Inpatient
My TDoc has brought up this idea of going inpatient at this place for a couple of weeks and then you move to a residential unit and live there for two weeks. Why is the TDoc throwing me off to inpatient care? I looked up this place... expensive. The inpatient is covered by my military healthcare but no coverage of the residential unit. The inpatient has daily PDoc and Group. The residential has weekly PDoc and daily group. I am not helped by groups and my shame and guilt will NEVER come out to a group. I had groups before when I was inpatient last and it was very non-helpful and tended to reinforce my shame and guilt.
Why is she throwing me to an inpatient? Can she no longer help me? If she stuck and she is trying to get me unstuck?
Replies
Also not to mention... I can't get four weeks off of work. I would lose my job.
What do you want from the hospital?
You dont want groups therapy. Understandablely
So why not create what you want and need at home.
Is it the schedule at the hospital that would help or the constant monitoring?
Structure is that what you are missing.
If you knew what you wanted you could give it to yourself
She may be at a point where she doesn't know what to do to help you. I'd just ask her point blank, "why are you suggesting these options, can you not help me anymore?" From your posts it doesn't seem like she's helped you much as things stand.
If you can't work with her anymore or don't think she's being effective then it may be time to try someone knew. Perhaps someone who deals more specifically with PTSD along with the BiPolar issues. Someone who can guide you through working on your PTSD, finding ways to deal with it, accept it and give yourself permission to get on with your life without carrying that baggage along. Not all Therapists are trained in all things, nor do they all know exact ways to treat certain things. Treating PTSD is different than treating Depression or Mania, things that happen in the "now". And honestly you have to be willing to do it, to deal with it, dissect why it has such a strong hold on you and once you've worked through it....let it go. You have to be willing to let it stop having power over your life 24/7. That's the only way any Therapy for the PTSD is going to work.
If your being honest with her about the self harm, the burning and starving yourself, I understand why she would suggest going into the hospital, because those things can devolve rapidly into Suicidal thoughts and actions. But putting someone who's married, has a home a support system and a productive job in a "Residential Facility" is way outside the box...its definitely not the general course of treatment. That seems like it would be more triggering for you than healing.
Thor,
Sometimes things go faster inpatient sometimes they don't. With your issues it sounds like it's not a guarantee...Is there any way you can cut some time for yourself in the midst of your regular life? Structured time that you design to do the stuff that really helps you...?
This therapy treatment plan is not working effectively for you. The added anxiety with going to expensive and loss of financial stability due to losing job over time off is not guaranteed to help you.
However, you have mentioned that part of the treatment plan provides you relief, so possibly explore that avenue.
For group therapy - if it is NOT an option (similar for me, it was NOT an option due to my hearing loss and reading lips - so on line here was accepted alternative) then that needs to be in writing so the therapy plan does NOT include it.
My major concern for you is that something is NOT connecting the pieces in helping find a stable medium (calm) level for you to have more than seven days of relief between episodes.
Viewing the combination of bipolar, post traumatic stress, depression, 'distress', and the anxiety that adds to the treatment plan means that multiplying parts are pushing the direction of your well-being. Finding the key to turn off part of it to give you relief in short periods will help, however, the major portion of treatment plans include "homework"= which provides details to help you heal.
Making time each and every day for your treatment plan at home or in a physical location that provides you with calm space will benefit your well-being.
Those are the suggestions I am sharing, please know we are all supporting you!
It was a suggestion, but the decision is up to you, right? I wish that there were more military therapists accessible for you - ones who can deeply empathize with your experiences and can give you guiding steps. I agree that finding someone new specializing in ptsd if you aren’t connecting properly with your therapist would be a good idea. I’ve had therapists who didn’t suit me and it made me feel worse. It’s not an instant process but if some time had passed and it’s not full of breakthroughs then it might need a new direction. Don’t give up.
Again, you bring up your shame here a lot, so it seems like it's coming to the point that you want to get it out to someone else so you don't have to bear the full burden of it alone. You don't have to share it ever, it's just that your bringing it up here every day seems to be you giving off the signal that you want to do something new with it, whatever that may be for you.
Maybe you've brought it up with your therapist, too, like you do here, I don't know. In which case that would explain his suggestion of inpatient. It's a safe space for many people to share a secret that's eating at them in an temporary, secluded group. That tends to be safe for a lot of people.
It's understandable if you're not one of those people, Thor. I'm not the inpatient type myself. I did it once, and it was not, not, not for me. Not that it's not for many people, just not for me. Having been arrested under a South American dictatorship 3 times and tortured by a South American death squad once, inpatient felt like that too much to me.
As for sharing your shameful secret, since I've had my many shameful secrets to get free of in my own life, I certainly would never take on anyone else's. I'm not the curious type about the shameful secrets of others. There's a reason for that, too.
When I was 12 and on our first missionary furlough year back to the US from 4 years in South America, being in the USA and out of that war zone down there I told my mother a US military adviser pedophile had assaulted me and 4 other kids from my elementary school. I'd talked to a teacher at my new school here in the USA who told me there were counselors in the USA for kids like me, so I went to my mom and told her so she'd get me help.
Instead, I unwittingly triggered untreated abuse my mother had suffered as a girl being raised on her Southern farm, and in her untreated shame she began beating me. From then on for the next 42 years that's how she treated me. She got my father to beat me by lying to him about me, and he was an untreated bipolar so it didn't take much for her to get him to fly off the handle. I mean beatings with closed fists that bloodied my nose and broke in repeatedly.
Nonetheless, as powerful as her shame was, aiming shame at me from it was a lie. I had nothing to be ashamed of. I was the victim of a sexual assault, not the perpetrator, and I had nothing to be ashamed of. Rather than be ashamed, I'm proud of myself and the second time that pedophile attacked me. Having learned what sexual assault was after the first attack (I was 10 and didn't know about sex yet) the second time he attacked me in South America I fought him off for 8 hours until he finally gave up and left me alone. That took a lot of doing because I was half his size at the time.
Nonetheless, my mother's shame about her own untreated past meant that I had to survive 5 years of beatings in the home from her. I went off to college from South America to the USA by myself early at 17 to get away. The beatings from my father she provoked escalated to the point that when he'd beat me he'd bring a shotgun into my bedroom to which he had had bars on the windows installed. I had to get out asap or he might shoot me in my bedroom in one of his violent manic episodes my mother provoked.
At college I got counseling for the PTSD that brings me here to DS. I finally got praise from a counselor for surviving without retaliating and for getting away from danger. That's how I dealt with my shame. It's not a suggestion that you deal with yours at all, or that if you were to do so you do so in any particular. way. However, I mention it because you mention your shame every day now, and so I'm reminded with pride of how I dealt with those who unfairly shamed me in my life.
Thanks for reminding me of that point of pride, it reminds me of my PTSD recovery. I hope for recovery for you, too. whatever your reason may be for bringing the subject of your shame up here day by day. Sending you support as your sort through what your frequent mention of shame and what it may mean for you these days. We're here for you, always, whether you open up to anyone here about your shame, whether you open up to someone elsewhere about it, or whether you just keep mentioning its existence without naming it. We're here either way.
Muji, your writing brings out so many painful memories to the surface for me, and your sharing them with Thor as he comes to the point of where we all reach in letting go of the moment in a way that we are able to express it without fighting the feelings, emotions, thoughts, and images that combine into a full surround experience, just as fresh as the moment it originally occurred.
Thor, I agree with Muji, I hope for your recovery, and the more you express the words, in whatever form provides your safety net, the better the recovery.
The value of all the support, encouragement, and understanding that suggestions are to help you figure out the option(s) that provide you the safety net for your well-being, you got this, whatever it takes!
Email I sent to my TDoc on some of the questions that I had:
TDoc - this push from you for a residential setting for me has a bunch of questions in my mind:
1. Why now? Is there something I have done or is it that I have become a difficult patient?
2. Are you no longer able to help me? Has PTSD become to much or my Bipolar?
3. If you are worried about the self harming/burning (I burnt yesterday over the old scar tissue to hide the burn) and food starving why not consider a local hospital inpatient. The same hospital that Dr. Fernandez works at and start intensive ECT rounds for say two weeks. Dr Smith would probably support it with self-harm and starving. I’m only one step from suicide already. Why can’t I stay local? And receive intense treatment from my doctors.
4. Can you still help me?
Can you answer there before our Wed session?
Thor
Sent from my iPad
Thor, you have to do what works best for you. Sounds like your therapist may not have enough experience to deal with the complexity of you your situation. It might be better to find a therapist who is better equipped to guide you. There are several trials that I have mentioned in prior posts. Maybe you can try one of these new therapies to see if they work. Your doctor can check to see if any trials are happening in your area.
I am sorry you are suffering so much. Thor. I really hope that the VA can come up with something that helps. We are here for you a Thor.
Excellent questions, Thor.
I hope you are able to get the help you need from the local doctors.
Update thinking about this but going local inpatient for 7-10 days. I don't lose my job, I don't have to fly someplace to be in a nuthouse when there is one right here. I am looking at the doc adjusting my drugs, use of intensive ECT (3 times a week), keep me away from self-harm, see doc daily. I would also get the time away from everything to thinking about my shame and guilt. Am I truly guilty as the Navy said I was or was I the convenient scapegoat? The consequences of their judgment lie heavily upon me and my life. I can't resolve me being an innocent and the consequences I have been inflicted upon. If you are guilty, you are punished and this is not light punishment but life-altering punishments. This is why I self harm to punish myself for what I did. See, I am guilty.
Thor, I agree with you that you're making the right choice for your full well-being.
Three things, it's local, it's within your time frame, and it offers the one thing that is helping you maintain for a short while the balance of calm and inner calm. Seeing doc daily will give you focus on reaching the inner calm through the exploring of those moments which have turned inner turmoil into both judgement of your self, your worth, and your well-being, through no fault of your own.
The treatment will help you find the way to recovery of your memories to a place where you can express them in a balanced reaction in moment(s) of 'distress' as you face 'stress' in triggered words, moments, places, and people.
The drugs will allow your mind and body to relax, refresh, and repair.
The shame that comes from being charged "guilty" when evidence is not presented factually nor objectively, but due to political agendas, is one that is not personal, nor is it expected to be exonerated publicly when proven beyond reasonable doubt that it was inaccurate, invalid, and in some cases, false from origin.
The guilt that comes from the inner calm being shaken thoroughly through actions taken by others, both personal and professional, and our reaction, response, and belief in the system is a different ball to bounce around to finding a way to inner calm with those on the ball being ballooned out, blown out, and banged loose.
Your goal is for your well-being.
I hope this helps.
You may be guilty of a specific action taken upon being commanded by a superior officer to accept an 'unethical, untrue, and invalid' order to action. There is nothing wrong in accepting and attempting to complete an order that is wrong whether you do it or not. That is what the military requires, and in the aftermath, when political action is entered into the situation, it no longer meets military standards of engagement, it becomes a media standard of engagement. The media has no wrong reporting standard - there is no oversight of 'truth'.
An order given in private between two officers that is 'wrong' , often involves coercion. This is rarely revealed in public. If you are made the convenient scapegoat, then the reverse process will often reveal the origin and that individual(s) are often faced with serious consequences for their future in private.
My hope in sharing this is that it gives you a way to work through the whole situation for your well-being in private.
Support and encouragement for you.