Archive for the 'Post Traumatic Stress Disorder' Category

Our journey with therapists

I’ve seen 4 therapists in the last 5 years.  That seems a high number.  M was told by Liz that we have very high expectations of therapists, maybe they are too high?  Here’s a brief run-down of what happened with each –

Debra seen for 6-8 months.
Worked part-time from home.  Her methods were based on Mindfulness and Cognitive Behavioural Therapy.  She was intelligent and studying towards her masters.  Reason why we stopped seeing her was because of boundary issues and she was stopping therapy work to concentrate on her masters.

Carol seen for 2.5 years.
Worked part-time from offices.  Her methods were based on Cognitive Behavioural Therapy with some influence from other methodologies including Dialectical Behavioural Therapy. Reason why we stopped seeing her was because of boundary issues and her fascination with our dissociation. She loved playing with Aimee. She wasn’t helping us move forward in any meaningful way and we’d started to become convinced that she had planted the whole idea of DID in our head.

Bob seen for 6-8 months.
Worked full-time from her extremely busy offices. She came highly recommended and we saw her to try and find out if we were making this dissociation thing up. She had extensive experience with abused teens and children. Things went a bit haywire with Bob when she was trying to force an integration of personality states to counter what she described as a “fragile personality structure”. We stopped seeing her when the short term contract was up with ACC.

Liz seen for about 6 months.
Works part-time from offices. She was the only therapist willing to take on a client that came with warnings about dissociative issues. She has other dissociative clients and came recommended from another therapist. We don’t know if we can go back to see her.

Earlier this week we posted a rant that was fairly quickly deleted.  It covered the issues we’d had when seeing Liz on Monday and problems we’d seen throughout the time we’d been seeing her.  Some of these include:

  • Turning her cell phone volume down during sessions.  It has rung during session, so you get the noise of a vibrating cell phone dancing across the desk as you’re trying to talk about something important.  She has also looked at the cell phone to see who is calling while in session.
  • She has a habit of clearing her throat when being asked something difficult or is faced with challenging ones within the system.  Mickie is generally silent during sessions when fronting, which prompted much throat clearing and a conversation about us living alone meaning that we don’t know how to socialise and make conversation.
  • On Monday there was a discussion about our night-time photography trips and the reason why we’re doing them – to get hurt.  Liz suggested that the reason why we hadn’t been hurt was because of someone or something looking out for us.  She was meaning a higher power of some sort.  Any talk of religion is a huge trigger for us.  It felt more like the focus of the discussion had moved from helping us, to preaching to us.
  • She is unable to remember our basic biographical information – we’re the youngest of four, get on alright with the oldest brother and have minimal contact with the entire family.  This is the sort of information that she has asked several times, including constructing a sociogram with us.  If the information was important enough to ask several times, it’s important enough for her to remember or to write on the front page of our file for easy reference.

Monday’s session was particularly bad.  The religion trigger set off a negative reaction with W.  M came forward to protect W when she realised what was going on, but it was too late.  This meant that M came forward annoyed that Liz was talking religion without checking out who was present and their beliefs about the subject.

It was after Liz again asked M about our basic biographical information that things got particularly tense.  M asked why Liz had to keep asking about this information, Liz responded that she might get a different answer one day.  M pointed out that we would always be the youngest of four children and unless something major happened, we’d still feel the same about the family as we do now.  Liz said our expectation that she would manage this information was too high, M asked what a reasonable expectation would be…

To be fair, M was defensive as Liz had challenged one of the young ones she protects.  But Liz was helpless to find us all a way through that defensive mechanism.  We left without making a further appointment.  If this has been a one off bad session we would have had a cool-off period and made another appointment.  But it isn’t, it’s the latest in a series of unusual sessions.

Now we’re stuck.  We don’t trust Liz and don’t know if we can go back to see her.  But if we don’t, are we doing so because our expectations are too high?  Are we being unreasonable with our expectations that a therapist will manage basic information, silence their cell phone and not talk about sensitive issues without checking who is present?  Maybe our reaction is off the scale because of our dysfunctional thinking and reactions?

—————-
Now playing: Audioslave – Cochise
via FoxyTunes

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Hospitals – the psychiatric type

In the town where we grew up, there was a psychiatric hospital.  It was spoken about in hushed whispers as a scary place where crazy people were fenced in and tortured.  In reality, the hospital catered predominantly for those who were institutionalised during a time in our history when those with even minor problems were often hidden away.  We were told as part of our abuse, that if we told the secrets we would be sent to prison or this hospital forever.  So our early contact with psychiatric hospitals was negative.

If you place these experiences within the context of our rather traumatic experiences with the medical profession, you get a picture of someone who has deep seeded issues and fears about all things medical.  The young ones especially react with terror even when driving by a hospital.  We avoid dentists, doctors and nurses where at all possible.  In many ways this fear enabled us to appear high functioning for many years – if there was a threat of having to ask for help through therapy or medication, well that just wasn’t acceptable.  Time to stamp it all back down into The Basement and carry on being invisible.

Then arrives the dissociative train wreck we experienced when about 34.  Our coping mechanisms fell apart.  Then there was the final straw – we were teaching a group of 40 students when something about the interactive whiteboard markers caused Angel to come forward.  So there you have a 5 year old drawing pictures of flowers on the whiteboard while a group of adult students look on.  M comes back to find half the board covered…

So back to therapy we went.  We were in the throes of an abusive marriage and suddenly facing a childhood that wasn’t as perfect as we’d convinced ourselves it was.  These factors led to constant suicidal ideation and intent, which in turn resulted in us needing to find some support to keep safe.

In New Zealand there are a few support lines for suicide help – Lifeline, Samaritans, Youthline, the emergency number or the local mental health hotline.  Lifeline, Samaritans and Youthline are confidential – unless they feel you are in danger, in which case they will try to get your details and send around the Police.  Emergency services transfer you through to the mental health hotline, unless you are already need emergency care.  Once you’re in the mental health system, you are told to call the mental health hotline.  Usually you wait for 5-10 minutes on hold before the phone is answered – ever been suicidal during the Christmas season and had to listen to Christmas carols for 20 minutes while waiting to see if someone can help you stop killing yourself?  You can at least double the waiting time if you call after midnight, as that’s when they go down to one or two operators.

If you do manage to get through to a human, you’re asked for your details – name, phone, address, caseworker and then why you’ve called.  If they consider you to be at risk, they will send around the local mental health workers to assess you.  If they consider that you aren’t at risk, they will discuss grounding skills you can use before sending you on your way.  The problem with this is that at any one time we can have up to 5 suicide plans – apparently that means we don’t really mean to die as we’re not focused on one plan (we consider it covering our bases in case one doesn’t work).  We can also begin the phone call with one who wants to reach out for help; but by the time we get to actually talk to someone, we’ve switched to one who either won’t talk or says that everything is fine.  So in many ways the service doesn’t suit us (and a majority of the population).

If you are considered at risk, you get the joyful experience of being escorted up to the psychiatric ward of the local hospital.  Where you begin the wait for some poor registrar who has been working for at least 10 hours and is surviving on a combination of adrenaline, coffee and sugar.  This person then has to assess your level of danger.  Most registrars haven’t dealt with anyone with a dissociative disorder, let alone tried to understand if there really is a risk.  They have a thankless job of walking a tightrope – is the patient telling the truth?  To make this job more complicated, during our experiences with registrars they’ve encountered –

  • Aimee (9 yrs old and carefree) who smilingly told the nice young registrar that she was too young to drink.  Quite forgetting that the body she shares is in it’s mid 30’s and sitting cross-legged on a hospital bed while drips are hanging from each arm to pump us full of drugs to counter the drugs we’d OD’d on.
  • Sophie (16 yrs old) who is our safest bet for these assessments – no one would section Sophie.  The main problem is getting close enough to hear her as she talks very quietly when scared or worried.
  • M who is the other safe bet.  She’s confident and knows how to work the mental health system to ensure that we are released.  Release is always her goal as the young ones she protects are violently triggered by hospitals.
  • Ellie who won’t be sectioned as long as she can keep her swearing and scorn for the medical profession under control.
  • Frank who is the worst one to front for an assessment.  He doesn’t get suicidal, but doesn’t understand what constitutes aggressive behaviour as seen in the eyes of a psychiatrist.  He doesn’t actually get aggressive, but his anger at being in a hospital is seen as aggression.

It’s at this point where we’ve usually been sent home.  But on two occasions we’ve been admitted or sectioned under the Mental Health Act.

Event 1:  Sectioning with two nights in hospital.

  1. Night of admission, put into art therapy room with triggering artwork around the walls.
  2. Given a single room across from an alcoholic man in his 40’s (the father is an alcoholic).
  3. As punishment for being admitted W used all of her strength to try and break the arms by bashing them against the storage unit in the room.
  4. A miracle was there in the form of a part-time night nurse.  She realised we wouldn’t sleep so asked if we wanted art supplies and then she sat and talked to us.  She didn’t care who she talked to, she just sat on the floor and let us talk and draw.  She got us Arnica cream for the bruised, swollen mess that was now our arms without a fuss.
  5. Then there was the daytime registrar.  We had asked to be released as the hospital was too triggering.  He went through the whole assessment again.  He asked why our symptoms made us special.  We tried to explain that we weren’t special, just sometimes experienced dissociation.  He dismissed the dissociation saying it wasn’t important.  Then when returning after talking to the consultant, said that the dissociation made us too unpredictable to release.  Yes, the one symptom that he totally dismissed, became the thing he used to keep us in.
  6. That night the same part-time nurse told us how to get out – say the words “I have no intent”.
  7. The following day a different registrar got the consultant to come in and talk to us.  He was going to let us out for the day, but M came forward and dazzled him with a veil of sanity.  We were outta there.

Event 2:  Admitted to the secure unit with one night stay.

  1. Saturday afternoon attempted suicide through an overdose and was taken to ER by the husband.
  2. Put on a drip and was overwhelmed by the dissociation.
  3. Overheard the nurses say that we hadn’t really overdosed, but were just attention seeking – our bed was right beside the nurses station and strangely enough the curtains aren’t sound proof.
  4. As soon as we were coherant, we asked to leave.
  5. After a 5 hour wait, we were assessed by the same psychiatrist who once picked up the phone while we were in the room and told the DBT specialist that “the borderline actually turned up, do you want to come meet her?”
  6. Because of all the triggers, Ellie and Frank weren’t able to control the anger very well.  We were escorted to the secure unit by the Police.  We didn’t threaten anyone or even raise our voice, but we were considered to be irrational and dangerous because of the barely contained rage.
  7. We were released the next morning.

If we are ever sectioned again, we’ll request to go to the secure unit.  It was comparatively peaceful and safe.  If any of the half a dozen patients even raise their voice, they are immediately surrounded by about four staff and taken away to be calmed down.  The only downside was that the cups of tea were lukewarm – hot water being a dangerous weapon.

This is a very light hearted look at our experiences.  In reality, during the sectioning Sophie was nearly destroyed when her twin came from The Basement to tell her why they were created.  The day after we were released from the secure unit, the ex-husband tried to kill us.  Other incidents have occurred while we’ve been waiting to be assessed, including one I’d like to forget where a patient masturbated while looking through the window at us.

We sit in wonder when people say that they voluntarily go to hospital.  It’s a concept that we don’t understand – why would you volunteer for torture, ridicule and scorn?  We know our perception is warped and that hospitals help people every day.  But it’s not something we identify with.  It was once recommended that we go to Ashburn Hospital for a minimum of six months to try and break our cycle of destructive thinking.  Just the thought of that was terrifying.  I wonder if part of the reason is that in New Zealand the focus within the psychiatric ward seems to be on holding you in a safe place until the suicidal intent goes, rather than helping you in a long term way.  It’s reactive rather than proactive.

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Now playing: Dixie Chicks – Wide open spaces
via FoxyTunes

Hell & Anger

We did this clip over a year ago, but heard the song on the radio earlier and it reminded us about this clip.  Just trying to keep occupied…

Note: It contains images which are only suitable for adults and might trigger.

Protected: Evil little girl

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Photos and coping

It’s been a rough week.  There’s so much happening at work that it’s just chaos.  Work is usually our anchor – it forces us to get out of the house and interact with people.  But there have been so many changes that the anchor sort of got cut free for a few days.  We walked out on a meeting on Thursday – something we’ve NEVER done before (no matter how much we’ve wanted to).  Part of the changes, are a renovation to the office space, which will mean the area being reduced by 30m sq.  The flow on effect is that three people in our office are having to be relocated elsewhere in the organisation and another three people are going to have to be shifted from where they currently sit.  Ordinarily, we would have jumped at the chance to go to another office area, but the new office space is open plan with no walls behind the work station.  We HAVE to have our back to a wall, doesn’t matter where we are, we just do.  But everyone else in the office is suggesting that we move.  Our team leader and the manager know that we have to have a wall behind us, but the manager made a point out of talking about us during the meeting and using us as an example as to why some people can’t work in every office space.  That was the last straw, we had to get up and leave.  She’s a really nice person, but she’s not a good manager.

As a further blow, our cynical friend is one of the people moving out of the office.  She needs to do this in order to stay calm while her husband deteriorates from the cancer.  So the only person we talk to and laugh with is leaving the office.

All of this lead up to a fairly intense bout of suicidal intent.  We contacted (via email) the woman’s programme we go to and Liz detailing what was happening.  The interaction with Liz was interesting, it got to the point where we knew that if we didn’t head her off, we’d be sent up the the hospital for a risk assessment…

To Liz:
… shouldn’t have contacted you or anyone, it’s just attention seeking.  It will be fine, at work now and then go home and forget everything for awhile.

Liz’s response:
I have found that talking about things, hard stuff, etc does help.  If it had not done so, I don’t know where I would be today.

Are you attention seeking?  Doesn’t sound like attention seeking from where I sit.  Although saying it is, will be another way that you avoid talking / dealing with it, aye?  Of course talking about hard stuff can seem to make things worse. Do they get worse before they get better?  Sometimes it works that way.  Sometimes there can be immediate clarity and balance.  I would like you to know that I am available to talk about this situation when you are ready to.
Regards
Liz

She saw through our rubbish, avoidance etc.  Will be an interesting session tomorrow…

As for our photos… we’ve realised by taking photos that our focus of the world is very narrow.  We’re not comfortable with the expanse of a landscape and the idea of taking photos of people is absolutely terrifying.  We tried taking photos of the mother while she was here, but immediately dissociated.  Yesterday we went for a walk and tried to take some photos of the surrounding landscape (managed a couple – try 1 & try 2), but we much prefer the narrow focus (e.g. dew drop).  I wonder if this is about our style of photography, or being caught up in PTSD and dissociative issues?

Why you shouldn’t read newspapers

Today has been one of those last straw days.  It started out fairly normally, the traffic on the way to work was light because the university students are in the middle of exams.  Our cynical friend at work was in a good mood and it was all looking positive.  Then…

Blow 1:  Our cynical friend didn’t come out to morning tea with us all – which is unusual.  When we were walking back to our desk we saw the graphic surgical procedure pictures she was looking at.  They had found a cyst which they are going to operate on.  As if she hasn’t got enough on her plate.

Blow 2:  We’ve been nominated as the union representative for the workplace.  Considering how we don’t like arguments or confrontation, I’ve no idea why they elected us – especially as we refused to volunteer.

Blow 3:  Each website we visited today that had an Ad banner, was advertising the “Death Quiz”.  It invited you to fill in the quiz to find out when you would die.  Considering how suicidal we are at the moment, those subtle messages are not helpful.

Blow 4:  One of the most vivid abuse memories we have is an event that occurred on the grounds of the local kindergarten.  Today in the newspaper feeds, a headline jumped out – that kindergarten had been set on fire.  It started on the couch they kept on the porch.  How the kindergarten is used on the weekend at night as a gathering place for teens was mentioned.  SO and W are triggered so badly.  We were already unsteady, but this has pushed us over.

Blow 5:  We were 3 minutes late for our desk shift because we got caught up in a conversation about a major system upgrade that is happening next week.  Another team leader came up and yelled at us for being late in front of other team members.

It’s now 1am and we’re terrified of trying to sleep.  We know the nightmares will be there.  It’s just one bad day right?  We can do this……….

—————-
Now playing: Christina Aguilera – The Voice
via FoxyTunes

Trio meet Liz

Up until today’s session Liz has predominantly talked to Sophie.  Today, Liz got B acting as a filter for M and One.  This group present quite differently to Sophie.  Sophie is gentle, shy and talks very softly; while the trio are observers, direct and carefully consider all responses.  As an example, if Liz asked who was present, Sophie would immediately respond with her name; while the trio would want to respond with “it’s none of your business”, but would mull it over and then say “mainly B”.

This trio is what Carol used to call the no-affective response powerhouse.  It can be quite intimidating and definitely throws an inexperienced therapist.  But for the trio, there were questions and issues that needed addressing – informing Liz of what happened at the support group appointment and questioning the whole “who have you become” statement.  It also made the observations of Liz easier, as the softness of Sophie was eliminated from the equation.

It became obvious that Liz has decided that father abuse is the main issue – despite the fact that there is no mention of this abuse on our records and us not having mentioned it within session.  We’re losing approximately half to three quarter of the sessions to stress and dissociative related memory loss, so it’s possible it has been mentioned and we’re not aware of it.  Liz is looking at the family dynamics and trying to understand them – we wish her luck.  I thought that’s why they invented ambiguous labels like “dysfunctional”, so that you didn’t need to poke at some things.

We made our discomfort with the “who have you become now” phrase known.  Liz clarified that she wasn’t meaning anything about us acting different roles when there was a switch.  It will be interesting to see if she uses it again.

I’ve often thought we must be an awful client for any therapist.  We don’t attach in any sort of way to anyone and because of the compartmentalisation we appear to contradict ourselves so often it must be hard for the therapist to keep any sort of event straight.

In other news, it’s all over with Kriss and the young ones have just started a blog of their own to help increase communication and participation – worked a little too well last night with us being woken up by a young one who wanted to write that they liked the header image that was used :)

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Now playing: Audioslave – Cochise
via FoxyTunes


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