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.”
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.
My calendar said that we had our second appointment on the 29th, but I don’t remember that one. I can tell my meds have changed because I found his instruction sheet. He always writes everything out because he knows I may not remember. This visit was on 05 November.
My meds have changed again. Now my Geodon has changed from 240mg at bedtime to also include taking an 80mg dose in the morning along with a new drug called Provigil @ 200mg in the morning to help sharpen my focus and concentration. Its primary use is for the treatment of narcolepsy, shift work sleep disorder and excessive daytime sleepiness associated with obstructive sleep apnea. Other potentially effective, but similarly unapproved targets include the treatment of depression, schizophrenia, and disease-related fatigue. I guess my disease-related fatigue is the insomnia due to the depression
His primary concern is that I can keep myself safe. He has always been the only one with whom I’ve been able to be completely honest. I have been seeing him since June, 2000 when I was first diagnosed with BP (BPD didn’t become diagnosed until 2005 after my previous attempt at suicide). Aside from wanting to keep me safe, he is very concerned over my lack of sleep. He told me that I couldn’t expect to see measurable progress until I can overcome the insomnia. He’s also concerned about my weight loss. I’ve lost eight pounds since 28 October because I’m not eating. The only thing I eat is a small snack when I take my two doses of Geodon because it has to be absorbed with food.
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 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.
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.
