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.

Will Therapy Ever End?

Our current therapist made a comment recently that made my heart sink. They said they thought we’re likely to need, at least, some supportive counselling for the rest of our lives.

The body is in it’s early thirties. If we make it to even eighty, that’s another fifty or so years of therapy. Maybe not weekly like now, but perhaps monthly.

Our current therapist will also be retiring in the near future. We’re trying not to worry too much about that, and trying to focus on getting as much DID focussed work done as possible in the time we have left.

That’s one of the hardest parts about having DID. Finding a therapist who has enough knowledge and experience to actually be helpful to us. In the last eight years we’ve just been lucky to come across therapists who are excellent at working with trauma and dissociation.

We’ve recently spent several weeks in hospital. None of us regret the admission. We got a lot of work done, and nearly all of us were able to talk to our therapist. No easy feat when there’s eighteen of us!

Our therapist is confident that we’ll have the majority of our trauma and DID based work done before they retire. I’m not sure how realistic that is. As much as ongoing therapy (for the rest of my life) makes my heart sink, I also can’t imagine our life without regular therapy or hospital admissions.

Does therapy ever end when you’ve experienced chronic childhood trauma?

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.

Our Sensory Toys

Over the years we’ve slowly accumulated a rather nice collection of sensory toys. These toys, often aimed at children with Autism Spectrum Disorder
and/or Sensory Processing Disorder, are also helpful for people with anxiety and trauma based disorders.

We have a complicated list of different diagnoses including both physiological and psychological. I’ve seen so many different doctors, specialists, therapists, and allied health professionals. All have given different advice and guidance on managing my symptoms.

When it comes to my mental health the things I’ve found most helpful are the ones I’ve discovered on my own, or suggestions from professionals that I’ve tweaked to better suit my needs.

No one every suggested sensory toys for grounding. Ever. I can’t remember how I stumbled upon them. Mostly they were fun toys. I knew I’d pick at skin, fingernails, and clothing when feeling anxious, so something to play with helped. Sometimes that meant taking a soft toy to therapy to hold and play with. Now I usually sit and run my fingers over the plastic bottle of Diet Vanilla Coke I have before/during therapy. It has raised bumps, lines, and the label, plus the lid. Lots of different textures.

At home I have more choice: a weighted soft toy, a fidget cube, two different tangle toys, and a weighted blanket with fiddle tags.

Our collection of sensory toys: A weighted hedgehog soft toy, a fidget cube, two tangle toys (smooth, and textured), and our 8kg (17.5 pounds) weighted blanket with our DIY fiddle tags.

Different parts have preferred items. The pastel tangle toy is Miss 12 G’s, but not the textured tangle toy. That hasn’t been claimed by anyone yet, but I quite like it. I close my eyes and focus on the texture of each piece, try to describe it, then picture it. The fidget cube is relatively new, and liked by several of us – Miss 5 likes the colours, Miss 12 G likes pressing/touching different parts of it in order (all about patterns with her!).

The big weighted hedgehog toy belongs to all of us. Not only is it weighted (I think it’s 1-2kg), but the fabric it’s made of is all different textures that can be touched, rubbed, ruffled, and played with for all different sensations. It’s comforting (the weight), and distracting (the textures) for all of us.

That brings me to our 8kg (17.5 pounds) weighted blanket. I still have absolutely no regrets about buying it, and spending so much time sewing fiddle tags on. We still find the weight calming and reassuring, and the fiddle tags good for grounding like the sensory toys.
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Drifting

As I write this I’m dissociated. I’m detached from my body, from my emotions, from the world around me. I’ve tried drinking coffee, hoping that the caffeine kick will get me more connected with my body, but nope.

I’ve aimlessly don’t more chores than my body can usually tolerate all because I can’t quite feel my body, the pain, the deadening fatigue.

Grounding? I can’t think what helps. I can’t think what I’ve done in the past.

I’m drifting. Staring blankly into space before realising I’m doing so and trying to jerk myself back to reality, then drifting again.

I know self-harming would be grounding. The sudden pain would bring me back into my body. That’s not something I want to do, or something I’d ever recommend though!

I thought getting my brain working, writing blog posts, would help. It hasn’t. This is the third post I’ve worked on today and I’m quite rapidly becoming more and more dissociated.

Thankfully there isn’t anything that I need to do today. No work, no obligations outside of the house. I just need to eat, drink, and take care of myself.

There’s so many grounding skills I could try, but I’ve been here before and they tend not to make much difference.

• Counting everything I can see around me that is red (or blue or yellow)
• Drinking icy cold water quickly
• Putting an ice pack under my feet (and focussing on the sensation, not dissociating from it)
• Counting backwards from one hundred in multiples of three
• Saying the alphabet backwards