Hi all…

I've been reading posts but been pretty silent for the past week. I guess I just wanted to post where things are at for me - partly to connect and partly to not just do this all alone in my head. But warning - this might be long and not say much...

I’m at a “short term residential” treatment place. It’s a 2-4 week program. Right now we have 2 weeks approved by my insurance and I’ve been here 9 days. We might be asking for one more week (for three weeks total) before I head back home. It depends how the next few days go and where I’m at come Monday or Tuesday of next week (and how much of a pain my insurance will be about it).

The place is a part of a larger hospital system. This treatment program has residential clients and just day clients. Since I am from out of state (2,000 miles away) I am residential – and even if I was local, I’d probably still be residential. There are about 15-18 people in the program during the day, (broken down into different groups) and then about 6-7 of us who stay past 3pm, overnight and on the weekends.

For me, it’s what I needed so badly.
Most everyone here has PTSD along with other problems. The “model” they work on is that here they do “stage one” treatment: learning skills to manage emotions and be stable and function in life – and to be able to handle the stage two work. Stage two is actual “processing” of the trauma, processing other issues, and “deeper work.” Stage three is less defined and harder to for me to explain right now.

I was doing what they would call “stage two” work, and totally crashed in therapy with a therapist who moved too fast too much… and I quickly fell apart.

There is a lot of very focused purposeful group therapy, art therapy, some issue specific groups – like disordered eating, or anger management… Most of the work is in group therapy. For me, I also meet with a “case manager” (i.e. a phd they call case managers to help emphasize “partnership” in the treatment) 3 times a week – and have “check ins” when needed (the staff is great!) to learn to manage and even better recognize feelings and emotions and thoughts… I also meet with a great psychiatrist who also does therapy 2-3 times a week and I have see the medical doctor and nuerologist while here too. The place where most of it is done is like a huge house. The treatment is downstairs and the upstairs are dorm style rooms.

It’s very much a program people have to choose to be in. They have clear boundaries and “rules” without being overly strict. We have free time and are allowed to do almost anything we want as long as it is not self or other harming in that time – and they constantly encourage us to be structured, and use the skills we are learning in the free time, and to connect with other residents. We cook dinner together every night and all the residents have an extra group or two at night and groups on the weekends (but the weekend groups are much more laid back.) In my free time, I have been able to travel into a nearby city, see the sights, and go for walks… They also have a small gym/yoga studio nearby they give us access to a couple times a week. All of the staff are people who have been working here for years and they actually do a pretty darn good job of coordinating things and staying on the same page with clients. I’m quite surprised.

The last 9 days have been amazing. They have been so hard and good and intense.

Part of my PTSD is related to abuse by someone who worked in a hospital – so hospitals are deeply triggering for me. When I began to get very dangerously unsafe, this place became the best option. Even being here – there’s been a lot to do to deal with it. Thankfully this place looks nothing like a hospital and operates very differently.

I came here as really the only alternative to inpatient – of which no one thought was a good idea for me and wouldn’t really provide what I needed. My case manager (psychologist who manages my care here) says I have really jumped in and made a lot of progress. I’ve faced seriously intense feelings and thoughts and emotions and been able to ride them out with no self harming or getting more out of control than crying (no angry outbursts or hysterical crying). I’ve had some numbed out moments and the staff has walked with me through them – when I finally risked to trust them enough to tell them and let them help me. Everything is very “skills” based and it feels so empowering - it's just where I'm at right now and kinda exactly what I needed right now. Just for now.

Even in art therapy the art therapist talked with me about how to use what I was learning to do in expressing emotion in a healthy way through art in other settings and at home.

The structure and the freedom and the skills and the support here has been just what I needed. I wouldn’t say I’m all ok. One thing they really emphasize here is that they can’t make all the horrible feelings go away – but in time they will get better and easier – and here you can learn and practice skills to manage it and endure it better… and they constantly focus on how to do this stuff and this work outside of here. They want everyone to move on to stage two and this is like a launching pad. They talk a lot of pacing the work and learning to self assess so you know when you need to slow down in stage two and when you can speed up. In some ways, it’s been very validating of what I thought wasn’t working with the former counselor I have.

My DBT therapist back home has been keeping in touch and talking with me every couple of days and I leave here a message now and then about how I’m doing and what I’m learning.

I have faced and been through some very serious and scary moments of being numbed out or flooded being here… Just being here is hard, and then facing my life and everything inside of me, and everything back home…

But the structure and the skills and the staff… they are pretty darn good at what they do! and somehow really helping me feel very empowered.

Empowerment and confidence - something I really needed so badly. I had no idea I would begin to restore it by coming here - to a very short term residential treatment facility.

I can’t quite express it – but in many ways, there is a bit more processing going on for me than intended. (and none of the staff here thinks it’s bad – a part of my ‘trauma’ is linked to hospitals and this has elements of that – doctors and they are close to a hospital that they do send people if they do become unable to at least commit to work with staff to stay safe and alive.)

I can’t put into words much of what the week has been like emotionally. I’m just here. Today alone has been super hard and very good. I walked through some huge triggers and learned how to handle them in a new way I had never tried before. And it took a lot of courage for me to tell the staff how triggered I was and they were wonderful – didn’t get reactive and didn’t invalidate or ignore – but just walked with me through it as we tried different things to mange what I was going through. Things they have said about PTSD and my “symptoms” and my emotions and my battle – have been really mind boggling. Really huge – actually pretty healing in some ways – in deep ways. And confusing.

I have about a week left here. We might ask for another, but we don’t know yet (and yeah, the uncertainty is awful.) My first time here was focused on just being here and working through being here and diving in and “settling in” to the program. The staff says I have done that very well – and my counselor back home says she is very proud of the work I have done. Proud. Whoa.

Now this next week is focusing a bit on what’s back at home and transitioning and working how to really go back and continue getting more stable and more stronger – to keep working on the stuff I have done here and move on and deal with the challenges at home.

When I started to un-package that today, I nearly came undone. For the first time in a very long time I wanted to die.

I’m scared to be here and so glad to be here.

I’m exhausted and worn out by the work here. At the same time, I have never endured this level of emotional pain and NOT self injured or melted down (including numbing out) in one way or another… until this week. At the same time, I miss home very dearly, badly want to be doing this work there and build on this. Yet I am scared of leaving here, scared of facing everything at home….

And when it all hit me this afternoon, I started to think of dying. It was momentary and I went inside and just told the staff I wasn’t ok. We didn’t talk about all I was feeling – I literally was so overcome I couldn’t even speak very many words. I was able to say I am so numb and yet so freaked out and I just am not ok. They helped me move through it and past it. It’s not resolved – but the emotional intensity is down. I can now put some of this into words… which is why I am posting here. I guess I just really needed to share this. I’m so worn out being here and so glad and so homesick and yet so scared to go home. I’m scared of me and losing the ground I have gained here. I’m scared of all I have to face at home. I know this weekend’s goal is to “put things away” as much as we can, the groups are about containment and helping there “be a time and place for therapy” and then to put the issues away… and yet still have support to deal with what comes up on it’s own (as it does for all of us residents here).

I think I just needed to say that. I’m so sorry for the mini-novel I’ve written here. I think I just needed to write this and not leave it just alone with me right now but at least post it here and connect here.

so sorry this is so long...