11 ways not to crash and burn in social work school

Reading time: 7 minutes

If there’s one experience that unites social work school students, it’s a feeling of chronic overwhelm.

The Master of Social Work (MSW) program is a generalist degree, meaning it covers a lot of ground, spanning clinical practice, research, and macro advocacy.

Jampacked curriculums are how social work schools prepare students for the reality they will most likely have to wear many hats throughout their careers.

To fulfill our (well-earned) reputation as masters of resourcefulness, our teachers pile reading after reading upon us, leaving students buried under an ever-growing pile of work.

To make matters more difficult, within weeks of starting their degree, students are thrown into the field placement deep end.

The rationale here is that the best way to learn is by doing. Without practice, there’s a good chance that much of the coursework—often covered at a breakneck pace—won’t stick.

Struggling to keep up, we let our self-care activities fall by the wayside. Anxiety, study burnout, and imposter syndrome often result.

But this doesn’t have to be the case. Here are 11 tips I believe will go a long way to helping you not only survive, but flourish in social work school.

1. Prioritize with the 1-2-3-4 method

Your workload as a social work student is formidable. The only way you can ever hope to get (and stay) on top of it is by prioritizing.

To do this, organize all your tasks into the following categories:

Do first
Schedule
Delegate
Don’t do

Next, complete each task in order of priority. When another task is added to your list, make sure to continue assigning it a number and an action (if applicable).

More information on the 1-2-3-4 method can be found here.

2. Learn the value of strategic “nos”

If you’re a perfectionist, completionist, and/or a workaholic, you may struggle with assigning items to the final category, “Don’t do.”

But refusing to say “no” in this profession can come at a considerable cost to your wellbeing.

In social work school alone, you may be bombarded with invitations to extracurricular events. But between attending class and field placement and writing essays, you’ll probably lack the mental bandwidth to fully participate.

My suggestion would be to say “yes” only a handful of events you are certain will advance your learning or professional goals. As for everything else, feel free to ignore it.

Remember, even if you can’t attend the desired event, you can always ask the organizer in advance for access to a recording or slides.

If neither is available, ask if a peer may be willing to take notes on your behalf.

3. Calendarize

With so many responsibilities to juggle, the only way you can stay on top of it all is by making liberal use of your smartphone’s inbuilt calendar.

When scheduling items in this calendar, only add those from categories 1 and 2. Consider using a free service like Google Calendar or Apple iCloud Calendar to help you keep all calendar items synced across all your devices.

Next, make sure to set reminders. My suggestions are to use both instant notifications and email reminders to ensure you never miss an assignment deadline or another commitment. Find a system that works best for you.

When calendarizing assessment due dates, you may find it helpful to break the task into baby steps and set mini-deadlines for each.

Before you can write a paper, for example, you’ll need to complete some often lengthy “pre-work” tasks. For example, conducting literature searches, reviewing readings, and completing an outline.

Allocating time and due dates to each of these activities can help keep you on task. It can also convey a sense of progress and positively affirm your efforts.

This brings us to point four…

4. Reward yourself

All human endeavors are ultimately driven by the promise of reward. It makes sense therefore that when setting out to accomplish a task, we need to have first identified the payoff.

Rewards can be intrinsic: completing the task may be in itself an affirming experience. They can also be extrinsic, such as buying yourself a small gift upon completing a school semester.

This may sound like self-bribery, but everyone can benefit from a much-needed boost to our motivation levels from time to time.

Rewards don’t have to be anything huge. They can be something as simple as treating yourself to a coffee.

Just finished a grueling paper on social work policy? Go out for a walk. Spent the morning poring over a stack of readings? Take the rest of the afternoon off to relax in the park. You’ve earned it.

5. Maintain boundaries

Boundary setting is crucial to remaining sane in the social work field. This applies as much to interpersonal relationships as it does to managing your time, especially where schoolwork or your field placement is concerned.

As you plan out each day, don’t forget to set limits on the amount of time you dedicate each day to work. Make sure to pencil in time for unwinding.

Set a window each day to reply to all non-urgent emails, calls, or text messages that relate to school and your placement. Once that window closes, don’t reopen it.

Treat “you” time as sacrosanct. The only thing you should be prioritizing during downtime is rest and rejuvenation.

Maintaining boundaries in this fashion can help protect you against burnout, both as a student and as a fledgling social work professional.

6. Self-advocate

Our lecturers drill into us the importance of self-advocating. Social work school and your field placement present numerous opportunities in which you can hone this invaluable skill.

If there’s something you need to know or want to learn, ask a teacher or field supervisor.

Given you are paying for access to their expertise (through either school fees or your own labor), you have a right to advocate for as many learning opportunities as you feel you need.

If you require an extension on an assessment due date, ask for it. Your lecturer will likely be more than willing to accommodate your request.

Should your requests go ignored, persist, but be sensitive to the reality that what you’ve asked for may not always be possible.

Exercise the fine art of picking your battles, and be prepared to switch gears should the situation call for it.

7. Manage up

Fieldwork supervisors are usually torn between many competing responsibilities. What can this mean for you? Inconsistent supervision.

Meetings may be rescheduled at the last minute, or supervision sessions may be interrupted and even canceled. For social work students, these situations can be frustrating and demoralizing.

In such instances, I recommend managing up. Keep reaching out, asking questions, and making requests. Send emails to your supervisor daily, outlining your priorities and any tasks or activities you plan to undertake.

Solicit your supervisor’s input, but should you not get it, be prepared to take initiative.

Keep your appointed field liaison apprised of the situation. Be accountable by keeping a log of all your activities, interactions, and communications as proof you held up your end of the field placement bargain.

8. Live and breathe win-win

Like any situation in life, we should approach the social work profession as an opportunity to champion both our interests as well as that of others.

Invite the input of all with whom you work. Collaborate to find solutions. Embrace differing viewpoints, and always disagree without being disagreeable.

Never leave anyone feeling like they’re “one-down”. This is a sure way to breed resentment and burn bridges.

We have all at some point encountered difficult people. We have all seen firsthand how their behavior hinders their success. We can learn from this by striving to model our personal best.

See it as your job to leave a positive impression with all whom you cross during your educational journey.

You never know if you will rub shoulders with these folk again later on—or if you might find yourself in the position of asking for their help.

9. Elevate your classmates

All social work students are united by a common struggle…to survive school!

Try to grow your social work community by performing acts of service for classmates.

Lend a hand when needed. Celebrate others’ wins, praise their achievements, and give without expecting to receive.

Again, there may come a time when you have to call in a favor. Now’s the time to start collecting brownie points.

10. Raise your voice

Whether it’s conducting a one-on-one therapy session, facilitating a group, or advocating for social justice, confidence is key to our success as social workers.

If you think confidence is something we are all born with, think again. Confidence is a trait that can be cultivated through practice. You can get the ball rolling while still in social work school by speaking up.

Sharing our thoughts and experiences in front of our peers is an act of courage. It requires that we be emotionally vulnerable and open ourselves to the possibility of being ignored, judged, or criticized.

Given many of our classmates are little more than acquaintances, we may have little cause to trust that what we say will be heard and respected.

Still, there’s no better forum in which to make mistakes than in school. Mistakes are, after all, how we best learn.

Consider the fact that you have a unique perspective that others may from hearing. Silencing yourself thus deprives others of the chance to grow and learn.

Speak your passion, and chances are you’ll energize others to do the same.

11. Be a proactive learner

We are all ultimately responsible for our own professional development. So any time you identify a gap in your knowledge or skill set, think of ways you can close that gap.

If you don’t understand course content, approach your lecturer after class and request clarification.

If you need to brush up on your clinical skills, ask your field supervisor for more in-depth training. Reach out to faculty members to see if they have additional resources that they can share.

Should your budget allow, purchase additional trainings from a reputable nonprofit organization like PESI and split the cost with your classmates.

Failing that, a quick Google search can yield an array of free manuals, demonstrations, and tutorials.

If you think you’d benefit from constructive feedback, don’t be afraid to request it from someone you trust and know has your best interests at heart.

Finally, consider finding a mentor to help guide you on your journey. You can start by identifying someone you admire within your social work school.

Cultivate a relationship with this staff member, then seek out their insights and support.

Wrap up

Social work school is a challenging experience, but engaging fully with that experience is sure to pay dividends.

The degree to which you exercise curiosity, organization, dedication, and resourcefulness now can help determine your ability to overcome many of the obstacles you’ll encounter later in the field.

Treat your MSW as a trial run; a chance to internalize and embody principles so often preached by this profession. You can do this by advocating for yourself as you also strive to empower others.

By setting good habits and establishing best practices now, you’ll both ease your way and lay the groundwork for a happy—and healthy—career.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

LGBTQI+ Wellbeing

Enough with the toxic culture of COVID-19 shaming

Essy Knopf Leave a comment

Reading time: 6 minutes

After 10 months of trying to evade COVID-19, the virus finally caught me.

No—I had not been flagrantly breaking coronavirus restrictions. While others attended social gatherings, held parties, and failed to honor COVID-19 safety guidelines, I scrupulously stayed in my bedroom.

When I did emerge, it was only to exercise, shop for food, and spend time with my partner. But wearing my face mask the minute I walked out the front door and keeping my distance was not, as it turns out, enough.

COVID-19 numbers in Los Angeles hit new highs in December 2020, and as an extra precaution, I took to avoiding my roommates and wearing a face mask whenever I stepped foot in communal areas.

My immediate social circle shrank from two to one. Seeing just my partner seemed like a fair compromise to make, even if it flew in the face of rules not to mix with members of other households.

Two weeks later, my partner came down with COVID-19. By the time we received the positive diagnosis, it was too late: I too had been infected.

Until this point, I had steadily nursed anger towards those whose reckless actions were fueling case spike after case spike—the same people, undoubtedly, I saw walking the streets without a mask.

But catching COVID-19, I found myself suddenly wondering if I was no different from those I had so harshly judged.

Even as I succumbed to the tidal pull of illness, I was sliding down a spiral of another kind entirely: shame.

the thoughtful gay coronavirus toxic covid-19 shaming — Down and out with flu-like symptoms.

How ‘COVID fatigue’ is fueling a COVID boom

During the subsequent days spent in bed recovering, with only self-doubt for a companion, I began conducting a moral inventory of the (deeply questionable!) actions that had led me to this point (spending time with my partner).

But could I really be to blame for seeing a loved one, even when that decision was taken against the advice of health authorities?

As a Los Angeles resident, I had been living under a dark cloud of COVID-19 isolation, anxiety, and uncertainty for the better part of a year.

Infection transmission and financial security remained a constant concern and watching the cyclical surges in case numbers was enough to leave most people stricken with helplessness.

For these surges were the product as much of a select few choosing to gather on holidays, as they were lax enforcement of rules.

If the public and the authorities weren’t willing to take the necessary measures to stem the tide of infection, then what hope did we ever have of getting the pandemic under control?

In my imagination, I saw these individuals poking holes in a life raft the rest of us were frantically trying to bail out.

Certainly, in refusing to get tested, communicate their status, social distance, and take all the other necessary precautions, these people were acting as saboteurs.

But after so long spent in lockdown amid a national and global climate of chronic risk and uncertainty, was it really fair to fault people for wanting to spend their holidays with family?

Seeking soothing in a time of disaster stress

“COVID fatigue” (not to be confused with the actual COVID symptom) refers to a feeling of exhaustion with “being cooped up…being careful…being scared”. According to a UC Davis Health psychologist, it’s just another name for long-term disaster stress.

As a passionate advocate for mental health, I know that engaging with one’s social support network is a healthy means of coping and maintaining psychological well-being in times of crisis.

Polyvagal Theory argues that human beings’ autonomic nervous systems—the same system responsible for our fight-or-flight responses—are geared towards acting in service of their own survival through “co-regulation”.

Psychologist Deb Dana describes co-regulation as the “reciprocal regulation of our autonomic states” through social relationships.

It makes sense therefore that people burdened by disaster stress and long periods of isolation might want to seek the company of loved ones.

Video calls thus far have been the closest approximation for in-person companionship. Poor a substitute they may be, they are also a necessary evil when it comes to safeguarding loved ones against COVID-19 transmission.

Even so, why are people still taking risks?

essy knopf gay toxic covid-19 shaming coronavirus

How ‘optimism’ grants immunity to COVID-19 shaming

For the better part of a year, Los Angeles residents have been in a holding pattern, care of the ever-shifting restrictions and lockdown conditions.

Staying home and alone for such a long period is enough to exhaust anyone’s limited store of willpower. Given the high reward involved—reclaiming a former freedom—it’s no wonder some people might choose to stop adhering to COVID restrictions.

These people may be further motivated by optimism bias—that is, the belief that we individually are less likely than others to experience an adverse life event, like say, catching coronavirus.

There are also conflicting feelings around being told not to fulfill a personal right which, under any other circumstance, would be socially sanctioned. That is, spending time with family and friends.

As health authorities advised families against gathering on key holidays like Thanksgiving and Christmas, some may have chosen to deal with the resulting cognitive dissonance by seeking to justify or explain away their actions.

The stress of dealing with two conflicting pieces of information doubtless led many to suspend critical thinking about the potential repercussion of their actions.

The rise of COVID-19 shaming

In May last year, a viral video emerged of shoppers at a Staten Island grocery store hurling abuse at a woman who refused to wear a face mask.

New York City was deep in the throes of the COVID pandemic, so residents were understandably angered by the selfish and potentially dangerous actions of this individual.

Shoppers at the time appeared to be trying to socially shame the woman into donning a face mask, but however justified they may have felt, their actions carried the whiff of mob behavior.

Social shaming can be a powerful means of enforcing shared rules, especially those relating to the pandemic. In the words of shame researcher Dr. D a niel Sznycer, “The function of shame is to prevent us from damaging our social relationships, or to motivate us to repair them.”

The idea here is that shaming—a response to others’ disregard for COVID-19 safety precautions—should compel offenders to abandon their antisocial ways in service of the collective good.

Yet so often social shaming turns into outright abuse. As the popularization of terms such as “covidiot” indicates, the discourse tends less towards leveraging guilt (“You did something bad”) to inflicting toxic shame (“You are bad”).

Author Brené Brown counsels against weaponizing shame, noting that “shame corrodes the part of us that believes we can change and do better”.

When COVID-19 shaming turns toxic, it creates defensiveness and disconnection and sends the accused into fight-or-flight.

Looking at COVID-19 shaming through the lens of gay trauma

The gay community has also seen its share of toxic shaming in the wake of the coronavirus.

The popular Instagram account, Gaysovercovid, for example, has worked to name and shame those responsible for flouting coronavirus regulations.

COVID-19 shaming accounts like this work to reinforce social norms, using the fear of being “outed” on social media to dissuade would-be attendees of international circuit parties.

What they fail to acknowledge though is the purpose such behaviors may be serving for those who engage in them. Namely, nervous system regulation.

Gay men have a unique legacy of trauma, and therefore a greater need for regulation. Some chose to meet this need through the party lifestyle—a lifestyle the current global situation has rendered difficult, if not impossible.

Those who self-medicate with substances, compulsive sex, and other forms of self-gratification, are being abruptly forced off their hedonic treadmill, and this can be enough to trigger a state of collapse.

Survival in this sense is tied to the endless pursuit of distraction. For without distraction, there is introspection and realization of buried trauma and identity shame.

When confronted by the condemnation of others from within our own community, we’ll feel only more compelled to seek distraction; to maintain our place atop the treadmill.

COVID-19 shaming in such instances is limited as a mechanism for change, and may in fact have the opposite effect.

Seeking peace through compassion

If this situation tells us anything, it’s that our anger over this kind of behavior is an attempt to regain some sense of control and fairness in a world that currently seems void of both.

Authorities have shown themselves to be incapable of adequately responding to the coronavirus pandemic and curbing its widespread impact.

The result has been an entrenched sense of uncertainty, helplessness, and pessimism.

When we perceive our personal safety and financial security to be potentially threatened by others’ shortsightedness, we naturally turn to anger.

But that anger promises no peace of mind. Instead, we would be better served by engaging in self-reflection.

If you find yourself hooked by the desire to shame, ask yourself: how are the actions of others triggering me? What emotions are they evoking, and why? What steps can I take to start feeling better?

Instead of giving in to COVID-19 shaming, consider building a self-compassion practice. Self-Compassion author Kristin Neff has provided the following exercises and guided meditations.

Once self-compassion has been achieved, compassion towards others becomes truly possible. The Buddhist meditation practice of tonglen (“taking and sending”) may prove a valuable aid here.

You can also consider following some of the steps I outlined in my previous article, “How to keep mentally well during the coronavirus pandemic“.

Our goal in striving for such mindfulness is not to accept others’ reckless actions, but rather to break the stranglehold of negative feelings.

What this global catastrophe calls for is not assigning blame, but a recognition of the universality of our suffering.

It is only through such recognition that we can strive together towards a new social consciousness grounded not in self-interest, but concern for the collective.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

How to live your best life after an irritable bowel syndrome diagnosis

Essy Knopf Leave a comment

Reading time: 8 minutes

Chronic health conditions like irritable bowel syndrome (IBS) may seem like a life sentence—that’s certainly how I felt in the first year after my diagnosis.

And yet after many nights spent doubled over on the floor, waiting for waves of agonizing gut cramps to subside, I was more than ready for a change.

Emptying out my pantry and throwing out common ingredients now identified as the culprit behind my many symptoms, I found myself wondering, “So what exactly am I supposed to eat now? Air?”

After a few weeks and a truckload of futility, I had formed a solid dependence on a sludgy meal replacement powder.

Choking down this sad substitute for food, it became apparent that if I was going to achieve anything approaching my pre-IBS quality of life, I would need to explore all my options.

What do we know about irritable bowel syndrome?

Irritable bowel syndrome is a chronic, disabling condition for which there is no definitive treatment. The condition reportedly accounts for half of all visits to gastroenterologists in the US.

IBS is classified as a Functional Somatic Syndrome (FSS), meaning it’s not unlike chronic fatigue or fibromyalgia syndromes.

A FSS in scientific terms is “characterized by the presence of one or multiple chronic symptoms that cannot be attributed to a known somatic [bodily] disease”.

The development of irritable bowel syndrome is believed to be multifactorial. That is, the condition has multiple contributing biological and psychological causes.

One such cause is a disruption and impairment of communication between the brain and gut as a result of stress. More details on the specifics in this clinical review of irritable bowel syndrome.

Living your best life after an IBS diagnosis

Typically after a diagnosis, you’ll work with a dietician to identify all your trigger foods, usually via the low-FODMAP diet.

Together you’ll then reintroduce individual FODMAPs to test tolerance for each, a process that can take weeks, if not months.

An appointment at the gastroenterologist’s office may also need to be set up for you to be screened for other conditions, such as SIBO.

After these processes of elimination, the way forward however starts to get a little hazy.

Our knowledge about irritable bowel syndrome is far from complete. Symptom causes and treatment can vary from individual to individual. What works for some may not work for all.

Through my experience as a long-term IBS sufferer, however, I have found that symptom relief success is largely determined by three things: education, experimentation, and self-advocacy.

In the next few sections, I’ll list some of my hard-won personal insights, citing a range of publicly available studies.

It is important to note however that I am not a medical professional. Any statements made here regarding the efficacy of particular treatments pertain to my personal experience only.

All changes to your personal treatment protocol should be conducted with the support of your medical doctor, dietician, and/or gastroenterologist.

First stop: the low-FODMAP diet

Food plays a key role in shaping symptoms among IBS sufferers, and the low-FODMAP diet is a common go-to.

The low-FODMAP diet involves restricting the intake of certain carbohydrates known by the acronym FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols).

FODMAPs are present in anything from bananas to yogurt, to tea and garlic. Consuming more than the recommended amount can cause unpleasant symptoms, including diarrhea, constipation, cramps, gas, and bloating.

Some of the more well-known FODMAPs such as fructose and lactose are even known to trigger reactions among those without IBS.

The prevalence of lactose intolerance, for example, has already given rise to an entire industry of dairy alternatives, with products ranging from soy-based cheese, nondairy butter, and nut milks.

Given the complexity involved in low-FODMAP eating, it’s was with great relief that I discovered a smartphone app designed by the diet’s creators.

The Monash University FODMAP Diet app provides measurements of the FODMAP content for individual ingredients, as well as serving size recommendations.

The app is updated regularly, and serving size recommendations are known to sometimes change; in some cases, the kind of FODMAP listed may shift to another entirely.

For this reason, it’s crucial to always check the app when planning your next meal.

While the low-FODMAP diet can bring many with irritable bowel syndrome some relief, tolerances for each FODMAP, and other possible IBS trigger foods will still need to be monitored.

One effective way to identify one’s own triggers involves keeping a daily record of everything eaten, and the symptoms.

Not all IBS sufferers report resolution of symptoms while on the low-FODMAP diet, and so I must emphasize again the importance of working with a dietician to identify your triggers.

Other dietary suggestions for irritable bowel syndrome

Intermittent fasting: I have personally found that intermittent fasting (8 hours on, 16 hours off) can ease digestive distress by ensuring my gastrointestinal tract isn’t forced to work overtime.

Three meals maximum within this period I have found to be usually sufficient at keeping my appetite sated. I try to evenly space the meals out, with one meal at the beginning of the eating window, one in the middle, and one at the end.

If you’re eating foods with moderate amounts of FODMAPs, be warned that eating overly large portions or snacking in between can slow the transit of food through your system, resulting in FODMAP build-up and symptoms.

A low-FODMAP tea is helpful with managing your appetite during “off” hours. White, green, peppermint, mint, rooibos, honeybush, and licorice are all listed as safe.

Consider also adding a sweetener such as stevia if required. It’s zero-calorie and won’t break your fast.

Resistant starch: Resistant starch (RS) is a naturally occurring fiber. Some IBS sufferers report finding it can help with symptoms.

RS can be found in some milled grains, legumes, underripe bananas, cooked and cooled bread, potatoes, rice, and pasta, to name a few.

RS ferments slowly in the large bowel, compared to the rapid fermentation that results from eating FODMAPs, leading to the usual symptoms.

There are multiple forms of RS and your tolerance to each kind can vary. RS has been known to produce symptoms in some IBS sufferers.

RS as it turns out is my personal nemesis; nevertheless, I have found I can mitigate some RS-related symptoms with the help of the herbal remedies listed below.

Spicy foods: Spicy foods are a well-known IBS trigger. Chile is completely out for me, though I’ve found I can tolerate pepper and mustard.

Acidic foods: Vinegar is a big culprit here, to the extent that I’ve had to stop eating salad dressing.

Citric acid is another culprit that turns up in a variety of food, from candy to canned tomatoes. These days, I avoid it completely.

Caffeine: Caffeine is also a trigger. Even decaffeinated, it’s a no-go, probably due to the fact it contains compounds known to cause gastrointestinal upset.

Fat & oils: Eating anything high in fat or containing small amounts of oil I’ve found to be a major trigger. And apparently, I’m not the only one.

Note that cooking without fat and oil is possible, but requires some creativity. For example, I have found frying vegetables using a wok using a small amount of water can work.

When it comes to baking, you can also consider substituting oil with a low-FODMAP pumpkin variety or mashed unripe banana.

Medicine & supplements

Antispasmodics: Drugs such as dicyclomine (Bentyl) and hyoscyamine (Levsin) are commonly prescribed treatments for gut cramps. I make sure to carry a few pills with me at all times.

Antidepressants/Antianxiety medications: One meta-analysis found that tricyclic antidepressants can help soothe global IBS symptoms.

Another study concluded that selective serotonin reuptake inhibitors (SSRIs) are effective in treating co-occurring anxiety, depression, and psychological distress. This may in turn lead to improvements in global IBS symptoms.

A psychiatrist will be able to assist with determining whether this form of treatment is appropriate for you.

Fiber supplements: These can help ease IBS symptoms for some, although more studies are required.

One study recommends consuming no more than 5g of whole psyllium husk daily. I have found fiber supplements only exacerbate my symptoms.

Probiotics: A course of antibiotics is usually recommended when treating secondary conditions such as small intestinal bacterial overgrowth (SIBO). Probiotics can help counteract the havoc these drugs wreak on your gut microbiome.

There is evidence multi-strain supplements taken over an eight-week period can improve IBS symptoms regardless of antibiotics, though I have not experienced much success in taking them.

(Interestingly, fecal microbiota transplants are being explored as a possible treatment for IBS.)

Peppermint oil: This product is available in capsule format and can treat IBS-related symptoms. On the rare occasion I dine out, I’ll take two pills to minimize the impact of eating high-FODMAP ingredients.

Carminative (anti-gas) herbs: A new study has found that a herbal compound containing essential oils derived from Shirazi thyme, ajwain, and dill can significantly improve IBS symptoms.

When consuming foods high in resistant starch I usually take half a teaspoon of a similar three-seed combination: ajwain, dill, and anise.

As Shirazi thyme is not widely available online, I decided to sub it with anise seed, another carminative.

Note that the exact FODMAP content of these seeds has not yet been measured. It is possible that consuming them could cause you to exceed your FODMAP limits.

Activated charcoal: There is some evidence that activated charcoal can help with the absorption of gas in the bowel. I take 3x 780mg charcoal pills, twice daily, along with the three-seed combo described above.

Digestive enzymes: Broad-spectrum enzymes may support digestion among some IBS sufferers, but again more studies are required.

The good news is that there are commercially available enzymes targeting select FODMAPs: xylose isomerase (for fructose), alpha-galactosidase (for galactooligosaccharides, or GOS), and lactase (for lactose).

While I avoid dairy completely due to the fat content, lactase is an effective aid for those who suffer lactose intolerance.

There is evidence that enzyme treatment using alpha-galactosidase enables IBS sufferers to consume nuts, legumes, and beans without any of the usual side effects. Taking one 400 GALU tablet with each meal has proven a godsend for me.

For a complete list of which food items the alpha-galactosidase enzyme targets, check out the Monash University FODMAP diet app.

I have found taking a handful of highly concentrated lipase tablets can help mitigate some of the worst symptoms from eating fat.

Addendum: As the resistant starch and fat content of nuts, legumes, and beans can cause symptoms for me, I continue to limit my intake.

Exercise

In one trial, increased physical activity over a 12-week period was shown to improve irritable bowel syndrome symptoms.

For those of us who spend too long sitting, the current recommendation is to get 30-40 minutes of vigorous exercise daily.

Exercise is also known to improve general mental health. Given many IBS sufferers experience anxiety and depression, there’s a strong argument as ever for getting your daily steps in.

Stress

Stress: IBS is a stress-sensitive disorder that can bring your GI tract to a standstill, triggering symptoms such as gas and bloating.

I have found strenuous activities like hikes, traveling long distances, or attending an unfamiliar or anxiety-inducing setting can trigger tummy upset.

Having a comfortable environment and routine can go a long way to ensuring healthy bowel activity.

Seeking support with irritable bowel syndrome

Community: Reach out to friends you’ll know will be understanding and accommodating of your condition.

Find a community of fellow IBS sufferers online, or in your local city. Don’t go at it alone.

Psychotherapy: I can’t recommend this enough. You can find a list of effective psychotherapeutic interventions here.

Meditation: I have found 2x 20-minute meditation sessions a day helps ease stress and anxiety. Consider trying some of these free guided meditations.

Gut-directed hypnotherapy: This has been shown to have long-term benefits for irritable bowel syndrome sufferers.

A range of gut-directed hypnotherapy prerecorded tracks can be purchased online. (Alternatively, you can access several free general hypnotherapy tracks here.)

Moving forward

If you’re drowning in information right now, my suggestion would be to start small.

Trial run one or two of my suggestions. If, after a period of careful monitoring, your symptoms don’t improve, I would invite you to test another.

Pick and choose what works best for you, but always remember to seek professional insight into any new treatment protocol.

The National Center for Biotechnology Information website is a good place to explore studies regarding current, emerging, and possible future IBS treatments.

Finally, know that experimenting brings with it the possible reoccurrence of symptoms.

Demoralizing as this can be, take heart in the knowledge that every risk faced on the path towards healing, within reason, may ultimately prove a risk well taken.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

How 2020 became the year of the introvert

Essy Knopf Leave a comment

Reading time: 4 minutes

One day, we may look back on 2020 as one of great turmoil—but also a moment in history in which the humble introvert came into his own.

Initially, it may be difficult to look past the frightening headlines: massive bushfires in Australia, a global COVID-19 pandemic, and Black Lives Matter protests, to name just a few.

Yes—coronavirus has cost many their livelihoods…and even their lives. But in the West, as countries were locked down and stay-at-home orders were issued, the wheels of a “Quiet revolution”—to use the term coined by author Susan Cain—were turning.

While countless extroverts bemoaned the lockdowns and the loss of freedom, some introverts viewed social isolation as not deprivation, but rather as an opportunity for quality time activities and peaceful reflection.

An introvert living in an extrovert world

In her celebrated book on introversion, Quiet, Cain notes that Western cultures tend to favor the Extrovert Ideal:

“the omnipresent belief that the ideal self is gregarious, alpha, and comfortable in the spotlight. The archetypal extrovert prefers action to contemplation, risk-taking to heed-taking, certainty to doubt. He favors quick decisions, even at the risk of being wrong. She works well in teams and socializes in groups.”

The extrovert for this reason is held in hallowed regard, in favor of the many quiet and invaluable achievements introverts have made to society.

Consequently, when we introverts are measured against the Extrovert Ideal, we are often found to be lacking:

“Introversion—along with its cousins sensitivity, seriousness, and shyness—is now a second-class personality trait, somewhere between a disappointment and a pathology. Introverts living under the Extrovert Ideal are like women in a man’s world, discounted because of a trait that goes to the core of who they are. Extroversion is an enormously appealing personality style, but we’ve turned it into an oppressive standard to which most of us feel we must conform.” (Cain, 2012)

Growing up in societies that celebrate the Extrovert Ideal and mislabel anyone who doesn’t subscribe to that Ideal as “antisocial” has left many of us with feelings of inferiority.

Despite the fact our brains are wired differently from birth, the introvert’s preference for contemplating life instead of diving headlong into it often earns us dismissal.

The ‘Quiet revolution’ is here

Under scrutiny, introverts have been long forced to conceal and overcompensate for their unique natures.

Then, almost overnight, the coronavirus pandemic made social isolation the new norm, one infinitely more comfortable to the introvert.

Those privileged enough to hold onto their jobs and allowed to work from home were granted a reprieve from open-plan offices and thus sensory and small talk bombardment.

Suddenly, we were allowed to attend Zoom meetings from the comfort of our bedrooms—often while wearing pajama bottoms, no less.

As someone myself who is on the autism spectrum and has sensory sensitivities, Zoom has become a cherished substitute for face-to-face interaction.

(And let’s not forget other fringe benefits for the socially anxious, such as having acquaintances’ names listed below video feeds, in the event we forget).

For introverts, remote working seems like a no-brainer evolution of our current, counterproductive workplace culture. We have, after all, known for a while now the many benefits of remote working—benefits that are by no means restricted to the introvert.

The rise in remote working has put a pause on the much-loathed commute. Where before we introverts may have felt forced to spend a lot of our downtime recuperating from these various stresses, we can now apply ourselves to our activities and interests with renewed energy.

Meanwhile, social lives that might have once entailed exposure to overstimulating circumstances have also been placed on hiatus.

Introverts can now pick how and when they engage, measuring out social interactions in thimble-sized doses, over the phone, instant messages, or at a socially distanced hangout.

Extroverts living in an introvert’s world

Separated from the social contexts in which they have long excelled, many extroverts have understandably floundered.

Those who previously maintained their sense of self—and in turn their personal wellbeing—through social interactions have been forced to adopt a more solitary lifestyle.

The struggle of this transition is most visible in the endless parades of newfound skills on social media, the most prominent example being baking.

This phenomenon I believe is less an act of social performance than proof of the extrovert’s continued existence. It speaks as much to an existing sense of isolation that predated coronavirus (and which was accelerated by the rise of social media) as it does the degree to which that isolation has since grown.

But extroverts alone are not suffering from the side effects of our new lockdown culture.

Coronavirus has triggered a pandemic of a different kind altogether. Anxiety, depression, and suicidal ideation are reaching new highs.

One survey has even indicated that introverts have been suffering more as a result of the quarantine, though the reasons are not yet clear.

Being social creatures, it is safe to say that our collective need for companionship is arguably greater than ever.

Introverts’ inherent tendency towards solitary activities must thus be tempered, lest our circumstances lead to a complete lapse in social interaction.

Toward an ‘Introvert Ideal’

The coronavirus pandemic has seen some promising steps taken toward a different status quo, one that is, in many regards, shaped towards the introvert’s need for less stimulation.

It’s not yet clear how much of this new introvert-friendly normal will endure, post-coronavirus.

The Extrovert Ideal won’t renounce its place on the pedestal any time soon. And yet if the pandemic has proved anything, it’s that we introverts are not in fact operating from a place of lack.

Rather, we have unique strengths that have served us well in a time of great isolation and uncertainty.

There will come a time when an Introvert Ideal will receive its due. Until then, may the Quiet revolution continue.

To find out if you’re an introvert, check out this quick quiz devised by Quiet author Susan Cain.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

Can’t sleep? Here are some surefire steps to treat insomnia

Essy Knopf Leave a comment

Reading time: 7 minutes

As a teenager, I was anxious, isolated, and afflicted with insomnia.

Most days I spent indoors, indulging in geek interest escapism. Sometimes I would craft elaborate fantasy and science fiction stories. Other times I would voraciously consume books, movies, and video games.

Refuge could also be found, of all places, in hammering out essays at the computer. (That such projects could bring order to my otherwise unpredictable school and home life probably speaks to the systematizing nature of my autistic brain.)

The downside of my constant computer use was that relaxing became difficult. A day spent glued to my screen would inevitably leave my mind restless, my sleep broken.

Still, I continued to return to my computer, until what had begun as escapism gradually turned into workaholism.

Developing insomnia

Without friends, family, and a community to ground me, my self-worth became proportional to my productivity. There was always more to do, one more task needing completion.

Trapped in a vicious circle of feeling isolated, I sought reprieve in workaholism, which in turn only exacerbated my loneliness.

Living with constant internal pressure was motivating and could even be affirming. Just look at how productive I was being! So what if my peers at school bullied me – just look at these shiny achievements, these notches in my academic belt!

Caught on a treadmill of what I would later recognize as grandiosity, and terrified of the fall that would follow the moment I stepped off it, I became mired in anxiety and depression.

But rather than slowing down, I ramped up my commitments. At the height of my workaholism, I found myself juggling a full-time job, a feature documentary, a web series, a novel, and organizing two research trips abroad.

Getting to, and staying, asleep by this point had become an elaborate, multi-staged ritual, beginning with a double dose of Benadryl, followed by an hourlong walk around the neighborhood while I waited for it to take effect.

Sometimes I would end up at a 24-hour gym, working the elliptical until the fatigue hit me…unaware that all this activity was probably only making my objective all the more difficult.

When I got home, I’d pull my blackout curtains, slip on an eye mask, put in my earplugs, fit a pair of headphones, cue a soothing audio track, and lie down on a makeshift bed on the floor.

This, of all places, was the only place I was guaranteed to nod off, for reasons I still don’t understand. After many a tossing, turning and blanket adjustment, I’d doze off, only to wake a short while later.

Climbing into my real bed, I’d return to sleep, to rise the following morning, still tired but wired, ready to chip away at my ever-growing workload.

Some nights, however, I would doze off, only to be woken by a hypnic jerk, a kind of whole-body twitch typically preceded by the sensation of falling.

Again and again, I would doze off, only to be jerked wide awake. The steady background hum of anxiety would be cranked up into a shrill roar, putting sleep still further out of reach.

The journey towards recovery

Self-generated projects until this point had been the main source of meaning in my life, and yet they were as much a palliative as they were problematic.

The comparative ease with which others were able to accomplish sleeping – a basic bodily function – told me that something in my case had gone awry. Believing there was no recourse, however, I kept up my unwieldy sleep routine for years.

My mother’s staunch opposition to any form of dependency made prescription medication seem like a false option. Sure, I was already relying on Benadryl, but then again antihistamines weren’t habit-forming drugs.

And even supposing I could scrape together enough money to get a proper diagnosis, I would have to contend first with the fear that the professional I saw might dismiss my problem outright.

The situation reached a tipping point one night while I was doing my regular insomnia shuffle around the neighborhood, I became caught in a rainstorm.

Any sensible person would have run home, or at the very least ducked under the cover of a tree. But to return home before the Benadryl took effect would mean yet another sleepless night. So I pushed on.

The wind picked up, turning the rain horizontal. Next thing, it was inverting my umbrella, leaving me exposed to the elements.

After about half an hour of this, I surrendered and trudged home, sloughing off my dripping clothes and climbing into bed.

When sleep did not come, I grew increasingly anxious. The anxiety snowballed into hypnic jerks, which in turn fueled the anxiety.

The night stretched on, each hour punctuated by an anxious glance at my phone screen to check the time. Heavy with the dread of facing a new day unrested, I lay there, waiting for my morning alarm.

Come the following night, I still couldn’t sleep, and my insomnia ballooned into a record 50-hour spell that only ended with a no-refill script for Valium.

The doctor I saw granted me this small mercy on the condition I see a sleep specialist. The specialist in turn requested I visit a sleep clinic.

Two weeks later, I packed my bags like someone preparing for a red-eye flight and drove through the dead of the night to the evening ghost town of a local business district.

Strolling through a deserted highrise lobby I was overtaken by the peculiar feeling I was participating in some secretive, perhaps even illicit activity.

The elevator opened to the clinic’s front desk, where I was greeted by a man in scrubs who directed me to a sleeping cubicle.

After having changed into my pajamas, I stretched out on the bed as countless electrodes were attached to my head and chest until I resembled some primitive robot trailing electrical cables and hydraulic tubes.

Just how exactly did these people expect me to get to sleep?

The thought of it alone caused my anxiety to surface. Palming a pill, I settled into bed and waited for the heavy embrace of drug-induced sleep.

Seven hours later, I woke to the nurse removing electrodes. Hollow-eyed, I dressed then shuffled like a zombie from the room.

Treating insomnia

“So far as I can see,” the sleep specialist said, poring over my results, “you have a perfectly normal sleep cycle.”

I frowned my disagreement.

“So why am I struggling to fall asleep?” I pressed.

Alas, the specialist had no answer for me. Instead, he suggested an alternate treatment for my anxiety, something known as biofeedback.

A round of treatment would cost something in the range of five thousand dollars – an expense my insurance company was unwilling to subsidize.

With my wallet still smarting from the cost of other, unrelated illnesses, I turned to my final recourse: pharmacological treatment.

Explaining my long-standing problem to my psychiatrist, I caught myself making excuses.

“I don’t want to rely on drugs,” I said, “but this problem has gotten way out of control.”

“Well, it sounds like you’ve tried everything else,” my psychiatrist replied. “Don’t you think you deserve some relief?”

“Maybe,” I thought, feeling nevertheless that I had, in some unexplainable way, compromised my integrity.

With there being no one-size-fits-all medication for anxiety, I would now have to navigate a gauntlet of medications.

The most popular option was selective serotonin reuptake inhibitors (SSRIs). Think Lexapro, Prozac, and Zoloft.

Mainstream SSRIs however come with certain unpleasant side effects. After a couple of doses, my libido took a total nosedive.

The next recommendation was an antipsychotic medication that left me foggy-brained. One morning, while still under its spell, I pulled out into traffic, miscalculated my timing, and was almost hit by another car.

Fearing I might not be so lucky next time, I switched to a combination of antidepressants and antianxiety drugs. Thirty minutes after taking my first dose, I fell into a deep sleep.

When I woke eight hours later, it was to the discovery that the insomnia problem I had been battling for more than 15 years was, more or less, gone.

No more frazzled nerves, poor concentration, and feeling dead on my feet. As for the constant companion that was my anxiety? His hands had now been prized from the steering well and his butt relegated to the backseat.

Before, sitting down for 15 minutes to meditate had been an exercise in self-torture, my thoughts flinging themselves in every which way in a bid to escape any semblance of control.

With the current chemical cocktail, however, I was suddenly able to achieve some degree of focus.

Insomnia is a modern epidemic

Sure, these pulls could put a cap on my anxiety and insomnia – but they couldn’t completely suppress it.

In moments of stress and overcommitment, my mood disorder would flare up again, offering proof that if I wanted to truly get better, I would need to take a more holistic tack.

This in short would involve psychotherapy, undertaking a regular meditation practice, and making daily relaxation time a priority.

It also meant addressing ongoing insomnia triggers, such as an overreliance on digital devices, and workaholism as a coping mechanism for social isolation.

My challenges as I quickly realized were not exclusive to me. Smartphone dependency and “the cult of busy” as we all know are almost universal features of modern life in the West.

Some critics have even called our times an “age of distraction”, with obsessive work and device exposure creating conditions ripe for mental illness.

Even when faced with the physical and psychological manifestations of our stress, we often try to ignore them – much to our detriment.

Finding a solution that works for you

If there’s anything my journey to overcome insomnia has taught me, it’s that we can’t ignore our problems or rely on Band-Aid fixes.

Those of us who are looking to kick our sleep woes to the curb can find some relief by adopting one or more of the following changes:

Restricting device usage: Use the wellness feature on your Apple or Android devices (sometimes referred to as “night light”). This reduces the amount of blue light emitted around set times. This light can have the effect of keeping your brain in “awake” mode. It’s also worth turning on your phone’s do-not-disturb mode and enforcing a no-device usage rule around bedtime.

Practice good sleep hygiene: Create ideal conditions for sleeping. Go to bed and get up at a regular time. Ensure your bedroom is quiet, dark, relaxing, and comfortable. As an addendum to the first point, try to remove electronic devices from your sleeping space. Employ blue-light-free bulbs. Avoid large meals, caffeine, and alcohol before rest. Use your bedroom exclusively for sleeping. More tips here.

Exercise regularly: Keep physically active during the day. Dispel depression, anxiety, and restlessness with a daily gym routine or aerobics workout.

Consider psychotherapy: Therapy can provide a safe outlet for pent-up emotional tension, which can in turn affect your ability to sleep. Therapy can also support your efforts to develop coping strategies.

Stop overworking yourself: Identify an eight-hour daily working window. Use hacks to enhance your productivity. Exercise self-discipline to stop work spilling over into “you” time.

Make relaxation a priority: You can’t be productive if you’re feeling depleted. Replenish your inner reserves every day with fun and enriching activities. Catch up on your favorite TV show, take your dog to the park, or try a new recipe. Consider doing meditation, breathing exercises, or yoga to help you unwind. Adopt what Jon Kabat-Zinn calls a “non-striving” attitude.

Consider natural remedies: While Benadryl can assist with occasional insomnia, natural treatments like melatonin, valerian root, magnesium supplements, lavender, and passionflower extract may prove equally effective.

Explore additional help: Attend a sleep clinic. Explore alternate therapy options. Seek the guidance of a psychiatrist. Investigate prescription medication.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

How to flourish in spite of chronic illness

Essy Knopf Leave a comment

Reading time: 8 minutes

As the coronavirus pandemic wears on, stories have emerged of survivors who continue to suffer chronic illness weeks and even months after recovering.

As anyone living with ongoing symptoms can attest, the challenge is never strictly physical. Being sick often carries a psychological toll, fueling stress, anxiety, and isolation.

Having myself suffered a gut disorder since my early teens, I know firsthand the restrictive – if not crippling – effect ongoing health problems can have.

What these experiences ultimately taught me however is that even when overcoming illness might seem impossible, fighting your own definition of “betterness” certainly isn’t.

An ailment unknown

From the age of 12, my stomach became permanently bloated and tender, my digestion troubled.

After a family dinner, I’d usually wind up locked inside the bathroom as my gut purged itself. Sometimes the voices of my siblings would drift out of the kitchen, and I’d hear their complaints that I was deliberately shirking post-meal cleanup. How little they knew.

Stabbing pains came and went often at random. One moment I’d be sitting at my computer, and the next I’d be stricken, doubled over, or collapsed on the floor.

These spells of agony sometimes lasted for days. During a family cruise vacation, I was afflicted by fluctuating blood sugar levels, and caught myself returning to the buffet repeatedly, wolfing down one dish after another.

Then, halfway into the trip, my digestive tract gave out. For three days I lay in the fetus position in our windowless cabin in a cocoon of darkness split by red lightning-strikes of agony.

“It’s just the stomach flu,” my mother said when I asked to be taken to the onboard doctor.

“Mum, something’s really wrong,” I insisted. “My body isn’t digesting anything.”

“They’re going to charge me $100 and all they’ll do is give you an aspirin,” she complained. “Just rest. It’ll pass.”

But 72 hours later, the symptoms had failed to ease. The constant pain and nausea had robbed me of my appetite, and after three days of fasting, my mother’s seeming indifference turned to concern.

She thrust plates of salad in my face, insisted on feeding me forkfuls despite my protests.

Days later, back on solid ground and mostly recovered, I looked back on the hellish episode as a freak incident. But chronic illness persisted.

Sticking with self-diagnosis

For the next decade, the same symptoms came and went with the suddenness and ferocity of summer thunderstorms. Their cause, at first a mystery, was eventually identified as wheat.

The symptoms after all were on par with those of Coeliac disease. And when I indeed subtracted wheat products from my diet, the symptoms eased to the point of being manageable.

My doctor suggested I get an endoscopy so I could be formally diagnosed. She explained that in order to avoid a false negative, I would need to start eating wheat again.

Having already tasted freedom, I had no intention of going back into dietary bondage. Besides, what would the test prove, other than what I already knew for a fact?

My resistance to getting tested was in part due to my parents once dismissing my symptoms as psychosomatic.

My antique distrust of authority figures, and the fact I alone had championed my own health, left me somewhat resistant to the doctor’s suggestion.

It was I, after, all who had determinedly spent three hours Googling symptoms; I who had found the name for my chronic illness.

It followed, therefore, that only I could determine what was best for my own health.

“You have no way of knowing for certain,” the doctor said when I declined the offer of an endoscopy. “It could be Coeliac disease. Or it could be something else entirely.”

“I’m good,” I said. “Thank you.”

“Well, it’s your health,” she replied with a shake of the head.

“It is,” I snapped back. Just who did this woman think she was to question my judgment like this? A qualified medical professional?

No one and nothing was going to dissuade me. Defiant, I marched out of the doctor’s office, clutching my self-diagnosis to me with the kind of protectiveness reserved for a newborn.

The struggles of identifying chronic illness

Still, I never achieved complete symptom clearance. All it took was a handful of nuts or a glass of milk to kick off a round of wind and intestinal purging, while beans had the opposite effect, bringing digestion crashing to a halt.

A dietician suggested that maybe I was eating too much fiber. She proposed I try cutting back on certain trigger short-chain carbohydrates like lactose and fructose, known by the acronym “FODMAPs”.

But by the following week, I was embarking on a month’s long trip overseas, and soon forgot the dietician’s proposal.

Later, believing I must be suffering some kind of allergy, I attended a leading clinic. If I was hoping to come away with a diagnosis, I was instead left only with a patch of irritation on my left forearm, something akin to a mosquito bite.

The allergen prick test revealed I was reactive to American dust mites, but not wheat and diary.

The clinic recommended nevertheless I switch to a diet low in certain naturally occurring food chemicals called salicylates, amines, and glutamates.

These chemicals are present in anything from chocolate, to coffee to cheeses. Eliminating them completely naturally proved quite the chore, and even once I did, my condition scarcely improved.

After a few months of attempting to be vegan, things only worsened, my belly swelling as tight as a drum.

When a rash surfaced on my back like an inflamed continent, I conceded that maybe my self-diagnosis was wrong.

Previous adversities had left me reluctant to ask for help, to trust that others really had my best interest in mind. Yet this same reluctance meant I had inadvertently prolonging my chronic illness.

chronic illness COVID coronavirus thoughtful gay

Seeking treatment

A somewhat lengthy and expensive battery of tests confirmed that I indeed had been wrong about having Coeliac disease. What I was actually suffering from was Irritable Bowel Syndrome (IBS).

While both conditions share common symptoms, what my body seemed to have been reacting to was not the wheat protein gluten, which typically causes the immune reaction in Coeliacs sufferers.

My triggers were in fact FODMAPs, the carbohydrates previously identified by my dietician. This explained why my body responded adversely to high-FODMAP foods such as wheat, milk, nuts, and beans.

Had I listened to the dietician and trialed the low FODMAP diet, I would have been spared not only my usual raft of symptoms but the development of a new, secondary condition: small intestinal bacterial overgrowth (SIBO).

If IBS could be at times unbearable, SIBO had the effect of only exacerbating the symptoms.

Treating the SIBO with antibiotics decimated my gut microbiota. It also triggered a secondary infection of a parasite known as blastocystis hominis, suspected of stowing away on my body during my trip abroad.

The blasto infection sent me running to the toilet every hour, and could only be bested with still more antibiotics.

Suffice to say, it was months before I returned to any semblance of digestive normality.

Accepting what can be changed

Part of the problem was that IBS is a condition whose triggers vary from individual to individual. One person may digest a slice of cheesecake with ease, while another will be stricken by paroxysms of diarrhea.

When I expressed my desire to “get better” to my gastroenterologist, he laughed. IBS was a “functional” condition, quite unlike more serious conditions like Crohn’s disease. Expecting complete recovery simply wasn’t reasonable.

Was this, then, what I was paying this man for? A tidy response absolving him of any responsibility? Yet another “hypochondriac” dismissal?

Certainly, chronic health conditions are often complex, and the problems they throw up insoluble. But if my gastroenterologist wasn’t interested in helping me explore the possibility at least of improved health, then it fell once more to me to try.

To this end, I explored all manner of remedies: antidepressants, antidiarrheals, antianxiety medications, fiber supplements, peppermint capsules, digestive enzymes, natural supplements, antispasmodics, probiotics, exercise, hot pads, meditation, acupressure, and hynotherapy.

By isolating potential trigger foods, I discovered that the recommended fiber supplements were actually making things worse.

Another contributing factor was a substance known as resistant starch, which can be found in many IBS-friendly staples. As it turned out, something as seemingly innocuous as reheated rice or potatoes often was more than enough to ruin my digestion.

The modifications I eventually settled upon involved quitting coffee and curtailing fiber, fat, oil, sugar, and resistant starch. Intermittent fasting, which involved restricting my eating to an eight-hour daily window, proved infinitely helpful.

Meals were kept to three in total and limited to reasonable portion sizes, taking the pressure off my admittedly delicate digestive tract. Adding peppermint supplements, enzymes, and anti-diarrhetics further supported my digestion.

Lifestyle changes were also in order. There was to be no more round-the-clock workaholism. Time would need to be made now for a regular exercise routine, daily meditation, and relaxation.

As it turned out, the gastroenterologist had indeed been wrong for laughing off my complaints. A better state of health was indeed possible.

While some health conditions may be in part or completely out of our control, management or easing of symptoms is always possible. Quality of life is never an unrealistic goal.

Identifying a key need and a strategy

“What do I need most?”, “Is it realistic?”, and “How do I achieve it?”

For those of us suffering from chronic illness, these three questions can be the determining factor for both our physical and psychological wellbeing.

In my case, my foremost need was being able to eat nourishing, delicious food without getting sick.

The dietary limitations imposed by IBS meant eating out was a fraught affair, so avoiding tummy upset going forward would require I make all my meals from scratch, going forward.

Even after I threw out all my current go-to recipes, many of the IBS-friendly alternatives I found online contained other foods that were triggers for me, such as oil.

The only way I was going to fulfill my tasty food cravings therefore was by getting creative. So for the next year, I recipe tested like heck, substituting problem ingredients with symptom-free alternatives.

Most meals I produced during this period were, for the most part, healthy, if a little bland. But by the second year, my culinary game was on the up, and I had at least four passable meals under my belt. Then suddenly they weren’t just passable – they were delicious.

As cooking IBS-friendly meals from scratch could be an expensive and time-consuming process, I began bulk-buying and batch-cooking.

This strategy ensured I spent less time in the kitchen carefully measuring ingredients. Instead of or shuffling through the supermarket, poring over the price tags of often more expensive low-FODMAP alternatives, I was now able to spend more of my time savoring the fruit of my labors.

Seeking support with chronic illness

Being forced to carefully monitor everything I eat, while managing occasional flare-ups can at times be stressful.

Sometimes I’ll catch myself trying to “silver lining” the situation, reassuring myself of the benefits of having IBS. The forced dietary changes for example have rendered me permanently lean.

Some fitness fanatics might consider this an ideal result, but practically speaking, not having “rainy day” body fat can be a problem during periods of illness when I’m most prone to rapidly dropping pounds.

Chronic illness has brought many periods of frustration and despair. Key to our endurance in such instances is having someone we can talk to about our difficulties. As the old adage goes, “A problem shared is a problem halved”.

While loved ones can ever truly know what it’s like to walk a day in your moccasins, they can certainly empathize. But if you find no respite in venting to friends and family members, a sympathetic-ear-for-hire may be another option.

Therapists not only provide a supporting environment – they are specifically trained to help clients with identifying custom-fit coping mechanisms.

Therapy for some isn’t financially tenable, while others may not be comfortable opening up to a stranger. In such instances, it’s worth exploring other avenues, such as online communities or support groups for people with your condition.

Failing that, a daily “mood” diary is always a great fallback. In moments of stress or high emotion, consider jotting down in detail what you’re feeling, why, and the circumstances or situations surrounding these feelings.

Diary writing when suffering chronic illness can be cathartic for the sheer reason that it allows us to divest ourselves of burdensome thoughts and feelings. Without an outlet, they may otherwise continue to rattle around inside our brains, draining our strength and impeding our wellbeing.

Diary writing in this sense is preventative, acting as a pressure valve. It allows us to release what we are carrying in a safe and constructive way, offering us valuable perspective on our difficulties.

Takeaways

Be open to help – and self-advocacy.
Change what you can, accept what you can’t.
Identify one key need and how you can fulfill it.
Seek emotional support. Keep a diary.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Wellbeing

Dogs are not tiny humans, OK? Now please just read ‘Cesar’s Way’

Essy Knopf Leave a comment

Reading time: 5 minutes

My 18-part blog series on dog ownership, Anxious Seeks Canine, was, firstly, an admission of guilt, written before I had gotten my hands on such classics as Cesar’s Way.

Between picking at my own stitches, I was also skewering the role my neuroses had played in my shaping relationship with my pup Cash.

Yet for all the self-awareness writing Anxious Seeks Canine demanded of me, one year on after giving up my dog, I was no closer to a better understanding of what exactly had gone wrong.

Sure, Cash had been an anxious dog; about as anxious, in fact, as I myself was.

Sure, I had done the best according to what I knew at the time. And yet, walking away from the experience, I found myself wondering what exactly I could have done differently.

This is what ultimately led me to read celebrity expert Cesar Millan’s book, Cesar’s Way.

Millan highlights the fundamental error owners commit when adopting dogs. Specifically, our habit of trying to understand them from a human-centric perspective.

Dogs may share our mammalian heritage, but their needs and priorities are inherently different from our own.

And it’s when these needs and priorities clash with our own that problems develop.

Cesar’s Way: Exercise, discipline, affection – in that order

One of Millan’s key points can be distilled into the following statement: dogs require “exercise, discipline, affection – in that order”.

Too often these priorities are placed out of order, with affection first.

Consider the owner who matches their dog’s over-excited response upon returning home.

Believing that their dog has suffered through loneliness or even the perception of abandonment, s/he may over-empathize and lavish them with attention.

The problem of course is that this is a very human attempt to interpret a distinctly non-human thought process.

anxious seeks canine cesar milan cesar's way dog ownership — Iz not human. Cannot do.

As Millan points out in Cesar’s Way, dogs don’t necessarily live in the past or future as we did, in remembering and anticipation. They don’t construct causal narratives about their relationships.

Rather, they dwell in the present, responding less to memories than to prior conditioning.

As gay men, many of us have all experienced some measure of abandonment, if only as a result of our sexuality, be it from friends or family members. It stands to reason therefore why we act so lovingly towards our “fur babies”.

Yet the downside of giving affection first is that you may be unwittingly reinforcing whatever behavior the pet is engaging in at the time.

In this case, the owner is conditioning the dog to work itself into a state every time they leave or return, thereby intensifying their emotional response and instilling greater and greater levels of separation anxiety.

Take for example my habit of greeting Cash with squeals and baby-talk. In time, my dog came to connect my response with his feelings. Very quickly, my infantilizing patter began setting him on edge.

Any wonder then I never made true headway with easing Cash’s separation anxiety.

The importance of being active

From day one, Cash was bursting with excess energy. When I stood up from my desk, he would rocket to his feet, n preparation for what, I never knew.

Our daily walks involved Cash tugging me behind him, like a freight train climbing a mountain.

Three 20-minute walks each day was, in my books, more than sufficient exercise. Not so in Cash’s.

Even after hours-long hikes, my dog still somehow found the energy to chase me to the door.

Suffice to say, my largely sedentary lifestyle was not working for him. Being cooped up in my apartment went against his very genetics as a Husky-Corgi.

anxious seeks canine the thoughtful gay cesar's way — My high-maintenance pooch.

As a result, Cash remained perpetually anxious, freaking out when left by himself or exposed to other dogs, barking incessantly, snarling when they got too close, and trying to mount them.

If my squeals had only fuelled Cash’s anxiety, his anxiety only fuelled the conflict he’d anticipated fear, my dog’s aggression inevitably drawing retaliation.

It didn’t help that during my visits to the dog park I was, as Millan terms it, “punching out”. Rather than actively monitoring my dog, watching his body language, intervening early, and correcting undesirable behaviors, my attention went instead to a book or laptop screen.

Suffice to say, adjusting my lifestyle to better accommodate my dog would have gone a long way to remedying the situation.

Setting and following rules, boundaries and limitations

Shelter, food, and affection – none of this guarantees your dog will necessarily respect your place as head of the household.

However hopelessly dependent your dog may be upon you for their survival if given an inch, they most certainly will take a mile.

As Cesar Millan notes, dogs are pack animals. They seek to establish hierarchical relations. When human beings treat them as their equals, dogs may respond by attempting to assert dominance.

They may, for example, disobey you, or engage in other less obvious behaviors, like insisting they be the first to go through a doorway.

In Cesar’s Way, Millan argues that your dog doesn’t necessarily want to be the leader. Their response is simply an attempt to fill a perceived power vacuum.

Feeling forced to take the job of “top dog” can have the effect of creating anxiety for your pet, not to mention frustration for you.

By employing discipline – setting rules, boundaries, and limitations – however, we can avoid this situation entirely.

While regular obedience training can certainly help, if you fail to apply the same discipline to other facets of your dog’s life, there’s a good chance the training won’t take.

What’s important here is consistency. A dog is more likely to be happy and stable if it knows =what to expect to you. This means being firm with not just enforcing rules, but ensuring that you yourself uphold them.

For example, Cash only dragged me during our walks because I had failed to set clear, consistent rules about his role and place in the pack.

By removing food bowls after a certain amount of time had elapsed, and always ensuring I was the first to eat, I managed to quickly communicate my role as pack leader.

A no-pull halter also had the effect of stopping all attempts to dive through doorways, while forcing my dog to walk at my pace.

But most importantly, it communicated to Cash that he no longer needed to take the lead.

And for all my dog’s dislike of the halter, I sensed immediate relief on his part, as he no longer felt compelled to play a role for which he was not able.

When to use positive reinforcement

According to Cesar’s Way, we should give attention only to those behaviors we want to positively reinforce.

As for undesirable behaviors? Millan says they should be corrected immediately, by providing a replacement activity indicating what it is you would rather your dog do instead.

Affection is a form of positive reinforcement and is best earned, for example, when the dog respects a rule or obeys a command. Even then, Millan says we should only offer it so long as our pet is calm and submissive.

There are times as well when affection should be withheld: “When your dog is fearful, anxious, possessive, dominant, aggressive, whining, begging, barking – or breaking any rule of your household”.

By clarifying and reinforcing your expectations of them you condition your dog to behave in desirable ways. This not only encourages obedience but establishes your pet’s place in your household’s “pack”, thereby strengthening her/his sense of purpose and wellbeing.

This is key to dispelling the anxiety Millan notes dogs can develop as a result of living with human beings and is the cause of many of our difficulties as owners.

For those of us with firsthand experience with highly-strung dogs, the Cesar’s Way philosophy thus offers a clear path to a more balanced and content life, not just for pets – but owners as well.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Stories

Anxious Seeks Canine – Part 1: ‘I am sending you’

Essy Knopf Leave a comment

Reading time: 9 minutes

“This is a story about how I almost died. Almost. Well not exactly. But I COULD have died. I could die anytime, as a matter of fact. Is that a lump I feel in my armpit?”

Anxious Seeks Canine is a memoir blog series about a gay man living with Asperger’s, mental illness, and the relationships that may very well be fueling it. Names and identifying details have been changed to protect the privacy of all featured individuals. Except for the dog. Here’s part 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18. Subscribe for more posts.

I

“I think we have good energy.” I stared at Derrick, trying not to laugh.

“You realize horses cost a lot of money, right?”

“A few thousand dollars, at most,” Derrick replied.

“Really,” I said. “And where would you keep it?” Our tiny apartment was hardly big enough for two people and a dog as it was.

“At the stables,” Derrick said. “See, I think it would be a great investment. I could rent it out to other riders. Before long the costs would cover themselves. I’d even be able to turn a profit.”

I was on the verge of disputing the claim when the pointlessness of it all struck me.

Derrick was mercurial when it came to life decisions. This I figured was him trying to persuade himself as much as me.

And sure enough, when Derrick returned from his riding lessons a week later, he was under a cloud.

“Bitch,” he muttered. I gave him a look. “The trainer,” Derrick added. “She quoted $12,000 for the horse. Can you believe it? Then she had the nerve to ask for a commission.”

I knew better than to rub vinegar into my boyfriend’s wounds. But still, I had to ask the question.

“So…are you still going to buy a horse?”

“I’m not giving her a damn cent!” Derrick said, storming into his room.

Reality had dealt his modest dream a death blow. But by the next day, his mood had changed.

“Good news,” he said, bouncing through the door. “I’m going to buy a motorcycle.”

“You’re- What?” I replied.

“I sat on one today,” Derrick explained. “It was so cool. Look.” He showed me a photo.

“But you don’t even know how to ride,” I pointed out. Derrick scowled.

“I’d learn,” he said.

Still, I couldn’t muster enthusiasm for this latest obsession. Last time it had been a trip to Coachella. And the time before that, an overwater bungalow in Tahiti. Derrick was quietly treading the waters of a mid-life crisis.

I made myself a bowl of cereal. Derrick’s expression got all furtive.

“So… How’s your therapy going?”

It was a fishing expedition – I was sure of it. I tried to keep my tone neutral.

“Pretty well so far.”

“Have you told her about us?” I hesitated.

“No, not yet. See, she’s Christian,” I said. “I’m worried she’ll pass judgment. You know, about us.”

“You should really tell her,” Derrick insisted. As if doing this might somehow help crystallize our relationship.

Right now, Dr. Kukosian was impartial. Trying to keep your private life private while stretched out on a therapist’s couch might sound like a losing battle, but the last thing I wanted to do was incite her prejudices.

Defending one’s “lifestyle choices” was not a task I particularly looked forward to, especially when it might result in me being more or less kicked out of therapy.

The therapist pickings were slim. Los Angeles was a city ripe with dysfunction, with not enough sympathetic ears to go around.

Though if I was being honest with myself, Dr. Kukosian’s religion was an excuse, and Derrick had good cause to be worried.

anxious seeks canine the thoughtful gay — This picture captures my initial joy and optimism during the first few weeks of my relationship with Derrick.

II

Dr. Kukosian’s office was on the ninth floor of a high-rise at the heart of Glendale. This floor, I eventually learned, had been rented to a private Christian college. The doctor’s counseling room – more of a booth, really – occupied a far corner.

Dr. Kukosian sat in an armchair, clad in a cardigan, capris, and an unfaltering smile, listening patiently as I ran through the week’s events.

Fifteen minutes into the session, I ran out of things to talk about. Dr. Kukosian’s encouraging smile loomed before me.

Her non-directive therapy style had left me with a chronic fear of silence. Broaching the subject of Derrick was no longer a choice, but a necessity. It was time to let the homo out of the bag.

I opened by mentioning that I had a partner. Then I casually slipped in a masculine pronoun, carefully watching Dr. Kukosian’s face for a reaction. Nothing.

“So you moved in with him after only two months of dating?” she asked. Her lack of disapproval was anticlimatic…disappointing, even.

“Well, my lease was up at my old place,” I said. “He had a spare room. The rent was cheaper. I wanted to save money.”

Here I was, trying to justify my decision, less worried about being condemned for being gay than I was for being, well, reckless.

“Seems like that happened very quickly,” Dr. Kukosian observed.

“Anyway, it’s just temporary,” I said, hearing a criticism where there wasn’t one. Dr. Kukosian processed this with a sagely nod.

“And how are things between the two of you?”

I considered how best to respond.

“Well, he has an anxiety problem,” I began.

My therapist would have to be deaf not to hear the irony of this. I was here, after all, because my own anxiety had recently migrated to my face, leading to weeklong bouts of jaw clenching.

“Derrick’s a workaholic,” I continued. “He’s often go-go-go all day, night, and weekend. We don’t have any time together. He forgets all our couple’s appointments and blames me for not reminding him. I’ve basically become his maid and dog-minder.”

“And how does that make you feel?” Dr. Kukosian asked, perhaps sensing my exasperation.

“Like I’m a…a fixture in his household,” I said, grappling for a metaphor. “Like a lamp or a chair. Like my needs don’t matter. The dog isn’t mine. She shouldn’t be my responsibility.”

That, however, wasn’t the worst of it. I’d known from the beginning that Derrick had anger management problems.

Early on in the relationship, he’d mocked my taste in music during a car ride. I’d mimed slapping him and an instant later his fist connected with my face.

It had not been deliberate, but rather a knee-jerk (or should I say elbow-jerk?) reaction. Still, it had made me cry, and in an unexpected show of contrition, Derrick had pulled over and gotten down on his knees to apologize.

A few days later, on the return drive from a visit to see his family in Sacramento, Derrick had woken from a nap to hear me telling his dog, who was misbehaving at the time, that she was “out of control”.

“Maybe you’re the one out of control!” he shouted, before turning over and promptly falling back asleep.

At first, I was bemused. But the outbursts had continued, eroding my sense of security.

Another time, we were driving through his friend’s neighborhood while he was in the car. I made what I believed was an inoffensive observation, noting that the houses around us looked “rather squat”.

Perhaps Derrick thought I was, by extension, insulting his friend’s home, because his reaction had been to snap at me.

“Just shut up, okay?”

And when Derrick wasn’t taking his frustrations out on me, he was usually humblebragging.

As a manager at a tech startup, Derrick had crossed paths with more than a few industry luminaries. But after weeks of namedropping, I’d taken to joking about Derrick’s claims to fame.

“Elon Musk and I are totes besties,” I’d once exaggerated. “You don’t believe me? I’ve got his father’s number on my phone. Look, see? Wes Musk. We’re on great terms.”

Derrick retaliated by threatening to kick me out of his apartment.

Derrick was in his 40s, so my expectations had admittedly been skewed towards him possessing a certain degree of maturity. Skewed, if not faulty.

Over the course of months, Derrick had gone from charm offensive to lashing out at random, until finally, I’d withdrawn into my room, taking with me all my goodwill.

Our lives from then on had been parallel, occasionally crossing but never connecting. When my attempts to bridge the divide had been ignored and even scorned, parting ways had seemed the inevitable conclusion.

“It sounds like a very stressful situation for you,” Dr. Kukosian said. “Maybe for the sake of your relationship it would be best if you just moved out?”

Later, after the session, as I stood at the university urinal relieving myself, I noticed a poster taped to the wall.

“I am sending you,” it read. It was a quote, attributed to none other than Jesus Christ.

Sending me where, I wondered? And more importantly, why?

I considered the Korean characters beneath the quote. Supposing this wasn’t just a mistranslation, the phrase could have once made sense, in some other time and place. It was also equally possible it never had, and never would.

All the same, I decided to take it as a sign. Jesus or no, I was going to leave Derrick.

III

The following day, Derrick asked if I would be willing to volunteer my services as a personal assistant at his startup.

The business was short-staffed, and given Derrick had helped me with picking out my first car, I figured I owed him the favor.

But shortly after I arrived, I witnessed Derrick ball out another manager in front of several other employees.

Over lunch, I hinted to Derrick that I was worried about the possible fallout.

“Perhaps it would be better next time if you just walk away?” I suggested. Derrick glowered.

“Well, maybe next time I just won’t ask for your help,” he replied.

I studied my lunch. For the better part of the morning, I had been running around doing errands on Derrick’s behalf. Was this his idea of gratitude?

That night, Derrick missed yet another couple’s dinner, returning home hours later to find me practicing yoga. Trying to look as defiant as I possibly could from my position on the floor, I announced I was moving out.

“Okay,” Derrick said. Uncertainty flickered across his face, hardened into something else entirely.

“I don’t have any hard plans yet,” I said, trying to soften the blow, “but I have started looking around.”

I braced myself. Having laid the groundwork, I figured now was as good a time as any to pull the trigger.

“I was thinking,” I began, “it might be best if we both took some time out from the relationship.”

The subtext being forever – not that I was going to spell that out. Right now, Derrick was a powder keg I had no intention of lighting.

Derrick leaned back on his heels.

“I think that’s a good idea,” he said.

“… You do?”

“I’m pretty busy right now with work,” he said, playing it cool. “And you want more than I can give you.”

Was that a jeer I heard in his voice? If Derrick was hoping I would rise to the accusation, he was going to be sorely disappointed.

“Are you sure you’re okay with it?” I pressed.

“Fine,” Derrick insisted. His refusal to meet my eyes told me he’d suspected this was coming.

And really, how could he have not? I’d told Derrick on multiple occasions how his behavior was driving me away. His response had been to label me “too sensitive”, or worse still, ignore me completely.

Fearing my short credit history and lack of savings would hinder me in my search for a new apartment, I’d dragged my heels. But then my mental health had taken a turn, and moving out had become a matter of survival.

Over the next week, Derrick wavered between anger and brittle formality, staying away from the apartment. I began to walk on eggshells, fearing that if I wasn’t careful, Derrick might try to evict me on the spot.

A friend heard I was looking for a place and asked if I might want to take over his lease. The studio proved tiny, but it had recently been renovated, with exposed brickwork and a kitchen sink the size of a drydock. Cute, serviceable, and – most importantly – available right now.

In less than 24 hours I’d signed the lease, packed my belongings, and booked a moving truck.

IV

Moving day rolled around and I received a text message from Derrick, stating in precise detail the condition in which he wanted my room left.

“Make sure when you move out to vacuum,” he wrote. “I want you to clean all the dust off the skirting boards.”

This, from a man whose idea of cleanliness involved letting his dog defecate in the house while the Rumba was on.

All week conflict had been brewing. And soon it would explode.

At 9.30 pm, I made my final trip back to the house to collect some potted plants. While collecting the last one, I spotted movement through the open front door.

After a day’s absence, Derrick had returned home. His earlier silence over text told me he was itching for a fight.

I leaned over the threshold and dropped the keys on the TV stand.

“Here’s your keys!” I called, turning to leave. Derrick poked his head out of the bathroom.

“Wait a second,” he said, drying his hands and hurrying over. “I want to talk to you.”

“Really – I have to go,” I replied. My friends were waiting outside in the car, and we were long overdue for dinner.

“That’s fine,” Derrick blurted, using a word I’d come to associate with its exact opposite. Then he launched his opening salvo: “You need to stop talking shit about me.”

I stared, deadpan. Derrick forced a smirk.

“It’s actually kind of sad, the fact you need to go around talking about other people behind their backs.”

Yes, I had complained to a mutual friend about Derrick’s emotional abuse. So far as I was concerned, I could shout my story from the rooftop if I wanted to.

Suffice to say, Derrick didn’t really want an apology. He wanted a scene. But I was not going to give him one.

“Bye,” I said. And off I went, bounding down the front steps. Derrick rushed out onto the landing after me.

“Good luck with your writing career!” he screamed. “I hear it’s going really well so far!”

It was a knife twist out of some soap opera playbook.

Giddy with the ridiculousness of it all, I launched myself into the waiting car.

“What happened?” my friends wanted to know.

I looked back at the security gate to Derrick’s apartment complex. Any second now I expected him to burst into view, a spurned lover set on shrill revenge. The idea left me torn between laughter and mortification.

“Just drive!” I said. “Quickly!”

The next day I received a text message from Derrick, written in the frosty prose of a job rejection letter. I was hereby notified he would be invoicing me for all outstanding bills. Derrick also demanded I remove myself from our shared auto insurance plan.

“Well ahead of you there, buddy,” I wanted to reply. Derrick was so out-of-touch he hadn’t even noticed when I’d cut the tie two weeks prior.

If I’m being honest, the relationship had been a slow-motion train wreck.

It was not the first, and as circumstances would soon prove, it would not be the last.

Anxious Seeks Canine continues with Part 2: ‘Too soon bro’.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

Stories

Anxious Seeks Canine – Part 2: ‘Too soon bro!’

Essy Knopf Leave a comment

Reading time: 7 minutes

Anxious Seeks Canine is a memoir blog series about a gay man living with Asperger’s, mental illness, and the relationships that may very well be fueling it. Names and identifying details have been changed to protect the privacy of all featured individuals. Except for the dog. Here’s part 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18. Subscribe for more posts.

I

My tendency to plunge headlong into things often created problems that could easily have been avoided. My relationship with Derrick was just another case in point.

“It’s the anxiety,” Dr. Kukosian said at our next session. “Anxious people move too fast.”

A politer version perhaps of “fools rush in”. But was there anything I could do to fix it?

“My patients who have overcome their anxiety continue to face this problem for the rest of their lives,” Dr. Kukosian explained. I stared at the ceiling.

“You’re saying I’m stuck with it?” She nodded slowly.

I eyed a canvas print of an oil painting on the wall behind her. It depicted a scene of biblical rapture. What right did these apostles have, being so happy?

“So… What should I do?” I said, feeling more than a little helpless.

“Every time you feel yourself rushing into something, slow down,” Dr. Kukosian said.

Slow down? I only had one speed, and as far as I could see, the gear stick was broken. But if the Derrick experience had taught me anything, it was that I shouldn’t jump into another relationship ever again.

My new resolve lasted a total of four months.

One day, while scrubbing myself in the shower, I caught myself talking to my dead dog. By talking I mean babbling, something between doggolingo and baby speak.

“Oh Deedeesco, bwye you so kyute?” I said in a singsong voice. “I bwanna sqbuish dat. Gib cuddle?”

To the casual listener, it would have sounded like I was suffering from pathological echolalia. But it all made perfect sense to me.

Soon I was babbling while dressing and cooking dinner. I stopped strangers in the street.

“Can I pet your dog?” I’d ask, my hand already halfway to their pet’s mane.

“Oo… You iz berry sbweet, isn’t you?” I’d coo to the dog. “Oy loik dat.”

The owner would force a smile, but their body language would be practically screaming: “Could you just please get AWAY from my dog?”

Before long I was staying up nights, scanning pet adoption websites.

Many of the ads read like personals, some adopting a pitiful, pleading tone.

“Marisol is a sweet, affectionate pit bull cross. Her previous owners were, unfortunately, unable to keep up with her energetic nature.”

Other ads bordered on insolent.

“Must have a large yard. No small children. Adoption possible after two weeks of successful fostering.”

Some came with detailed questionnaires or requests that struck me as a tad over-the-top.

“In the event your dog became ill, how much would you be willing to spend for treatment? $500? $1000? $3000.”

“Record a video tour of your home to give a sense of where the dog would be living.”

Most hotels didn’t even offer a video tour, and yet here was a pet adoption agency demanding a visual guarantee you could offer their homeless dog a picture perfect abode.

I winnowed my options and made a few calls. The first on my list was a scruffy, adorable-looking Chow by the name of Thompson.

“That dog is not available for adoption,” the lady at the pound told me.

“Well, why not?”

“He has aggression issues,” she said. “He’s only available for adoption to specialist shelters.”

“So why list him at all then?” I asked, genuinely puzzled. The woman hung up on me.

Moving my way down the list, I fired off emails. My selection criteria, as it turned out, were entirely superficial, cuteness prevailing over practicality.

One response arrived. Yes, Sandra the low-slung black mutt with tender eyes was still available. I sent an email back, expressing my interest in meeting her.

“Unfortunately you cannot meet her until after you have adopted her,” went the reply.

Say what? The lister confessed then that Sandra actually lived in South Korea.

Only once I had forked over the adoption fee would the agency fly Sandra out to Los Angeles to begin her new life with me.

It was potentially the canine equivalent of a catfish – a dogfish – and a risk I was not willing to take.

A few days later, a shelter contacted me about a tan Jindo called Ki.

“Ki’s foster Miska has offered to come by and talk you through the ins and outs of Jindo ownership,” the email read. “Miska will bring Ki along for you to meet. Please do not touch Ki during the meeting, as Jindos are generally wary of strangers.”

I crammed information about the dog breed in preparation for the meeting.

There were a few warning signs. Jindos for example were wary of strangers. But as had been the case with Derrick, I chose to focus only on the positives.

Wow! Jindos were a breed known for their bravery and their loyalty towards a single person – traits largely absent in the people I dated. What was not to like?

That afternoon Miska arrived with Ki in tow.

“First thing you should know,” Miska began, sitting on the edge of my desk, “is Jindos kill.”

“Er,” I blurted.

“They have a high prey drive,” Miska explained. “Ki kills something about once a week.”

“How-” I began, and stopped.

“Just last week we were walking and he suddenly pulled free,” Miska went on, oblivious of the effect her words were having. “Next thing, I see him tossing a rat into the air.” She mimed, laughing in what I hoped was chagrin. “Then he broke its back.”

My eyes went to the dog perched on the windowsill, staring intently at something I couldn’t see. Prey.

“He’s killed pigeons before, and a few stray cats,” Miska added. My eyes returned to her.

“How do you know they were stray?”

“They didn’t have collars,” Miska said, as Ki came over to study me. I dry-swallowed.

“Otherwise Ki is just lovely,” Miska said, as if this would negate everything that had come before. “He’s so protective. As a woman I can walk him anywhere at night.” She stared down at her foster pet. “I’m going to really miss him.”

“I bet,” I said dubiously. Doubts piled on. “So the shelter told me Ki would need more than an hour of walking every day?”

“At least,” Miska said.

“But Ki wouldn’t like it if my friends touched her, right?”

“Definitely not,” she said. “Sometimes if I touch her while she’s lying down, she growls at me.”

And there it was: the soft hiss of escaping air. The balloon of my Jindo aspirations had been pricked and was rapidly deflating.

Maybe Miska was trying to be funny. Maybe she’d overstated her case. But truth be told, any murderous tendencies were for me an immediate dealbreaker.

My reservations expressed, I thanked Miska for her time and saw her and Ki out.

II

Days later, I got a callback for an ivory-haired husky-corgi called Cash.

There had been a lot of interest in Cash, the adoption agent informed me. Given how cute he was, it was any surprise he was such a hot ticket. But, the agent told me, I was still welcome to come by and meet him tomorrow.

Nursing the beginnings of a cold, I drove to the adoption center in Eastside Los Angeles. As I walked through the door, I spotted Cash sitting beneath a chair, a red bandana twined about his neck.

He peered up at me, bushy tail wagging, and I was smitten. To hell with all the other contenders – this dog was going to be mine.

I sat down beside his current owner Anja, a silver-haired woman with a voice as soft and sweet as cotton candy. As Anja gently patted Cash, she explained she’d only recently adopted him, but that he hadn’t been the right fit for her household.

“He kept jumping all over my other dog, who’s pretty old,” she said. “Once he scratched her in the eye. I had to take her to the vet for treatment.”

The excitable fur ball between her knees strained to the end of his lead, sniffing the gap beneath a door.

I made kissing noises to get Cash’s attention and he trotted over to lick my hand. Next thing I was squishing my face into his. This was my attempt at affection – and probably the textbook definition of the worst way to introduce yourself to a dog.

Cash gave a Husky growl of protest.

“I’ve never heard him make that noise before,” Anja said, fascinated.

The adoption agent came over to ask how things were going.

“I want him to adopt Cash,” Anja said. “Can he take him today?”

The face squishing trick, it seemed, had worked. Anja had sensed our special, instantaneous bond; had recognized that there would be no greater owner than I.

The agent frowned.

“There are still a few families who would like to meet Cash first,” she said. Anja insisted. A gentle tug of war ensued, until, finally, the agent caved.

An hour later I strolled out of the agency, Cash’s leash in one hand and a box of dog supplies in the other.

III

Getting my newly adopted child into the car proved something of an ordeal. The instant Cash realized what was happening, he flailed, bracing his paws against the frame of the door, like a cartoon character resisting a lifetime of imprisonment.

It took two of us to get him inside. Cash immediately settled on the floor, unmoving and unresponsive.

I searched for “dog relaxation music” on YouTube then connected my phone to the car’s audio system. Soft, languorous synths oozed from the speakers.

These were the kind of sounds you’d expect to hear in a crystal shop…and probably the closest thing to musical waterboarding. Whether Cash enjoyed it, I couldn’t tell, huddled as he was beneath my chair.

When we got home, I carried my new pet over to the bath and ran some warm water, rubbing strawberry-scented shampoo into his fur.

Cash struggled with a desperation born of certain hydrophobia. I drew the shower curtain to prevent him from leaping out, and when that didn’t work, blocked the path of escape with my body.

Afterwards I dried him and he sat, staring at me with doleful eyes as I ran a brush through his tangles. The adoption was beginning to hit home.

But so was my cold. My throat in the last few hours had grown raw, and my nose was watering.

Binning a fist-sized wad of hair, I flung the brush away and sat, exhausted, on my bed. An uncomfortable pressure built inside my sinuses, giving way to pain.

“Cash?” Cash wandered over. I sat him on the edge of the bed, buried my face in his fur, and proceeded to cry.

Cash was having none of it. His eyes bulged. “Too soon bro!” they seemed to say.

He leapt down, vanishing into the kitchen.

I lay back, trying to repress a sneeze and failing. Lying on my back, with my face parallel with the ceiling, this had the unfortunate effect of simulating rain.

There came a noise, like someone trying to squeeze ketchup from a bottle, and levered myself up. That was when I spotted Cash squatting, in preparation to defecate.

“No, Cash! No!”

Diarrhea spattered the tiles. Completing the motion, Cash stepped backwards, directly into the puddle.

“Cash stop- No! STOP STOP STOP STOP!”

At the sound of his name, Cash trotted back over to the bed, leaving a trail of muddy pawprints.

His pale, arctic-fox face peered up at me. Wary, expectant. My tear-stained face stared back.

Here we were: two sick, miserable beings in need of love and comfort. It was, if anything, a promising beginning.

Anxious Seeks Canine continues with Part 3: ‘You’re weird’.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

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Anxious Seeks Canine – Part 3: ‘You’re weird’

Essy Knopf Leave a comment

Reading time: 6 minutes

Anxious Seeks Canine is a memoir blog series about a gay man living with Asperger’s, mental illness, and the relationships that may very well be fueling it. Names and identifying details have been changed to protect the privacy of all featured individuals. Except for the dog. Here’s part 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18. Subscribe for more posts.

I

“Why do you want to date me?” The question hung in the air for a few awkward seconds. Derrick scrambled to find an answer.

“… Because I like you,” he said, his face devoid of emotion.

“And why do you like me?” I was like the four-year-old who’d just discovered the word “why”. Once I started, I absolutely refused to stop.

“You’re weird,” Derrick replied. “I like that.” As good a reason as any to be with someone, I suppose?

What Derrick had failed to articulate, however, was that I was there – and that was enough.

Whether we were actually compatible was a question to which Derrick was not interested in devoting his attention. And I accepted this. Broken, complicated ol’ me. Probably didn’t deserve any better.

You see, when I met Derrick, I was recovering from the worst illness of my life. Since my teen years, I had struggled with an undiagnosed gut disorder.

For a decade, I had believed my symptoms – gas, bloating, constipation, diarrhea, eczema, fatigue, severe mood swings – to be the result of gluten intolerance. After removing gluten from my diet, these symptoms improved but didn’t resolve completely.

Gradually I removed other possible offenders like dairy, with varying degrees of success.

After years of on-and-off illness, I made an appointment at a leading allergy clinic. Every single test came up negative.

At one specialist’s suggestion, I adopted a diet eliminating naturally-occurring food chemicals: salicylates, aminos, and glutamates, which can be found in anything from fruits, to cheese, chocolate, and sauces.

While these chemicals can cause reactions in some people, they didn’t appear to be a source of bother to me. Next I trialed going off animal products altogether…only for the symptoms to intensify.

A large red rash appeared on my back, and neither anti-fungal or cortisone creams could persuade it to go away. My gut became permanently distended, prone to swelling every time I ate.

With my health in shambles, I had no choice but to cut back completely on dating.

II

WebMD told me I was probably suffering from a condition called irritable bowel syndrome (IBS).

IBS was a somatic condition linked to anxiety and depression, and given my predisposition to the latter, this made me an ideal candidate. Notwithstanding the fact that feeling like I was in the third trimester of pregnancy wasn’t depressing in its own right…

A doctor confirmed the diagnosis and suggested I undergo a test for a secondary condition called small intestinal bacterial overgrowth (SIBO).

The results confirmed that I had indeed had well and truly become a human incubator for single-celled organisms. At last, I had an explanation for my symptoms.

Where IBS could be treated with ongoing dietary restrictions, SIBO required antibiotics. A couple of weeks of treatment reduced my gut to its normal size, only for new symptoms to emerge: chronic fatigue, followed by dizzy spells.

After petitioning my doctor for help and receiving a handful of taciturn emails, I flew to Australia to stay with my folks while trying to figure out what the hell was happening.

A helpful country town doctor put me through a battery of new tests. Receiving the results was like opening a grab bag, only to find a cluster bomb.

IBS and SIBO had left my gut ravaged, and in their wake some kind of parasite had set up shop, requiring yet another course of antibiotics.

On top of this, I was suffering from a Vitamin D deficiency, on account of all the sunlight I was not getting from lying in my sickbed.

But the kicker was that the cause of my chronic fatigue was something altogether unrelated: infectious mononucleosis – the so-called “kissing disease”.

Turns out I hadn’t been wrong to stop dating, only that I probably should’ve done it sooner. In my ailing condition, I had sought comfort in the wrong person, and he had given me a case of mono. It had been a teen rite of passage, a decade too late.

I swung very suddenly from a state of chronic fatigue to one of chronic embarrassment.

III

Still only partially recovered from my illness, I returned to Los Angeles. To say the experience had left a dent in my spirit was something of an understatement.

Look people – I almost died. Almost. Well not exactly. But I COULD have died. I could die anytime, as a matter of fact. Is that a lump I feel in my armpit?

Being so sick had only heightened my existing anxiety, leaving me overwhelmed. It might’ve helped if I’d had friends or family around to care for me in LA, but I was a newcomer to the city.

Any surprise then that I warmed so quickly to Derrick. From the very beginning, he lavished attention on me, taking me out to dinner at least twice a week.

He was solicitous about my health, swearing I could always count on him for help. It was the kind of care I’d secretly longed for.

Other people fantasize about filthy rich dreamboats, but not I. What I wanted was a nurturing parental figure who doubled as a part-time chef. Realistic, I know.

But Derrick couldn’t have been any less equipped to provide that, given he himself wanted to be parented. By the three-month mark, suspicion had set in.

Derrick had a mantra he liked to repeat, usually every day, sometimes at three-minute intervals: “I’m tired”. I’m not entirely sure what he wanted to accomplish by telling me this.

Around this time, Derrick also shifted from charm offensive to preoccupied and avoidant. We went from eating out every second night to not eating together at all.

While I could make do without bribery by takeout, a complete lack of companionship was pushing it.

At first, I tried sympathy. When Derick continued to complain about being tired however, I changed tactics. I bought a shirt with the phrase printed on it and gifted it to him, “so he wouldn’t have to keep telling me”.

Derrick was so offended he threw the shirt into the bottom of his closet. There it remained, until I, tiring of my boyfriend’s tiredness, dug it out and wore it myself.

They say there are five stages of grief. When I broke up with Derrick, I discovered a sixth: absurdity.

In the week after, I’d broached the subject, and Derrick had airily declared he was “done with this relationship”. “This relationship” being the one from which he’d quickly become absent anyway.

With that, he had stalked from the room, only to reappear moments later to ask if I would mind his dog over the weekend. When pressed for an explanation, he said he was going away on a road trip to Vegas – and I was not invited.

IV

To his credit, Derrick made a few tangential attempts to ingratiate himself after the breakup. Once, he dangled the possibility of ex-sex. Another occasion, he coyly asked if he could wear my hat…because he “liked it”.

Once I even caught him spritzing himself with my cologne, as if he were trying to savor my soon-to-be lost odor. It was almost too painful to watch.

Having weathered Derrick’s outbursts, forgiven his shortcomings, and soothed his insecurities, I’d been forced to overlook my own needs, until at last my reserves of empathy had finally run dry.

Soon I began drawing lines in the hardwood. When I caught Derrick trying to smuggle yet another bland mid-century credenza into our apartment, I responded simply with: “No”.

Derrick hadn’t allowed me to bring my own furniture into his home, telling in me in uncertain terms that it looked “cheap”. To diss my taste in furniture was one thing, but furnishing his apartment without my input? Unforgivable.

When Derrick insisted on keeping his latest acquisition, I wrapped a clawhammer in newspaper and placed it atop the credenza.

I’m not entirely sure if I’d “nailed” the Godfather reference, but the next day, the credenza was gone. Still, the little battles waged on.

Derrick had a habit of burning California white sage in the house in the place of air freshener. The smell had a rancid quality which he seemed to favor over that of his dog’s various messes.

It was an odor that happened to leave me with blinding headaches, such that I was forced to keep the door to my room closed. During the Vegas trip, I started throwing out every bundle of the stuff I could find.

The day before Derrick returned, while doing his laundry for what felt like the fiftieth time, two twenty dollar notes fell out of Derrick’s jeans pocket. I didn’t hesitate, pocketing it as compensation for all the thankless janitorial duties that had been fobbed onto me.

This moment turned out to be the last high point in our steadily declining relationship.

Did I linger to savor it? No. What I did instead was divide our Q-tip supply into two neat piles, stuff my share into a zip-lock, and departed his life as fast as humanly possible.

Anxious Seeks Canine continues with Part 4: ‘See cash? Like this’.

Essy Knopf

Essy Knopf is a therapist who likes to explore what it means to be neurodivergent and queer. Subscribe to get all new posts sent directly to your inbox.

www.essyknopf.com

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