Meanderings of my mind in comments, poetry and prose dealing with personal struggles especially relating to Bipolar Disorder, Borderline Personality Disorder, and reconciling being Christian and queer, along with the average day-to-day real-life situations: My Rites of Passage.
Yesterday was the last session of my group therapy program. I began this intensive program 21 October and we have met three hours/day on Mondays, Wednesdays and Fridays. Yesterday marked my 30th session.
Initially, I was very phobic to these sessions. Similar to my attitude when I was involuntarily committed , and knowing I was only obligated to attend for two weeks, my original intention was to skate through those six sessions with no effort on my part. I was still pissed off at the world for how I had been treated to date; I did not want to be in therapy and I certainly did not want to get better.
You just cannot imagine the amount of rage that pulsed through my veins—think Incredible Hulk. However, as the mandatory two weeks came to a close, something was triggered inside of me. Somehow, I came up with the idea that I no longer wanted to go on feeling the way that I did. That level of rage and profound depression was eating away at me and I simply had no more energy left. I voluntarily agreed to stay in the program having no idea that it would take this long.
There was a very detailed daily check-in sheet we each had to fill out. It was basically a way for the therapist to determine and track our progress. The dynamics of the group evolved over time with old patients being discharged and new ones being admitted during my stay. While the overall group was large (in my eyes), averaging around 18-20 folks, once everyone took the 10-15 minutes to fill out the check-in sheet, we always split into two smaller groups. The groups remained split while everyone reviewed their sheets, and we all came back together as one group after the break to start the second half.
I could handle the smaller group in which we each shared what was on our sheets. Based on our input, the therapist would probe further with each of us and ask penetrating questions. The sharing half had a tendency to be somewhat tedious at times. Every so often, there would be patients that liked to hear themselves talk. Repetition is the key word here. They would go on and on about one particular issue and even talk over the therapist as if they had no interest in listening to her feedback. I could see the frustration on the therapist’s face every once and a while. As a result, sometimes the first half of the session would take a long time.
After the break, when we all gathered back together, I had a major problem. I had a rough time being around large groups of people. The noise level would always increase and sometimes everyone would talk at once. That started freaking me out. Therefore, I retreated from the large table in the room (it was actually five conference room-sized tables arranged in a large square) and sat in the chair against the door right by the back emergency exit—it was as far as I could get from the group. The emergency exit was not wired to an alarm, and when it got to be too much for me, I’d walk out the door and take a breather. Being that it was the end of autumn as winter approached, the cool, brisk breezes usually refreshed me.
The second half of the session was psycho-education [I’m sure that Alfred Hitchcock could have had valuable input here :)]. This outpatient therapy program was based on dialectical behaviour therapy (DBT). When I tried to commit suicide back in 2005, I went through a DBT program after I got out of the hospital. At that time, I thought that DBT was pure bullshit. It all centres on learning tools or coping skills to manage various stressors (depression, anger, rage, anxiety, etc). Being that I had been diagnosed with Bipolar I Disorder (BP) and Borderline Personality Disorder (BPD), everyone thought that this type of therapy would be one from which I would benefit. Back then, I thought all these coping skills were stupid. Sure, it might work for some, but I just could not imagine me taking the time to think through whatever emotion I was feeling at the time and remembering which tool would help me through that situation most effectively.
When I realised that this time around would be centred on DBT, I was quite cynical. However, after about four weeks into it, I discovered some tools that could actually serve me well (see this for a list of tools). Without a doubt, using these skills effectively requires constant practise. You cannot expect to utilise a skill and then have it at your fingertips until you practise it. Once practised, when you face an emotional obstacle, you can more readily adapt effectively.
I also realise that there is a lot of controversy around DBT. Some who have been through the training think that it is bunk as I did. I can say that I do not agree with the entire skill set. I learned what tools I knew I could use and left the others behind (there are some I still think are bullshit). All I can say is that it is up to each individual to determine what works in his or her best interests.
That being said, the first half of my last session was great. Our small group only consisted of seven patients and our small group never had the loud mouths (I am grateful that Mr. Noisy was in the other group!). I knew three of them; the rest were new patients. When I finished sharing my check-in sheet, I received wonderful feedback from the therapist. She basically said that I had done a 180˚ from the time I started the program and was extremely pleased to see the progress I had made. It had taken me all this time to see the huge steps I had made. Don’t get me wrong; I am far from being all fixed up. That is why I am going to continue with an individual therapist. BP and especially BPD can take quite some time to manage. While some professionals banter about the word recovery, I think the best I will be able to muster is to manage my BP and BPD to a tolerable level. Only time will tell.
The second half of my last session was surprisingly smooth. While Mr. Noisy was present and accounted for (as well as the other few loud mouths), the group discussion on the continuing module of assertiveness was quite ordered. It was quite appropriate that my last module would be on this topic. As I have mentioned previously, despite my butch bravado, I really could bolster this skill.
Saying goodbye was harder than I thought. All of the patients who had been around for a while (with the exception of one other patient, I had been there for the longest duration) took their time saying goodbye to me and wishing me luck for my future. As someone laughingly said, “Hope to see you at Wal-Mart should our paths ever cross again.”
Monday was supposed to be my last day of group—the insurance company had only authorised sessions through then. I was not prepared for it to end. Despite my attitude at the beginning, I have gotten a lot out of this therapy and I think that I have made significant strides. I asked my therapist what process I had to go through for discharge and she told me she didn’t think I was ready, especially with the Christmas holidays coming up—she knew I would be alone as, once again, my family enjoyed their celebration with no nod to me. I am beginning to get used to the idea of spending the entire holiday season alone. My son came to visit me two years ago, but he lives out West and, for both of us, it can get rather expensive just to fly in either direction. So, the therapist told me to return on Wednesday as she was going to submit a request to see if the insurance would authorise additional days.
The second half was on self-esteem—something I am sorely lacking. Despite my butch bravado, I saw traits from the description of those who have poor self-esteem and I ranked right up there. That actually pissed me off a bit. Nevertheless, in reality, I do not always stand up for myself and usually take a back seat. I am not exactly a doormat, but I am not as assertive as I could be. It’s odd as at work I can take the lead with regard to directing projects (considering I have taken that blasted Six Sigma training), but when I am relating to others on a personal level it is more apparent.
As the session drew to a close, I wondered if today was going to be my last day. I gathered my stuff and flew out the door as I had another iron infusion directly after group.
I came back Wednesday morning and was pleased to find out that the insurance company had authorised three more sessions, including Wednesday, through December 30th. That would take me through the New Year’s weekend leading right up to when I was supposed to return to work. When our “small” group was sharing, I tried to process the difficulty and anxiety I was feeling about returning to my job. I fear that I do not remember how to do what I have painstakingly spent three months trying to learn. I try to stay in the moment as I still have another week to go, but I cannot help worrying about it. I feel stuck and do not know how to reinsert myself into the routine. I got a lot of good feedback from the therapist and others, but it did not necessarily quell my anxiety.
The second half of the session was on assertiveness—something that I am not very good at as I am more than likely to be either aggressive or passive aggressive. The entire group, as usual, gathered for this part and our entire group is getting way too large for me. It is enough that my little group, when we split for the first half, has too many people. I have discovered that there are a couple of noisy “talkers” in the other small group. As the therapist began her discussion on this topic, those talkers always had something to say about everything and would get into their own discussions if they disagreed with each other. The more they spoke, the louder they got and more people started getting into the action.
It was becoming too much for me. I wanted to listen to what the therapist had to say and ask my questions if any came up. After a while I thought, hell this is a topic on assertiveness, I think I will try it on for size. Rather than just jumping into the fray as everyone else had been doing, I raised my hand (OK, that does not exactly project an assertive position). The therapist piped up (she was pretty good about keeping the group on topic) and nodded to me. I waited for everyone to get quiet, looked around, and gave everyone eye contact. Then I explained that it was hard for me to be around large groups of people, especially when it got loud and everyone was interrupting each other. I told them that when they got carried away, I felt anxious and asked everyone if they could respect my position.
At first, everyone just stared back at me and then the therapist chimed in first. She said she was glad I spoke up and voiced my concerns and told me that it was an assertive position I took and was very appropriate (I thought to myself, “So there, hah!”). Then the noisiest of the bunch jumped in and said to the therapist, “Excuse me, but don’t you control our group?” She said it was a group discussion, but everyone had to be aware of each other. Then Mr. Noisy said, “Well, I’ll respect your position.” I looked at him and wanted to say, “What am I, chopped liver?” What I really wanted to say was, “Fuck you” but I did not (so OK, I was not completely assertive). For a while everyone seemed to settle down, but it did not take him long to go back to his diatribes and, once again, everything exploded. There were ten minutes left to go, so I just decided the statement I would make would be just to pack up my stuff and leave the room. I was not that quiet about it (here is where I was being passive aggressive), pushed back my chair and got up and walked out of the room. I though, “Well, we’ll have Friday off for Christmas, so that will give me a breather.” However, I was glad my insurance had authorised two more sessions.
I have skipped posting on these group sessions on a regular basis because there was nothing unique about them, or anything of substance. However, I had some good news to “share” with the group this time that allowed me to rate some good scribbles on my chart for a change. I was able to successfully demonstrate skills that deals with my isolation issues since my past weekend had me actually enjoying time spent with friends outside of my house. The key factor for me isn’t just being able to connect with people, it also has to do with getting me out of the house and exposing myself to conditions that actually force me to isolate (being in situations where there are lots of people). However, it was no small feat for me to have initiated those phone calls that resulted in those plans.
While there are still four more problem areas as outline in my treatment plan, I obviously have much more work to accomplish. My therapist still feels I am not ready to go back to work this coming Tuesday and will be putting in an extension for my FMLA for an additional two weeks. I am frustrated with this because, while my job is incredible stressful, I love what I do. She just firmly believes I am in no shape at this point to handle that level of stress.
The second half of the group was spent on anger management issues, something that directly applies to me. While I have been able to deploy some of the tools to combat my isolation issues, I have so many additional skills that I have been taught that I still cannot use. Therein lies my problem. Anger is a big one for me. When I become rage filled, that last thing to enter my mind is any of the tools.
This post was never meant to be. Late last night, with full resolve, I put into place my deeply rooted desire to carry out my intended plan so foolishly done with exacting ineptitude only five weeks earlier. However, quite obviously, this did not transpire.
I don’t where to start with this one, but in so many of my posts, I have demonstrated extreme rage towards my pastor. I have also invalidated another person with whom I’d grown very close to over the course of our friendship (she is the one who brought me those nifty tools to use to keep me safe at night during my midnight walks even while vilifying her).
As much as I have disparaged my pastor publically via this venue, there is something else I must do equally as public. I realized that I had to let go of all of the anger and hostility I have felt towards him. In addition, I have to come to understand how valuable my friendship is with him. I recognize that these emotions and thoughts regarding both of these individuals were irrational.
Today marks one month since I tried to commit suicide. This afternoon they came over to my house at my request. I needed to apologize to both of them for the unkind ways in which I treated them through my various posts. I realize now that their only motivation is one of compassion and concern. I didn’t see that in the midst of my turmoil. For the first time, I believed that it was possible for someone to care for me that much. I have to learn to accept that at face value—it is what it is. To know in my heart that their friendship and just as important, their acceptance of who I am while wrestling with BP and BPD, is a hard concept for me to accept. Nevertheless, I believed everything supportive and loving they said to me.
I do not have much to say about today’s session. The therapist is concerned that I am not eating except a small snack to take with my Geodon. She is also concerned about my insomnia. I did not have much to share. Not much had changed from Wednesday, but I was able to report that I was not having any suicidal ideation Thursday night. Very depressed, yes, but I was able to leave it at that. She pointedly asked me if I could remain safe through the weekend and I could only tell her that I have demonstrated successfully one tool, and that was all I could promise her. I also told her that my psychiatrist has requested me to call him for a check-in call on Saturday and Sunday. She seemed rather pleased with that.
In actuality, my blogging has actually helped me with the ideation Thursday night. I spent a good deal of time writing, reading others’ blogs, and keeping up with my LGBTQ-oriented Facebook account (OK, a translation for you straight folks: Lesbian, Gay, Bisexual, Transgendered, Queer/Questioning), along with my Twitter feeds.
Something weird happened at break. One of the folks in my small group came up to me and wanted to know why I ignored her after trying to say hi two times. I had to honestly tell her that I really had not noticed her (remember me; I am all about blinders around other people). She started crying and I did not what the hell to do as she did this in front of everyone. Then everyone stared at me. Well, I am sorry that I must have hurt her feelings (I can recognize that from classic BPD symptoms), but I am not responsible for her feelings, only my own. I felt, with everyone staring at me, that I at least had to apologize. I really didn’t want to have to interact with her at all, but what was I to do? It is not as if I go around intentionally trying to hurt someone, or be rude or uncaring. I just simply want to be left alone. Soon enough, break was over so I went inside where both groups join and found my seat on the far wall. I also asked the therapist if I could crack open the emergency door right beside me in case I had to leave the room (I do not want to make a spectacle of getting up and walking by everyone to leave through the normal door). She said that was fine (no alarm attached to the door)
I came home and found this gift bag by my front door inside my porch. Curiously, I picked it up and brought it inside. The attached note said, “For your walks around the neighbourhood…a few things I thought would come in handy.” It was signed from the only church member (outside of my pastor and his wife) that I had been relatively honest with about some things. Evidently she has been reading my blog and noticed my entries concerning with my dissociative states while walking or driving. Inside the bag was some pretty neat stuff. It contained an atlas with very detailed set of maps of my city along with a street index finder. I found my house (conveniently already marked with an icon as there is a large city fire department up at the corner. Nevertheless, I am going to put an X right where my house is anyway because with a past dissociation, the fire department’s presence did not mean anything to me. I’ve even post-noted my relevant pages). It also marks subdivisions and schools—things I pass by on a regular basis. In addition, there was a device with a red blinking LED visible to one km with a range of 180˚. It came with a strap and three batteries. I can attach this to myself to make me visible when I take my late-night walks. There was also an LED pen light with a magnifier lens that only weighs 38g and has a metal clip attachment. The last thing in the bag thrilled me to no end—a new tool. This seven-in-one tool is only 12cm long. Get this—it contains an LED light, compass, thermometer, clock, safety whistle, safety mirror and a 2X magnifier. It comes with a lanyard I can wear around my neck. Now I can be all decked out in LED!
OK, time for an honest reality check here—my perception vs. my reality. This person does want to be close to me—not because of the gifts, but because of the intentions behind them. I wrote her a long email thanking her (I did not feel prepared enough to actually talk with her at that point). In the same email, I told her everything. I even attached two documents on bipolar and borderline personality disorders to help her understand the effects these have on me. She responded with such a kind email; it gave me some contact with another person who now knew me the way I wanted her to know me—no pretence about anything. She let me know that she clearly knew what my boundaries were and that she was not going to be in my face, but essentially would let me make any contact. Fearing that I would lapse into my normative state of isolation, I told her that it was OK to call me, but if I felt I was not capable to talk, she could leave me a vm. I was OK with that, so after reading the email, I actually felt better prepared to call her. I am trying so very hard to reach out, but I can only take baby steps. I fear rejection; I fear abandonment.
Now, onto my next hurdle—trying to use “radical acceptance.” The principles are 1) solve the problem, or, 2) change how you feel about the problem, or 3) stay miserable, or 4) accept the problem. It takes away the “judgements” and removes the “shoulds.”
The hurdle—all of the anger and resentment I have felt toward my pastor for placing the 911 call and coming by the house to show the police my text message. My perception? That he was disappointed with me, angry because I did not call first and ask for prayer before I got in that state, and that he would think less of me. Therefore, I took a very deep breath and wrote down everything I wanted to say before I called him so I could focus and concentrate on what I really wanted to say.
I called his house and thankfully, he answered. I am not really sure what I would have said if his wife had picked up instead…I wasn’t prepared for that scenario. I told him who I was not knowing if he would recognize my voice. Then I told him I had something to say and would he listen to me without interrupting me until I was done. I asked him if he would meet me because there were some things that I needed to say to him alone, that we could meet in a public venue of his choosing as long as I would not be seen as making a spectacle of myself if I got emotional, and it had to be a place where I could smoke (damn these city ordinances banning smoking to even include many outside venues). We settled on standing in the church parking lot (right across the street from me) for this Tuesday at 1630. When I finished what I said, he asked if he could say a few things. I hesitated momentarily—this wasn’t a planned two-way conversation. I wanted to say what I had to say, set the time and place and get off the phone, but I ended up saying OK. He helped fill in some more of the blanks. Evidently there were already three or four police cruisers and the EMS there across the street in the church parking lot before he arrived (I had been told earlier by one of the first responder cops that they parked there with no lights flashing on purpose so as not to alert me in case it was a situation of “suicide by cop”). The cops asked him who he was and he explained that he had placed the 911 call as a result of my text message. They asked to see the text message, but they would not let him cross the street to my house at any point. He told me that the only reason why he came over was that he was very concerned and worried about me. He said he had tried to call me after receiving the text message and I did not answer. Again, the problem with my perception vs. reality.
Am I ready for this conversation? I do not know. I have to find a way to let this anger and resentment go. While it is by no means my only trigger, I have obsessed over this a lot—primarily because I have always respected him. He is a WYSIWYG (what you see is what you get for you non-computer geeks) kind of guy—shoots straight from the hip with no guile. From the very beginning, he has accepted the fact that I am a lesbian and never has judged me. I owe him the same respect.
I couldn’t resist this video. It actually had ME chuckling a bit! It’s well worth listening to for you group therapy gurus out there!.
Yesterday I was a little more active about filling information on the daily check-in sheet we use for “sharing” (gag). I was able to verbalize and demonstrate (what they are looking for according to my treatment plan) three skills I have been using to further my treatment.
You know how I mentioned that I can be out driving my car and all of a sudden I don’t where I am, how I got there or how to get home? (which only causes an anxiety attack to no end). Well, what I’ve come up is this plan: I Google the map from house to location (and also do a return map) and I keep that in my car. I study the map so I know what exits to pay attention to if I’m on the interstate. I have been using “mindfulness” (skill #1) by concentrating hard on where I am at all times, mentally checking off the exits. In addition, I will call the location ahead of time (even if it’s been a place where I have gone before) and ask for prominent landmarks that I can start looking for as I approach the location. I mark these landmarks on my map.
When it comes to more locally centered destinations, I can zoom in on Google and it will note landmarks (restaurants, gas stations, churches, etc). It’s still up to me to study them ahead of time so I don’t have to be looking at them while I’m driving. I’ve have even had to resort to do this when I plan to take a long walk around my neighborhood. The other night, when I just wanted to get fresh air, I Googled the diameter of the area usually a minimum of a two-mile stretch (residential, no populated landmarks) and made notes on the map with regard to street addresses to go with the street names and would place arrows to make sure I would know how to get home. In addition, I take my walks when it is very late at night—no traffic, no noise. You might wonder if I’m taking a risk doing this so late. All I can say, pity the fool who wants to fuck with me whether he has a gun or knife. Besides, you’ve heard the phrase, “suicide by cop,” well, couldn’t this be just as easily “suicide by rapist?”
The other immediate issue I have been working on is facing being around a large group of people. When our whole group therapy rejoins us for the second session (we always split into two smaller groups for the “sharing” session), I can’t handle the room that is now filled of people. All of the chairs are taken. I can’t sit next to someone, or even be in close proximity. My coping skill has been to “retreat” (skill #2) where I find a chair alongside the wall, as far as away from the table that is possible. Again, I use “mindfulness” when I start freaking out and the walls feeling like they are closing in around me. I simply close my eyes so I don’t have to see anyone and just zone on what the therapist says. Sometimes I have to use my “deep breathing” (skill 3) when I actually have to open my eyes and look at the white board, or have to participate in the discussion (my extent of participation is usually having to ask her to repeat what she just said because I don’t understand something, or my poor concentration is acting up).
So, I am using three skills so far that seem to be working to an extent. I’ve developed quite a lot of neighborhood maps, by the way. I’m not one to retrace my steps every night. Since I am still alive writing this, the severe suicide ideation I experience on an all too familiar basis, what I have been doing for that one is to get out of my house, because it seems that being all alone in my house has become a trigger, so I “retreat” and take a long, hard walk. The exertion helps dissipate the wrathful rage I am experiencing at the moment, so by the time come home I am usually spent and exhausted. I simply take my bedtime meds knowing that they will knock me out for about two hours tops. When I wake up, the suicide ideation is usually at bay, even when I go into the other room and put all my “instruments” back in their lockbox for no one to find. I’ve carefully labeled it quite prominently Bank Statements, so no one would even bother looking there if the cops ever had the probable cause to search my house.
This morning was rather interesting. Did the usual sharing, but when I commented that I couldn’t remember anything from the time I left group last Friday (but that I remembered Saturday and Sunday) she asked me if I remembered calling her Friday afternoon. I drew a complete blank. She said I wanted to meet with her afterwards today to discuss my treatment plan. It was news to me (as she scribbled). Well, we did discuss my treatment plan. I asked why, under master problem list, it listed merely “depression” and no indication of persistent suicide ideation. She explained that I had not been honest from the beginning about that on my daily check-in sheets, and only just started mentioning it. I tried to explain to her that the ideation isn’t just something I think about here and there, but that I struggle with this almost every evening. The only thing that has kept me alive has actually been using one of the coping skills. I am discovering that my house…my fucking house (or rather, being in it all alone), has become a trigger. I have to leave the house and I end up going for a walk—a long walk. My reasoning? It’s late at night, and walking releases so much of my energy. When I finally get home, I’m worn out—physically and emotionally—utterly spent.
She looked at me and told me that she thought I needed go back inside the Big House—that this outpatient treatment program, in her opinion, wasn’t going to be sufficient to keep me safe. I pleaded with her not to make that recommendation (i.e., have me committed again), that I had shown that I was successful in using my skills. I practically begged her to let me go as long as I made the commitment to her that I would use my skills when I was in that head space. I tried to stay calm, although my heart was banging so hard. However, she relented but there was this look in her eyes that scared the shit out of me. All I kept thinking to myself was to just deep breathe and stay calm. I didn’t want to trigger any action on her part.
I was very uncomfortable walking into the group room today. While the entire group is split in two, everyone has to come into my room to pick up and fill out their daily check in sheets. Then they go to another room. The room is fairly large; there are 6 conference-sized tables arranged in a large square. There is a seat for everyone, but it still too many people for me. At least half of them leave after 10 minutes or so.
Today’s “sharing” session (which generally lasts for two hours) was the usual boring routine until it got to me. I have decided to be honest about everything: the isolation that is now bordering on the extreme to include not even wanting to sit near someone, the rage/anger, suicide ideation (as long as I can assure them that I am not going to act on it), etc. I told them about my egging the police cars Sunday afternoon as an example of how my rage is getting out of control since I am now acting out my impulses. I admitted the desire I have to want to beat the crap out of any cop, and that I have been looking for ways to provoke an incident. I also told them that the two cops who responded first to my 911 call back on 10 October would be coming over to my house this afternoon to answer some of my still yet unanswered questions. Boy did that get their panties in a wad. They asked me if I thought I could control myself while they were at my house. I told them I was seeking answers, and as far as this meeting was concerned, I needed their help so I could fill in the gaps. I’m smart enough to know not to bite that hand that feeds me. Then I was asked how I would respond if they told me something that made me angry, or if they patronized me in any way. I didn’t have an answer for that one. They’d better not patronize me. That’s about all it would take to send me over the edge. Who the hell do they think they are, anyway, strutting around flashing their badges and guns like they own everything? (but, of course, I didn’t say that!). They didn’t think it was a good idea, and suggested instead that I meet them at the police department. Oh, yeah, like I’m gonna want to go THERE (aside from the fact that there are too many people around). I just told them I would think about it, but most probably I was going to stick to my guns and have them over. Right now as I wait (should be here in about 45 minutes barring getting a call beforehand), I don’t feel that my anger is out of control. My driving force is to get these much-needed answers. I can behave, or at least play the game, to get what I want. We’ll see.
The second part of the outpatient program today was the presentation by the therapist. She usually touches on various stressors, reactions to stressors, and discusses possible coping skills (today was about anxiety vs panic and their associated decriptions/indications of the related attacks). However, as soon as we came in from our break, she announced that the whole group would be together for this. I immediately got up from my seat at the table and found a chair that was against the wall far away from the table. Everyone piled in and thankfully filled all of the seats so it didn’t look too abnormal to take a seat on the wall (however, I moved there before most of the other group had come into the room). I had a hard time during that session. Just too many people. And, God, can some people whine!
(later) Well, the officer just left. He was as nice as could be and sat down at the table I have on the porch. He said the police always respond to “suicide person” calls as SOP. He and the ambulance parked across the street (where the church parking lot is) so as not to alert me, reasoning being that the alleged “suicide person” may try suicide by cop (it’s a shame they know THAT trick). He went on to say, especially after interacting with me today, that I was highly intoxicated and could not walk without assistance. He walked me into my house to secure my wallet, keys and sandals, but said that he did not search the house. He can’t remember if all my house lights were on or not.
But, here is the kicker: my pastor arrived (he was waiting for the police. He also parked across the street) to show them the text message I sent him. That really pisses me off. OK, I get that he felt some professional obligation to call 911 based on the text message I sent. But to meet the police at my house??? That crosses the line in my book. That pisses me off to no end. Why couldn’t he just leave well enough alone? What was he out to prove?
The cop was completely courteous and respectful. He even said that he wouldn’t even have recognized me by my actions given the state I was in then vs how I was when he talked to me today. It said it was quite an amazing difference.
Today is a day off for me. No appointments with anyone. Yesterday evening I made another decision, diametrically opposed to this one only made here.
I had nothing but time on my hands yesterday after my first encounter with my therapist. I spent much of the time playing catch-up in reading the many blogs that I follow and reading comments made to my posts, along with some personal emails I actually received from truly caring individuals. As the day progressed, I did feel the intensity of my rage lessen somewhat (certainly not from anything purposefully done on my part, I assure you)
I had already made the decision to come back and see the therapist for a second appointment—a commitment that I didn’t think I was capable of making, much less caring about. Early evening it occurred to me that if I am going to make an effort with this therapist, I should at least be responsible enough to go back on my meds (a value judgment?). I went back to my bedroom and lined up all the containers (three of which are for blood pressure since it seems I’m having an issue there as well and swallowed them all (I always feel I have to add the caveat: as prescribed LOL). With my history, making the statement “swallowing them all” takes on a whole other connotation!
Went back to my living room and spent the evening listening to some really fine jazz (John Klemmer, Stanley Clarke, Chick Corea, Miles Davis, Jean-Luc Ponty, Al DiMeola). As the evening rolled onward, I made a concerted effort to also start trying to structure the time I try to go to sleep (an ephemeral experience to say the least). Even though I felt far from tired, I took my bedtime meds, crawled into bed and tried to read a book. I am so frustrated with this last action. I opened up to where I had last read (just the previous day) and I had no memory of what this book is about (I’m only about 12-15% into the beginning). This repeated problem really pisses me off, because, if given the chance to be focused enough to read, at least concentrating on that action temporarily quells all my racing thoughts. *Sigh* I return to the first page and start over.
After a few minutes, I realized that I had made an error with one of my blood pressure medications, a mild diuretic (hydrochlorothiazide HCL, hereafter referred to HCTZ). This one, for obvious reasons, taken once a day, should only be consumed in the morning—certainly not just before going to bed. When I hopped up to hit the head, all of a sudden I did not feel so well. No, I wasn’t dizzy per se, but I felt as if I couldn’t catch my breath and also somewhat disoriented. It occurred to me that perhaps the blood pressure crisis I experienced while incarcerated was indeed situational after all. Was my blood pressure now too low? I walked around for a little bit and found myself having to sit down. Very weird feeling.
So, as potentially stupid as this action could result, I decided to drive up to the nearest CVS and use their BP machine. I had much difficulty driving; it required far more dedicated concentration and focus that what I am used to. When I walked into the store, the lights were too bright and there were too many people milling around. Without asking, I blindly walked to the rear by the pharmacy and found the machine.
Now, mind you, when I was first put on the initial does of medication, my BP had skyrocketed to 228/156. When I was released 11 days later, I immediately saw my primary care physician and my BP was still elevated (165/110). What was eerie in both measurements was the fact that my heart rate was only around 56. My PCP decided to alter the medication I was discharged with from the hospital. He effectively doubled the dose of one (clonidine HCL from 0.1mg to 0.2 mg, but dropped it from, 3x/day to 2x/day), increased to dose of another (lisinopril from 30mg to 40 mg 1x/day) and added the HCTZ at 25mg 1x/day).
I sat in front of the machine and it turned out that my BP had dropped to 137/61, HR 72. The diastolic measurement concerned me as I thought that was a bit too low which might have explained how I was feeling. I drove back home, still trying to catch my breath and thought about calling my PCP in the morning. Went back to bed, read a little and actually experienced the feeling of being sleepy (hooray for me). Perhaps adding the Geodon to my bipolar cocktail might have made the difference. I actually got about five (count ‘em FIVE!!!) hours of uninterrupted sleep. I cannot even remember the last time that happened.
When I woke up, I decided to get my BP measured again before calling my PCP. Weird. It was back up to 150/95 HR 61. (I decided to purchase a BP wrist monitor while at CVS this morning to save on having to drive each time. The first reading, while still at the store, calibrated closely to their BP machine, so I was at least on a level playing field) Knowing it was still slightly elevated, I decided not to call my PCP and took all my meds this morning as prescribed. It has now been one hour. My BP is 112/66 HR 71. Perhaps my BP meds are stronger than they need to be. I’m going to take the rest of the BP meds today and monitor this closely and then possibly call my PCP tomorrow and ask if I should perhaps reduce my dosages.
Speaking of tomorrow, I have my second appt with my shrink. As far as he knows from the phone call he received from my therapist yesterday, I have been off my meds since last my discharge. While I did fill the scripts the shrink gave me on my first visit with him post discharge, I never bothered to take any of them (still in the “I don’t give a damn” mode). I am sure his first response is going to be along the lines of “Why won’t you help me be a better doctor to you?” What can I say? I am now willing to take my meds, continue with this outpatient program for this week and next, and then pick up with my individual therapist the following week.
Well, I am finally caught up with keying in everything I had written in my journal since my “visit” to the ER. No more date stamping my titles! You know, my handwriting can really suck at times!
I agreed to this appointment as a condition of my release (in addition to the outpatient treatment program I am in, they wanted me to start seeing an individual therapist). Just so it would appear that I was being a “good little girl” I showed up.
While I was in the waiting room, filling out yet more “new patient” forms (hell, they already have a copy of my records from the hospital, why can’t they just read that?), I could feel my anger building. I didn’t want to be here. I had no expectations. And I sure as hell don’t trust the system not to lock me back up if I say how I really feel.
(For the first time since I started this blog, I am not so sure I feel safe even writing what I really do feel here. No one who knows me personally has the link to or the name of my blog, not that I can remember, anyway. At what point do I end up surrendering my 1st Amendment rights?)
I was actually somewhat surprised by this first visit. I wasn’t even sure we would “click.” I tried to get through to her that I did not care whether things “improved.” Of course she asked me if I was suicidal and I just laughed and asked her if she really expected me to answer that after everything that had happened (she started scribbling on her clipboard). She asked a few questions about my history and previous suicide attempts (more scribbling), but all-in-all, she got it that I was incredibly angry. She said my continued participation with her was strictly voluntary at this point.
Sure, I told her that I thought that my life sucks (did not expand on why at this point, but more scribbling anyway), that I had no clue as to how I thought she could help me, and that I thought DBT was for the birds (more scribbling). Then I simply asked her, “How can you even deal with me if I’m in a space where I don’t even WANT to use the tools—that I just don’t give a damn?” And she said that this would be a good place to start. At least she acknowledged where I was rather than determining that I was “unwilling “or “uncooperative.” She said that a return visit was clearly up to me. She didn’t try to preach about tools/coping skills or what I should be doing. She said that obviously I had to decide if I wanted to try to figure out why I was feeling the way I did well before I could do anything about it. It was the first reasonable thing I had heard anyone say to me to date.
I could tell that the time was almost up. She asked me if I felt suicidal, would I be willing to call the hospital, and I emphatically told her absolutely not (more scribbling). Then she handed me my sheet with which to check out, gave me her card, and told me if I wanted to come back to just call and make an appointment.
As I stood in line to sign out, I looked at what she checked off under “diagnosis.” She indicated bipolar (good catch) and anxiety disorder (yet a new label for me, oh goodie). However, conspicuously absent (despite the records from the hospital and the information I filled out on her “new patient” form) was borderline personality disorder. She was still in the hallway, so I called her back up and asked her about that. She said that she didn’t think it was appropriate. Well, I got tagged with that label back in 2005, and with everything I tried to learn about BPD, it seemed to be right up my alley. I told her that I thought it was amazing how no one wants to deal with that issue with me, not even my own psychiatrist and now her. She said that I was operating under an assumption that she didn’t think was accurate, but reached over and checked it off on my sheet and walked back down the hall. What’s up with that? Is BPD the dreaded mental illness that no one wants to discuss? All anyone ever wants to deal with is my bipolar.
When I went to pay (yay—only have a 10% co-pay and today’s, the most expensive appointment since it was an initial workup, was only $12), for some reason I did decide to make a return appointment. Don’t know why, or what I expect, but I thought I’d give it a shot. She has been the only person so far that seemed to be interested in the reasons why.
Meanwhile, she’s going to contact the outpatient therapy program @ the hospital to indicate that I did complete the follow-up appt (I went to see her today instead of the outpatient program), as well as contact my psychiatrist (he asked me to have her contact him for ongoing continuity of care). Since I admitted to her that I hadn’t bothered taking any of my meds since discharge, I guess that cat is out of the bag. I see my shrink Wednesday. I wonder what that visit will be like?
It’s Sunday evening. This weekend has pretty much been a wash. Accomplished absolutely nothing. I’m trying to figure out how many days it has been since I last slept. I feel like I’m on auto-pilot.
I did manage a quick grocery trip finally since being home. That was a strange experience. I found myself just wandering down each aisle trying to figure out what I needed. I’ve never walk in without my list. I didn’t even know what I needed. So I got the basics and beat feet outta there. Too many people.
But I am starting to see a pattern emerge. My anger and rage is escalating for no apparent reason (yeah, I know for you DBT fans out there, there has to be a trigger, but damn if I know what it is). On the way home from the grocery store, I stopped by this little sushi restaurant right around the corner from my house to order something to go. As I pulled into the small parking lot, I noticed five (yeah, count ‘em—FIVE) patrol cars all sitting there unattended. The only other places in this small shopping centre is a bank (closed since it’s Sunday), a Starbucks, a deli and an ice scream shoppe. I had to park next to one of them. I got out of my car, looked around, and couldn’t see a cop in sight. Then I walked into the restaurant (nope they weren’t here). For some reason, as I was waiting for my order, I became increasingly pissed off by the fact that there were at least five cops somewhere sitting on their butts doing nothing. So much for my tax dollars at work.
By the time I left the restaurant I was so riled up over this (don’t ask me why!!!), that I opened up my trunk and got out the carton of eggs. I grabbed four of them and slammed two of the patrol cars. God that felt good. Never mind the fact that anyone in any of these establishments could see what I had done through those large plate glass windows all facing back at me. Never mind the fact that those FIVE lazy cops were somewhere on the other side of those windows. I don’t even remember what I was thinking. Really stupid, Alix. That’s all I need on top of everything else. But nothing happened; no one came flying out the doors. I turned around, closed my trunk, hopped in my car and drove out of the parking lot (yeah, all the while checking my rear view mirror just waiting to see the blue flashing lights on my tail). As I said, this place is literally around the corner from my house. All I had to do was hang a right out of the lot, drive past six driveways and I was home. When I pulled in, I waited for a minute, so sure that the cops were right behind me—still nothing.
