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.

Stuck

I’ve reached a point that I’ve reached many times in the past. A point where outpatient therapy isn’t working. A point where I’m fleeing the images I’m continually seeing in my head, the nightmares, the body memories.

Therapy involves talking. Talking about the flashbacks, the body memories, the terror, the fear, the anxiety. It means facing what I’m scared of and trusting my therapist to go there with me.

At the moment I’m running from all of that. Listening to what younger parts have to tell me seems okay in the moment, but it allows everything else to come up. Once that door is opened it’s very hard to close.

Talking about that in therapy leaves me sitting in an awkward silence. Too scared to talk about what’s really going on, but still frustrated at my fear.

Opening up that cupboard of painful, traumatic memories leaves me feeling overwhelmed. When that emotion reaches a tipping point I zone out. Dissociate to the point of being completely unresponsive. So unresponsive that I’ve been referred to as unconscious whilst in that state.

That unique ability makes outpatient therapy difficult. I’m desperate to talk about everything going on inside, but terrified of not coping, of losing control, of zoning out. Dissociating at the moment, to that extent, is almost guaranteed if either I or my therapist push talking.

That leaves me with only one choice. Another hospital admission. I’m frustrated and angry at it coming to this point again. I don’t want to be in hospital. I want to be okay. I’d prefer to stay at home in my own space, with my own things, and my freedom. Sure, hospital isn’t bad. It’s actually one of the most helpful things I could do right now, and the staff are amazing, but I still don’t want to do it.

I have a month or so until my admission. A month or so to try to get practical things organised for the time I’m in hospital.

Depending on how I cope in the lead up to this admission there may or may not be new posts. I’ll try to keep up with posting every two weeks, but prioritising self-care means this may not happen.

No One Tells You How Hard It Will Be

I spent almost four weeks in a psychiatric hospital. The admission was helpful, and worthwhile, but being at home is very different.

Whilst in hospital most days looked like this:

7:30-9am: Breakfast

8am: Morning announcement usually announcing the day, date, and time, that morning medications were being dispensed, and the dining room was open until 9am for breakfast.

9:30am: Community meeting which was five to ten minutes of information about the group program, complaints, suggestions, compliments, new patients, patients being discharged, birthdays, and new staff. You’d also go around the room saying your name, and answering an ice-breaker type questions.

10am: Anxiety Management group which was controlled deep breathing for five to fifteen minutes depending on who was running it.

11am: Morning group if you were assigned to one.

12-1pm: Lunch

1:30pm: Afternoon group if you were assigned to one.

3:30pm: Occasionally a walk, but that would depend on nursing staff having time, and patients actually wanting to do it.

Afternoon: During the week there’d be yoga, a fitness class, a psych education group, or art therapy. Each group running only once per week.

5-6:15pm: Dinner

8pm: Relaxation group

8:45pm: Night time medication

That was how my time was spent. I’d also see my psychiatrist six days a week for twenty to fifty minutes. Plus chatting to nurses if I wanted to. If I needed to talk someone was there. If I wanted to rest I could. There was no cooking or cleaning. All I had to do was wash my own clothes.

Home is very different. I’ve had to unpack from moving house. I’m living in a new, somewhat unfamiliar, suburb. There’s dishes, cleaning, and washing to do. I’m trying to be sociable and keep up with friends, but I’m struggling with that. I’m back to showering once or twice a week because I’m physically exhausted, and my mood is low.

I’m anxious and unsettled. I’m scared to leave the house. I burst into tears when I need to leave the house alone. I hide inside because it feels safer than outside. There are so many things I want to do around the house and outside. I have plans for our garden and courtyard, even if they’re small. I have plans for all the things I want to do, but doing them will be a slow process.

I’m safe, and I have support, but I’m struggling. Adjusting to being at home, and to a new house, new suburb is hard (and slow) work.

I was excited to come home, and I don’t regret coming home (I have freedom!), but it’s hard.

Home from Hospital and Still Journalling

Journal, journalling, writing, diary, diary writing, psychiatric hospital admission, mental health, mental illness, dissociative identity disorder, dissociation, DID, trauma, PTSD, post traumatic stress disorder, parts, alters, alternate personality, multiple personality, mpd

One hundred and ninety four pages written and drawn in twenty six days twenty two hours and forty five minutes. That’s how much we did whilst in hospital. It was a long admission – nearly a whole month away from … Continue reading

The Psych Hospital

I’ve been in a psychiatric hospital for one week now. I didn’t come in for a rest, a break, or any kind of respite. This admission is about intensive therapy. Tackling the hard stuff.

Thankfully, today is my day off. The one day each week that I don’t see my psychiatrist. The group program today consisted of a walk that I didn’t go on. I’ve had a chat with my morning nurse, and will do the same this evening. Sundays are quiet here.

During the week the days can be intense.

To begin with there’s the 8am wake up. An announcement over the PA stating the date, time, and that morning meds are being dispensed. The dining room is open from 7:30-9am for breakfast. After breakfast I return to my room and either do some journalling or catch up on the previous night’s TV shows online. At 9:30am there’s a community meeting.

Then the groups start. At 10am there’s an ‘anxiety management’ group which consists of deep breathing exercises for five to ten minutes. Morning group runs from 11am-12pm. One of the psychologists does an assessment early on in your admission and assigns you to appropriate groups.

At 12pm there’s lunch in the dining room. Nothing exciting there. Good, fresh food, and you can eat as much or as little as you like. Afternoon group runs 1:30-2:30pm, and again, you’re assigned to a group.

Afternoons are quiet, and sometimes there’s an educational type group, a walk, or yoga. I tend to fill my afternoons and evenings with journalling, drawing, and processing memories. It’s hard work. I usually see my psychiatrist in the mornings which often means missing morning group.

Dinner is 5-6:15pm, then night meds at 8:45-9:20pm. I’m usually asleep before 10pm, but toss and turn because night staff do checks every single hour overnight.

It’s non-stop. Yes, I get time to myself in my room, but I spend that time journalling and completing homework from my psychiatrist.

I’ve already learnt a lot about our system since being here. I think we’ve done more work in six days with our psychiatrist than we’ve done with our psychologist all year. It’s useful, helpful, but gruelling.

Today I’ve done some knitting, watched two movies, and chatted to friends online. I do have unaccompanied leave, but it’s cold outside and my bed is warm and comfortable. I’m trying to rest, and prepare for another day of nurses, doctors, groups, talking, journalling, processing.