling with constant fever, up to 39.3°C. I didn't tell my family about this... though my in-laws knew about this from my wife. I had a similar sickness back in February 2020. Fever, tick. Possible cause from stress, tick.
Two weeks later, I was hesitating to go to the hospital because of the pandemic condition. However, because my wife and her family pushed me [and also because I had seen her exerting so much effort in taking care of me], I gave up and so we went to the a hospital. I was admitted to the emergency room. I received an infusion and had my blood tested in the laboratory.
From the full blood test, it appeared that my blood cells weren't in a good state, the red blood cell count was quite low and the platelet count was at the low-end of the normal range. It wasn't typhus or dengue fever... it was just a common viral infection, the doctor said. That was a relief. My fever disappeared in around 3 days after that.
With regards to this, my therapist said something about the relationship between stress and platelet count. She said that she also faced the same thing before. In February, two years in a row, she was sick but the doctor couldn't figure out what the sickness was. What she knew was her platelet count dropped, but it was the same as me—neither it was typhus or dengue fever.
Later on, she recognized that her life was quite stressful when she got sick. After that, in a conference related to psychology, she met with Carl Jung's grandchild [if I remember correctly] and he/she told her that mental stress can impact blood cells, in particular platelets. So, probably that was the case for me twice last year (February and October).
Although what she said validates my concerns that mental health can affect physical health—which fed my ego because back then there were people who said happiness doesn't affect health—I would still try to find references to ensure that what she said was valid. Bear in mind that I am not an expert in this field, so my thinking below could be wrong... and you don't have to agree with me.
Instead of finding facts that back up my therapist's argument, I found that mental stress raises platelet activity... which is probably a good thing? Not satisfied with what I found, I spent more time looking for more references and I learned about thrombocytopenia, a condition in which someone has a low platelet count. The following is a direct quote from that article.
Thrombocytopenia might occur as a result of a bone marrow disorder such as leukemia or an immune system problem. Or it can be a side effect of taking certain medications. It affects both children and adults.
Thrombocytopenia can be mild and cause few signs or symptoms. In rare cases, the number of platelets can be so low that dangerous internal bleeding occurs. Treatment options are available.
In my case, thankfully my platelet count didn't drop too low to the extent that internal bleeding occurred. Since I didn't have bone marrow disorder, I tried to read another article that claimed severe stress may send immune system to overdrive. In the article, the writer remarked that stress was tied to a 36 percent greater risk of developing 41 autoimmune diseases. However, I don't think I was carrying an autoimmune disease... so I was still not satisfied.
I went back to the Mayo Clinic's article and figured out that viral infection can also contribute to lower platelet production. This aligns with what my doctor said, which led to the next question: "How did the virus infect my body if I had an immune system?"
I know that when we are healthy viruses can't break through our body's immune system, so I searched for possible factors that may weaken the immune system. I discovered this article "Stress, Illness and the Immune System", which its writer claimed, "When we’re stressed, the immune system’s ability to fight off antigens is reduced. That is why we are more susceptible to infections".
I also discovered a similar fact from Healthline, "Effects of Anxiety on the Body". The following is a direct quote from the article.
In the short term, this increases your pulse and breathing rate, so your brain can get more oxygen. This prepares you to respond appropriately to an intense situation. Your immune system may even get a brief boost. With occasional stress, your body returns to normal functioning when the stress passes.
But if you repeatedly feel anxious and stressed or it lasts a long time, your body never gets the signal to return to normal functioning. This can weaken your immune system, leaving you more vulnerable to viral infections and frequent illnesses. Also, your regular vaccines may not work as well if you have anxiety.
I think this was also what my therapist said to me during our session (but I forgot to write it down). So, I guess, "mental health impacts physical health" is a valid argument? Maybe. But, even if you don't think it is because there hasn't been any thorough research about it, I suggest you be kind to other people, that's all. It's simple, really. What does it cost for you to be good to people? None.
The calm before the storm
In December, I and my wife planned to go to Bandung to visit my in-laws. We prepared that intensely—we decided that we would isolate ourselves in the hotel for 2 weeks and do PCR test—just to ensure we wouldn't be a spreader.
Before traveling to Bandung, we visited my parents first for a quick catch-up. At that time, I hadn't seen my mother for like 3 months because I didn't have the best relationship with her (see "Marriage and Emotional Affection"). Again, thankfully no dramas were produced during that occasion. Our plans went as we expected: we went to the hotel, we isolated ourselves, got ourselves PCR-tested, and then we went to our in-laws' house.
On January 11, 2021, 1 day before we went back to Jakarta, suddenly my mother flooded my WhatsApp with all kinds of ramblings related to COVID-19. It was like exactly the same compared to when COVID-19 just entered Indonesia: she bombarded me with COVID-19 related news more than 3 times a day. Eventually, I fed up and I muted all keywords related to COVID-19 on Twitter because I wanted my timeline to be my safe space. I also told her that "this news is boring". I mean, I didn't even go outside the house. I work remotely. It wasn't like I went outside to a co-working space every day to work.
Anyway, for this case, I didn't know what was the trigger for her to do that to me. During our stay in Bandung, we didn't really go outside unless it was absolutely necessary (e.g. my sister-in-law's family got food poisoned at that time so we needed to take care of them). I straight got a panic attack at that time and cried on the bed. It lasted for 2 hours before I could finally go back to work.
On January 14, my father told me that he was tested positive for COVID-19 and currently self-isolating at home. I thought, "right, probably this was what caused my mother to shovel all of her ramblings at me". At that time, I didn't really feel anything. I felt like I probably should be sympathetic for my father. I didn't. It was a conflict, a mix of sympathy and ignorance. I felt sympathy because he was my father after all, but at the same time, I didn't want to "care" because he let my mother be a dictator in the house and broke our family... my brothers in particular. It's not like a "broken family" that we usually hear of, but the damage is there.
Day after day, I noticed that my father wrote less text to me and his texts contained a lot of typos, so I could only guess that his condition worsened, although he always denied it. One day, my mother "forced" me and my wife to visit him, with the hope that we would lift his spirits and all that. That was conflicting. People were discouraged to visit COVID-19 patients to prevent further spreading, but here we were, getting invited to visit one. We did so though, just to "please" my mother, although she doesn't really get pleased by anything.
When we arrived there, I legitimately wanted to cry. He was really thin compared to the last time I saw him. The way my mother treated him also didn't help. My father was in a weak condition, how could she yell at him? My mother would question a lot of things to my father when his voice was already low that we could barely hear him. Surely, there is a thing called empathy? We decided to not stay there longer because we couldn't bear the scene. Before we left, my mother shouted from the ground floor [to my father who was on the second floor], "You're not sick anymore. That's just your psychology. Doctor Ronald said that the virus can only stay for 10 days in our body".
Yes, speaking of which, during my panic attack on January 11, she also sent me that video of Doctor Ronald and quoted what he said a lot as if her life depended on it. She held strongly the argument that as long as there was no fever, it was going to be fine.
Guess what? The next night, from my mother's story, my father's body temperature rose to 37°C. The next day, he was brought to the emergency room in a hospital. The doctors/nurses did tests (including roentgen) and showed us the result. What I could say is, what people posted on social media weren't lies. There were a lot of white spots on my father's lungs. His blood-oxygen saturation was around 70% when he arrived, so he needed some machines to help him breathe. We could only pray from that moment. Unfortunately, I went home with my mother along with my father's driver. Along the road, she quoted this "Doctor Ronald" over and over and it made me sick. I just stayed quiet and hoped I wouldn't lose my temper.
This was why I was really mad when there was a doctor who said that the relationship between health and happiness aren't confirmed scientifically yet. If what he said reached my mother, who knew what she could have done. Maybe she would have treated my father worse, using the doctor's argument as an excuse.
The next day (Saturday), my brother asked me to go to my parents' house to get my father's luggage (which he prepared the day before going to the emergency room) and his phone. However, when I told my mother so, my mother said lines such as, "Why do we need his phone? Your brother is just the same as your father, he won't listen to me. He's heading towards insolence". The "insolence" word was what triggered my panic attack, again. I had been threatened with "insolence" words-or-similar in the past, so reading that word again from her spiked my stress levels up.
I turned off my phone for 1 day. I could only remember having a "numb" feeling the whole day. I didn't feel like living.
The day after was Sunday. I tried to turn my phone back on and recognized that my mother had created a group that consisted of her, me, my wife, my oldest brother and his wife, and my older brother (who was living in Japan). The group's purpose was mostly to talk about the condition of my father and insurance. Most of the time, I was just silent reading the group. Sometimes, I needed help from my wife to "decipher" what was going on in the group because my brain was still screwed up.
Fast forward a few days later, my father was transported to another hospital that had an ICU room available (there were no available ICU rooms in the current hospital where he stayed in the emergency room). After that, we could relax a bit, because my father would receive proper care. At this moment, I and my wife decided it was the right time to visit a therapist.
My therapist said that I was conflicted when I learned my father was positive because there wasn't enough emotional bond between me and him... which was true. Sometimes, I hoped my father would be assertive towards my mother when she did something wrong. That wasn't the case, he let things go on, he told us to keep our [me and my brothers] mouths shut. As such, there were "unresolved feelings" inside us... or at least, inside myself.
I also felt as if my father and my oldest brother were lying to me. Before my marriage, they said something along the lines, "After you get married, you will be free". However, we do not really live "free". We still feel my mother's grasp. Even she forced me to cancel the apartment unit that I had paid its down payment in favor of the apartment unit that she chose... just because its rate was cheaper. Yes, it is cheaper, but its interior is inferior to the one that I chose. The stove's height is really low, as well as the kitchen sink. Every time I did the dishes, my waist always hurt because I needed to bend my back. Still, my father did nothing.
Freedom is all about the parenting standards, my therapist said, and is quite common in Indonesia. For a child to be free from their parents' dictation, they must break through their parents' standards, which can include: having more wealth than them, making a living for them, having more children than them, having higher degrees than them, and many others, perhaps.
As with my mother restricting my father from his phone, my therapist said that COVID-19 patients, to the contrary, should be allowed to use their phone—though with care. She said that COVID-19 patients are really having a tough time. They are sick and people can't visit them. The phone is the only thing that makes them reachable and in turn, makes them feel "less alone". They shouldn't be allowed to read stress inducing things from their phone, though.
Some techniques, approaches, or tools that I learned
On top of getting explanations on my screw-ups, I also learned about things that could help me when facing similar challenges in the future.
- Mindfulness: This is mostly about knowing my limit. I should be aware when I'm starting to get stressed. After I realize that the anxiety starts to creep up on me, as soon as possible I need to find/do things that could drop my stress levels.
- Usage of essential oils: I think this is a good suggestion and there's a supporting argument in this Healthline article as well, "Aromatherapy is often used as a natural remedy to relieve anxiety and stress". I and my wife have been using aromatherapy since I recovered from the viral infection in November, but we only use it in our bedroom. Probably it would be good if we use it in the living room as well because anxiety and stress don't care about the location of occurrence.
- Narrating from the third point of view: I thought this is similar to journaling—it is not. When we do journaling, we tend to do it from our point of view. Narrating, on the other hand, is done from the third point of view. By doing this, we increase the chance to see the issue that we are currently facing from the outside, which eliminates some bits of subjectivity in the process.
- Learn to be assertive: The reason I was a silent reader in my family group was because my mother and my oldest brother were both dominant and I didn't want to take collateral damage from their debate (not to mention it was really tough to decipher their discussion). It is okay for me to declare that I don't want to be dragged into the middle of a "war".
- Facing guilt is worse than facing hardship: With the previous reason said, there are times where I should have voiced my arguments as well. For example, when I truly wanted to contribute but hesitated because of the heated discussion. My therapist told me that facing guilt is worse than facing hardship. This is true because I felt like I should contribute, but because I didn't want to be a victim of war, I shut myself up... at the cost of me second-guessing my decision the whole day.
- Set boundaries: Boundaries are really important. We should explicitly say "yes" to everything that is okay to us and "no" to everything that isn't. Sometimes, people without empathy think that silence means "yes"... which is dangerous for us. This also means there are things that we can't control. As such, we should focus on what we can control instead. For example, I can't control other people's attitudes, but I can control my reactions to their attitudes. This is quite hard for me because I think I'm a people pleaser type-of-person. Sometimes I do forget about it... and this is something that I need to work on.
- Paraphrasing: As I wrote in the previous point, I am this kind-of people pleaser. This makes me an easy victim to my mother. Whenever she bombarded me with a gazillion of messages, I foolishly always tried to read and decipher them all. This led to me getting emotionally exhausted, because most of her messages have only one core... which was hidden—whether it was in the long wall of text, or it hadn't come out yet. Paraphrasing is a technique where we repeat what the others have said in our own words. From what my therapist told me, by paraphrasing, I can "pull out" the core of my mother's message without needing to think extra hard to decipher her message: just reply with her own words and let her rethink what she said before. Eventually, she will reach the core of the message herself.
Since my father was admitted to the ICU room, everything went better. We could ask about his condition from the nurse via phone, and I didn't realize how happy I was when I could hear him talk normally again when he was permitted to receive phone calls inside the room.
After my father was tested negative, the hospital gave him the green light to go back home to self-isolate and recover. However, one day after, he and my mother had a debate. My mother thought that he shouldn't use his phone because it would make him stressed... which was quite ironic given how my mother treated him. My father thought otherwise—he needed it to have "fun", which was what my therapist suggested. My mother threatened: if he wouldn't give up his phone, then my mother would leave him. My father didn't want to give up his phone, and so my mother went. My brother (who was already living in his own home), came to pick him up so his family could take care of him.
I don't usually write religious things here, but during a prayer that night, I cried when I recited the beginning of the final verse of Surah Al-Baqarah (Q2:286), with the translation as the following:
Allah does not burden a soul but to the extent of their ability; for it is what it has earned (positive degrees), and upon it what it has earned (negative degrees).
I had never cried so hard when I recited a verse of the Quran during a prayer before. I was thinking about my father. He just got back home from a severe illness and was in the process of recovery, but his wife didn't treat him well, threatened to leave him, and finally left him. I genuinely couldn't imagine how it felt. I just trusted God at that time that He knew my father was a strong person and he would be okay. (As a side note: one hour later, my mother texted my brother and said that she made a mistake by leaving him, though my brother didn't want my father to return.)
At the moment, my father is recovering well. He said to me that what improves the recovery process is peace of mind. Although my brother's house isn't as big as his, there is peace in it. Probably it's because there is no one to yell and dictate him around. Please include him in your prayers so that he can get back to his tip-top condition.
Hopefully, this post is useful. Whoever, whenever, wherever you are, if you are currently facing hardship, I'm hoping that God makes it easier for you to face it. If you are currently living a good life, please don't forget to lend a hand to those who need it.