Outpatient Therapy, Day 6

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.

I am missing a time block from the time I left group therapy this past Friday from about 1215 until I woke up @ 0135 (you know, when I eventually go back to work, there is no point in having to set an alarm!). However, what concerns me most about the dissociative states is wondering what I do when I am in that headspace. I have to ask the obvious question: what happens if I become suicidal during a dissociative state? Will I have the frame of mind to attempt to use my coping skills? I only have this as a vital concern because the last time I committed suicide I cannot remember almost nine hours (which of course could actually have been precipitated by the incredible amount of ETOH I consumed along with the benzos).©2009