Struggling

[Throwaway98765]

I'm about to start internship and am feeling overwhelmed in practically every area of life, and not sure where to go for help. I'm not even sure what I'm doing here - maybe looking to see if others have felt the same way?

My parents who I always thought were solid just announced a divorce that is taking the whole family by surprise, I just discovered I have an annoying and painful but benign health problem, last week I had 1.86 in my checking account, I'm having significant relationship stress due to the internship move and just other crap, my dissertation isn't finished and my adviser is lukewarm in the helpful department - it just feels like every possible area where there could possibly be chaos there is chaos. I really want to talk to a therapist but I can't right now because I'm moving in three weeks and am in a weird in-between health insurance situation. I'm not going to hurt myself but the thought has crossed my mind, very quickly followed by doubt about my ability to be helpful to others if I can't manage my own distress. I'm trying to be grateful for things like weather, beautiful scenery, adventure etc but it feels very forced and I just want to curl into a ball and cry for a week.

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[mypointlesspov]

I'm about to start internship and am feeling overwhelmed in practically every area of life, and not sure where to go for help. I'm not even sure what I'm doing here - maybe looking to see if others have felt the same way?

My parents who I always thought were solid just announced a divorce that is taking the whole family by surprise, I just discovered I have an annoying and painful but benign health problem, last week I had 1.86 in my checking account, I'm having significant relationship stress due to the internship move and just other crap, my dissertation isn't finished and my adviser is lukewarm in the helpful department - it just feels like every possible area where there could possibly be chaos there is chaos. I really want to talk to a therapist but I can't right now because I'm moving in three weeks and am in a weird in-between health insurance situation. I'm not going to hurt myself but the thought has crossed my mind, very quickly followed by doubt about my ability to be helpful to others if I can't manage my own distress. I'm trying to be grateful for things like weather, beautiful scenery, adventure etc but it feels very forced and I just want to curl into a ball and cry for a week.

Hi. I tried messaging you but can't for whatever reason You are most definitely not alone. I'm glad that, despite the hardships you're facing, you're still trying to see some of the lighter side of life. I know I'm just an internet stranger, but feel free to reach out if you ever need someone to talk to.

 

[psyche27]

I'm about to start internship and am feeling overwhelmed in practically every area of life, and not sure where to go for help. I'm not even sure what I'm doing here - maybe looking to see if others have felt the same way?

This may not be what you want to hear, but do you need to take a year off and get things in order and then go on internship next year? It’s not the easiest choice to make but if that’s what you need to do, reach out to APPIC for an informal problem consultation and see if it’s an option to withdraw for health reasons and reapply in the next cycle. Better that than having it all fall apart on internship and possibly jeopardizing your future.

As for access to a therapist, call a crisis line or see if your university has an after hours therapist number (often times it connects to a service of licensed therapists called ProtoCall if it’s not handled in house).

 

[temppsych123]

OP, I'm glad you posted. First off, you are not alone - "real life" doesn't stop happening because grad school/internship/postdoc/whatever is happening. Also, the fact that you're struggling right now doesn't mean that you can't help others, make it in this profession, etc. - you are recognizing the problems you're having right now and taking steps to address them, which is the critical part of self-care that helps us ensure we're taking care of ourselves and our patients. I had my own life events occurring while I applied to internship that definitely made me question whether I should opt out of the match and take a year off; it felt like the end of the world to me to even think about that possibility, but my grad advisor was supportive, and when I was struggling later in internship and reached out to a supervisor, he was also supportive of me taking a medical leave, if I needed to do that. So, if you decide to do that, it's not the end of the world - every year a small number of people don't end up starting their internship as planned for medical leaves and other situations such as those, or have to take a leave during internship. We're people, too.

If you don't want to take time off, or that doesn't feel right to you right now, I would recommend putting your energy into looking for a therapist in the city in which you'll be doing internship, since you're right, finding someone for just a couple weeks in your local area might not actually be as helpful. But, if you can start making calls to therapists who your insurance will cover (once the new insurance starts), you can deal with all that back-and-forth, leaving messages, trying to find a time to schedule an appointment stuff now, and be more able to start seeing someone quickly once you're able to do so. I found that, when I contacted therapists in my internship city and mentioned that I was coming to start internship, most people were pretty agreeable in terms of finding appointment times that would work for me, or recommending others for me to contact if they were somehow tied to my internship site in a way I didn't know about. I have also found that, with the insurance situation, some therapists are willing to bill you and have you pay via invoice later, which often takes about as much time to process (a couple weeks) as getting health insurance set up at a new place.

In the meantime, I do think making use of crisis services (either the National Suicide Prevention Lifeline, 1-800-273-8255, or the crisis text line, text HOME to 741741, or local resources) is worthwhile - those services are meant for any kind of crisis, even if you aren't acutely worried about your safety, and certainly if you are. It also sounds like you're working really hard to see the positive side of things, be grateful, etc., but it's also ok to spend some time being genuinely upset! If you feel like you want to curl up in a ball and cry, well, maybe that's not the most awful thing to have happen when you're dealing with all of this stuff. I think sometimes we put pressure on ourselves to be "alright" so quickly in the face of difficult situations that we don't let ourselves actually feel the very valid negative emotions that go along with it.

Good luck to you, OP!

 

[smalltownpsych]

Sometimes it seems like life can just throw a big ball of crap at you all at once. You should hear me talk about some of the stories of my internship move experience/nightmare. This happens both for us and our patients. It seems that sometimes when you are pushing through the next hurdle on an extremely challenging path of growth which getting a a doctorate is, that we hit crisis points. If we learn how to get through it and to the other side then we develop more strength and resiliency. I have had quite a few moments like that in my career and have used various resources to cope. Most of them healthy and adaptive such as leaning on family, community support, spirituality. Some less adaptive such as spending money I don't have or non-stop video games. Curling into a ball and crying is not so bad a choice so long as I can get up and keep going.

 

[futureapppsy2]

At the risk of being unpopular, I would say do NOT withdraw from internship if at all possible. Withdrawing from the match contract, especially, this late in the game will severely hurt you if you have to go through match again, and this field, ironically, still has quite the stigma against mental illness. Do take care of yourself and reach out to friends and crisis lines if need be as well as try to find a therapist in your internship location.

 

[DynamicDidactic]

try to find a therapist in your internship location.

Many psychologists often offer a discounted rate to psych grad students. Worth asking before all the insurance stuff is handled.

FWIW, a lot of us can empathize with your situation. It does get better.

 

[PsychPhDone]

I'm about to start internship and am feeling overwhelmed in practically every area of life, and not sure where to go for help. I'm not even sure what I'm doing here - maybe looking to see if others have felt the same way?

My parents who I always thought were solid just announced a divorce that is taking the whole family by surprise, I just discovered I have an annoying and painful but benign health problem, last week I had 1.86 in my checking account, I'm having significant relationship stress due to the internship move and just other crap, my dissertation isn't finished and my adviser is lukewarm in the helpful department - it just feels like every possible area where there could possibly be chaos there is chaos. I really want to talk to a therapist but I can't right now because I'm moving in three weeks and am in a weird in-between health insurance situation. I'm not going to hurt myself but the thought has crossed my mind, very quickly followed by doubt about my ability to be helpful to others if I can't manage my own distress. I'm trying to be grateful for things like weather, beautiful scenery, adventure etc but it feels very forced and I just want to curl into a ball and cry for a week.

I'm sorry you're dealing with this giant pile of crap. Any chance you can disclose to your new internship director about the divorce and ask if the program has a list of non-affiliated therapists to make contact with? I started internship after a significant negative life event and received a lot of support from my supervisors -- it was helpful for them to know I was dealing with something. With the SI you're endorsing, a therapist is probably the way to go with this, though.

 

[temppsych123]

At the risk of being unpopular, I would say do NOT withdraw from internship if at all possible. Withdrawing from the match contract, especially, this late in the game will severely hurt you if you have to go through match again, and this field, ironically, still has quite the stigma against mental illness. Do take care of yourself and reach out to friends and crisis lines if need be as well as try to find a therapist in your internship location.

I agree that withdrawing is not ideal - any time you apply for the match in the future, you'll have to disclose it and explain why - but more trying to indicate that even things that seem unchangeable (I have to start internship on X date) are, actually, changeable, if the benefits outweigh the costs. Not something that I'd undertake lightly, but withdrawing from internship is a better outcome than acting on thoughts of hurting oneself, for example. When push comes to shove, your health and well-being have to come first.

 

[futureapppsy2]

I agree that withdrawing is not ideal - any time you apply for the match in the future, you'll have to disclose it and explain why - but more trying to indicate that even things that seem unchangeable (I have to start internship on X date) are, actually, changeable, if the benefits outweigh the costs. Not something that I'd undertake lightly, but withdrawing from internship is a better outcome than acting on thoughts of hurting oneself, for example. When push comes to shove, your health and well-being have to come first.

Well, of course. I was just saying that withdrawing from internship shouldn’t be done lightly. I also think the reaction to students who are experiencing psychological distress is too often “well, just quit/take time off” and I think that can be iatrogenic at times. Obviously, sometimes that’s an appropriate choice (like if there’s professional impairment or acute severe suicide risk), but I think it’s often suggested too hastily.

 

[psyche27]

Well, of course. I was just saying that withdrawing from internship shouldn’t be done lightly. I also think the reaction to students who are experiencing psychological distress is too often “well, just quit/take time off” and I think that can be iatrogenic at times. Obviously, sometimes that’s an appropriate choice (like if there’s professional impairment or acute severe suicide risk), but I think it’s often suggested too hastily.

It’s not something that a person should rush into and not something that should be done without consent from APPIC. However, taking a year off when everything falls apart is infinitely better than falling apart ON internship and being kicked out as a result. FWIW, unless they’ve finally changed the AAPI there is no requirement to disclose an internship that was left with permission. The question specifically asks for you to disclose if you left without permission. As a TD this is somewhat a thorn in my side, but does help take into consideration the stigma that results from having to take a leave for health reasons.

 

[Sendtrees]

I hesitate to give advice directly to the OP, but I am struck by how quickly the discussion turned to taking a leave of absence and even delaying internship, which would be a major career hit. I didn't read anything in the original post to inspire such an extreme response. The OP is in the midst of a difficult transition after a terrible process (finding an internship) where the "prize" is "getting" to move, sometimes across the country, after spending an enormous amount of money already. If on top of that, life intrudes with a health problem or family drama, things are going to feel really ****ty. I didn't see anything suggesting that the OP can't handle these problems, just that they are feeling depressed in response to what's going on. I'd feel depressed, too! Thinking about hurting oneself does not make this into an emergency. The OP will know better than any of us whether it is or not, but here's one more response normalizing these feelings. Also, great idea to start contacting therapists in the place you're moving to.

 

[Throwaway98765]

I appreciate the thoughtful responses and discussion this has generated. It’s hard to remember that shepherding others through their sh*tstorms doesn’t make me immune to them myself, and so hard sometimes to accept that in life I will struggle even if I’ve already struggles. I wish it was like having your wisdom teeth taken out - “ok- struggled, went through a tough thing, done now”. that would be great!!

 

[ellenew]

I have followed this thread since it was posted and wanted to check in to see how you're doing, OP.

 

[psychRA]

I hesitate to give advice directly to the OP, but I am struck by how quickly the discussion turned to taking a leave of absence and even delaying internship, which would be a major career hit. I didn't read anything in the original post to inspire such an extreme response.

It doesn't sound like OP is seriously considering withdrawing, but I'm posting my thoughts on this in case it's helpful to other folks in similar situations in the future.

I wholeheartedly agree that withdrawing from internship is a HUGE deal that should only be considered in very extreme circumstances. Keep in mind that programs do not have to give their permission if they do not want to, and also that they will want some kind of explanation as to why the intern wants to withdraw. Yes, you don't have to disclose details, but bear in mind that a vague explanation like "personal issues" or "family problems" may not sit well with an internship program.

On the other hand, the problem with going into more detail is twofold:

1. First, in a case like this one is that many of these stressors (e.g., financial stress, relationship problems, unhelpful advisor) aren't necessarily going to be resolved a year from now. And (unfortunately) they're not limited specifically to this phase of life and/or training, so they're stressors that may recur in the near future. An internship program may chafe at having to take the hit and lose an intern over issues that may or may not come up again during the next cycle.
2. Second, many sites are going to have concerns about the coping skills of an intern who cites a parents' divorce as reason for needing to withdraw. Please know that I'm not saying this to be harsh or judgmental; my own parents divorced when I was a teen, and I am recently divorced myself. I totally get that divorce is absolutely miserable for everyone impacted by it, and I am in no way minimizing that awfulness. I want to say that it does get better, and once the acute shock of learning the news has passed you may feel much less overwhelmed. And I also want to share my opinion, as a staff member at an internship training site, that stress related to a family divorce is not a solid reason for withdrawing from internship.

I really went back and forth on saying those pieces. Maybe in a perfect world we wouldn't need to justify that type of decision, and it wouldn't matter whether the internship site felt that our reason was "good" enough. But since we don't live in a perfect world, I want to be realistic about the implications of withdrawing from internship. It may not matter that you don't have to report the withdrawal on your APPI when you withdraw from internship with permission from your site, because sites do talk to each other.

 

[Throwaway98765]

While I appreciate that advice to take leave or withdraw/postpone internship for a year was well-meaning, I was also surprised by how quickly that was suggested. I’m not going to withdraw, and never considered it as a serious option.

Finishing internship as soon as I can is ultimately going to help me get past some of the stressors (mainly going from no money to a little less no money, and resolving the stress of being in a liminal weird developmental limbo by being one step closer to PhDone). @psychRA brings up the fact that some of these stressors aren’t time bound, and wouldn’t necessarily be gone in a year anyway. As much as the upheaval of moving, transitioning, saying goodbye, embracing the unknown, and being in chaos effing sucks for now, I know the best thing for me is to endure it and get through to the other side.

I appreciate the discussion about withdrawing because it has helped clarify my position and made me come up with a plan to be busy (outside of internship) and work to develop a support network in my new city. I think this discussion has also clarified for me what my limits are in terms of working and being able to complete internship, which is helpful. It’s also been interesting to think more generally/culturally about growth, putting up with things, and enduring as a result of these posts.

And @ellenew I’m doing better this week! Still sobbing occasionally but I’m just riding those waves and continuing about my business. As @smalltownpsych put it, curling up into a ball for a little while is just fine as long as you can get up and sort through one more pile of books.

 

[CatLover&PsychEnthusiast]

Ouch, I’m sorry! I had a huge family crisis the year I was going to apply to internship and luckily it was before applications were due and so I made the tough decision to take an extra year. Oh the difference a few months and some self care can make! Good news is I’m coping well and got through that really rough time. I’m sorry you’re on the other side of the internship application process and having all this happen. As far as getting emotional support perhaps consider the NAMI “warmline” it’s free

 

[CA_PsyD_FL_LMHC]

I have heard so, so many stories of people heading to internship with their lives in tattered pieces. You are not alone! Cry it out, my friend. I also recommend a good screaming-into-a-pillow when it is warranted. If everything is garbage right now, you have every reason for be devastated. The fact that are you feeling things deeply just means you are not burnt out. Radical acceptance is a real thing, and it sounds like you are working your way through this as best you can.

 

[CA_PsyD_FL_LMHC]

Woke up today and you were on my mind. The messaging feature (as others pointed out) isn't working for your profile, so I'll just drop another little reminder here: Come vent if you need to.