I'm Going Around the Bend - Are You, Too?

For those who have not yet found the courage to use psychotherapy. And for those who dared and found out that it is good for them.

Even the stones that have been placed in one's path can be made into something beautiful.

Johann Wolfgang von Goethe

About this book

Denise Hürlimann and I had not seen each other for two years, before meeting again by chance while shopping. We exchanged a few words between the cornflakes and jam shelves, and it felt like no time had passed since last - the difference being that I was no longer one of her patients. After that, we both went on our way again, but my mind suddenly went into high gear. I’d had this idea for a long time, but didn't really know how to process it. That day, however, it clicked loudly and clearly, and everything was very clear to me: I wanted to spread the experiences I had gained in my time in psychotherapy and to encourage other people to accept psychological advice themselves. Long story short: I wanted to write a book with my former therapist.

The next day I bravely picked up a tip that I had learned in therapy and have successfully used since then: Without hesitation, I picked up the phone and asked Denise Hürlimann for a meeting - if she didn’t have time, she would tell me. As she was always very busy, I initially expected rejection. Amazingly, however, she agreed immediately, and so we sat together over coffee a few days later. I had prepared myself well for this meeting and carefully gathered all the arguments that could help make my dream come true. But before even presenting them all, Denise Hürlimann was thrilled. We quickly agreed that we should at least try. You can be the judge of whether this attempt was successful.

More and more people are suffering from depression. In Switzerland alone, one in five is said to be depressed. We don't know how many there really are - even in our surroundings - because there is often a lack of courage to talk to a therapist or to speak openly about it. Barriers are high, and even I couldn’t believe when the doctor confirmed that I was burned out. However, when my husband fell ill with cancer, I was definitely dependent on help, because my emotions were oscillating at break-neck pace. I was extremely fortunate to find not just a psychotherapist in Denise Hürlimann, but also an accomplished psycho-oncologist who knew the needs of cancer patients and their families.

I learned a lot from my experience of therapy - about myself, my environment, life. And so, in this book, Denise Hürlimann and I alternately talk about lived experiences on the emotional roller coaster, and a narration of this ride from a psychotherapeutic practice perspective. A tale of ups and downs, dips and progress, of grueling challenges and liberating insights.

Mirjam Indermaur, summer 2019

Prologue

My name is Mirjam, and I may be just like you. Probably like many other people. At five feet two, I'm average, my appearance is average, and my life, too, is probably average. If you were to get to know me, you might say I'm open and interested. That's true (mostly). And some say I am a powerful woman. That is (often) misleading.

When I slipped into exhaustion depression over ten years ago, I couldn't believe it. I had everything you could wish for: a great husband, great sons, a good income - what was there to complain about? Since then I have been experiencing random emotions that leave me, someone who loves talking, speechless and negative.

When I was growing up, the idea of someone having a mental health problem was incredibly strange. No one really understood why someone would be constantly unhappy or confused. At the time, people described this as ‘going round the bend’. Today we strive for political correctness, and there is no place for this expression.

But society is still not ready to deal with people with mental health problems without bias. That's why I consciously use this expression - somewhat provocatively, but with the best of intentions. I would even say I use it lovingly. Going round the bend like that takes a tremendous amount of effort, but it also encourages you to get to know yourself better and to make the necessary perspective changes - provided you can get help.

So I’m going round the bend. Are you, too?

Suddenly everything is different.

Despite my often poor memory, there are moments that I can recall at any time. One such moment is the moment we got the results of my husband's gastroscopy. We sat in the waiting room after the examination and were actually certain that nothing bad would come of it. But then the doctor called us into the consultation room and frowned. There was something that shouldn't be there, he explained. He drew a stomach and placed a lump in it that didn’t belong there, like he was explaining something to small children. As if through a rush of noise, I heard that it was not yet possible to say exactly how bad it was, and maybe it wasn't dangerous yet. I can only remember the words bad, dangerous and cancer. While I was stunned, my husband tried to stay calm and focused on the facts. He had everything explained several times, and - as he later told me - he was unable to hold onto anything. We left the doctor's office having been told that we would be hearing from our family doctor and that further investigations would be needed very urgently before anything could be attempted. To attempt? What was that supposed to mean?

Our drive home only took twenty minutes, but it felt like several hours. Neither of us spoke, we didn't know what to say. My husband and I had been together since we were teenagers and had what would be called a harmonious, happy relationship. Our life plan has so far worked out quite well with jobs and careers, and we have rarely had to face any serious problems. After almost twenty-five years of marriage, we could count the number of serious crises we’d gone through on one hand. But what we encountered now far exceeded anything that we’d ever faced.

When we arrived home on February 25, 2013, everything was different. In the morning, we gave our sons the recurring lecture about how dishwashers don’t empty themselves. By lunchtime, we were no longer interested in such banalities. We were glad that the medical investigation lasted so long, because by now, our children were all on the move somewhere else. My husband was calm and wanted to be alone, which I understood. I, in turn, tried to act solution-oriented in the usual manner and to just do something useful. But it was precisely this instinct hat made me do the worst thing possible: I sat down at the computer and searched the words stomach cancer. With that, I opened Pandora's box.

I sat in front of the screen like a robot, reading progressively more nightmarish information. A spiral of refusal set in in my head, and all I was getting were screams of No, no, no! I was in shock and was completely non-functional. I desperately searched for a glimmer of hope, but the more I wished for it, the more bad news I found.

When our sons came home, they met a tearful mother and a silent father. Somehow they seemed to feel that the mother's condition was better than the father's, probably because they saw me cry earlier. They asked what was going on and I explained to them that their father had cancer and that we had no idea how to move forward. They were also shocked, but handled it differently. Our youngest, Emanuel, was innocent enough at the age of ten not to suspect anything bad. He simply heard that his father was sick. Patrik, who was already doing an apprenticeship, hugged me and said nothing further. Joshua, our oldest, again tried to reassure me with facts about gastric cancer survival and withdrew to get more information by himself.

Although we all had no real appetite, we sat together for dinner and sorted out our thoughts. Within a few hours, our despair transformed into the will to be stronger than this disease. My husband tried not to show his fears and to show strength. Our boys were unusually quiet and forgot to argue about who had to clean up the kitchen as they usually would.

After a restless night, the call from our family doctor woke us up the next morning. He had already received the results of the investigation and immediately arranged an appointment in the hospital. We spoke to a specialist there on the same day and were filled in on the next steps. Various tests to confirm the diagnosis were pending, and soon my husband was so busy that he hardly had time to dwell on anything.

He was now being taken care of. The hospital staff dealt very competently and efficiently with treatment options and completely focused on the patient. But - and this may sound a little selfish - while he was being called brave, we as his family felt rather left out. To make matters worse, the doctor in charge was constantly changing, making it difficult to establish a relationship of trust with any of them.

My husband is a sensitive person, but rarely talks about feelings. In the course of his illness, there were only a few moments when he spoke to me and our sons about his fears. After so many years together, I still sensed what was going on inside and I assured him that we would get through this together. I wanted to be angry with him about this injustice, to defy cancer and defeat it. But my reactions to his illness were not his. He was calm and composed and did not want to mentally burden his family if possible. I alternated between being angry or desperate, committed or hopeless. In fact, at the very beginning of treatment, there were a few days when my husband had to comfort me.

At the time, I was ashamed of my lack of strength. In retrospect, however, I think it was sometimes useful to let him take the lead, because even before he was diagnosed with cancer, he was the one who was responsible for everyone’s wellbeing. On the one hand, it frustrated him that he felt less able to maintain this role, but on the other hand it also motivated him to get well so that he could be that strong figure once more.

Our everyday life had changed, our emotional state was not in balance and our external behavior was not always understandable. After the many subsequent appointments for chemotherapy, during which I always accompanied my husband, he always left the hospital physically weakened, but psychologically strengthened. He drew strength from the medical information he received and assumed that he would be helped and that every chemo appointment would bring him one step closer to health.

For me, things were very different. Suddenly my back hurt, sometimes my head hurt, I would have a constant cold, or my stomach went crazy: I developed various symptoms, which, after thorough investigations, all turned out to mean nothing. As a precaution, I had every single one of my medical problems investigated: It would be a disaster if I had also lost my good health. Nevertheless, every time I had a new ailment, my guilty conscience also plagued me: how dare I pay so much attention to my own body while things were going so terribly for my husband? And how dare I try to get our doctor's attention when nothing was obviously wrong with me?

The therapist

My name is Denise Hürlimann. I am a behavioral therapist and psycho-oncologist. I accompany people in psychologically difficult situations, people with diagnoses such as depression, anxiety or addiction problems, with personality or obsessive-compulsive disorders. Often I am also visited by patients[1] who want a professional perspective on a particular situation and who want to think through it with me.

As a psycho-oncologist, I treat and accompany cancer sufferers and their families. Cancer often has far-reaching effects for everyone. The field of psycho-oncology offers targeted support to those affected and their relatives, helping them cope with the change in life situation, uncertainties and fears. Psycho-oncologists are consulted either after the diagnosis, in the course of oncological treatment or afterwards. Our goal is to reduce the burden and thus improve the quality of life of those affected.

My tool of choice is the so-called cognitive behavioral therapy, one of different therapeutic modalities in psychotherapy. There is also psychoanalysis, Gestalt therapy, system therapy and body-oriented therapies. As a behavioral therapist, I believe that the way we think and evaluate people is critical to how we feel and behave. And that the experiences we have gained over the course of our lives have a major impact on what we expect from ourselves and our environment, and how we value experiences or the world around us.

It has now been proven that cancer can make you depressed and anxious. The experience of one's own integrity, physical