Is There Anything I Can Agree With My T For When I'm Too Dissociated To Safely Get Myself Home?

[barefoot]

I regularly get quite spacey in sessions and have on a few occasions ended up triggered/retraumatised and severely dissociated. It happened last week - I have a 90min session but ended up being there for three hours as my therapist was concerned about me leaving (I couldn't feel my body and was completely disorientated...could barely keep my balance when I stood up...felt like I'd been drugged.)

My therapist is lovely and was great - she worked hard to ground me, she offered to get me drinks/something sugary to eat, she guided me to getting things out of my bag that usually help (hand cream, perfume, strong mints) and she was very insistent that I shouldn't leave as it wasn't safe for me to get home alone in the state I was in. I got up to leave four or five times and she persuaded me each time to stay, even though I was really confused and felt very suspicious of her. In the end though, I just left - she followed me downstairs and to the front door and was telling me she was really worried and could I please stay longer, but I left. It takes me almost two hours to get home - a walk in central London, a tube journey, two train journeys and then a walk at the end to my house. I'm not surprised that she was concerned. I have no idea how I managed to get myself home.

My therapist had wanted me to get a cab home from her place (it costs £200!) or had wanted me to phone my partner to come and collect me (it would take my partner two hours to drive there). I don't think either of these are practical solutions.

My partner wants me to arrange something with my therapist like, if I'm in that state, my therapist should call her. I don't think my therapist would feel comfortable with this - I can't see her calling my partner unless I give my express permission for her to do so in the moment. Also, I don't feel comfortable about it either - I don't want to feel that my therapist will just call my partner if I haven't asked her to - even if in retrospect it will look like the safest thing to do.

The difficult thing is - although I can now look back on my session last week and see that I was irresponsible to leave when I did because it wasn't safe, in the moment, I'm so disorientated, confused and fearful to really get that. And my default setting to everything (please stay here longer, would you like some water, it would be a good idea for you to phone your partner, how about I call you a cab to get to the station) is always a very definite "no".

So, I was wondering....do any of you have any kind of agreements/strategies with your therapists for these sorts of instances? I've got a session this afternoon so will discuss this then, but I'm interested to hear how any of you deal with this or whether anyone has any suggestions?

 

[GardenGirl0214]

I'm sorry you were in such a distressed state. I'm sure that was scary for you!

A similar situation happened to me during a session. I did stay until I settled down
and my therapist stayed with me.

My suggestion would be to tell your therapist today that if you get that way again, she can call your partner. If you ask her, I'm sure she will do it rather than let you travel ho,e alone in such a distressed emotional state. I would tell your partner ahead of time that you plan to have your T call your partner if you become unable to travel home from the session. You may not need it , but it's a good idea to have a safety plan in place just in case. Good luck!

 

[barefoot]

Thanks @GardenGirl0214

I know that sounds sensible. But I feel resistant to leaving it to my therapist's judgement of when she'll decide she needs to call my partner. It's not that I don't trust her judgement. More that it makes me feel..sort of out of control, I suppose? And I know when I'm in that state I'm not in control... But it feels a bit like just handing over my power to someone else for them to decide how bad I am and that action is needed. But then, if I'm not able to make that assessment myself in the moment...?

I think a difficulty is, even if I agree this with her now, when it comes to it and she says about phoning my partner, I'll likely say no. And then I can't see that she'd do it against my wishes - even if we've agreed something beforehand.

It complicated...! But I agree with you - it does feel like I need to have some kind of safety plan in place...

 

[Deleted member 28403]

Well, here is a thing I prefeer. When getting into a really unstable state, to take fast acting medications, to keep me a bit more stable, while I recover and prepare myself.

It's sort of a thing that works for me. Maybe you could arrange with your T to give you medications or similar in the occassion. Or otherwise, quick grounding that lasts long enough for you to get safe.

It's quite a difficult game to play with yourself, trying to get through it all

:hug:s I hope it gets better for you

 

[ladee]

Do you have anything at home that helps ground you? Such as a blanket, a teddy bear, a special cup (I say that because I have cup for my coffee that is very heavy), a perfume, a book, anything tangible that you use at home to feel safe.. The list may have been silly, but you get the idea. Possibly you could take that with you. We all have somthing that helps, something to hold onto , in my case.. Hope your next session is not so hard. Very grateful you made it home safe. And very happy to hear that you realize it was not a safe thing to do....When we realize something our self, it has more value to it.... stay safe.

 

[Bloomy]

I wonder why you started to dissosiated that much? Where you allready in that space before the session or did it happen under the session?
Initial thought is to stop talking about anything that can bring one further down the dissosiated path? Talk about something casual? Just call it a day and say its enough?

My therapist would not offer me any of what your offer you. No extra time and no follow up.

Ive learned my self to self talk my self out of it.
First to recognize and acknowledge that Im not witin myself. So the next question what will it take me to get back.

I have a short way home so I often need to detour. To walk works for me. Then can I track myself into constructive thoughts. I vision what I will do when I come home. As makin coffee and seettle down. Then I know Ill need to go out later to get more fresh air and preferable in a place with some nature around.

Dissosiative state is a horrible space to be in. Was at therapist today and I know I wasnt present as we said goodby. But I did this things above and need to follow it up though the day to get me into that there will be a new day tomorow.

Sorry I dont have any better advice to come up with. Wish you all the best do and Im sure youll find a way out that works for your needs. Slowly but surely. Hang in there.

 

[barefoot]

@Saelben I don't take any meds, so I don't have anything that she could give me.

Which leaves the grounding techniques... Perhaps that's what I need to go back to working on more again, because I'm obviously not very good at it! I often don't notice that I'm starting to get spacey and by the time I register something's not right my head is so far gone and I'm so disorientated that I find it impossible to ground myself. I'll talk to my therapist today about work I could do on grounding so that I can get better at that.

 

[barefoot]

@ladee Perfume and putting hand cream on are two things I use for grounding and they are always in my bag. The trouble last week was that I think it was the most confused I've ever been in those circumstances and when she suggested I get my perfume and hand cream out of my bag, it was very confusing because I felt like my bag (which was right next to me) wasn't my bag. To the extent that I asked her, "Is that mine?" And when she said it was and I looked in it, it just seemed so alien. It wasn't familiar to me at all.

Perhaps I need to tell her where things like that are in my bag and give her blanket permission that she can go in my bag and get these things out for me if that happens again...?

I think today's session will be fine - I think she will deliberately keep it light after last week's shenanigans - particularly as I'm not going to see her for a month after today's session (ugh!)

 

[ladee]

Ya @barefoot, it's hard when we are already in it sometimes before we know what has happened... but concentrating on grounding is a great idea.... and is there some way she may notice when it first starts to happen, a change in you tone, your body language? Possibly she could stop and ask if you are ok, then possibly spending a little time grounding, and if you can proceed, fine, If not.... take up where you left off last session.. ya, not too heavy this time... a month is a long time to not see your T.. wishing you the best. You sound very aware, whether you give yourself credit for this or not, but sounds as if you are really trying and want to learn how to do things to keep yu from being so upset... So, good healing for you today... wishing you well.

 

[barefoot]

@Bloomy I wasn't spacey before I went in, It happened during the session. But I don't think I realised for a long time so at the end I stood up to leave and I couldn't really feel my body at all and kept losing my balance.

When I full-on dissociate (as opposed to just being a bit spacey) I find it really difficult to comprehend/process what someone's saying to me and even more difficult to form some thoughts of my own and speak them. So, at that point, we're not still talking about whatever subject made my head go in the first place because I can't really engage with/speak about anything anyway.

It was like I had an overwhelming urge to go unconscious. To black out. Maybe I would have been better to give in to that and crash out on her sofa for a bit instead of sitting there going further down the dissociation route? Maybe I'll ask her about that today.

I am in awe of your ability to notice when it starts happening for you and to be able to actively do something about it for yourself (at the time and afterwards in the fallout too). This is clearly something I need to get better out. I seem to get to a point where my head is so far gone that I'm then too confused/disorientated and my brain is too shut down to get a hold of it and do something to change it. I spent all of last week in various degrees of dissociation. So, I wasn't able to ground myself then either. My brain (and body) just felt so scattered.

Hmm...ok...this sounds like something to bring up in my session today!

 

[Friday]

A hard slap across the face, or a hotel room. Or both. LOL. PlanA. PlanB.

Similar, I had a 5 hour drive -or train ride, depending on the day- between office & home.

 

[Sandstone]

How long did it take you to come back to yourself? I wonder if there is a way to compromise on the taxi idea. Would it have been enough to take a taxi to your first train?

I admire your determination in undertaking a journey like that. My longest trip has been a walk a bus a train and a walk, about 75 minutes. On one occasion, when I got to the last 15 minute walk home I was still so dissociated that my legs didn't work properly. I agree with you that more grounding practice is probably the way to go. I find it very hard to recognise how much I need it