Inpatient vs. outpatient care
By Mr. C | July 12, 2008
Tay asks: “I was wondering if (you) had any insight on inpatient vs. outpatient care specifically with someone suffering from dissociative disorders. what are the pros and cons and (do you) know of any inpatient places that deal with these disorders.”
Mr. C. says, Dissociative disorders often take a lengthy time to heal, making it difficult or impossible to get well on the eight outpatient visits that might be authorized on the average insurance plan. The advantage to going inpatient is that you can often move more quickly through your healing. Another advantage is that you don’t have to go home, be responsible, and function after intense therapy sessions. If you are unable to function effectively in your daily activities (such as having a job, acting the part of parent or spouse, caring for personal hygiene, etc.) consider something more intensive than regular outpatient. There are also levels of care that are in-between standard outpatient care and inpatient care, including intensive outpatient (usually treatment a few hours on most days) and day treatment (treatment all day and staying at night at a place of your choosing). Of course, each of these comes with its own cost, which is a factor to consider also. Inpatient is usually the most costly, as you might guess.
Although I have worked in a state hospital where dissociative disorders were occasionally seen, I don’t have first hand knowledge of inpatient settings that actively focus on these disorders. Even though I can’t recommend any particular program, here are a couple of websites that you might be interested in:
http://bsd.clinicalsocialwork.com/treatmentcenters.html
http://www.networktherapy.com/directory/find_facility.asp
I recommend that you get as much information about a program as possible before signing on the dotted line. Look at their webpages online, and contact someone as well via email or phone. Tour the facility if possible. Find out about their treatment philosophy and see if it sounds like something that would work for you. Ask about their treatment team. It would be important for them to have a psychiatrist on board. Get information about their daily schedule–how much treatment does a person get in a day, and what kind of treatment is it? Find out about cost and if they have scholarships or financial help (if you need it). If you can find anyone that has been to the treatment center, ask them about their experience.
I’m sorry for your suffering and hope that you will find the best treatment possible to relieve it. Best wishes for good healing!
Topics: Uncategorized | No Comments »
Internal Bruising
By moonflower | July 11, 2008
I had therapy this week and, it was intense. One of those sessions in which you regress and experience deep emotions that are under lock and key.
My therapist is very good at stopping me when I hit one of those points and encouraging me to feel and experience the moment. My preference is to just glide right by those icky bits.
I always wonder why I resist this, getting to the other side of the pool of tears? I still resist that process over and over when I know it is what helps get me safely to shore.
This particular trip, brought about by me beginning to cry about a memory. Then I told him there was a voice in my head screaming.
I told him, there is a voice telling me to shut up and quit being a baby.
He asked, “who’s voice is it”?
I said, “mine own” or, “maybe not mine, maybe hers”.
He said, “yes, I am guessing it is her voice you are hearing. Why shouldn’t you cry when you feel pain?”
Because it is a waste of time and nothing gets solved by crying.
While in the zone of regression, I cannot make eye contact with my therapist. If I do, I will lose sight of the process and the little one will go back into hiding.
I begin to sob, painful, deep sobs. I ask aloud, “why did you hate me so much, why do you hurt me?” I was just a little kid that had no idea what was going on or what I’d done to cause your rejection of me. She hurt me.
There are people that always ask why it is necessary to re-experience your history. This is the reason it is important, to release those trapped emotions that you were not allowed to experience at the time the damage was inflicted. My guess is that our brains go into defense mode in order to move past the experience not realizing that they get trapped in there.
My biggest reason for doing this kind of work is to set that pain free. I do not regress in ever session, I’m not sure I could handle it, the payoff is usually an insight that allows me to connect the dots.
It drains me emotionally for the rest of the day, I compare it to a car accident with internal bruises.
Topics: moonflower, therapy | 1 Comment »
I Can’t
By guest writer | July 8, 2008
By Kay
One of the hardest things for me to do is to say that I can’t. It goes against the very positive message that I’ve had engrained into me my whole life, that I can do anything. Saying otherwise feels like giving up, and I hate that.
The psychologist I was seeing last summer never suggested that I couldn’t do things. The issue at the time was the same as it always is, that I was going between unemployed and underemployed, and my parents weren’t pleased by it. My psychologist suggested that instead of letting my depression drag me down to the point where I was sleeping instead of working, I should see working as a step in treating my depression, and most of our sessions were spent discussing ways to become employed, her encouraging me to take on more work, even suggesting places for me to apply. When I did start working full-time, my 9-5 schedule kept me from staying in bed all day, and both my psychologist and my parents declared that it was therefore helping me to get better. I didn’t tell them that I was struggling to keep my eyes open at my desk, and spent every lunch hour napping, and that I was still miserable.
Then I went back to school, and was no longer working, and was struggling with my classes, and my parents were on my case to get a part-time job during the school year. After a few months of going lower and lower, I found myself trying to explain why I hadn’t gotten a job to my new psychologist at student counselling.
“So, you’re having trouble keeping up academically, and you’re sleeping through classes. And you’re exhausted all the time. And you were hit by a car, and you’re still recovering from that. Well, it sounds to me like you’re not in any position to be looking for employment on top of all that, not if you’re not going to be thrown out for not paying the rent any time soon.”
“But my parents-”
“Your parents are right, you’ll have to work at some point in the future. But maybe right now you can’t, and that’s okay.”
A few months later I was referred to a psychiatrist, who diagnosed me with ADHD. I tried to articulate to her how exactly I managed to lose things and forget things so much.
“It’s not as if I want to, it’s just that when I need to remember something, I don’t know how to make that information be in my head at that moment. I’m always thinking about something else, and I’m not even thinking that I should be trying to think of what I need to remember.”
“Of course. You don’t forget thing because you’re trying to. It’s not even because you’re overly indifferent. You would remember if you could, but you just can’t.”
Both times it made me feel a lot better to think that I couldn’t, because if something is truly beyond my limitations, then it means that it’s not really my fault. It’s difficult to explain it to a lot of people though. I have a lot of conversations, especially with my parents, along the lines of “what do you mean, you just can’t? Is there something physically stopping you? Have you been tied down or something?”
The idea still bothers me a lot. I hate to think that I have limitations, and I hate even more to admit it to others. And I never want to use my problems as an excuse for not trying hard enough. But a mental illness by definition means that sometimes I can’t. If it didn’t limit me, it wouldn’t be a mental illness, because there would be nothing wrong. So I’m trying to learn to acknowledge those limits, and work from there.
Originally published here.
Topics: adhd, depression, guest writer | 2 Comments »
The Hues and Overtones of Manic Depression
By guest writer | July 2, 2008
By Jb
Being an Art Star is about struggling to remember.
[Rev Jen]
Bipolar disorder gives me colors, hues that “normal” people can’t understand. My mania is the color behind your eyelids when you look at the sun with your eyes closed. It burns brightly and strongly, and it is hard [so hard] to turn away. You can’t move–it’s just there.
My depression is the black-blue in the center of bruises, the color that sits dully, the one that makes you cringe when you press it. It reminds you of pain. It is tender to the slightest touch.
The other day, I told my friend that I wanted to stop feeling the feelings, and most of that is true. But a small part of me, the smallest part per billionth aches for the feelings. It’s the part that relished their return, the part that wanted to get out of bed and drive around the city, the part that wanted to drape itself down a staircase and cry. It’s the part that feels most alive when it feels sick, the part that wants to smile at the cars that drive by. The part that wants to break itself into pieces, the part that wants to fuck and fight and talk shit and sleep and cut. It is self-destructive and can be [was once] all-consuming.
So we talk about why I want to take more medicine. Yesterday, I had some depressed moments. I thought of driving to the lab, stealing one of the razor blades. The fantasies expanded, more than they ever have [I've never cut]. I thought of which one I would chose, the one least likely to have chemicals on it. I would boil a pot of water and drop the razor in. I would wait, slowly, patiently. When it was done, I would lift it up. When it cooled down, enough to use but still warm with the memory of water, I would press it in. Where? Somewhere less noticeable. Not the flashy, needy, begging wrists, no matter how much that vein shines and pulsates out. No. The ankle, perhaps. The upper shoulder.
The upper shoulder–when I first started treatment, I would write on my left shoulder in brown thin line Sharpie. I would remind myself that there were four things that were important, that I wanted, that I needed: prayer, honesty, fidelity, love. The things you turn to when razors cut across your mind, the
things you turn to when you are stuck.
So I remember that the only thing that can fight a broken mind is that same mind, wanting to be fixed. That same mind, that same ache for things to be ok. It’s the aching yearning mind that reaches out for help. That mind compels you to talk when you don’t want to. That mind helps you remember that the palette you have in your mind is beautiful but poisonous. Bright things usually are.
So, with one part relishing the darkness, wanting desperately to succumb to the heaviness of depressed eyelids, the other parts push back, open the mouth, and say–to whoever is listening, but mostly to that one rogue part–”I want to stop feeling that being human is an irrevocable injustice.”
This is why you keep living. This is why you keep shaking the pills into your hand. This is why you torture yourself with therapy, why you eventually give up all of the bad thoughts you’ve been hoarding. For true happiness and true sadness, for human emotion that your human peers can relate to and comfort. For this, you give up being a superhuman. For this, you finally become what you’re meant to be. Yourself.
Originally posted here.
Topics: depression | 6 Comments »