Tag Archives: treatment

Emdr (TRIGGER) 

Did some emdr kinda spontaneously on Monday. I was really struggling with some intrusive memories/body memories, and Dr C had extra time. 

We aimed for my resistance to emdr, and to deal with the fears around it. That quickly progressed to the body memories. It was fragments of things flooding in and washing each other away just to come back in a few minutes. It was intense. I think I was dissociated through some of it because we worked on re-centering and returned to the fear around exploring these memories. 

One of them was really weird. I think it might have been a memory of both the dissociative experience and the abuse melding together. It was similar to a strange dream, where impossible things are happening, and I’m at once experiencing them and watching them. I was at once floating in the ocean feeling the sun on my body, and being molested in a bed… 

It was incredibly intense afterwards and I kinda freaked out. It was the longest I’ve sat in Dr C’s parking lot after a session (almost 50 minutes) trying to center again. I’ve text her a lot since then. I feel like I might be pissing her off. 

Part of the emdr also covered the self-harm. It feels like the shame and guilt around it are gone, but at the same time, there’s a fear of the consequences. I guess that’s good. I want to destroy the parts of my body that remember the abuse, but I also want to avoid the hospital. 

I made another appointment for later this morning to process this with her. I felt like I was bothering her too much through text. I’m also hoping that seeing her in person and talking about this will help set my mind at ease about the process. I’m starting to remember some of this discomfort and turmoil after the first round, and I’m starting to remember that it passed in a few days. It’s been a bit better this morning. 

I had a really weird dream/memory/thing last night (another thing she said would be normal and expected). In it, I was a kid curled on my bed trying to sleep (similar position to how I was laying in bed last night, so I’m guessing the position was a lead-in to the memory)… it was another impossible situation though. There was a snake moving around the backs of my thighs and found its way between my legs. It felt very strange, not what my pet snakes feel like when I hold them, so I’m guessing it was something my understanding substituted for what was actually happening at the time… it reminded me of an article I read a few years ago that described the arrest of a man for animal abuse and assault when the kid said the man molested her with his pet snake. I think the man told the kid his penis was “his python” and so the kid kept calling it that… it’s quite difficult to make a snake do something it doesn’t want to, and a snake has no interest in worming it’s way into tight body orifices… 

Anyway, so… yeah. I’m waiting for time to pass before I have to leave for my appointment. My body is still shakey from my lack of sleep, and probably also from everything the emdr has stirred up… I wish I had the availability to do that intensive emdr now, but I have to be at work for the next few weeks… I might dissapoint my boss and end up needing coverage soon if I stir up too much. I’m trying to be available out of a sense of obligation to help out (staff vacations need coverage, and one of the main customer service reps is leaving for a full-time job after my boss gets back from her own vacation), but maybe I need to be a little less available. I have the option at this point not to work at all and just concentrate on my therapy. In theory, I should take the time I need to help me alleviate my symptoms… but at the same time, work is a good distraction. I didn’t exactly plan to be less available when we are already under-staffed, so I shouldn’t feel guilty about needing to say no, but I do… L and I need the extra money to help fix the car situation… and I have a huge thing about helping out, even to my own detriment, when someone needs it (especially someone I like/respect/care about). When I first started working there again, I was a bit better about maintaining my boundaries and not taking on too much. I’m falling back into that need to please everyone. I can see it heading to a huge disappointment when I finally find the courage to say I can’t cover too much… ugh. 

If I could find a way to just do therapy super intensley until I got to a point where I could get a handle on the symptoms and triggers and side-effects, then I could be a real, functioning human again. Insurance has limited that though. They don’t want to pay my therapist for more than one session a week. They don’t want to pay for an iop or php because I’m not in crisis (and if I was, they would want me inpatient first)… it’s frustrating how little they help when the whole reason I have them is because I struggle with mental health issues enough to make regular functioning near-impossible… there’s hope though. I just switched to the basic Medicare, which I’m lead to believe covers stuff easier than the crappy advantage plan I was on… starting September 1 st, coverage for therapy should theoretically be easier. 

There’s a tightness in my chest from all of this… Maybe I will ask Dr C about trying an iop as adjunct to the emdr we are doing. Maybe medicare will pay for it in hopes of getting me to a place where I can get off disability and get back to a real life. I just wish there was a close trauma iop or php… Maybe I could get into that place in Boston this time around (I was too acute 5 years ago when we first tried it. I landed in DC because their program was able to do crisis stabalization).
Sorry this was so disjointed and scattered…

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well then…

That day of respite from all the heaviness yesterday is over today. I’m trying so hard to beat this thing. Is there treatment that actually works?? I’m doing the behavioral stuff I’ve learned over the years, going to outpatient therapy, doing meditation…

Meds tend to make things worse, but I am about ready to give them another try. Worst case I totally tank on them and everything finally ends.

I just don’t know anymore.

The only suggestions I keep getting from my treatment providers is to keep doing the stuff I’m doing, it’s just not helping…


Honesty in treatment

I’m a believer (most of the time) that honesty in treatment is the key to making any progress.  I say “most of the time” because sometimes my fear gets the better of me and I want to hide the ugly or scary parts of myself.

In an attempt to “just breathe” and get through the weekend, I tried to take a step back from myself for a moment.  I opened up my journal and started to write a list of what I get from my behaviors and actions.  I wanted to be as brutally honest as I could be with myself, so I resolved not to show it to anyone.  I wrote all the contributing factors down no matter how shameful or embarrassing they may be.  I was originally going to make it a cbt/dbt-style exercise with pros & cons, and some challenges to the reasons, but I eventually decided to stick to simply listing the reasons.  I am not necessarily in a place to objectively challenge any of those thoughts or beliefs, so I didn’t want to torture myself further by trying (honesty can be scary, especially with all the judgements flying around in my head).  I came up with a pretty comprehensive list.  I think I covered everything I get from my behaviors. I even managed to cover some stuff I do not like to admit to myself that I get, but I wrote them down in an attempt to be brutally honest with myself.  I find myself very stuck in therapy partly because I cannot get past the shame and embarrassment of a lot of things.  I’ve made some progress with De on some of the shameful stuff, but there’s heaps more back there still.

My problem comes now in the sense of urgency I feel at needing to talk about this stuff.  I’m afraid that if I don’t talk about it right now, in the moment, and to someone who can follow-up with me on it, I will lose my drive.  I will find ways to talk myself out of the reasons.  The thick walls of shame will fly back up in a flash, and I’ll be stuck again.  My hope is to be able to talk to De about all this, but there are boundaries in place over extra contact (boundaries that I desperately need right now).  I have to wait until Tuesday to talk about it.  Intellectually (and from a professional perspective), I totally get this and know I should wait.  The little kid in me is having an emotional shit-fit however.  She’s stomping her feet and dying to beg for a chance to address this in the moment.  I’m trying to calm her down.  I know I cringe at admitting most of the list to De (a professional I have grown to trust), let alone anyone else I may not know or that may not have the professional perspective.  I know this needs to wait to be addressed in an emotionally safe environment, but damn I wish it was now.  I am trying to compromise with the emotional side of myself.  I wrote it out where De will be able to see it and know it exists, but I have asked her not to read it.  I am trying to commit to myself to leave it up where she can see it, and to trust that she will not read it before Tuesday (I have no reason to believe she would not do as I ask).  I know I need to address this stuff to be able to move past it, but I also know shame can cripple me in it.

On one hand, it’s really good that I have the freedom to show or hide from De whatever entry I need to.  It helps me censor myself and practice self-containment.  On the other hand, it allows me to hide things I may need to address but am too ashamed of  admitting.  My ability to communicate is ever-evolving.  I am still learning balance.  I’m hoping the blog helps with that.  I know if it were something I could not edit (like an email after it is sent), I would drive her and myself nuts more than I already do. I think honesty is incredibly important in treatment, but so is self-control on my behalf.  With the blog I am learning that I can be more honest when writing, but I am also learning that there are some things I need to learn to reign in.  I am able to spill a lot to her, but also go back and hide things or reveal things after the initial emotional spillage.  As L reminded me this morning, sometimes things need to “marinate” before being addressed. I’m grateful De puts up with me and my alternating emotional explosions and implosions (sometimes she gets way too much info, other times I am unable to give her anything at all).  I’m learning the balance with honesty also.  Right now, I am at the stage of needing to be able to tell her everything and be taught what needs immediate addressing vs. what can wait… I hope she doesn’t hate me for this learning process. She only has to put up with me for another 2.5 weeks anyway (I know, not an excuse to completely lose my shit right now)…

::deep breath:: the process of learning things as an adult that I never learned as a kid is incredibly trying and painful… and way more difficult because as a kid, it was expected that I didn’t know this stuff.  As an adult, I should know better by now and be past these little hissy-fits.


when we are taught that “no” means “yes” but “yes” also means “yes”… (TRIGGER WARNING)

…and there is no real “no.”

A friend posted this blog link on facebook tonight.  I had wanted to see Divergent anyway, but now I want to read the book before seeing the movie (I tend to find they skimp on messages in movies).  It got me thinking; not only are movies and tv glorifying sexual violence, but we are trained that being “hard to get” is a turn on, and no never actually means no.  This is more pronounced with people who grow up in chaotic and abusive situations.  

When I was discussing the concept of rape with a co-worker many years ago (she was working towards licensure as a therapist and in the process of completing her PsyD), she defined rape and assault as needing a decisive “no” with physical resistance.  At the time, I had not mentioned my experiences with Duckboy to anyone except my own therapist, but even to her only in the most vague terms.  I was taken aback by this friend’s rigid and adamant definition.  I tried to gently give “other” scenarios (my own experiences without divulging that it was myself I was speaking about, but hypothetical subtleties in situations), but she refuted it all.  She said if the woman was truly not wanting any contact, she would fight back and scream “no” until her voice was hoarse if she had to… “what if she says no, but he doesn’t pay attention? …what if she was trained to refuse once, but if he pushed the idea, she had to go along with it? …what if he laughed her “no” off and continued what he was aiming for? … what if he said she was leading him on, so had to do it? what if she was scared because he was so much bigger and stronger? what if he could hold both of her hands in his one and pin them above her head? what if the “no” caught in her throat as she was trying to say it but all that escaped was tears and shaking her head? What if…” To all this, her reply was that it did not meet the definition of rape, and was barely teetering towards assault.  That conversation was had early in my acceptance of what had happened (there’s something about being in a situation that makes it feel normal, especially when you have always been taught to go along with whatever the stronger/louder/older person says without argument).  Prior to this conversation, I had started talking to JF about what had happened with Duckboy, but this conversation had me ashamed for feeling that any of it was something that should not have happened.  I started telling JF that it wasn’t anything wrong; that Duckboy had just been “a little forceful about the sexual stuff, but it was ok…”  I think she had tried to get to the truth of it all, but I was too ashamed.  It was not only not ok to fight back, but it was not ok to be disturbed by any of it if I hadn’t fought tooth and nail to get away.  If he had no scars or bruises, I was consenting… I think it’s at about this time that the cutting had moved to my legs.  I don’t really remember doing it, but I do remember having the gyn ask what the words on my legs were (and later JF asking about them because I had flat-out denied the existence of the cuts that were most certainly visible to the gyn).  The gyn thought she read “slut” and “whore”, but she wasn’t sure about it so JF wanted to talk about it.  I told her I wasn’t sure what they said, and that I didn’t remember writing them (I honestly did not remember it. I think that was one of the many times I had “checked-out” and cut myself only to wake in the morning to new cuts)… I remember telling JF that I didn’t really know why that would even cross my mind.  When she asked if it related to Duckboy, I reiterated that he never did anything wrong; he was just a little forceful… I stopped talking about it shortly after that.  Words appeared in blood on my legs, but I refused to talk about it.  I was lost in the shame of feeling wronged when I “obviously” wasn’t. I started OD’ing on pills to help drown out my head (though only once was I “caught” and sent to the ER. One other time I was sent to the ER because the nurse thought I meant I had taken that many pills only 2 hours ago, not 14 hours ago), and to help ease the dissonance between what I felt, and what “society” (or at least a handful of “friends”) said was right or wrong.  Mind you, my therapist, the nurse I trusted, and the gyn all colluded on the idea that what they understood had happened was indeed “wrong”, but for some reason I didn’t listen to their opinions… I didn’t address any of the assault or abuse stuff again for almost 15 years, but it crept back to my awareness regularly in the form of body memories and flashbacks.  I remember the times I would close my eyes and “just get it over with” when a friend asked for “benefits” even though that was all purely consensual.  He attributed it all to my coming out later that year.  I never told him about Duckboy.  For years, I was adamant that what went on with Duckboy was all in my head in terms of “appropriateness.”  Even when the flashbacks interfered with my relationships (apparently I went pale and stopped breathing for a few seconds the first time my ex pulled out a realistic dildo. She had offered to stop, but I recovered my bearings and did my best to ignore the flashbacks taking over enough to convince her there was nothing wrong), I refused to acknowledge the damage done by Duckboy.  It was only after the millionth recommendation from the millionth hospital social worker that I sought sexual assault counseling this past summer.  Even when the body memories caused me to cut severely in an effort to rid myself of them, I refused to acknowledge a history of assault.  When asked about it, I attributed it to the body memories, but refused to give details or call it anything other than him being forceful.  There were the body memories that came before Duckboy, but I had no actual memories to pair them with, so they “didn’t count.”  You can’t really work on something you don’t remember except on a physical and emotional level… at least, I have no idea how to do it, and I thought it was all in my head (ok, so it is, but in a different way).  I know the basics of the situation from second-hand stories of what went on, but at the same time, my involvement is constantly denied after the first admission of occurrence.  I was too young to really remember, so I only have the stories they told me about it.  I know the guy served time for it.  I know he assaulted more than one kid at the parties. I know I was told I stopped going to bed when the other kids went because I would throw a tantrum at the parties.  It was before my brother was born, so I can assume I was younger than one and a half.  The only reason I even know anything happened was that I was told to alert my parents if the guy ever tried to contact me (after he was released… I might have been 12 or 14).  But all I have of that time are distorted nightmares and vague body memories. The stuff with Duckboy isn’t too concrete, but I remember more than I do of the earlier stuff.  I have explicit memories of what he did, and fears connected to specific events.  I react strongly and violently when touched without expecting it, especially by someone I don’t know and trust.  I have scared family friends with my reactions when they were only trying to be genuinely, harmlessly playful (things that are harmless to someone who has never been violated turn into assaults for someone with a history).  Triggers are rampant in medical settings because of the nature of medical exams.  Even when I trust my doctor, dissociation is almost inevitable.  I have yet to figure out if it’s more helpful to be alone with her, or have my wife there.  It gets confusing and full of flashbacks either way.  Speaking of doctors, I’m surprised more gyn’s are not more sensitive to assault histories.  I think they are almost as uncomfortable addressing the possibility of abuse (past or present) as we are divulging it.  It took me years to find Dr. F.  Before her, no one asked about any specifics beyond the existence of an assault history.  Dr. F actually sat down and talked before having me strip for the first time.  She checks in regularly and is always asking what helps to make it all easier.  I have not yet made any effort to find a gyn here because it’s so difficult to find someone that’s willing to take time and space to make things feel safe… Even at the hospital, when the doctors knew there was a history and those triggers had led me to the hospital, simply labeled me as “resistant” and “defiant” when I insisted on a female doctor for any exams.  There was more than one occasion when I was not given a choice to refuse the exam or ask for a female doctor. There were several “unwarranted” exams that I was not able to refuse.  Then they wondered why I “left” during the exam. They deemed me a danger to myself for dissociating in a very uncomfortable, vulnerable, and triggering situation… They replayed the old scenarios in new ways.  You would think that with a greater push for awareness and understanding of assault situations (and trauma in general) that they would work harder to keep from triggering people and re-victimizing them.  There’s still a lot of growth that needs to happen in that field…

Anyway, what was my original point?  Oh, the thoughts on the rape scene in Divergent… well, I guess I addressed it.  I’m glad that our kids are now being taught more often that “no” means no, and not a veiled “yes”.  I’m glad that we are educating everyone on the concept of respecting boundaries.  I’m glad that society is changing, albeit slowly.  It gives me hope that one day my future kids will know that they don’t have to do anything that feels so wrong. I will never tell kids not to fight for their right to refuse to do anything.  I will make sure they know they can always look to my wife and I for support around anything… and I will forever be vigilant for signs of abuse with the people I care about. No one deserves to be hurt.


Updates

I will be seeing De on Friday.  She did not say she was referring me out over the phone, so I’m hopeful to still be able to see her.

I made it to a walk-in clinic today for my ear.  The breaking point was when it hurt a lot to try to listen to music this morning (without even trying my headphones). I have infections in both ears, as well as some gunk going on in my chest – fun times.  My insurance has not totally kicked in yet, so I can’t get any of the scripts filed.  The state told me to call back Friday and see if I met my deductible.  I hope so, because I could really use those ear drops.

We go to see J tomorrow for couple’s therapy.  I’m thinking it will be an emotionally tough session.  L resents when I chose to go inpatient.  Intellectually, she knows it’s better than the alternative, but she still feels left alone.  Intellectually, I know that she’s more mad at the situation than at me, but emotionally I feel like I again cannot get things right… my hospitalizations are turmoil on so many levels.  I’m glad we have J to talk it over with in a way that feels more safe.  Both L and I retreat into our intense emotions when talking about this stuff.  And I’m scared that this time she said she was getting burnt out on my depression.  I totally get where she is coming from, but I also fear the consequences. 

Losses (and the threat of losses) from my break-downs make it difficult to follow through on asking for help, let alone asking before it’s too late.  That, and I go very quickly from “managing” to “complete mess”. There’s not often much time for me to realize I need help.  Pair that with not really knowing what I need in terms of help, and I end up waiting until things are at the “drama” stage.  My emotional meltdowns pick up speed faster than a luxury sports car let loose on the Autobahn (sp?).  I need to figure out how to change that…

Anyway.  As long as I keep moving (and can sleep through sunrise), the hopelessness stays at a slight distance.  If I wake up before the sun, or stop occupying my brain, or if I’m reminded how useless my insurance is, the sadness and hopelessness starts to seep back in.  I can’t allow that right now.  The holidays are approaching.  I want to be here for that.  Also, De will be less available at that time, so I need to keep it together if I want to stay out of the hospital for New Year’s…


making things meaningful

So, in an attempt to find a way to make money fast, and relieve some of the financial pressures on us, I stumbled upon a blog that is all about doing what you love, and making what you do meaningful (the guy makes money off of this, which is how it connected to making money fast), but his original idea is founded in doing what you love…

That got me thinking… I have this blog that, while mainly started for myself, I would really like it to also help others. I began thinking about my struggles to find treatment that works. What are the barriers to finding other helpful and effectual treatments for trauma? What are the instinctual defenses and coping strategies we turn to when we don’t know what we are supposed to turn to?

It reminded me of the way EMDR came about. The woman who developed it noticed that she would go for a walk thinking about her problem, noticed that she unconsciously looked from side to side during her walk, and noticed that she felt better when she returned from her walk. So I began thinking about what my instincts are when I’m stressed. I thought about what others do. People around me are constantly talking and talking about the things that bother them. I do the same thing, I need to get it out and tell someone (or more than one person) what happened or what is bothering me. I think it is not only the telling, but also the audience. So I have 2 ideas that I need to flesh out.

The first is to actually tell the details of the trauma. This poses some dilemmas. One is that it triggers the hell out of me to think about or tell my trauma, so I will need to have support after the telling (that, or I am rendered speechless by the pure force of the emotion and the events in my head, which makes the telling piece difficult). The other is that it has the potential to overwhelm the other person… Clinicians and treaters are just people. They are people with their own troubles, fears, and vulnerabilities. To come up with a viable treatment model that utilizes this spilling of trauma, I’d have to develop (or utilize) a really good support system for the treaters as well as the clients. I would want someone to be able to talk to whenever I needed them, either in person or over the phone. I would want to provide this, or something similar, for the treaters also. I would want to ensure that talk about suicidal thoughts or self-injury would prompt support, and not automatic hospitalization. This somewhat builds on the DBT concepts of riding the wave of emotions, but this time with support and someone “holding your hand” through it all.  While I see the value in learning to handle your triggers and urges on your own, there is also something very powerful about having someone there with you to witness it.  I have always felt this want for someone to be there through the experience; to help keep me safe when I can’t do it anymore.  I turned that desire into action one day while I was working with a particularly difficult adolescent.  She was bent on destroying the house, and pushing the limits of all the staff present (and her house-mates),  At one point, she managed to turn on the stove and was about to put her hands on it to burn herself.  None of what we were saying was getting through to her, so I stepped in front of the stove and took her hands.  I held them as she tried to push past me (she was about a foot taller and a good 80lbs heavier than me, and I’m not small).  I told her again and again that I would keep her safe and I would keep the house safe.  In that moment that I held her wrists, she looked at me and something clicked.  She moved away from the stove after several minutes (and a few half-assed attempts to pull her hands free of mine) and stopped pushing my buttons for the rest of the day.  It only lasted like that for the rest of the shift, but it made a difference for that time.  I think it’s a very powerful thing to have someone there with you in a non-threatening way to help keep you safe when you cannot do it yourself…

The other idea is a spin-off of having witnesses to the journey.  It also builds on a theory I saw on a PBS special.  That theory advocated the telling and re-telling of the trauma until it lost its impact.  They did not flesh out all the points of the treatment plan, but from what they showed, I think it has some merits.  Anyway, and please tell me if this is a horrible idea, I think it might be helpful to do this in an intensive group setting.  Wait! you may say, this will cause a huge domino effect of triggering… Well, that’s kind of the point.  I noticed in groups, the most benefit I got from many of them was when someone’s experiences triggered something in me and I got a chance to deal with it.  This would be tricky as a group where the point is to tell triggering things, and not just walk on eggshells around topics.  But I think with the proper support available (MANY treaters on hand, at least 1.5+ per person in group, because some people need more than one person to bring them back), this could be a viable path to dealing with all the crap we don’t always think of accessing during treatment.  The groups could start with a topic and go from there.  Forget necessarily censoring the details of the event… While I understand that ambiguity of the event to another may help them access their own demons, I find it tends to limit me in the telling of the event.

There are definitely details to flesh out, and many, many conversations with other professionals to figure out the viability of these theories… But I’m determined to figure out a treatment option that works for me… and hopefully I can come up with something that may help others too…

Bring on the firestorm of criticism for this horrible idea! (It goes against all convention and current thinking and insurance company standards…)