reframing insomnia
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reframing insomnia

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Posted by F43 on May 31, 2009 at 06:07:57:

I had a chat with my psychiatrist a few weeks ago about insomnia and tapering off Zopiclone. I love him. It's clear that he finds me his least worrisome patient (given he's dealing with patients with bipolar mania and paranoid schizophrenia), but indulges my concerns about insomnia for an hour regardless. Each time I see him, he offers me a gem for my own reflection on the origins/cause of my insomnia.

This last time, he gave me two. He expressed confidence that my insomnia would resolve, but he didn't elaborate. When I pressed him on this, he said, "Most patients who are motivated to eliminate their symptoms are usually successful." Which made me feel extremely optimistic and powerful, as in, "Yeah! I'm definitely motivated to resolve this!" Then I pushed him on his statement that my insomnia is a symptom (which is engraved on this website, but has the Ring of Truth coming from my psychiatrist, because he is this delightfully insightful person. I mean, how many psychiatrists ask their patients, "How's your love life?" each visit, and then shake their heads meaningfully at the answer, and write it down carefully in their notes?) He elaborated on what insomnia could be a symptom of, in my case.

This short discussion set off a very productive few days of me asking myself, yet again, what psychological dynamics are producing my insomnia. It was so useful to spend time with pen and paper to work this out, as I did at the beginning of the year. (Grief and a sense of loss, conflict between self-image and life circumstances, frustration, loneliness, feeling overwhelmed with responsibilities, and uncertainty about what's next.) The bottom line is that this was a positive exercise worth repeating regularly. It reinforced that insomnia has been a product of many psychological disruptions at once, and that there is no cognitive "forcing" of these things to resolve. As in, life takes its own course, and when the circumstances that produced these conflicts change, as they are slowly doing right now (e.g. I'm coming to the end of my phd and I'm on the job market, which will open up my world), then they will resolve.

The experience reinforced two messages: 1) I need to be compassionate with myself because I've been through a prolonged period of upheaval; and 2) I need to be patient with my insomnia, but also not despair that it will be with me forever. My psychiatrist and my therapist are completely confident it will resolve. I have already been looking forward to ending this unhappy chapter in life, and starting a brand new one, but now with a great deal more optimism that my insomnia will not be a permanent feature.

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