My Instincts Say Run, But What Do They Know?

[Sandstone]

My T has suggested that since I can't identify when I am getting overwhelmed, and can't ask for help when it happens,(see https://www.myptsd.com/threads/but-you-knew-this.52272/) I should live at a residential home for four weeks while doing actual trauma therapy. This depends on me being able to fund it through my Personal Budget. I don't know if she is proposing only to see me weekly, as now, through that time.


The place itself sounds great, offering "a therapeutic, safe and supported environment for women ... to work towards a level of recovery before being supported to move onto appropriate independent living in the wider community. Placements can be for planned respite, emergency respite or medium term. …offering a range of in-house therapeutic and practical activities to re-establish life skills. A wide range of activities take place, either individually or in groups, for example Exercise & Relaxation, Assertiveness, Dealing with Emotions, Creative Writing, Cookery, and Budgeting. We also have the benefit of an Art Therapist and Massage Therapist"

BUT

• what if it takes more than four weeks?
• what if I turn out not to need it at all?
• can I deal with being away from home and husband so long?
• can he ditto?
• shouldn't I be learning to manage this stuff for myself?
• it's not a specialist trauma place, I have the impression it deals mainly with the severe end of BPD

Everything within me is screaming No, run, but I think that is the more the combined fear of facing it, and of being told when I do face it that it is all too trivial to justify being like this. I'm also afraid of being trapped and powerless if I go there, of losing control of my life. This week I'm feeling perfectly OK and stable, and much more inclined to scrap the lot than to go ahead.

What would you do?

 

[joeylittle]

If I could afford it, I'd make sure it was going to give me the kind of therapeutic environment that I needed (getting more detail, seeing if there might be a better place for me), and then I'd go. Therapy is hard work. If you can make your environment focused to support your mental health full-time, it will let you focus on your recovery full-time.

I'd only be asking what kind of skills training they do there, and whether or not your therapist would continue to work with you, or if she is suggesting taking a break. And I'd probably find an alternative to that one program, if only to see what a different program looked like, so I could be confident in my choice.

 

[Hope4Now]

• what if it takes more than four weeks?

• what if I turn out not to need it at all?

• can I deal with being away from home and husband so long?

• can he ditto?

• shouldn't I be learning to manage this stuff for myself?

• it's not a specialist trauma place, I have the impression it deals mainly with the severe end of BPD

It will definitely take more than four weeks to process your trauma. But four weeks of this kind of intensive work can provide you with a foundation of self-management skills that could take much longer in weekly therapy...if the skills training matches your needs. That's the tricky part, I think.

IMHO, if you are struggling with the self-harming urges, you would benefit from intensive work like this.

As for marriage...four weeks is a long time...you have to weigh that against the great leaps of healing that could occur.

This last...that it's not a specialist trauma place...would be the big concern IMHO. I agree with @joeylittle that you should look into other possibilities as well...and ask your therapist to help if you choose to.

Everything within me is screaming No, run, but I think that is the more the combined fear of facing it, and of being told when I do face it that it is all too trivial to justify being like this. I'm also afraid of being trapped and powerless if I go there, of losing control of my life. This week I'm feeling perfectly OK and stable, and much more inclined to scrap the lot than to go ahead.

You ought to go read the thread about the double-bind theory. I'll post the link to it. You might find some resonances there.

I don't know if this is helpful to you at all, but I'll throw it out there. I have been caught between similar things for a year now...If I accept how bad things really are, that is very scary...and I fear going crazy/losing control. SO, I keep control as best I can...by all sorts of means...often by convincing myself that I am just fine now, thank you. Until I'm not fine. When the part of me that says, "I'm fine thank you," is in the forefront, it's possible that:
a) I am just fine at that moment
b) I have depersonalized and/or derealized the times I'm not fine ("Oh, that wasn't me!")
c) I am not at all fine at that moment, but the part of me that says I'm fine is in denial (e.g., in the middle of a really intense body flashback, I kept saying to my husband, "I'm okay, really, just go back to sleep."

Here's the thread, The Double-Bind Condition: https://www.myptsd.com/threads/the-double-bind-condition.52469/

 

[Sandstone]

an alternative to that one program

This is rural East Anglia. I don't think there is anything else within a hundred miles. A year ago we spent a lot of time looking and found nothing nearer than London or Derby, except for military programmes. And since the NHS won't agree to fund me IP at any of the specialist units, I have only the option of things I can pay for myself or through my State funded Personal Budget. I'm not sure that a generic unit is what I need, and I can't persuade my husband to say what he thinks about it. When I was an Inpatient he insisted on visiting me every day, a three hour round trip, plus three hours allowed visiting time, even though he was still working full time, and I don't want him to wreck himself

 

[Sandstone]

I'd only be asking what kind of skills training they do there,

I'm not sure they do any - I think its more of a respite place.

whether or not your therapist would continue to work with you,

She is - this is to avoid taking a break - so that is good

IMHO, if you are struggling with the self-harming urges, you would benefit from intensive work like this.

I was about to say I'm not. But this is the problem - I was and then I completely forgot that I was. It seems impossibly remote now, and I can't imagine it.

I keep control as best I can...by all sorts of means...often by convincing myself that I am just fine now, thank you.

So far as I can see I really am fine - but it is at the cost of cutting out most of my life. If I stay at home, in control, then I am in control

 

[Hope4Now]

I was about to say I'm not. But this is the problem - I was and then I completely forgot that I was. It seems impossibly remote now, and I can't imagine it.

Yep. Same thing with me with any "symptoms." When I'm in it, I'm drowning and utterly exhausted. When I'm not it seems far away/unreal. I think this is part of our illness or injury or PTSD or whatever it gets called...just part of who we are that needs healing.

 

[digger]

So far as I can see I really am fine - but it is at the cost of cutting out most of my life. If I stay at home, in control, then I am in control

This reminded me of something a GP once said to me. I had a (physical) condition that was causing me a lot of pain and for various reasons it was hard to get my pain levels managed. I was effectively housebound by it for a while but proudly declared at my next GP appointment that I had it under control so long as I didn't do anything - he had to gently point out to me that pain that was stopping me from doing anything wasn't really what they would class as 'under control'....

Is it really 'fine' to be cutting out most of your life?

 

[Sandstone]

Well it's much better than the alternative. I continually wonder if I'm just hiding out of cowardice, and perhaps if I tried doing more it would be OK. I suppose if I went to this place for four weeks I would have to do more, so that is an argument in its favour

 

[digger]

I suppose if I went to this place for four weeks I would have to do more,

And it would be in a safe place to 'test' how doing more felt.

 

[Sandstone]

We aren't really any further forward. The relevant person was on holiday last week, so my T couldn't find out if my Personal Budget is large enough or applicable to this residential place.

We had the joint session with my husband, and he seemed to say he recognises when I am going downhill because I get more silent, but wouldn't usually act beyond keeping others away. Like me he had no faith in the NHS provision and especially not in the Crisis Team, who he said he had often identified as making me worse by their unreliability.

That all seems very negative. I did say I can see why they might be frustrated, because I look and sound so normal before I tip into desperate action. So they would see someone with nothing wrong with them

I just seem to be stuck in the frustration of having told them over and over how risky this would be and them not hearing until it was too late. We have started now, I'm reading, thinking working at it all and I'm getting the desires to run, hide that led on to the desires to OD and terminate my thinking. I thought they had weighed up the risk against their budget and decided it was safe t go ahead. Now it looks as though, after endless alleged meetings about how to proceed, they didn't do any sort of analytical thinking, they just acted.

I think the way ahead has to be for me to work on stabilisation for myself. I find any work of that sort very hard, and my reading is beginning to make sense of why. Does anyone have any useful resources on recognising hyper-arousal and reducing it?

 

[barefoot]

I had a very tough few months last year when I just couldn't get my body to calm down at all. I hadn't really seen it coming...I just suddenly seemed to be in the full on, intense, desperate thick of it with no real idea about how or why it had happened. Now when I look back on it from a (generally!) much calmer place, I think my getting caught out by it was partly because I didn't really know what I was dealing with - it started just before I was diagnosed with PTSD and I a knew that I didn't feel 'right' and that the anxiety was somehow different than what I'd experienced in the past...but I couldn't put my finger on what was going on, which just made me cling to the fact that I was fine because that denial helped me to feel less out of control of myself.

Anyway...I wonder if you are doing any breathing exercises?

 

[barefoot]

Sorry - I posted too early!

My therapist kept talking about diaphragmatic breathing as a way of calming my body down (because it stimulates the parasympathetic nervous system, which is for repair, healing, rest etc as opposed to the other part of our nervous system, which does the opposite). I have to admit, I was sceptical that it would make much difference but thought I'd give it a go as I had nothing to lose. I really believe it made a huge difference to stabilising me and making me much calmer - hyper vigilance and off the scale anxiety reduced fairly quickly. The key is to do the breathing exercises every day - not to just wait until you realise you're in the middle of full-on anxiety/panic/hyperarousal.

Even 10 mins a day is said to help to keep up the maintenance. At my worst though, I was doing it 3 or 4 times a day for 20-30mins each time. I found it really helpful to do half an hour of it before bedtime too - made a real difference to me falling asleep - and staying asleep!

If you haven't tried, I'd really recommend it as it's a really simple thing to do that you can fit into your day really easily. I'm definitely a convert!

I also cut out caffeine, which I think helped too.