highriseconstruction

I apologize. The last post took the easy way out. When faced with discussing one’s hardships, one feels tempted to speak in generalities, abstractions, and platitudes. Especially in a setting like a blog, where one’s words become available to the whole world, enemies and friends alike, the choice to be ‘real’ looks quite risky. If I’d kept a thicker wall between my web persona and my real identity, maybe the decision would be easier, the risk of authenticity less. Part of me wants to stay satisfied with my prior discussion about the way our minds scramble to rescue us from facing difficult truths, and not take the next step, and explain how it works for me in specifics. Justifications abound: “No one wants to know personal details.” “What if word gets out in my day-to-day life?” “It’s not that important, anyway.” Unfortunately, my conscience buys none of these evasions. This site is supposed to be ‘real,’ as I’ve committed to more than once. The side effects from medications (see below) that are such thorns in my side need to be publicized, and I’m not going to help anyone with flowery but vague language.

When I wrote about building a flimsy raft of concepts, I was mainly talking about the arguments my mind constructs to protect my psyche from despair about psychiatric drug-induced testicular atrophy. I was referring to my elaborate but shaky superstructure of justifications that I use to persuade myself that the severe injury to my reproductive organs is “not such a big deal.” My mind scrambles to locate hidden benefits, searches the internet for suggestions I am not alone in this problem, tries to explain it away as something similar to the menopause all women live through, and so on. I was talking about the strenuous but misguided efforts to make peace with one of the most painful catastrophes I’ve suffered.

Those who did not follow the long series of posts (e.g., this one) where I explored this injury in detail won’t know the following facts:

1. My testes shriveled up as a result of psychiatric medications (I suspect the culprit was the combination of olanzapine with an SSRI antidepressant, but since I was on many drugs it is hard to be certain.) The injury left me sterile, and dependent on applying testosterone gel to my body every day.

2. During my early adolescence, my stepmother inflicted a regular program of sexual putdowns, humiliating demands, and criticisms of my body (sometimes after she barged in on me in the bathroom.) This behavior dovetailed with provocative and exhibitionist behavior on her part, in a household that often hosted parties built around group sexual activity.

3. That since the abuse and early exposure to warped sexuality left me with scant confidence in my male identity, the gonadal atrophy devastated my self-esteem.

To try to make the destruction in my reproductive organs ‘OK’, I lean on mitigating statements: “I had already decided not to have children.” “The testosterone replacement I use provides me a higher male hormone level than experienced by most middle-aged men.” “Unless one looks closely, my reproductive organs look normal.” “Women don’t often fixate on a man’s testicles.” And so on.

All these statements are true. Unfortunately, the only times they reassure me are when I’m already feeling pretty strong and sure of myself. If I happen to be a bit down and self-critical, another thought-prison has much more power: “I’m deformed.” “I’m asexual.” “My stepmother was right,” “I hate my body.” “Without normal testes I must be weak (I think of the phrases, ‘giant stones,’ ‘brass balls,’ ‘grow a pair.’)” “If anyone finds out, they’ll ridicule and despise me.”

That deep-seated fear of being repulsive, effete, and unlovable holds far more power than any attempt to talk myself into feeling better. Della, my stepmother, did a good job of pounding negative voices into my brain. No rational statement stands a chance against the shaming and de-sexing criticism that she spoon-fed me.

The atrophy has driven home the point that I will only be at peace by accepting things as they are, and not trying to explain them away. Tranquility depends on recognizing that both modes of thinking (“The atrophy is no big deal.” and “I’ve been destroyed and can’t go on.”) represent accretions on reality; neither one is ‘truth.’ Only by dropping both patterns of thought can I achieve any semblance of stability around the damage the medications inflicted.

When I stick to this moment, I remember that I am clothed, sitting in a coffee shop with strangers who aren’t paying any attention to me, and I look like a perfectly healthy man. I am not standing naked at the center of a circle of enemies who are pointing out my physical flaws. From the outside, I look like a regular guy, and in fact I feel that way, too. Although I sometimes experience a difference in sensation in my reproductive area, this change is subtle and quite possibly imaginary. It is certainly not painful or even uncomfortable, and unless I focus my attention on that region it fades completely. For the most part, and in most moments, my body feels strong, vital, and even sexy.

The vertiginous terror that I am “hideous,” “unsexed” and “not a real man,” is only a fantasy based on false assumptions and cultural biases. It is an echo of Della’s voice. It is not ‘truth.’ I could equally argue that I am “not bad looking,” “still able and hungry to enjoy coitus,” “a man in every way except for loss of a few grams of flesh that no one sees.” But hosting arguments between good versus bad viewpoints is no way to achieve sanity. The inner debate becomes like an “Ultimate Fighting Championship” of the brain: all violence and showmanship, with nothing useful accomplished or decided. The only path to serenity is to let the gladiators out of the cage, take a few steps back, and let everything be seen in perspective.

Dealing with medication-induced testicular atrophy has convinced me that ACT’s basic tenet is valid: our minds try to make us feel better by constructing explanations for why our hardships aren’t so hard, but that strategy can’t provide consistent relief. Only absolute, minute-by-minute acceptance brings lasting peace. If I stick to this very instant, and what is actually happening, my body is my friend, and I feel fine.