Well, things have run into some hiccups. First off, sorry that Part 2 of the newsletter hasn’t happened. Other than that, I thought things were going terrific. VF was proud of me that I’d been out of the hospital for a while. I was in a crisis unit in April, and don’t remember the last time I was actually inpatient. I’m trying to look back at any issues and mainly I just had anhedonia and chronic pain. So, for the anhedonia, I wasn’t really able to feel positive emotions for probably at least a month? So, usually I try to force myself to do pleasant events (or whatever Marsha Linehan calls them) which, in my case, would including playing The Sims 4. Unfortunately, when I tried playing that recently, I never got any actual positive emotions, because I can’t feel positive emotions right now. Also, concentration is crap. So, it was like, no problem: if pleasant events aren’t pleasant, I can just be productive. So I was cooking, cleaning, etc. The second problem was chronic pain. So, I was cooking and cleaning, but my ability to do those things was limited by pain. Like, I can walk a mile with not very many issues, but when I try to do household tasks, it’s a different story. Basically, I have left-sided chest pain and labored breathing at baseline, even if I’m at rest and haven’t moved in a while. Then, if I try to wash dishes (for example) behavioral activation is limited, because I quickly start hyperventilating. If I ignore it, it just increases, which would be fine, except after 2-3 minutes I feel like I’m going to vomit. If I push past that, then I actually do vomit, which is a waste of food, especially when I put a lot of effort into cooking it. So, I’m probably out of shape, but I don’t think that’s the main thing, because walking places is fine. I don’t have a car, so I walk frequently. However, when I’m doing something that my amygdala has apparently decided is dangerous, I’m in agony. Which, again, “I didn’t realize how painful this really is” isn’t the best for behavioral activation. I’ve confirmed with cardiology that my heart is in perfect health, which is terrific. The issue is, that, evidently, I have chest pain, breathing difficulties, and nausea/vomiting due to anxiety. CBT does not help because that whole methodology works if there is a negative thought. Well, I don’t have a negative thought. So people suggest affirmations like, “My heart is fine” which paradoxically don’t work because my prefrontal cortex never had any doubt that the suggested affirmations were true. So apparently something is setting off my amygdala, but I have no clue what it is. As I put it to one person, the only things I’ve been able to rule out are negative thoughts and cardiac problems.
Therapy Gone Wrong
So, anyway, that was the situation and, like I said, I’d been out of the hospital and VF thought I was doing great. On Tuesday of last week (9/16) I had therapy. Waking up in the morning has been a huge issue for my entire life, despite my initiating a conscious effort starting literally 25 years ago. Before that, when I was a little kid, when I woke up in the morning, my mom would rage and sometimes physically assault me. She said to go back to sleep. So when I woke up in the morning, I remember it was super hard to go back to sleep. It was hard at night because I was scared of monsters, but much harder in the morning, because my body didn’t want to sleep. But I practiced a lot because I hate getting the 💩 beat out of me.
Well, then when I was about 10, Mom decided she wouldn’t attack me if I got up in the morning, so I started setting my alarm for 6:00am. I had a pipe dream of being normal, and kids that went to school woke up around then. Unfortunately, the only other person up was my father, who, to make a long story short, felt really creepy. He probably was well-intentioned as he silently stared at me endlessly while holding his stuffed penguin, but I felt dirty. So, fast forward 25 years, and I’ve been trying to get onto a sleep schedule this whole time. I had slept a lot over the weekend, because my work week 9/8-9/12 had been exhausting, plus I was getting over a cold, but I was worried that dissociation could be a factor.
So, once I had explained this to my therapist, she asked my wakeup routine. So, after 25 years of working on it and a pathological fear of being late to work, I have a 3-pronged attack. I have an extra-loud alarm clock (100-120 decibels) that goes off at 5:30am. Then, I have an app, which is voice-only and does nothing except repeatedly say, “The time is X. It’s okay, just take your meds.” It updates so at 5:31, it will tell me that. But, I usually sleep through the extra-loud alarm and also the talking alarm on my phone, so part #3 is that at 5:35, my “Fitzap” goes off. It is a splendid device from China that has metal on it, and you wear it as a watch. At the desired time, it starts emitting electric shocks. I set it at level 8 out of 10, and I don’t remember the number of shocks. This wakes me up enough that I notice the loud alarm going off, so I walk over and turn it off. Thanks to the voice alarm, I know to take meds. Which is morning meds, plus a 200mg caffeine pill. Then, I go back to sleep. At 6:00am, the other extra-loud alarm clock goes off (yes, I have two, both far enough from my bed that I have to walk), and everything is the same except the talking alarm app tells me that I have to go to work. This usually works okay, which is good, because before I started this system, I would usually pull an average of one all-nighter a week, on the logic that if I don’t sleep, I can’t oversleep.
Anyway, the therapist didn’t think this was ingenious. Rather, she insisted that I should be able to wake up every single day with an alarm only, by using positive affirmations. I mentioned that I had extensive experience trying to make that work. So the therapist said that if I can’t wake up at 6am every single day, then I can never have kids. She drove home the point by insisting that if I don’t wake up to an alarm, then I would never hear a baby crying.
Triggered
So, that was triggering. I’d been being productive 24/7 because my ultimate goal is to one day be able to have children. I turn 36 in November, which is hard. So, being told that I can’t have kids if I’m a heavy sleeper was really painful. Most people say that their sleep changes after having a child. But even if she was right, that would have been a huge conversation, not a casual musing.
So, a few hours later, I texted the therapist that I was triggered. I did specifically include, “I’m not saying you’re a bad clinician or you’re fired or whatever. I just feel like if something doesn’t work, you have the right to know. So I’m not sure exactly what to do because sending long messages is mean, but it’s also not effective to just let things pile up without letting you know about the problem.”
She apparently wasn’t terribly concerned, because I didn’t hear back from her until the next morning, when she scheduled a check-in at 1:00. By the time that rolled around, I was mostly recovered, but I did want to talk about why the comment the previous day had been hurtful, so we could avoid that moving on.
Abandoned
Anyway, the therapist said that she’d talked it over with her supervisor, and she was transferring me. The language she was using was very vague, but she said she didn’t feel like she had anything more to offer me, treatment had been failing for months (which she sure hadn’t told me previously), and I would do better with someone else. Her example was, “Sometimes you’re trying to explain something to a student, but they don’t get it, so you send them to the teacher across the hall and then they get it.” However, the therapist was not able or willing to talk about what the transition process was going to look like. We only had 15 minutes anyway, so that was part of it. I did text her to clarify if this was temporary and whether she and I would continue to work together, but she never replied. Meaning, I’d never been given anything in writing, so she can backpaddle anytime she needs to avoid looking bad.
Now, mind you, I had been very hesitant to start therapy because this is typically what happens. I wanted an AI therapist, because that way there wasn’t a human to get attached to who can hurt me by leaving. But if you ask AI itself why there are no AI therapists, even it will say that therapy requires a “human connection.” This also applies to self-help books. Supposedly, you can’t just pair AI and self-help books because you need a “human connection.” I told this to my therapist. I told her that all I needed was for someone to not abandon me, because I had abandonment trauma, and I was in therapy because I figured if I could develop a secure attachment to a therapist, then I could have healthier connections to social supports. The people in the hospital had specifically recommended this lady, because they said she had plenty of experience and would be unlikely to drop me. I was concerned, but after seeing her every week for several months, I actually started to trust her. Then she delivered this death-blow. In a 15-minute check-in, without even acknowledging what she was doing. That I had told her right from the beginning, this was the one thing I needed her not to do. She knew I was smart, and usually listened to me when I told her what I needed. But suddenly, this was the issue in which I had no say. I told her that this was going to make it harder for me to open up when triggered. Her overall attitude (without saying in so many words) was just, “You’ll thank me later.” Well, this is the fifth time that this has happened, and I’ve never looked back and been glad that this happened. There have been some people (ie Dr X and the 14-month hospitalization) who technically terminated, but I knew this in advance, we had an idea when it would happen, and they fully understood that it was hard and why it was hard. And guess what, that 14-month hospitalization was a huge help and I’m still eternally grateful. My most recent therapist could have done the same. But it sucks when the conversation in which they tell you they’re terminating is also the last time I talk to them. I say this because I just want to clarify, therapy isn’t permanent, and usually there will be a termination. It’s the way that it happens that makes the difference between something that’s sad but also is good exposure and makes me stronger over the long term; vs a trauma so severe that it outweighs anything positive that happened over the course of treatment.
The Aftermath
So, the problem is, therapy can feel like it’s helping, but after the same thing happening five times now, I still think it’s harmful overall. If I had just not been in therapy the past several then I would have had less abandonment issues than I do now. This woman wasted months of my life that I could have spent working with someone who wouldn’t abandon me.
Anyway, I’d been SI-free for months, but it obviously came back after that. The termination was on that Wednesday, and Wednesday night was rough. Let’s just say, I’m alive thanks to my cat, and VF. It was a tough week, and all I could think about 24/7 was suicide. However, I couldn’t tell this to anybody, because of the risk that I would be sectioned, put on a “bed search,” and possibly end up back at HBM in Worcester. So that sucked, because I couldn’t call social supports, or they’d urge me to talk to a clinician, and we’d end up in the same place with a possibility of HBM in Worcester. So I was awake all night, kind of in the place where I have to just either commit suicide or not commit suicide, but I can’t talk about it with anyone. I intensely remembered years of not killing myself simply because I wanted to protect my family, only to find out that at least my mother had wanted me to commit suicide all along. So if I was miserable, who was I helping by remaining alive? My family wanted me gone, and people of certain political persuasions don’t like those of us who use a lot of resources without a successful career. It felt like everyone wanted me dead. Honest to goodness, there wasn’t much helping me hold on. I had memories of Emerson because they all definitely preferred me alive, I had my cat, and I had the people at VF. And a couple social supports but I worried I was a lot for them, and for the most part had to avoid them. Which was 100% not their fault, and it’s likely that I underestimated at the time how much they’d be hurt if I died.
Hospital
So, it was really hard to figure out what to do. I was at a point where I literally couldn’t think about anything other than suicide at any point in a 24-hour day, and it had been almost a week. I also could not divulge to a single soul what my “plan” was, or that I even had a plan, because that’s what had screwed me when I was at HBM in Worcester. Basically, I was all alone trying to figure out if the best option was to kill myself, for days on end. The weekend was heck. Finally on Monday, I called my clinician at VF and begged her to come over. Which she did, because that’s I guess part of community-based supports is they drop in all the time. Usually not on quite such short notice.
Now, I’d been doing risk/benefit analyses in my head all weekend. Like, dying had some issues, but would obviously be better than HBM in Worcester, and asking for help was the only thing that could save my life, but I didn’t want to end up back at HBM in Worcester, and I wondered if the people there had traumatized me so badly because they wanted me to die, adding to the sense that my suicide would be the best thing for most people overall. Anyway the lovely woman from VF convinced me that the mathematical risk of HBM was low and my life was important, and I finally agreed to go to the emergency room.
Inpatient
Well, as I type this, I’m at the bougie hospital where they know me. Without risk of being locked in an asylum and never seeing the light of day again, now I can finally be honest that YES I HAD A “PLAN.” Just being able to speak freely is helping. Plus, I finally got sleep. I don’t know if I’m ever going to be able to try therapy again, and if I do, they could also just abandon me. And maybe someday I will wake up at age 80 and regret having lived that long. But, for the moment, I’m “safe.” I don’t have the option of killing myself, which eliminates decision fatigue.
As far as 🐢 and 🐈⬛️, they are under the care of an amazing pet sitter and are safe.