With that rheumatologist appointment last week…

I was unpacking it in therapy on Wednesday this week.

My therapist said how mindblowing it was.

She said it was a horrible thing that happened, but at the same time, she was really glad that it did happen.

I was curious as to what she meant.

She said how I reacted – how I treated myself, my thought process, has changed so significantly that she was absolutely mindblown.

And it took me a minute to wrap my head around what she meant.

But she’s right.

After that rheumatology appointment last week, at any other time, I would’ve gone into my car, self harmed repeatedly, and cried for a solid 30-40 minutes before attempting to leave.

Or I would’ve driven erratically while crying and could’ve possibly gotten into an accident.

Or I would’ve blown up my plans following the appointment, and taken it out on the people I was meeting up with, after I took it out on myself.

And I would’ve regretted all of it.

I for sure would’ve self harmed.

But that thought didn’t even cross my mind last week.

It wasn’t even in the scope of my thought process.

And my therapist said that’s how much my thought processes have changed.

That’s how much I’ve worked, in therapy, on myself, on my reactions and my go-to thought and processing actions.

And she’s fucking right.

And I sat there and teared up.

I can’t believe it.

I didn’t even think about taking what that doctor did and said to me, turn it inward, spiral down into a hot mess, and implode.

It wasn’t even an option to me.

It wasn’t even a thought in my mind.

Instead, I was thinking about my next steps.

What I can do about the shituation.

What my next move is.

How I can advocate for myself.

Who will listen to me and who will take what I have to say seriously.

I didn’t take what he said to heart.

At all.

Not even a little bit.

I didn’t internalize his shitty, lazy diagnosis.

I didn’t dwell on his negativity.

I processed through it, and quickly at that.

I dismissed him, and his dangerous diagnosis.

And I thought about what the doctors that do know me would say.

How they wouldn’t believe his Fibromyalgia diagnosis for a second.

And I didn’t take a thing out on myself because of him.

I didn’t self harm.

I didn’t go into a panic attack.

I didn’t work myself into an episode.

The only tears I shed were frustration tears that took no effort.

They just sorta streamed down my face as I sat there.

But they stopped quickly.

I didn’t burst into victim status.

I didn’t take it out on myself.

I didn’t explode on him and walk out of the office in a fury.

And that’s huge fucking progress.

I mean huge.

The thing is – I didn’t even think about taking it out on myself.

I knew that this whole shituation was a him problem, and I was just caught in the middle.

I knew it wasn’t my fault straight away.

I knew he just didn’t know what he was talking about.

This is how much I’ve been working on myself, and how much my thinking processes have changed over the last few years.

While in therapy today, I looked at my mood app, and the last time I self harmed was June 24, 2025.

Almost a full year ago.

I didn’t even realize it had been that long.

I knew it had been a while, but I didn’t realize it had been that long.

It’s been almost a year.

In the past, I would’ve taken what this doctor said and turned it inward.

I would’ve taken everything out on myself and the people around me.

I wouldn’t have gone out to dinner after the appointment with family and friends like I did.

I would’ve self harmed, cried, driven erratically, gotten home, cried more, and sat in solitude – in my frustrations, wallowing in self loathing because I went back to this stupid fucking doctor.

Instead, as it was happening, as he was ignoring my statements, while I was still in the appointment room, I was already thinking of my next move.

I need to find a doctor in Austin, is what I told myself.

Austin is bigger and more eclectic.

They have a more diverse crowd and bet I can find a better doctor up there.

There’s a better chance for a more holistic practitioner there.

I know there is.

That’s what I was thinking about.

Not that I’m a horrible piece of shit.

Not that I’m unworthy of a doctor’s time, and a solid practitioner.

Not that I’m stupid and worthless.

Not that I’m a useless, fucking dumb cunt.

Not that I’m alone in this world and everything is against me.

Not that I’m undeserving of help.

Not that I’m incapable of communicating.

Not that I’m worthless.

In fact, those thoughts didn’t even cross my mind.

And that’s what’s mindblowing to me.

I didn’t even notice this until Hannah, my therapist, pointed it out.

I mean, last Friday, the day after that terrible appointment, I was celebrating my birthday with my parents, and we were talking about the rheumatologist appointment, and my Mom commented that she thought it was so wonderful that I didn’t work myself up into an episode.

And I agreed.

I thought I knew what she meant.

But it didn’t register.

Not really.

Not until Hannah said something along the lines of “Your thought process has changed. You didn’t spiral into self loathing and self harm.”

And I hadn’t even thought about that part.

It clicked right then that that’s what my Mom was trying to say.

And I told Hannah what my Mom had said.

That she was so glad I didn’t go straight into an episode.

I talked to my Mom again last night, and she said that’s exactly what she was trying to say, but just doesn’t have the therapy words to say it.

I chuckled at that.

It’s funny how important wording is.

It didn’t click till Hannah said “you didn’t self harm”.

Because she’s right.

I would’ve turned to that straight away in the past.

That was my go-to coping mechanism for decades.

And it didn’t strike me till this week that I haven’t self harmed in a very long time.

That was mindblowing too.

My Mom said that she thinks I’m able to process through things easier and smoother because my mind is clearer now.

And I agree.

Ever since I started taking the therapeutic dose of Niacin and Vitamin C, my hallucinations have been kept at bay.

It’s strange.

But I am much, much clearer headed right now.

I’m able to truly think for the first time in my adult life.

But it’s awkward right now.

In the way that I feel like I’m suddenly by myself.

Here, I wrote something for “Poetry Night” at my therapist office about it, and I’ll share it with y’all.

It’s called “Unaccompanied”: 

It’s been quiet.

I’ve been living in silence.

Except for the birds.

It was freighting at first.

But it has become disarming through the weeks.

It’s still foreign.

In the way of not being normal.

But the quietness is slowly becoming reassuring.

I do not miss the bombarding, hateful commentary I’d receive for just being alive.

I do not miss the constant judgements.

The only thing is,

I feel very alone now.

The shadows no longer watch me.

The people behind me, the ones that follow me, have been holding their tongue.

I’m unaccompanied now.

The voices have detached from me for now, and have left me to fend for myself.

And I don’t know what my next move is.

I’m unsure how to navigate through this without the constant distasteful comments.

I’ve been defensive for so long,

I don’t know how to let my guard down.

I don’t know how to enjoy the solace.

I don’t know how to live like this.

There’s an acceptance I need to face now.

And I have to do it alone.

There’s no telling when the voices will surface again.

They follow no logical rules.

But for now, they’re subdued.

And I have to work through this.

I have to face solitude.

I need to continue to work on myself.

For the first time in decades,

I’m left to truly be able to think.

But I’m left.

I’m on my own.

…. That’s how I’ve been feeling lately.

Should I get used to the silence?

Should I anticipate the worst?

All I know is that right now is the clearest I’ve felt in my adult life.

I’m able to separate myself from others.

Like with the rheumatologist appointment – I separated myself from what the doctor was saying and doing.

I am not stupid.

I do not agree with him.

Instead of storming out and making a scene, I just sat there, nodded, and let the idiot dig his own hole.

I do not have to accept what he is saying.

And in the past, I thought I was what he was saying.

I would’ve thought that him telling me I have that fibromyalgia diagnosis – that is out of left field and inaccurate, is him telling me he doesn’t believe me, that I’m wasting his time, and that I’m a stupid piece of shit for even coming to his office. 

I would’ve thought that I was a useless, horrible, dumb, shitty, fucking idiodic piece of fucking shit for going back to his office.

I would’ve thought that him being dismissive, was my fault.

I would’ve thought that him being inattentive was something that I did.

I would’ve thought that there was something I could’ve done to change what he said.

And in reality, that’s inaccurate.

That’s fucking backwards thinking.

It’s not my fault that he’s a bad doctor.

That’s on him.

Period.

And because my thinking is so clear right now, and because I’ve put so much fucking work into myself in therapy the last four years, my automatic thinking when he started to dismiss me was – I need to find someone who will validate me, fuck this guy.

Not self loathing thoughts.

Not self sabotage.

And that’s a fucking beautiful thing.

It’s shocking I didn’t notice it until Hannah pointed it out to me – even after my Mom tried to point it out to me.

It’s like I couldn’t comprehend what my Mom was trying to say – I knew I didn’t spiral, and I was so happy that I didn’t.

But I couldn’t wrap my head around what she was really getting at until Hannah got specific.

They’re fucking right.

And I couldn’t help but cry in therapy as we talked about it.

For 42 years I have actively hated myself.

Inside and out.

I just turned 43 last week.

It’s a new year for me – and I feel it in my bones this year.

Not only did I get my DNA data back, and that was super fucking validating.

But this whole thing happened with the rheumatologist, and I couldn’t be more proud of myself – my new ways of automatic thinking, and automatic self talk.

It’s been a very long road to get to this point.

And it will continue to be a journey to keep it up – to maintain this, and make sure neutrality and advocacy are my first thoughts when something goes wrong.

Not self loathing and self destruction.

Not self harming and spiraling.

Not torturing myself and calling myself horrible things.

I have got to keep this feeling going. 

Because, for the first time in my life, my automatic thinking processes have changed for the better.

And I honestly never, ever, ever thought that I’d rid myself of that automatic, inner self loathing, self hatred and self harming.

Not to say it’s gone.

But it’s gone for right now.

Because I feel it at the base of my neck still.

But it’s inaudible at this time – it’s chained, and quelled.

Now, I’m finally in control.

The self hatred no longer holds me hostage.

I may feel alone at times, without the voices…

But I gotta say, today, I feel pretty fuckin good.

-Keren