Self-Acceptance - Victor Ashear

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that period.

      I felt immense pity and grief for that helpless little girl and gratitude for my aunt and uncle, who surely saved her from a much more destructive life and an early death. At the same time, I understood that any child who endures trauma, such as a lengthy separation from a primary caregiver before the age of five, is likely to suffer and struggle into adulthood.

      After that call, I finally knew what was broken, and I knew I could fix it. I began to ask more questions about my past and consider its place in the bigger picture of my family’s journey, partly to prevent dark history from repeating itself, partly to gain better self-understanding. But I have tried not to spend much time blaming my parents and their parents for the harsh parts of my childhood and the resulting challenges I face today. Instead, I try to compassionately view my elders as my peers in shouldering the burden of the negative aspects of our legacy. Otherwise, wallowing in blame eventually gets me stuck.

      I also found that self-reflection plays a crucial role in recovery. This grueling but worthwhile process involves finding the courage and strength to study your flaws and take responsibility for them without beating yourself up, an exercise featured in this workbook. Initially, this means tuning in to, examining, and possibly changing your inner dialogue. In my case, I began to notice an anxious and critical tone to my conversations with myself. That quickly led to another crucial insight: My primary problem is anxiety, which, in turn, underlies my depression. Discussing this discovery with my therapist and friends who work in the mental health field clarified the evolution of my mental illness.

      As a child growing up in a sometimes-volatile environment, I learned to prepare for the worst and remain on high alert so I could respond accordingly at the first sign of trouble. If I “failed” to ward off negative outcomes—even those beyond my control—then I took a berating not only from external sources but also myself, which exacerbated my anxiety and led to feelings of worthlessness. “Success” at keeping the peace reinforced my reliance on this survival technique, which, like any repeated behavior or activity, deeply entrenched neural pathways in my impressionable young brain, setting the stage for a general mode of operation that caused more problems than it solved in the first twenty years of my adulthood.

      These discoveries and ongoing self-reflection have helped me make considerable strides over the past decade: I married a sweet and supportive man, developed healthy and mutually satisfying friendships, and improved my workplace conduct. Major life challenges during that period, however, threatened my overall recovery from mental illness.

      In 2006, I moved from Casper, Wyoming, to Sheridan, a small community in the northern part of the state and my hometown, to spend time with my father and take care of him because I knew his time was short, even if he didn’t. At that point, my depression was in remission, but I began to experience intense pain and spasms in my lower back, among various other symptoms. Running, which had provided me with fitness, weight-control, a competitive outlet, and a certain level of mood management, slowly became unbearably painful. A seemingly never-ending search for answers ensued, and my medical issues forced me from self-employment as a freelance writer and editor into the local nonprofit sector, where I eventually became the county’s suicide prevention coordinator. As I spiraled into yet another depressive episode, I asked my gynecologist to prescribe me Cymbalta, an antidepressant my father had found useful for pain and mood management. Since half of my DNA comes from him, I reasoned, the drug would likely help me, too.

      While Cymbalta somewhat alleviated my physical and emotional pain, I still could not engage in running and many of the other activities I enjoy without hurting. Believing that I deserve to live life to the fullest, I refused to give up my search for the underlying cause of my debilitation. Near the end of 2010, at the recommendation of my gynecologist, I underwent exploratory surgery, which revealed the presence of endometriosis. I opted to undergo a hysterectomy, hoping that would resolve my pain. Since I had decided early in my adulthood to forego having children for many reasons, I did not grieve the loss of my uterus. However, I chose to keep my ovaries to avoid going into surgical menopause at age thirty-seven. The procedure did help to some degree, and once I fully recovered, I was better able to narrow down another source of pain: my hip. Still, none of my local healthcare providers could pinpoint the exact nature of my problem.

      At the beginning of 2012, my father became critically ill with end-stage chronic obstructive pulmonary disease (COPD) and nearly died. For several months after that episode he seemed to rally, and I fell into a false sense of security. Despite my chronic pain and because of my frustration with the side effects of Cymbalta, I decided to stop using the drug. Even with my primary care doctor’s guidance, I found withdrawal physically and mentally hellish, but I eventually stabilized.

      That summer, six years after the onset of my chronic pain, I saw a Denver surgeon who concluded that running on a malformed hip joint for years had caused significant damage. When he explained that he could repair the injury and that I would be able to run again, I rejoiced, and we scheduled surgery for October. That August and September, however, my father experienced his second COPD episode, ultimately receiving intensive care in Billings, Montana, 130 miles north of Sheridan. As his medical power of attorney and his only child, I spent most of that five-week period with him, watching his suffering in horror and beginning to endure the most drawn-out, excruciating heartbreak of my life.

      Dad managed to pull through again, to my uneasy relief. But by the time my surgery date arrived a few weeks later, my fight or flight response was “on” twenty-four hours a day. Completely frazzled, I agonized over the possibility that he might require another hospitalization or even die while I was in surgery or recovery six hours away in Denver. My anxiety skyrocketed as I simultaneously plunged into the deepest depression of my life.

      Dad and I both made it through my surgery without incident. Managing his doctor’s visits, staying on top of my physical therapy, and trying to navigate a major transition at work made my recovery particularly challenging. When I burst into tears during one of Dad’s appointments, our shared physician convinced me to resume my antidepressant use; this time I chose Wellbutrin. I also began seeing my current therapist.

      Around Thanksgiving, Dad endured his final hospitalization and passed away in his sleep at home just a few days after his release. Only people who have watched a loved one slowly slip away into the great unknown can understand the awful combination of devastating grief and guilt-ridden relief that follows.

      As 2013 began, I made a promise to honor my father as well as myself: I would allow my grief process to unfold naturally, ignoring any societal pressure to stuff my emotions or avoid discussing my pain. At the same time, I strove to continue my recovery from surgery and to resume a normal work schedule. Six months later, my employers fired me. Undoubtedly, my job performance had declined, but the news initially came as a significant blow to my ego and my finances.

      Yet, I soon began to view my firing as a blessing in disguise. I found suicide prevention gratifying, but my role had forced me to extend myself far beyond my natural boundaries as an introvert, requiring great amounts of energy without allowing enough time for rejuvenation. Now I could take time to rest, grieve my father, and resume my quiet career as a freelancer. Dr. Ashear, whom I met through the Sheridan County Suicide Prevention Coalition, asked me to help him prepare this outstanding workbook for public use; getting to know this gentle and compassionate man has been a privilege, and our collaboration sometimes feels serendipitous. I also started making a number of lifestyle changes, from incorporating vitamins and supplements into my diet to reducing my alcohol consumption to scheduling regular massages and chiropractic adjustments.

      Meanwhile, just when I thought my life was beginning to settle down, I realized my hip surgery seemed less than successful overall. My physical therapist explained that my injury had left me with stretched ligaments and that no amount of strengthening would rehabilitate them completely. The implication that ongoing pelvic instability would haunt me for the rest of my life, perpetuating my chronic pain and making running impossible, crushed me.

      Not long after that, I noticed the onset of new internal pain. My gynecologist suspected that my endometriosis had returned, and she advised that only the removal of my ovaries would solve the problem. So, with the first anniversary of my father’s death looming among the holidays, and in the face of turning forty

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