Paradox - what to do if you are so symptomatic you can't tolerate the level of care you need?

[Ecdysis]

So, I've recently applied for and been granted an assisted living scheme. I've needed such level of care for all my adult life (and needed to be removed from my childhood home by social services, but wasn't).

I've only applied for it now, at the end of my 40s, because prior to this, I was too scared/ too symptomatic/ too dysregulated to tolerate that level of care.

I've been on the brink of homelessness all my adult life and can definitely understand how people with mental illness end up on the streets because they're simply not able to comply with the kind of care they need.

I've often needed inpatient treatment throughout my life, but have refused it, because I knew I'd have massive breakdowns if I was "stuck" in an inpatient setting when my PTSD was at its worst and was absolutely panicked about getting moved to an involuntary psych ward against my will in such a breakdown.

So this is a theme that runs throughout my life - need a higher level of care, but am not stable enough to "endure" what that entails. Can't do daily appointments. Can't do a daily routine set by someone else. Can't have people around me daily. Just can't.

I'm like a feral cat - if you try and put me in a room or a box, I'll lose it and shred everything in sight.

Not receiving the level of care I actually need has done huge harm in my life.

But I don't know how to find truly trauma-informed care that understands and can work with these limitations.

So, all my life, I've pretended to be doing better than I am, to "escape" a level of care that I know I wouldn't be able to tolerate.

I think I may be at a point where a) things are so bad that I can't afford to do that anymore, b) I'm old enough and have done enough trauma therapy that I maybe, maybe, maybe can hold my shit together well enough not to go insane due to the constraints of any program/ setting involved in a higher level of care, and c) inpatient therapy/ assisted living and similar programmes are a lot more trauma-informed than they were 10, 20 or 30 years ago.

 

[arfie]

So this is a theme that runs throughout my life - need a higher level of care, but am not stable enough to "endure" what that entails.

another ditto, skin shedder. in my personal herstory, i've spent the meanest of such chapters using my wilderness survival skills to stay off grid, both in rural and urban environments. alas, i didn't stay far enough off-grid. the arresting officers agreed that i needed a higher level of care, whether i could endure it or not.

I'm like a feral cat - if you try and put me in a room or a box, I'll lose it and shred everything in sight.

i accused the shrinks who compared me to feral cats of being "cat people." i'd rather push a dog than drive a cat. call me, "the beaten crazy bitch wolf."

one psychiatric nurse practitioner i worked with grinned mischievously and said, "i can work with that." turns out that i could to. some days i'm more of a crazy female canine than others. i still bite if i have to, but i get back to the tail wagging as quick as i can. i've been taking lessons from four legged bitches from the animal rescue team. they are very plain-spoken mentors.

or am i lost in metaphor again? that happens that happens to me allot when i am in psychological ecdysis.

 

[Tinyflame]

I can relate entirely to that. I always figured it was my own deficit, my own fault, just bad luck I couldn't do more, or the fallout or consequences would be worse than trying to get help. I guess just recently I realized trauma usually involves all or most control stripped away so that might color my perception also.

 

[Sideways]

inpatient therapy/ assisted living and similar programmes are a lot more trauma-informed than they were 10, 20 or 30 years ago.

They definitely are much better where I am.

And here’s the thing: I’ve never met a person with ptsd who liked the idea of being confined in hospital. The concept of being confined making you symptomatic is typical of ptsd. So, good trauma inpatient programs don’t function in spite of that, they actually take that information on board and design their program and facilities to accommodate exactly that stressor.

For example, the trauma-focused inpatient program I did, every single patient was required to visit the ward before their admission, meet the staff, tour the facility, and have a session with the program manager about those issues and how they would be addressed by the program ahead ahead of time.

 

[Friday]

I’m one of those people who if they need help? Isn’t able to do the things necessary in order to get it, and once I am able to do the things to acquire help? No longer need it. Catch 22.

 

[Ecdysis]

I’m one of those people who if they need help? Isn’t able to do the things necessary in order to get it, and once I am able to do the things to acquire help? No longer need it. Catch 22.

Yup, me too. It's annoying, huh?

 

[Friday]

Yup, me too. It's annoying, huh?

On the upside? It means that THIS time you’ve sought help before you need it?

 

[Ecdysis]

On the upside? It means that THIS time you’ve sought help before you need it?

Nope... I have waited until the absolute last possible minute. I have let it totally wreck my life. I'm seeking help (with my teeth gritted and fighting all the way) because the next step would literally be homelessness.

I am trying to to the "older and slightly wiser" thing tho. I'm not quite as stubborn and reactive as I used to be when I was young-er.

 

[Friday]

Nope... I have waited until the absolute last possible minute.

LOL… You realize how much you’re belittling what you’ve accomplished?

Every other time you DIDN’T seek help, while you still could. This time? You did.

***

I’ve been homeless many many times since PTSD came into my life.

Sometimes with tons of money in the bank (I just cannot/could not parse the whole steps to take money and transform it into IDs, Leases, Phones, Addresses, Purchases, Paperwork). Sometimes I have access to that money, sometimes there are somehing like 6 steps in order to be issued a new debit card, passport, etc., so it just sat there in the bank whilst I slept & fished on the beach. Because that made sense.

Sometimes I’ve been flat broke. With no ability to wrap my head around the 6-12 week process of applying for any kind legal work, much less the up to 2 year process of applying for any kind of aid.

Then one day? A switch would just kind of flip, and the things needing doing made sense, and the tolerance to be able to do them, either wasn’t a big thing, or the ways to blow off steam came effortlessly & with great results. Or? I ended up back in a life or death situation, more than the whole food-water-shelter of living on a beach, and THAT cleared my head enough to be able to function, again. Oh. Right. Life. We do it this way!

***

Recognizing that things are & have been going badly for you, That your life is becoming a complete wreck… and taking steps to change that course? Is a BIG DEAL. Especially the first time, where you aren’t practiced in it, and it’s all new.

 

[Charbella]

Can you reframe some things? I get not wanting to be at someone else’s mercy. But for things like hating someone to do a schedule for me, I’d find out what the schedule was like and then decided what I do have the freedom to choose in those situations.

If you go into it thinking it isn’t going to work-it won’t.

I think the reason why I’m such a research driven person is because of the control thing. So research the place your going and maybe figure out things you won’t be able to change so you can learn to live with it and things you might want to negotiate to make your brain happy with it.

It sounds like you like to know the limits and live on the out skirts of them. Such as almost being homeless a lot. You aren’t because you don’t want to but you tend to live on the fringes of it, what might the fringes of the rules be like at your new place?

What’s worst case scenario at this place and can you live with it? Is it better than what you’ve got now? Can that motivate you to live with it?

 

[Ecdysis]

So research the place your going

So, this is kind of complicated, which is why I glossed over explaining the details... I've applied for an "out patient" assisted living program. So you live in your own home, and they drive out to see you. There's "in patient" assisted living programs too, of course, but I've not applied for that because, yeah, PTSD = feral cat. So I just need to tolerate them in my space twice a week for 3 hours each time. And that's still enough to trigger my PTSD loads, but I guess if I work hard at it, I can cope with it.

 

[Ecdysis]

Recognizing that things are & have been going badly for you, That your life is becoming a complete wreck… and taking steps to change that course? Is a BIG DEAL. Especially the first time, where you aren’t practiced in it, and it’s all new.

Thanks. It's a rough time and I feel like I'm failing at everything. I feel like I'm failing to reach out for help in time. I feel like reaching out = failing, in and of itself. Eh, you get the theme. So yeah, your reframing it as "at least you didn't not ask for help" or "at least you didn't ask for help even later" does help a bit. I'm not sure it feels like an accomplishment tho. Maybe I'll get there eventually. I guess what sort of feels like a sort of accomplishment is having PTSD symptoms under control "enough" to not do the full feral cat number on the people that I have asked for help. Well, maybe. I've also got a theory that the depression symptoms (numb, paralysed) are just so intense they're overriding the PTSD symptoms (fight/ flight). So I guess the jury's still out as to whether it's an accomplishment or a weird side-effect of the depression....

Ugh... everything in my life is so screwed... or beyond screwed... right now. Maybe I have to start laughing about it in that hysterical way that things start to seem funny when your mind is breaking and losing control...