Outpatient Fail

All of our therapy is outpatient. We see our therapist in their office every two weeks. We talk. They push us to talk about the things we’re obviously avoiding. Mostly it works. Until it doesn’t.

That was this week. This week therapy turned to shit. Shit. Complete and utter shit.

I’ve written about our excellent ability to zone out before. It doesn’t tend to end well.

Often it happens during therapy sessions. We’ll be discussing something and become emotionally overwhelmed. Often I feel incredibly anxious, sometimes sad or scared, but whatever the emotion – very overwhelmed.

By this point the conversation will stall. My responses become slower, my voice quieter, and I say ‘I don’t know’ repeatedly. I’ve already stepped back from my body without actually choosing to. At this point there’s nothing anyone can do to help me become more responsive.

Usually I’ll be asked to move by whoever I’m with (psychologist, psychiatrist, nurse) and be unable to. My body is frozen, and although I can hear and feel (and see if my eyes are open) I can’t move. Eventually my head tips to the side, the weight of it seeming to drag it towards my shoulder. From there my body can slowly slide sideways, and if I’m in a chair, out of the chair and on to the floor.

This time wasn’t that different. It’s just that this time was the first time this therapist had to manage it outpatient. They’ve dealt with it repeatedly in an inpatient setting. That’s much less dramatic. They let the nursing staff know what’s going on so I can be monitored, but generally leave me alone to come out of that state at my own pace.

Outpatient though? It’s a downright disaster. I couldn’t be moved. My therapist had other clients to see, but had to reschedule at least two of them. Eventually they had no choice but to call an ambulance to take me to the local hospital emergency department.

That’s when it got worse. I was unfortunate enough to get two male paramedics. Ordinarily that wouldn’t bother me. In such a dissociated state they were terrifying. They were men. Men are bad. Men are not safe.

To make it worse they repeatedly inflicted pain to check my level of consciousness. They did this four times with minimal response from me. Meanwhile I could feel all the pain, but wasn’t able to properly respond. The most they got was a mild grimace, yet they continued. Being conscious, but unable to move or talk is not fun. Throw in pain being repeatedly inflicted and it’s terrifying.

After being released from the emergency department I went home, crawled into bed, and slept. The following day was time to face the music. One super brief phone call from my therapist later, and we’ve planned a hospital admission for August.

August. The month where I had multiple medical appointments. The month where I was finally going to get my pesky wisdom tooth (last one!) removed. Everything has to be rescheduled.

It feels like defeat. Complete and utter defeat.

I can’t safely manage outpatient therapy. I have two more appointments booked with my therapist, but I’m not sure if I’ll go. I’m scared after this week. Scared that I’ll zone out again.

I did have a few thing against me this week. I’d overdosed (wishful suicide attempt) the day before and had a huge hangover from the medication I’d taken. I was rejected for the NDIS for my physical health issues. An outreach worker told me they’d be moving on, and someone else would be taking over my care. Then throw in a trauma anniversary, and the unrelenting depression that’s been haunting me for a year. All of that, even on a good day, is a bad combination.

Trying to stay present with all of that going on is next to impossible. Add in an emotional conversation with my therapist, and I don’t think I had any chance.

Anyhow, hospital it is. Hospital because outpatient therapy is a fail. Again.

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2 thoughts on “Outpatient Fail

  1. What your talking about sounds exactly like tonic immobility, which is a dissociative state. It’s not written about in the literature much for some reason, but I’ve had episodes like what your describing (fortunately, I’ve never been sent to an ER for it- which unless your unsafe really usually insn’t neccesary. How educated is your t on this stuff? Because I know my RetiredT who had a lot of experience was the first one who really “got” what this was). For me my RetiredT worked on finding things that could/would bring me out of if- and I learned more at a trauma program I was at. Some things I’ve done for others is an ice pack in the hand, with my hand over theirs, talking to them- an ice pack on the neck is also possible though less pleasant. This is NOT just you and it’s not even as uncommon as some people would think!

    • Our therapist has referred to it as a dissociative stupor. Generally they’re good with it, but because it can last for so long (5 hours average, 9-10 hours was the longest) they eventually have to call an ambulance. They have to go home or see other patients, and there’s no telling how long it will last.

      The ice pack thing has worked for more mild dissociation, but not this. Smelling lavender oil used to work, but doesn’t do much anymore.

      I’m so glad I’m not the only one!

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