Well…

We were still in Trauma IOP up until today. We started back in the partial hospitalization program today. We’ve been having more and more suicidal thoughts, and getting closer to acting on them. The therapist from the IOP asked, on more than one occasion, if we needed a higher level of care. We refused to go back inpatient, which we honestly think is what she would have been more comfortable with. She still advocated for what we wanted, though, when it came down to it.

Last week on Wednesday, we were literally at the top of a cliff, waiting for the other people to leave. This past weekend, we were counting pills and seeing if we had “enough.” We were honest with the IOP therapist after both.

Thursday, last week, when we checked in, we just wanted to get through it and be done. We sailed through our day in about 30 seconds, hoping she would miss the cliff part (?) or just not bring it up or something… that seemed to be the only thing she heard, honestly. She immediately asked about it, and the longer we were on the topic, the foggier the room got. The therapist could see we were slipping, and tried moving from asking us questions to having the other members of group talk to us, relating their experiences with suicidal thoughts. Check in that day took the whole day, because people had a lot to talk about, and we were the last one to check in (on purpose). By the end of it, we were barely holding on by a thread. The therapist held us after to talk, but we were too far gone to talk. We were semi-aware, we could hear, but everything else was completely gone. We heard her telling us she was there, and that she wasn’t going anywhere. We were hitting our head on the wall. She was still there. We were counting the ceiling tiles. Eventually, we started coming out of the dissociative state and into a massive panic attack. We were able to contract that we would be back in the morning, and she let us leave.

Coming back after the weekend, on Tuesday, we completely dissociated during check in. The therapist saw it a little too late. She saw us trying to hold on to what little bit of awareness we had. We couldn’t even say why we had dissociated, after the fact. Once group was over, we asked to talk to her, and told her we needed to step up to PHP. She said usually the clinic and the doctor want the patient to go into the hospital before going back into PHP. The IOP therapist said she would ask if I could just go straight to PHP, mainly because I was desperate to not go inpatient again. I would have just stayed in IOP and discharge at the beginning of next week, instead of going inpatient again. I guess because I’ve been in so many times, and also because of Covid-19, they decided that wasn’t necessary this time. She let me know yesterday what they had decided and I started PHP today.

The clinic, because of the coronavirus, is checking every patient’s temperature and doing a screening before they can go to the group rooms. We get it, everyone has to take precautions, these days. The clinic even discharged all the patients over 60 and those with preexisting conditions that put them at a higher risk of becoming seriously ill. But, so far, they are staying open. We don’t know how long we would survive if the clinic closed. We would not make it, we know that. The question is only how long…

So far, for right now, we are okay. We aren’t going to do anything tonight that would make it where we aren’t at PHP in the morning. We will be at PHP in the morning.

How’s it?

Well, I don’t really know at the moment… can that be my answer? I’m still suicidal, self harm helps with this, but I’m trying to not do that, I got close tonight but managed to abstain; I’m still psychotic, just not as bad; I’m still having flashbacks and body memories galore, every day, at least once a day; sleep is a crapshoot, it may happen, it may not, tonight it did not.

The PTSD (Post Traumatic Stress Disorder) and DID (Dissociative Identity Disorder) are really messing with me right now. I have been having a really hard time with memories of something that happened in September of 2000. These memories are causing a lot of problems, including crying spells, isolation, withdrawal, dissociation, self injury, and increasing suicidal thoughts. Basically, all of the signs of a severe episode of clinical depression. One that a psychiatrist would encourage possibly going back into the hospital to treat. Which is NOT going to happen.

I have school that I need to take care of. I cannot fall behind. Not this semester. I really have to make it through the semester this time. I cannot do the in-out crap again… I have got to stay out of the hospital.

It’s been almost 2 months now since I got out. The suicide attempt was on the 11th of December. I got out of the hospital on the 19th of December. Now, if I can just stay out… that is all I have to do.

The particular incident that is bothering me the most, that I am working on in IOP, is extremely traumatic. Even writing that sentence brought up enough thought of the event that I’m on the verge of tears already… The IOP that I am in is trauma focused, so everyone in the room is there because they have experienced something traumatic and are wanting to work on it and be able to better handle the memories when they come up.

When I was finally able to tell the group about the trauma that I am there for, the group was just quiet. I was fighting tears, I didn’t want to cry in front of people, not because it was IOP or them or anything, just because it was people. At some point in the course of the conversation, the group therapist started saying “it wasn’t your fault” repeatedly. Over and over and over. The first time she said it, I could feel the tears move higher up in my throat. The second time, I could feel them welling in my eyes. The third, I couldn’t fight it anymore. I started shaking with every breath, and I was balling my eyes out. I could hear that one of the other group members came over by me, and she put a tissue next to my hand. Then she asked if she could touch me… I nodded. She rubbed the back of my shoulder while I cried. I was glad she asked before touching me, that helped a lot. That was the main reason I said yes in the first place… because she asked permission, I felt like I could trust her. Honestly, at the time that I was crying, I couldn’t even tell which group member she was. All I had to go on was her voice, and I just couldn’t tell… it was only the end of my first week.

And now, at this very moment, my eyes are welling up, and I can feel the tears in my throat. I am trying to fight them, I don’t want to cry before I even get to IOP. I don’t want it to be that kind of day. I don’t want the day to start with crying. I don’t want to show up to IOP with puffy eyes, looking like I have been crying, before we have even started.

I haven’t slept. At all. I had a sleep study night before last, at the doctor’s office, and had to be there for part of the day so they could test me during several naps, a couple hours apart each. I was able to leave a little after 2 pm. They woke me up at about 6:30 am yesterday morning, and had me try to nap 3 times, but I don’t think I ever fell asleep during the naps, although I may have. So I have been awake since 6:30 am yesterday, with the possibility of a 30 minute nap. It is currently 7:42 am, so I have been awake over 24 hours already. Which means I am in an extra vulnerable state. I have class tonight as well, but I should be able to sleep a little between IOP and class. IOP is over at 1 pm and class starts at 6 pm, so sleep is a possibility. I was hoping to work on my speech class but then had insomnia. Oh, well…

But, really, I was going somewhere… where was I going with that train of thought?

I’ve just gotten to the point that the flashbacks and body memories are becoming too much. I can’t handle them anymore. I want them to stop, but the only way to really make them stop right away is to make me stop right away. Making them end means making me end. That is honestly where my head is at right now. My head is telling me suicide is the logical answer to getting away from reliving the event multiple times a day. (Don’t worry, I am being honest with the therapist at IOP. She knows that I am having suicidal thoughts and we check in about safety at the end of the day, every day.)

[Trigger][Description of Abuse]

I just cannot keep seeing the moment that *he* figures out that I’m pregnant, and the pure rage that comes over his face with the realization. He asks how far along I am. I tell him about 14 weeks, if I’m calculating right, and he gets even more furious which I didn’t think was possible. The fear I felt in that moment was absolutely daunting. I had never been that afraid of him during our entire relationship. During the flashbacks, I feel that fear, at that level, just like I am back in that moment, seeing the fury wash over his face… Next thing I know, I am on the ground and he is kicking me, aiming for my stomach. I do my best to stay in a ball and protect my child, but he keeps managing to get me out of the ball by grabbing my hair, kicking me in the back, or picking me up and throwing me onto the ground again. I didn’t know he was capable to lifting me. I mean, I wasn’t a tiny girl… at the time, I weighed around 185 lbs, maybe more. He jsut kept going and going for what felt like forever. I don’t know how long it really went on, I just know it seemed to go on for a really long time. After a couple of days, I started showing signs of a miscarriage. The symptoms kept getting worse as time went on and eventually I found myself just on my bed in the fetal position. My son eventually left my body, and the image of him is forever burned into my brain. He was so tiny, but he looked like a baby and he was a boy. I named him Michael and I cried for hours and buried him by myself. I hadn’t told anyone I was pregnant, because of the abuse and the fear of what would happen.

That is what I relive on a daily basis. The beating that caused me to lose my son, the sensations of the miscarriage itself and the images of my son once he was outside of my body. It’s torture.

[/Trigger]

Well, I need to get ready to go… I have to leave for IOP in a little bit and I’m not even dressed yet. Plus, I’m on the verge of tears again, and I need to find something to distract myself to keep me from all-out ugly-crying.

I hope y’all have a great day, and I will talk with you soon!

Change is scary…

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.