talking therapies and other things

A fellow blogger asked about talking therapies and it got me thinking that I never really wrote about this before. I have been through most psychotherapies, but mostly to do with psychodynamic. I never was one for DBT (dialectical behavioral therapy) or CBT (Cognitive behavioral therapy). I wanted to get better quick and these therapies, you had to do homework and stuff. It just made me more depressed. I know some people have sworn by them and have been helped by them. I know they work because I have seen the studies on them. Most recently, CBT is making waves with veterans who have suicidal thoughts. They use what is called Brief CBT and it helps the soldiers faster than “treatment as usual”. Treatment as usual is just a term used to describe what is standard care for someone. There are some specifics about it but I can’t remember them off the top of my head at the moment.

For suicidal patients, I still believe the standard of care should be CAMS, Collaborating, Assessment, and Managing of Suicide. It is a framework that has been shown to work best with suicidal people and its assessment, the SSF (Suicide Status Form) is very useful in getting to the bottom of a suicide crisis. People don’t know more about CAMS because they rather rely on their own method of treating someone who is suicidal, which is the “standard of care” but it doesn’t work. If you are suicidal, you agree you aren’t going to kill yourself and if you can’t agree with that, you are placed in the hospital. CAMS allows for outpatient treatment to occur and only takes about fifteen minutes in a 50 minute session to work on. I have written about CAMS. You can search for it in my archives.

I didn’t sleep well last night. I was just tossing and turning most of the time. I couldn’t get comfortable. I was hot, cold, cold, hot. I just didn’t get it. I finally took my meds around 0230 this morning and then was up till around 0530. I didn’t have supper and I wasn’t hungry. My appetite has been minimal these days. Going to my father’s place was a chore and left me more tired than I was before I left my house. I was only there for about ten minutes. He is a pain in the ass as he hasn’t been taking his water pill and then wonders why he is swollen. Pisses me off.

Now I am home and feel like I should nap. Except I don’t want to nap. I am wicked cold and need something to warm me up. I would have coffee but I don’t want the jitters. I still am not over my little caffeine overdose from the other day. Never again will I drink back to back cups of coffee. It was too much for my system. I felt great but not in the long run. It wasn’t intentional. I just wanted to stay up as I had again didn’t sleep too well. Think I might have tea next time.

Random 626

I am having a sleepy day. I wanted to go out but after therapy, I just laid down and rested. I really wanted to sleep but sleep never came. Now I feel so down. I wanted to go to Walgreens to see if they had the new Oreo’s S’Mores, but I didn’t do that either. I just stayed in bed after I found out I had my menses. I knew it was going to happen today and I was expecting it, but even so, it still shocks me when I bleed. It’s just so unnatural to me. I still wonder if I made a fuss when I was younger if things would have been different today. A friend of mine in Australia made a comment on my Facebook status and called me a “princess”. I was so damn hurt by it, I deleted the comment. That is how my day started.

My father called me, wanting to know what time I would by his house tomorrow. I told him and then he told me some stories about going out to Boston and stuff. I didn’t care. I just wanted to get off the phone with him. He annoys me. I am sure tomorrow is going to be fun.

I sent off my Brick Walls story to my psychiatrist. As expected, I didn’t get a response, but she did read it. I have the stats to prove it, well, more that someone did, not necessarily her. She likes my writing so I send it along to her every now and then. I see her next week, early. I also have to finagled the bagel on the time with my therapist. It will depend on what time I get out of my psychiatrist’s appointment. She never runs on time, so I am guessing she will be at least fifteen minutes late. Our appointment usually lasts about half hour. I can either spend a few minutes on the bus with my therapist on the phone or I can find some hide away spot in the hospital to have a session with her. I rather be home in my room.

My back is still aching me. I don’t know what I did to tweak it. Another reason I really haven’t left the house today. I didn’t sleep fairly well last night. I kept on waking up in the wee hours of the morning, again. I tried to fight through and stay in bed so not to wake up. But I still woke up around seven and that was that. I am so tired of not sleeping good. Feeling fatigued all day is a real downer. And after the fiasco I had with coffee yesterday, I wasn’t having any today. I drank too much coffee yesterday and had palpitations and was really hyper. It was not fun.

Hospitalizations: Fifteen Minutes of Fame

Hospitalizations: Fifteen Minutes of Fame

I had therapy. My therapist read my “Brick Wall” blog. She asked if we could talk about the bricks and we spent most of the session going over them. I also told her about my book problems, that I think it is disorganized. She said that it is her most prized possession, so I think she is biased in my writing abilities. She said my short story was heartbreaking to read. I haven’t gotten too many likes on it. I may have to play with the tags a bit. Anyway, talking about the bricks was difficult because it lead to where I was in my last hospitalization, where I wrote the story. I told her how no one was looking at the bricks, that they were just looking for the cement to dry before sending me home, so to speak. That is all they cared about. Stabilization and discharge were the key focus of what they wanted to do. What brought you in the hospital, they didn’t care about. Or if they did, it was always, “we’ll talk about it tomorrow” but never did. I hated that my needs were ignored and patronized. I flatly told them I was going to kill myself when I left the hospital during my initial few days when they wanted to discharge me. And it was true. I needed help and was going to stay inpatient to get that help. Except the help came back to me looking for help from outside services. The social worker that was working with me didn’t care about my needs. I ended up having to call places to look for outside support. I tried to get it but never had a call back or even an email back, though one place the email came back as undelieverable. It was a trying time. I wanted to kill myself so badly and yet I was supposed to make all these phone calls to show that I wanted to live? To do the work my team was supposed to be doing? I just don’t understand their mentality. Yet it has been nine months since I left the hospital. I am still here because the anti depressant they put me on really help stabilize my depression. Too bad it no longer works. I stopped taking it in December.

My therapist thinks I should write a blog about past hospitalizations and current ones. Thing is, I don’t remember much. I know things are different today than they were back then. For example, there are no longer any outside passes given. If you want outside passes, you are basically discharged. When I was in the hospital in August, they wanted to give me grounds privileges. This meant that I could go out for staff walks. I told them adamantly no because I was scared I was going to run. They gave it to me anyway. Granted that at the time, I was in an AFO so I know I wouldn’t get far, but they still took that chance of letting me go. Stupid, I tell ya. I should have gone away from the group and tried to escape. I don’t know what that would look like but I know it wouldn’t be good on either side. I would most likely get reprimanded like a child, even though I am an adult. But that would be on them. I told them I would run and if I did, it was on them, not me.

I remember a time when I was in the hospital 21 years ago. I was severely depressed and suicidal. I had attempted suicide and was hospitalized against my will, in fact the admitting staff forged my signature on the consent form. I went through my records after discharged. Anyway, back then they had ground privileges, which meant you could leave the unit unaccompanied by a staff person. Just as long as you stayed on hospital grounds. Well, I decided to walk around the block after working hours and got “caught” by off duty staff. My privileges were revoked the next day as I broke the “rules”. I never kept my privileges too long. I always did something to revoke them. One weekend I had to beg for an outside pass just to pay a bill (I was there for more than a month and if I didn’t pay the bill, my phone was going to be turned off). I told them I would be back within an hour and I did. It was the first time they trusted me to do this. It was tough because I was so suicidal and they weren’t going to let me try again, hence why my stay was 2 ½ months. That was my longest time in the hospital. It did help me but the demons were still there. I had major issues that I still don’t talk to anyone about, not even my current therapist. It’s just too scary.

Last night I was looking for former therapists. I came across one, Dr. B. She helped me probably more than all the rest. She was the longest therapist that I have seen till that point, three years. All the rest of the therapists that I have seen were year or less. I am going to send her my book and email address. I wrote about her in my book. It was hard not to include her because the opening introduction has her in it as that was my first serious suicide attempt. I had made other attempts before that one, but this one landed me in the hospital and then I was there for a long time. That is when you had good care and one on one contact with someone. Now they have these “teams” where there are all the staff from the unit meet with you for fifteen minutes or so and then decide what to do with you. Fifteen minutes to decide if you need further stay or discharge. It is nothing like the care I had 21 years ago. You met with your inpatient therapist, then a social worker, and then your contact person who was a staff member for that shift. This no longer happens and it’s sad. No longer do you feel safe in the hospital or cared for. It is the end of the era for hospitals. I will never go back, no matter how suicidal I get. They can just kiss my ass goodbye.

Pain and suicide

I started off my day in pain, around 0400. I hate waking up in pain. I stayed up for a little while and finally gave in to taking pain meds around 0800 when I just couldn’t take it anymore. I texted my therapist and she gave me a time for today. I really need someone to talk to. I feel like I am losing my mind with this loss of sleep. I went back to sleep after I had breakfast and the pain meds kicked in. I had weird dreams about my psychiatrist. We were on a boat and she wanted to give me a cortisone injection in my hip. That was the first dream. The second dream was also on a boat but other than that, I don’t remember much. What was weird, is that when I woke up, my hip was hurting me. I think I need to go back to physical therapy to get it looked at. It has been bothering me for some time now, since November of last year. I sneezed and pulled my back out. It took me a month to recover and then I sneezed again right before Christmas and took it out again. I have been limited in what I can do. Today I walked to Walgreens which is only a block and half from my house. By the end of the block, my hip was in agony and I didn’t think I was going to make it but I pushed through. It got a little better by the time I reached the store. I only went in for a couple of items and by the time I reached home, I was still sore. I haven’t done any lifting or sneezing the past few days so I am not sure why my hip is bothering me so much. I know it’s muscular because if I rub where it hurts, there are knots there. I just hope that it’s not the beginning of getting my nerve condition again. I have no other symptoms, like radiating pain down my leg or increase in loss of my bowels or bladder to make me think I am in trouble. But the thing with CES, Cauda Equina Syndrome, things can escalate quickly and without warning. The main reason I don’t want to make a fuss about it, is that I know most physical therapists don’t understand nerve injuries. Yes, muscle pain is common in back injuries but my back muscles have been injured because of nerve damage. That is why my hip goes out when I have a horrific sneeze attack.

My foot still hurts. It has been hurting more since I came back from the store. I can’t stand that I am still having trouble walking after all this time. Last night, I had swelling, severe pain, and the veins popped out in my foot. I don’t get how this is not CRPS, Complex Regional Pain Syndrome. I know the skin changes are not that drastic. But then when I see a doc, I don’t have the worse pain of my life. I might be a 3-5 on a scale of 1-10 when I see a doc. What annoys me is that my PCP doesn’t believe that I have this condition, even after three doctors have told me I have it. It just makes me want to kill myself in frustration. Severe pain always brings out the suicide part of me, not like it isn’t already there to begin with. The pain just gives me the little push I need to think about it more. I just feel trapped. I know that if I kill myself, more than 115 people will be crushed. The people most devastated will be my family and psychiatric team (therapist and psychiatrist). It is this reason why I haven’t attempted. I think that if I had a place to go to, I might be more willing to try. I don’t want to kill myself at home because I don’t want my family to find me like that. But I can’t afford a hotel room and I can’t risk someone finding me in a public place, like a park or something. I can picture myself going through with any of my methods that are running in my head, but I just don’t have the guts to actually go through with it. I am pathetic.