I’ve come to the conclusion that my basic needs fall into three general categories. I’m not talking about food, shelter, water, safety, but more what I need to do my best with the tools I have available to me. Nor I am quite reaching for self-actualization at the top of Maslow’s Hierarchy of Needs – that seems too unyielding for me right now. While my three categories are what I need at this time in my life — and that’s not to say others may find them useful as well — my needs may change at a different time in my life. One category may become more specifically defined or may account for more substantial heft.
The first and most important has to be self, or a love for myself. I’ve spent much of my life loathing myself and as a result working hard to destroy myself and my spirit in many creative ways. Right now I’m functioning at the highest level I ever have — with my job of five years, my writing, my relationships and social life, being relatively stable in terms of my psychiatric illness — and for reasons related to my father’s death, reasons which I don’t yet fully comprehend, I am in danger of throwing it all away because of my penchant for self-destruction, because of my father's penchant for self-destruction.
I need to love myself as a person separate and apart from others who have previously defined my life. Self-respect, self-satisfaction and self-love all have to be part of the equation.
Although I tried for a long time, I realize now that I can’t exist as a solo act. I need the company and love of others, and I need to love others and keep them company to achieve some semblance of balance. I believe that the trait of introversion exists on a continuum and if 10 is the most introverted than I am about a 7 or an 8. I need a lot of alone time to rest and recharge and think and be inspired, but that’s not to say I don’t enjoy intense but limited bursts of time spent with a small but very tight circle of family and friends. I am incredibly loyal and would do anything, no questions asked, for anyone I consider a friend.
In 2000 at my graduation party when I obtained my Masters of Social Work, the majority of the guests were either former or present therapists or counselors or some sort of paid professional. Eleven years later, at a lovely fiftieth birthday party that my generous brother gave me, I was surrounded by almost twenty of my friends and family. The only therapists in sight were my co-workers and my friends from the agency where I work. I just wish my mother had been able to see what a positive change had occurred in my life.
The third category I continue to work on is my health. Struggling with anorexia for so long has damaged my body, irreparably in some ways — but there is some damage that can be repaired. I have started walking again on the treadmill in the morning before work but not obsessively so (as I did when my eating disorder was at its height) and I have taken up the restorative practice of yoga.
I still need to learn to eat more calories on a regular basis and to make those calories count, packing them with dense nutrients. I have to cut back on the coffee and drink plain water instead of the flavored variety which has aspartame. My sleep cycle needs to shift; currently I am so exhausted that I fall into bed literally within a half-hour of coming home from work and then awaken way before the sun arises. I’m caught in a viscous cycle of not being to stay up past 8 PM.
I’ve been in therapy for half of my life — for all of my adult life and it has taken that long to get me to this point — where I am capable of seeing and realizing all of this and knowing that these are my next steps. And having confidence that I am capable of achieving them.
I like it when my patients can come up with a category of their own that makes the most sense to them. We don’t necessarily have to talk in terms of formal “categories,” but more often than not a recurring theme will present itself. It might be self-love but it might also be intimacy or grief. It’s as individualized as the patient and that uniqueness is always welcome and terrific to experience with them.
After a number of sessions, I typically hear from them “I feel like I am saying the same thing over and over.” I say in response that is a good thing because when each time we repeat ourselves new elements are added and we find ourselves going in different directions, off on various tangents. We never end up in the same place twice.
At the end of the session, the patient invariably finds that to be true and will look at me and ask “How did we end up here?” Or “Where did we start again?”
I’ve had the privilege of seeing my newest patient for a year and a half and the patient that has been with me the longest, I’ve been seeing for a substantial amount of time. I am fortunate in that regard. We’ve been through numerous steps forwards, steps back; that delicate dance of progress, that non-linear leaping of therapy.
In the end, each patient is his or her own guide (perhaps with a little assistance from me), deciding what life issue they would like to work on, what is most important to them at this time. Ultimately, it’s all related.
I’ve used to believe that of self-love, my relationships with family and friends, and my health — my life would not be at its best without any of these three components being at their peak. I haven’t gotten there yet and it’s possible that I might not — and the more I think about it the more unlikely it is that all three will reach their level of optimal functioning at the same time, and stay there — but I think this is one of those times where the journey is more valuable than the destination.