Intensive Outpatient – Week 9, Distress Tolerance, 2-Month Assessment

After IOP Thursday, the therapist wanted to meet with me for my two month assessment. It has gone by fast.

“How do you feel therapy has gone? Is there anything you need help with specifically?”

“At first I was overwhelmed with the material and I felt like I wouldn’t be able to incorporate it or even understand it enough. But I feel better about it now after practicing a lot of the skills. I guess I just need the distress tolerance part, I worry I missed the most important week of IOP because of the orientation.”

“Good news is you did not. We went over boundary enforcement for the upcoming holidays and we’ll be getting into distress tolerance on Monday. You didn’t miss out.”

I admitted I’d like some alone time with her on the material I did miss and she nodded encouragingly. For the class I said more practice with mindfulness. Those exercises are starting to grow on me.

I took the PHQ again, and the GAD, to assess my depression and anxiety levels. My anxiety is high but my depression is staying on the low/mild end. I am worried about a lot. I think things are going to get really bad.

I dread the holidays. I don’t work Thursday and made reservations at a restaurant for Thanksgiving and told my mom about it. Take it or leave it, I don’t want anything to do with the oh-poor-me pity party she has every year around the holidays.

Christmas is another story though. She will go on in a passive aggressive manner about how she’s all alone and is all alone every year, which is not true. My brother and nephews will visit but not till New Years which is the typical order of events. I work Christmas, and will not be able to see her till the day after. She won’t put up a tree or decorations like she used to, all in order to reinforce her sense of victimhood and persecution and isolation, all of which she chooses. No one victimizes her, no one is forcing her to stay home. She chooses these things and will guilt trip you all day as though it’s your fault. It is very difficult to be around her, she is a bitter old woman and the constant complaining and victim complex is exhausting.

So I am really not looking forward to holiday stuff, I never have, there are a lot of negative associations around that, for me. And probably most of the family. There is pressure to do something, to not let it slip by unacknowledged, for fear of making everything even more depressing. But I just want it to slip by, work a lot, to treat it as just another day.



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