I finished the partial hospitalization program last week. On Thursday, January 30th. I started a Trauma Focused Intensive Outpatient Program yesterday, February 3rd.
Change is scary.
I’ve pretty much been in PHP since June. There have been breaks for trips to the hospital, and one short step down to IOP for a few days before I was stepped back up to PHP because it was agreed I needed a higher level of care. So I have been in PHP since June.
I don’t even know if I’m ready for this group. The trauma focused IOP. Maybe I should be doing the dual diagnosis IOP or the DBT (Dialectical Behavior Therapy) group. I mean, DBT is THE treatment for Borderline Personality Disorder, and even though my personal therapist is adament that I do not have it, other providers who see me on shorter terms usually say I do. Simply because I self injure, in my opinion, and it makes me angry sometimes. I have done DBT groups many, many times. I know the material backwards and forewards… but, I did self injure a week ago, on Tuesday, the 28th. I also relapsed on alcohol, for 4 days each time, and showed up to PHP intoxicated 3 times. My clean date is January 29, 2020, at the moment. So the dual diagnosis IOP would make sense too, but there probably not much they could teach me that I don’t already know, having been doing the getting clean thing since 2006.
But am I ready for the trauma IOP? Can I handle it? I dissociated hard yesterday, and it was the first day of IOP…
During the first hour, we checked in. There were only three of us there yesterday, so we all had a decent amount of time. That was nice. It was awkward for me, even though I knew the therapist and one of the other group member a little. I don’t know, just saying some of the things I deal with, like the self injury (I mentioned the specific methods I use) and suicidal thoughts and I was able to say that part of the trauma relates to a loss that was too soon… saying those things was difficult in front of people that I have only really just met.
During the second hour, we discussed our goals for the week. The therapist wanted three goals: a physical, social and emotional goal. My physical goal is to not self injure this week. Social is to go to 3 meetings. And the emotional goal is to show up for IOP. As weird as this may sound, those goals are hard for me. Right now, those are pushing my limits. IOP starts in 3 1/2 hours and I have not slept. The sun is starting to come up… The sky is starting to lighten at the horizon behind the houses across from mine. People are starting to leave for work. And I have not slept. At all. Normally, my alarm would be going off in one hour, so it’s not even worth trying at this point. I’m just going to have to caffeinate, caffeinate, caffeinate. It’s the only way I will be able to make it to IOP today. And to the other things I have scheduled later.
During the third and final hour, we do mindfulness every day. Yesterday, the therapist did a self compassion guided meditation. I normally am not really that okay with guided meditation, except for breathing ones, body scans, or progressive muscle relaxation. I gave it a try. It didn’t go well for me. As I said above, I dissociated hard. Less that a minute in, I could tell I was losing my body. Then the tunnel vision started, all the way to a pinpoint. Then I lost my hearing completely. Usually, when I dissociate, I don’t lose my hearing. I am still semi-aware. I can still hear what is going on around me, I just can’t respond at all for a bit. But this time, I lost everything. I was completely gone. I don’t remember the rest of the meditation. The next thing I know, the therapist is asking me a question. I didn’t hear the question, but I could tell it was aimed at me. I couldn’t speak yet, however. I made a gesture with my hand to indicate “kind of.” It was all I could manage. I was zoned out again, when I realized she was asking me another question again, after a minute or two. I made the same gesture with my hand, because I still couldn’t manage words. At that point, she realized. She asked if I had dissociated, because I had mentioned earlier that certain guided meditations (safe space) make me dissociate. I nodded. She asked what would help bring me out of it, and I was able to squeak out a very quiet “time.”
The therapist did hold me after group for a bit, just to make sure I was okay to drive, and also check in with the level of suicidality I had marked on the check in sheet and check that I could be safe overnight and be back today. So I kind of have to go today. I can’t just not show up…
Some day, hopefully soon…
I will write about the traumatic event that has me in this mess. That led to the suicide attempts. That kept me depressed practically my entire life. That is giving me flashbacks and body memories daily. That has me still actively suicidal on a daily basis.