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My dad knew I was there for him.

Yesterday at La Cheim, I decided to work on a really big, persistent negative thought in the CBT group: my guilt over how I behaved with my dad in the final days of his life.

My dad was in very bad shape—almost entirely unable to talk and seeming sort of confused and dazed—for a couple of days before he died. He was awake a lot of the time, but he just stared at me, unable to talk. All of the other gathered family and friends (my dad's three sisters, for example) seemed to think it was important to "give us time alone," and so they mostly stayed out of the house, talking to each other and doing who-knows-what, while they left me alone with my dad.

I didn't know what to do, and I just sat in the living room with him in his borrowed hospital bed pretty much every waking moment. The room was too small and oddly shaped for a chair to be placed beside his bed, and so I sat in a chair at the foot of his bed, instead. If I'd been able to sit beside his bed, near his head, I could have held his hand and talked to him or read to him (I'm pretty sure I was rereading the first Harry Potter book at the time), but instead I was far from his head and it was difficult to interact. So I just sat there. And I read most of the time, if I remember correctly, frequently looking up to my dad to see how he was doing, make eye contact, and then go back to my book.

I've felt very bad about those couple of days, like I was cold, distant, unfeeling: sitting there reading and ignoring my dying father. It's very upsetting to me when I think about those couple of days.

And when my dad was actually dying, in his last few moments, everyone was gathered in the room with him, but I wasn't near his bed. His eyes were closed and he had been completely unresponsive for hours already. In those last moments, one of my aunts was sitting beside his bed and holding his hand, and she gestured frantically for me to come and take her place, but I shook my head. I've always regretted that, not going to my dad to hold his hand and talk to him in his final moments.

So I've held all these regrets and all this guilt, and they creep up on me sometimes, sneak up on me when I have weak moments of feeling down for other reasons. In a session with my La Cheim counselor, I realized that those feelings really weigh on me.

So in CBT, I decided to work on it. The first thing we do in our CBT group is identify a negative thought we're thinking. My negative thought: "I was cold and distant with my dad when he was dying."

The next thing we do is go through a list of "15 Styles of Distorted Thinking" and see if any of those distortions apply to the thought we've selected. I decided that my thought was being distorted in a variety of ways:
  • "Filtering. You take the negative details and magnify them while filtering out all positive aspects of a situation." (I was completely ignoring all the ways that I did interact with my dad: the talk I had with him when I first arrived, the smiles we exchanged during those last days, etc.)
  • "Polarized Thinking. Things are black and white, good or bad. You have to be perfect, or you're a failure. There is no middle ground." (I was painting myself with a completely black brush.)
  • "Mind Reading. Without their saying so, you know what people are feeling and why they act the way they do." (I realized I was making assumptions about what everyone else—including my dad—thought about my behavior.)
  • "Control Fallacy. The fallacy of internal control has you responsible for the pain and happiness of everyone around you." (I realized that I was holding myself wholly responsible for my dad's pain and happiness in those final days.)
  • "Shoulds. You have a list of ironclad rules about how you and other people should act ... and you feel guilty if you violate the rules." (I feel like I should have been doing something different, and I've been beating myself up about it for years.)
  • "Being Right. You are continually on trial to prove that your opinions and actions are correct." (I feel like I didn't do the "right" thing, that I did the "wrong" thing by reading my book.)

The third and final step in our CBT process is coming up with a "talk back" or a "more adaptive thought." I struggled a bit, trying to address my thought directly as it was written.

First, I wrote, "I was confused and in shock when my dad was dying," to replace "I was cold and distant with my dad when he was dying," but that didn't feel like enough. I added, "I connected with him and supported him as best I was able." And then I realized that I wasn't actually addressing the core emotion in my negative thought, the feeling that I had let my dad down, and so I ended up with "My dad knew I was there for him." I know that's true. We made eye contact many times; we spoke bits when he was able; he looked at me and looked at me. He knew I was there, and—if I knew my dad at all—that was what was most important to him.

Doing this CBT exercise doesn't magically erase negative thoughts, but it gives me a "talk back," a response I can use when the negative thought pops up. So now whenever I start to criticize myself or feel bad about my behavior in those final days, I'll remind myself, "He knew I was there for him." It's something I firmly believe, and so it helps to neutralize the act of beating myself up. That's the most important thing to me, that he knew I was there and that I loved him, and I'm sure he did.

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