Documenting my journey through the mental health system

I had to duck out of IOP early today – my lack of a need for sleep finally seemed to be catching up with me. I worked two extra shifts Friday and Saturday nights, trying to expend the energy in a productive manner, and only slept a few hours Sunday before coming back in for my actual full time job, doing 12 hour nights at the VA. By the time this morning came around, I was worn down and tired. I saw Dr Black in the morning right after work. She commented that I looked exhausted. I spent most of the hour processing the fact I’m going to have to move back into my house eventually. With my mom. Then I went to IOP where I felt very close to passing out from sheer sleepiness. I stayed for process hour, and when it was my turn I admitted to shitty sleep and feeling like I might have to leave early. The therapist was very understanding and said I needed to take care of myself.

We went from emotion regulation to mindfulness in the DBT program. I didn’t feel as bad leaving early because I have a lot of experience with mindfulness as it is all the rage in psychology today. I graduated college in 2011 with my psych degree and even then it was becoming well known as a research backed psychological tool for a variety of mental and physical illnesses. It helps ease anxiety, calms the mind, reduces pain, and overall eases the pain of life.

I know a lot about it, the research behind it, and I can acknowledge its benefits are real. I, however, have had much difficulty in incorporating it into my life. Like so much else. My mind is noisy, chaotic, often distressed, and there are voices that talk to me. When I am trying to practice mindfulness, I can barely make it a full minute just sitting watching my breath. If I don’t get physically antsy, I will get mentally antsy. I don’t try to “empty my mind” or clear it of thoughts. I focus on acknowledging them without judgment, on letting them pass, on reminding myself I am not my thoughts. This is a hard pill to swallow but I’m trying to believe it’s true – can we be separate entities from our thoughts? How is it we are not the sum of our thoughts?

I told Dr Black about all the flashbacks, feeling haunted, that it felt like I’d never get over it. I told her what specifically would replay in my mind and take me right back there – specifically, being strapped down and later forced to wear a humiliating anti-suicide smock. She said it’s probably not something I can get over but I can reframe my thoughts and perspective around it.

It’s bad enough this is where we are in mental health treatment, and specifically the treatment of acutely suicidal patients. The environment produces the behavior, Dr Black said, and it’s not my fault. By trying to keep someone safe, we tie them down, take away all control, and traumatize them. It’s a terrible ethical dilemma talked about by everyone in psych treatment. NAMI published a study talking about the sheer number of adverse events experienced by psych patients in emergency settings – from restraints and locked rooms, to security staff assisting in psychiatric care alongside nurses as well as injury from take downs, restraint, and medication. Psych patients are boarded – held against their will in emergency psych units awaiting placement – for much longer periods of time than other emergency room patients. I myself never spent less than two full days in these emergency psych holds and each time has been horrible agony.

So that’s my new challenge – agree with Dr Black that it isn’t my fault. Agree that I couldn’t keep myself safe and others were trying to keep me safe. That even though it was traumatizing and will probably linger in my mind the rest of my life, I can agree with a renewed perspective and let go of the shame and humiliation. I didn’t do this to myself.

I am overall at a loss on how to mitigate the pain of these flashbacks and memories. They are more than memories, I dissociate and go right back there, right back in restraints, right back to being drugged and humiliated. To being manhandled into a tiny psych hold cell and locked in. Just writing it out makes my heart beat faster. I wrote all these experiences out in great detail earlier in this blog, in several parts, so I’ll try not to perseverate here. I know it won’t get easier with time, because I’ve been through this before. I have to carry it around and live in some fear it could absolutely happen again. I told Dr Black this – I am terrified of myself and though I’m in intensive therapy, though I see her weekly and work hard to learn the coping skills and the DBT mindfulness and everything else, I can’t be sure all this will prevent another relapse. Another detainment, or detachment from reality, a loss of all perspective. It is awful to live with the fact that no matter how hard I try I can’t be sure it won’t happen again.