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I’m Going To Be Discharged From A Partial Hospitalization Program (Day Program) in a Few Days and I’m Worse Than When I Started

EveHarrington

MyPTSD Pro
I don’t know what to do at this point. The partial hospitalization program was supposed to help me but I’m not getting any better. Actually, I’m much worse.

I’m supposed to get 2 individual therapy sessions a week. Session one was just making a treatment plan. Session 2 was me being in crisis because I couldn’t handle the loud noise and ALL of the staff who was there that day pushed back on me and instead of trying to get people to talk in indoor voices and not scream across the room, or, you know, move my seat, they proceeded to tell me it’s my fault, they can’t disrupt the group by moving my seat (a bullshit excuse if I ever heard one). Yes, I was sitting right beside one of the people who insisted on talking on volume 697 every time she spoke. I have sensory issues and I wasn’t asking for the world. I don’t understand why asking people to use indoor voices or simply moving me was met with such pushback, but here we are, with a wasted individual therapy session. Oh and yes I have my noise canceling headphones but when you are sitting right beside the person who likes to yell, they can only do so much.

Seeing as how I only have a few days left, I doubt I’ll get two more individual sessions, most likely just one, and it would be the wrap up session anyway on my last day. Yeah, the individual therapy component is just a joke.

The medication is helping in one regard, but making my anxiety worse. I know I need to work through it and it may take a few months before I can figure out if I can handle this medication or if the side effect will go away. My anxiety medication was adjusted to deal with the anxiety caused by the new drug.

Oh. And what spurned this PHP? I found out within a week that I was losing both my outpatient group therapy and my individual therapist as she’s retiring. So, yeah, I don’t know what to do at this point. I only have my mom, nobody else. At least I still have my psychiatrist.

I REALLY REALLY REALLY need an ERP therapist but that’s like finding a needle in a needle stack. There’s nobody locally, so I’ll have to start contacting the online therapy people and hope for the best. I really don’t want to do online therapy but at this point I have no choice.

I just cry, all the time I cry. I guess I get discharged and hope for the best? The crisis text people are gonna get sick of me, I’m sure.
 
I don’t understand why asking people to use indoor voices or simply moving me was met with such pushback
There’s a broad range of types of groups.

My own experience of hospital-run outpatient programs was they were consistently run with very firm boundaries and expectations. About a lot of different things. And the expectation to be tolerant of other group members is almost always one of those boundaries.

It very often has to be that way in a hospital outpatient setting. Everyone in the room is there because they’re having a very hard time, to the point where they aren’t succeeding with more mainstream help.

While asking someone in, say, a work setting to speak a bit less loudly might be a nothing event, in a hospital outpatient group setting, it may very likely be perceived as a challenge to that person’s place in the group, and their space to be heard alongside the other group members.

Everyone in the room would, given some latitude, cope with their own issues in very different ways. In in a group setting, all of those small concessions quickly becomes anything from incredibly distracting, to completely dysfunctional.

One person’s simple coping strategy is another person’s nightmare. And even very simple things like preferences for where to sit can easily take over emotionally to the point where many participants won’t get much out of the actual content, if they aren’t managed with consistent and firm boundaries.

I’ve witnessed incredibly minor things completely blow apart the group dynamic and make it dysfunctional and unworkable. Things like someone deciding to sit on the floor, someone sliding off their shoes…I’ve been in groups where we weren’t allowed to wear perfume! And it’s always been part of the steps that are necessary to keep that kind of group functional.

One of the benefits of those firm boundaries, though, is that everyone knows exactly where they stand, and can experience how to tolerate their distress in a safe setting, where the expectations don’t change from one day to the next.

That type of environment, and those type of expectations, don’t work for everyone, though. I have worked in some groups where there was quite a bit more flexibility, but only in an inpatient setting where the admissions where coordinated in a way to assist with those fraught group dynamics.
 
I don’t do groups - no interest in them whatsoever personally. But for what it’s worth, I’d have had issues sat next to someone that insisted on talking at top volume the entire time. I’d just leave with a banging headache and a desire to turn round and tell them to turn it down. It’s hard to have empathy and listen to the content of someone’s words when they are ramming them down your eardrums at concert level volume. I would have thought being able to be respectful of other group members & talk at appropriate volume and manner were a prerequisite for joining a group.

Can you try to be open minded to online therapy being a success? I wasn’t sure how it would work at first but in the end I saw my therapist 50/50 online/In person and I Really really liked the online sessions, found them just as helpful & they fitted into my day so much better than the in person stuff.
 
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gentle empathy, eve. i have been in this place more times than i care to count during my half a century of recovery from child sex trafficking. don't accuse me of experting, but with my own 20/20 hindsight glasses, i currently believe it was my control issues which continually ushered in this phenom. i had inflexible notions on what i needed and precious little ability to open my mind/heart to try other people's ideas. the unavailability of what i thought i needed is what forced me to open my mind/heart to other people's ideas.

but that is me and every case is unique.
steadying support while you work your own case.
 
Update.

I am most likely being discharged in the morning because I have a COLD. (COVID negative). I was told that I could come back to the program in the next few days if I don’t have any cold symptoms (who in the hell clears a cold that fast?!?!??) and if I don’t come back in 2 days I will be discharged. Day 2 is tomorrow and I’m still very much in the throes of this damn cold. It won’t be gone in the morning.

I swear, you cannot make this shit up. I used to think people needed to chill about their anger regarding all the COVID restrictions because I erroneously believed that they were in the past. I was so wrong. And now I understand why some people are so mad.

I wasn’t allowed to go today because I have “COVID” symptoms. You aren’t allowed in the building if you have any COVID symptoms at all. It doesn’t matter if it’s not COVID and you’ve taken 759 tests to prove so. Because, as we all know, every single possible cold symptom out there also could be a COVID symptom.

Note, I called my therapist in the same health system and got a last minute appointment with her as she had a cancelation. And guess what? Outpatient therapy doesn’t require masks, they don’t ask about COVID symptoms, and they don’t take your temperature. Interesting how you could essentially walk in there with full blown COVID, no questions asked, but you can’t go to PHP with even one symptom.

Fun fact about me. I don’t clear colds easily. I had a cold in August (COVID negative) that had a lingering cough that lasted until November. I actually went to the pulmonologist at this point because my mom was so afraid that something serious was wrong with me.

So, you can see why I’m pissed. I know the discharge is coming. I know that I’m going to take awhile to fully clear all cold symptoms. I have my outpatient psychiatrist but I need to scramble to get an appointment. I did request PHP records be sent to him today so at least he’s somewhat up to date. I need him to see those records as it has one new diagnosis. I don’t know what to do about medication as I have a very limited supply. I am being left without a therapist. I am scrambling to find one of them as well. These are all things they require you to have upon a normal discharge, as they help set them up for you. But a sudden discharge like this, and I don’t get the standard set of services.

This was supposed to be my stopgap to keep me out of the hospital. I know it’s coming. It’s probably a few weeks away I’m guessing. I’ve been trying everything I can to get help and it’s just not happening.

The kicker is that even though I’ve been told I can return later using the same referral, I am doubting it. And I won’t have the ability to get another referral unless I bug my psychiatrist but he only works one or two days a week. I told the head nurse in the program that I won’t have a therapist to refer me and she had the balls to argue with me about how referrals aren’t necessary. LMAO, I set her straight, and I told her that referrals are 100% required now per the person in admissions.

This just sucks. Morons are still COVID crazy. It’s not even the same disease in terms of severity anymore but you wouldn’t know it dealing with these idiots. 🙄
 
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I was notified I’m being discharged and that I can go back if I get better.

I was told that I’d get a call about post discharge care. There is no post discharge care. The whole point in going to PHP was that I am losing my therapist and already lost group therapy. I stopped my medication prescribed by PHP because it was making me incredibly anxious as well as giving me problems with basic thinking.

How the hell would I get a referral to even go back? This is insanity.
 
It does sound very unfair to me too. I know it might be policy for the better of the group, but you are also a member of that group too. They should have given you praise for getting through it and not just left it at a scolding.

The whole cold thing. I don't do colds well either. They linger forever. Only advice, lots of steamy showers and take a shit load of vitamins.
 
I can go back if I get better.
This seems pretty reasonable to me.

Flu kills people. People with a mental illness have a compromised immune system, and are at higher risk of developing dangerous flu.

The idea that therapy can, or should, be delivered in a way that is neither stressful or uncomfortable is unrealistic.
 
This seems pretty reasonable to me.

Flu kills people. People with a mental illness have a compromised immune system, and are at higher risk of developing dangerous flu.

The idea that therapy can, or should, be delivered in a way that is neither stressful or uncomfortable is unrealistic.

I don’t have the flu. I don’t have COVID. I have a COLD and the world has gone bat-shit crazy.

The flu can be tested for as well as COVID.

If you have any symptom whatsoever that overlaps with COVID then they will not accept you.

How would you like to be rejected for “foggy brain” which is essentially dissociation and told that YOU can’t get treatment?

Yeah. I thought so.

(I know you have dissociation which is why I said dissociation.)

Edit. It wasn’t like this pre-COVID. Nobody was booted back then for having a cold. So this isn’t about the poor widdle old people who might get the flu. This is pure paranoid COVID bullshit.

I’m vaxxed and have no problems with masking. But being unable to get care that will prevent you from yeeting yourself off a building because of COVID paranoia? People should NOT be dying 4 years out because we have to protect others when someone has the g’damned sniffles. 🙄

People need to be outraged that COVID hysteria means that you can completely isolate a psych patient in the hospital if they only have a runny nose. Isolation is a known torture tactic, but it’s ok, because we can’t spread COVID! (Hardly anyone is dying of it anymore, it’s lessened in severity.) The world has gone f*cking mad.
 
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(I know you have dissociation which is why I said dissociation.)

Oof, was this necessary? I think most understand that you’re frustrated. That’s no reason to drag someone else’s stuff into something that has nothing to do with them.

I do want to point out though, the extra precautions are there for a reason. Is the death toll as high as it was? No, but it’s not non existent either. Which, yes, can be argued that there is a death toll for any of those illnesses. But I think people learned a lot about how easy something spreads and are rightfully so a little traumatized by those years. Also, I get it, you don’t have Covid or even the flu. But it’s just something people have learned to be abundantly cautious around.

Take the break and use the time to practice tools you already know until you’re able to go back. And do go back. Even if it’s uncomfortable having such a sensory experience. Sometimes the only way past things is through.
 
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