Dr. Natural Email (Jan 2, 2023)

Dr. Natural Email (Jan 2, 2023):

Andrew

We have an appointment on Thursday.  I continue to wonder whether psychotherapy can be fruitful given your current state of mind in which in your public posts you are prone to imagine there being a monster hiding in everyone you interact with, including your doctors, excepting perhaps your brother.  You are painting most of the world with the same monster brush.  I have a guess about why you are doing this now.  Simply put, your mother's encouragement in recent months of your leaving home and living on your own to foster your adult independence has been so terrifying and so infuriating to you, and you feel so helpless to fend for yourself in the real world, that you have done the only thing you feel capable of doing.  You have put your foot down and said no to medication because you are too frightened to say yes to a plan on your living independently.  The end result of your decision to stop medication is that you are now, in my view, adrift in a daydream world of self-righteous rage where accusations leveled against others distract you from the reality of your feelings of terror and helplessness.  

What do we know for sure.  What are the facts that don't change from moment to moment.

1) Even while you were taking medication your belief that your mother is a monster would rise and fall, depending on how your were feeling about her at any given moment.  Medication did not entirely eliminate your belief that your mother takes sadistic pleasure in your suffering.  However, on medication the frequency and intensity of these emotional tsunamis was less.

2) On medication you at times believed that the woman from Fountain House you were dating was a monster plotting to kill you.  In complete contradiction to this idea, at times you felt a warm affection for her.

3) On medication you never believed that Dr. C or myself were incompetent fools at best, and deceiving monsters at worst.

Facts, off medication.
1) The emotional intensity of your preoccupation with the idea that your mother is a monster has increased.
2) For the first time in many years you are entertaining ideas that not only your mother, but Dr. C and I are responsible for your suffering.  You have lost sight of the reality of our being your doctors trying to help you.
3) In the email below that I sent you some days ago, in the space of a few sentences you claim in your post that you father is a monster and that he is not a monster.  You seem unconcerned that you mind is working in this way, asserting one thing one minute and its opposite the next.  You seem unconcerned that you are living in a transient truth of the moment that depends on how you feel rather than an enduring reality that stays stead over time.    

I would like to focus our discussion on Thursday on the above.  There may still be time for you to pull yourself out of this tail spin.