Tag Archives: treatment options

Musings on emotions

It feels like this huge, crushing weight (grief does).

It seems like I’m feeling it too intensely sometimes… 

For some reason, it struck me today that some people have “sensory processing disorders” around emotions rather than sights, sounds, or textures… 

The same way loud noises  (or lots of sources of noise) can be overwhelming to someone on the autism spectrum, “loud” emotions can be overwhelming to some people… 

What if that emotional overwhelm they try to always pigeonhole as “borderline” is really just an autistic glitch around emotions as opposed to one of the other senses? 

What if introducing trauma/abuse/neglect into the mix early-on intensifies the inability of a person to deal with this emotional sensory processing disorder? 

We’ve all heard the theories that borderline is better explained by c-ptsd (which I totally agree with). What if we took it one step further and explored the possibility that “borderline”was actually in part an autism-like disorder? 

If you consider that one “symptom” of borderline is “feeling too intensley”, and you understand that even trained clinicians minimize the difficulty of dealing with extremely intense emotions (as they’ve been trained to do; “know that emotions come & go, like waves”), it’s easy to see the disconnect in effective strategies for clients. It’s something along the lines of comparing a stubbed toe to a shattered foot. Sure, you can probably take over-the-counter Tylenol for the stubbed toe & it will likely help, but doing the same for the shattered foot probably won’t make a noticeable impact. For such an intense injury, you need prescription-strength stuff. We should have something more than “Tylenol” to offer people. 

What if we understand that pushing someone to sit with intense pain (physical or emotional)  will likely lead to various ways of procuring relief… so you take a kid who can’t handle loud noises, and you tell them they need to sit through a rock concert. You’re going to get a tantrum and various, inventive ways to deal with the pain from the noise (think stereotypical autistic behaviors like flapping, screaming, hitting self, or attacking others). Now take a kid who feels emotions incredibly intensely, and ask them to tolerate those emotions. You pretty much get the same acting out in search of relief: self injury, tantrums, physical and verbal outbursts…

I’m a huge proponent for dropping the borderline diagnosis from the dsm. It’s an antiquated and “cop-out” diagnosis with way too much stigma attached. While there’s a push to remove the stigma, it’s still very much taught to young clinicians. Professors and supervisors alike instill fear and disgust around the diagnosis. Myths are perpetuated. Doctors do the same. It’s quick to be diagnosed (often inaccurately), and it’s near impossible to step away from even if it’s found to be inaccurate. It follows you and colors every other interaction with every other professional that sees the dreaded diagnosis anywhere in the file…

What if, instead of just working to destigmatize the diagnosis, we came up with more accurate understandings, and got rid of it completely. It was, after all, just a catch-all category for people who didn’t quite fit any of the other categories… 

What are your thoughts on this? Does it kinda make sense? Am I way out in left field? 

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The thought of psych meds makes my chest tight

​I’m going to see my pcp about trying an antidepressant again. It’s kinda freaking me out. The last time I was on meds regularly for this, I pretty much lived in one psych hospital or another… I haven’t been that bad since coming off all meds 5 years ago. I really don’t want to get back to that space again. :/

I dunno what’s better; dealing with ridiculous depression and anxiety, or risking another revolving-door hospital experience. Dr C thinks it might work out better this time, especially if I stick to just an antidepressant. But that’s how it started last time… I might plan ahead and insist Dr S not prescribe anything after like 6 months, and nothing other than an a/d… and maybe agree that if I end up hospitalized at any point, we work on stopping the meds immediately instead of tweaking or adding. 


Treatment up in the air

TM and I talked about treatment options again today. I was able to be honest with her about not knowing if my depression would get bad again, or if I could handle things till the move.
I also told her I wasn’t sure what would be the best course of action for my current supports… we tossed around ideas, and ended on me attending the iop intake next week. Hopefully I will get a better picture of both the program structure and whether or not it would make sense for me to go. She’s ok offering me at least 2 more sessions at the moment.
There’s so much wrapped up in this move, I’m not totally confident I won’t crash, but I also don’t want to make a crash happen by expecting one…
:sigh:
I also have to figure out treatment for after the move. Dr C has not returned my calls, so I’m not counting on her to be able to see me. I put out feelers to a few other people in the mean time… I really don’t want to have to go through all this again in a few months after I get up there.

TM and I also covered a bit of the details I gave her to read last week. I’m not sure I got anything out of what we talked about. Maybe I need to ask her to let me read it out loud next week… it would cause a lot of anxiety and triggers, but it also helps in the long run… I dunno. We might not have time though.

Might still want to cover that homework I had given her maybe 2 months ago. We never did anything with it, and it feels unfinished. If I’m admitting all that, I need a bit more closure on it with her, but what we covered today was triggering and unsatisfying. It didn’t bring the closure I had hoped, partially because my walls are up. She felt like a stranger today instead of someone I trusted. I’m not sure how I can go from feeling safe with her until the moment we talk about termination, then she’s suddenly someone I have no connection to… it’s frustrating. :/


Different treatments for depression with different origins

I came across an interesting article on the differences in treatment efficacy for depressed individuals with trauma history vs. ones without a trauma history. The article suggests that an early trauma history lends itself to a better response to CBT and talk therapy, whereas depression without an early trauma history responds better to medication (thought to be because of trauma’s impact on hippocampal development)… this would make sense when depression is thought of as an “allergic reaction” to certain situations. If depression is something like a fever (generic healing response which kicks in for several stimuli), then it would make sense that different reasons for depression need different treatment options. This is definitely something I’d like to look into further. I hope they do more research on both of these topics. I hope it also stimulates more reasearch about treatment efficacy for other mental illness. I keep hearing professionals claim they understand one treatment does not fit everyone, but I have yet to experience that open-mindedness. SO much of treatment is dictated by insurance and “empirically proven treatment models”, yet they ignore that not everyone responds to it the same way.

One fear I have around this research is that they will categorize people in one of two ways: either those that can be treated with meds, or those that can be treated with therapy. I would hate to see them again restrict treatment options based solely on this. The one thing we know about mental health is that we know VERY little about it.


just lost

I don’t know what to do anymore. I’m so lost. I don’t know how to ask for what I need, or even what I need… I thought I asked for more help, but apparently that came out as “it’s ok to go more than a week between sessions…”

Of course, there are no real options for additional help here. I’m limited. I know what I don’t need, but I don’t necessarily know what I do need. There’s this vague idea in my head that more intensive therapy would help, but there’s no way to access it, or any place nearby that I could afford… It’s so frustrating.

I feel totally alone right now (I know I’m not, but I don’t know how to reach out, or what to ask for, or even why I should be asking anything at all). I don’t want to do any of this anymore. I’m so tired. Nothing ever gets better for long. The things that are the most popular suggestions don’t work for me, everything else is nearly impossible to access.

I’ve had flashbacks that don’t go away for the past week… I don’t know anymore how to make them go away. I do the grounding, I do the coping skills off that stupid list, I try to breathe, I try to remind myself it’s just a memory… but nothing works.

I reach out, but apparently I’m reaching out to all the wrong people. none of this is worth it anymore. I’m so tired of struggling and getting nowhere. I’m tired of crashing. I’m just so tired of all of this. But there’s nothing to do. Nothing makes any meaningful changes… I’m just… done. I want it all done.


“leave the treatment up to the experts”

Ok, so I have heard that statement on more than one occasion from a therapist, doctor, or other “professional” I have just met, or (most recently) from my wife’s new therapist who has never met me, nor does she know my story…

It’s a phrase that really bothers me, because it invalidates any insight or experience I may have with any previous treatment. It invalidates my wife’s experiences with my past treatment, and it pretty much makes me feel like shit about myself. It’s based on snap judgements over incomplete information… The rational part of me knows that it’s based on prejudice and little knowledge of the individual. But then there’s that little kid in me who is terrified that I am as broken and hopeless as many make me out to be.

While I understand that I am seeking help from some of these “professionals”, I’ve also have had a great deal of time and experience with the treatments they are suggesting, and they have not worked for me. Why does a client’s self-assessment and prior experience count for nothing with some of these people? I’m educated in my treatment options, both personally and professionally. I have probably been in therapy longer than they have been practicing, and have tried SO MANY approaches, I have a decent idea of what works and what does not… I have a paper trail from previous providers 10 miles long of what works and what doesn’t. Why does that mean nothing to these people?!

Would a statement like that bother anyone else? Am I blowing it way out of proportion? When I encounter it, I am made to feel like I should bow to their superior knowledge and skill-set without question or opinion. It feels totally invalidating to me. And there’s never a discussion around why I feel that a particular method of treatment won’t work. It’s left at “I’m the expert and you need to do what I say”… UGH!

So far, I have switched from everyone that has said something like that to me. Therapy is supposed to be a team effort. If they can’t even listen to or respect what I have to say on treatment options, what’s to say they will do that with other things I tell them??

I have found a good number of professionals that are not like that, but the ones that are make me hesitate to reach out when I need to. They have me second-guessing myself and feeling like a hopeless wreck. I really don’t need any help in that department lately, thanks.

Sorry, guess I just needed to vent on that…


The choice to be a patient

lots of things I can relate to in this, and I really like the way some of it is said (I do not think English is a first language for the writer, but they get their point across well).

“for me it felt humiliating to be hospitalized. It was almost impossible to keep my dignity in those periods of time. Sometimes I did not even feel human anymore. We had to ask for everything, the medicine (we had to stay in a line to receive them), the food, going out and getting back to the ward. It felt really degrading when all the power was taken off from me. One can say, maybe I was not able to take care of myself anymore. But many times, I felt that what I wanted to say was not heard at all. Of course, in those periods of time I could not express myself so well. That is true. But when people are not willing to listen, talking becomes extremely difficult. Maybe it is dangerous to say, but I think psychiatry felt for me like the environment I lived in as a child. Neglect, silence and disrespect”

” I begged to be heard and for guidance to get out of trauma land. This was not honoured at all. Therapists and psychiatrists thought what was right for me. Many times they said that I had to stabilize, but it meant literally loads of sedative medication, and nobody asked me what had happened to me in my childhood.”

Mirrorgirl

I have just been on two course-days about dissociation, and was happy when I discovered a news-letter from ESTD (I am a member now). There I found the following post about how hard it is to become a patient dealing with abuse. I have so much respect for people who want to live a better life after abuse, since this is no easy task. I hope this can be a reminder of just that

Nina

By Esther Veerman

THE CHOICE TO BE A PATIENT

Being a therapist for patients with chronic childhood abuse and neglect needs a conscious choice. Not a lot of colleagues will do the same, and sometimes it is quite a lonely voyage that one starts to make. Becoming a patient with a history of chronic childhood abuse and neglect demands a conscious choice as well. It is not logical to start exploring the traumatic past, once…

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