IOP: Intense Outpatient Prison

M.D.D., D.P.D., G.A.D., P.T.S.D., I.O.P., C.B.T., D.B.T. . . .

W.T.F . . . ?

The evaluation process was daunting. As someone for whom sharing my life story is a particularly difficult feat, having to do so in an environment where the man opposite me was being paid to find something wrong with me made the circumstance all the more difficult. This is one instance in which my hard-headed, passive-aggressive, personality did not do me well in the least bit. However, I powered through, and was as open and honest as I could.

Per recommendation of my assessor, this past week I began an intense outpatient program (IOP) for teens “at risk” of committing suicide. The program entails three days of three hour group therapy sessions a week, with other kids my age who also struggle with suicidal ideation and have histories of failed attempts.

This wasn’t my first choice, as I would have rather stuck to regular outpatient services, but it’s where I ended up; and, after just my first week, I’m starting to think maybe it is where I belong. Even if just for now.

Overall, it has been a lot to take in, in such a short period of time. I found myself stuck in emotions I just couldn’t shake – a lot of sadness and frustration being brought to the surface, and the changes in services only added to the stress on my mind and body. In fact, a lot of my sudden emotion was a result of not knowing how to deal with this new set of circumstances, and constantly being exposed to three of my least favorite things in the world: being labeled, adults who think they’re above teens just because of the age gap, and people who pity themselves constantly. And, to no surprise, I was met with all three in my first day at IOP.

Immediately upon my arrival I went to see the psychiatrist for my initial medication management appointment. And Dr. Asshole was quite the treat. He called me his “puzzle,” for my lack of usable answers left him fishing for labels – I walked out with a few more tally’s on the board – I’m now at four: MDD, DPD, GAD, and PTSD. For those of you who are not psychiatry scholars, those are abbreviations for Major Depressive Disorder, Dissociative Personality Disorder, Generalized Anxiety Disorder, and Post-Traumatic Stress Disorder. And, no, even after months of some of them, I still have not a clue what any of that means! All I know is I walked out with a list of questions flowing through my head longer than my weekly grocery list. Overwhelming to say the least. Blackburn really threw me for a loop, though; as much as I disliked his demeanor, I’ve never had someone spit my crap right back at me before . . . He definitely listens, he definitely cares; yet, he challenges me in a way I’ve never been challenged. As frustrating as it is, I think maybe I need someone to be tough on me for a change – I need someone to beat this shit out of me. For once in my life I want to get better, and I know I can’t do it on my own. He may be an asshole, but he cares, and I guess that’s more than I could have expected. 

After meeting with the psychiatrist, I made my way into the group therapy room for the remainder of the session. Sitting around a large table was seven girls and a program therapist. The therapist quickly explained to me the “rules” of my stay, much as a dictator warns his enemies of the circumstances under which he will make his move to annihilate them. “No phones, no suggestive language, no making friends, and absolutely, under no circumstances, may you share anything personal about why you are here. . .” It was definitely one of the more intimidating moments I have experienced thus far in my life. Pet peeve number two: adults who indulge in superiority, is in full-effect. One would think it couldn’t get much worse, but, of course, it did.

That left only one more: self-pitying peers . . . Yeah, it’s safe to say it was not my day. 

Just praying I’ll get out of this intense outpatient prison sooner rather than later . . . 

I Will Survive. 

Blind-sided.

That’s all I remember feeling as I sat opposite my high school principal just two short weeks ago. Come to think of it, that doesn’t really say much . . . I don’t think anyone ever really imagines themself being accused of being mentally unwell enough to cause concern. That, in itself, would be rather concerning. However, there I found myself; stuck in a position I’ve faced too many times to count, yet this instance felt different. It’s like the air that filled the office got thicker with every lie I let slip through the fake smile spread across my lips – enough so that I had no choice but to choke on my own words . . .

“I’m fine.”

*cough*

“I haven’t done anything to hurt myself . . . I haven’t even thought about it . . .”

*cough* *cough*

“Of course I haven’t thought about suic . . .”

*cough* *cough* *cough*

“I’m sorry. I meant yes. Yes, I’m not O.K. Yes, I have hurt myself. Yes, I’ve thought about, and made plans for, how I will end my life.”

To no surprise, my suffocation lifted and the cough subsided . . .

Consequently, my biggest secret also laid in front of me in the form of my binder of TeenThoughtSpot posts – the only place where the darkness within me has ever made its way into the light. As she leafed through the pages, I felt my stomach drop a bit more with each turn until she finally reached the end. The relief lasted a mere second before I realized, laying right before her very eyes, was the worst possible thing she could ever find:  a note I had written to my mom . . . a note that explained it all.

As the consequent events unfolded, hours turned into days. One moment I was watching as my parents received news of my struggle from a monotone stranger, the next I was sitting in the emergency department waiting room of a local psychiatric hospital, waiting for some creepy old doctor to determine my fate. Once it had been determined my desire to die was not of critical necessity, they let me go. The relief I felt as I collected my belongings and exited the building, was greater than anything I had ever in my life felt. What I didn’t know, is that not being admitted inpatient did not mean everything was a-okay. Ahead of me would be an intense few months of figuring out who I want to be, and how I will get there – what will be only a mere step in my long-drawn-out journey to recovery.

For now, I’m just here – and for what I’ve dealt with, I would have to say that’s a hell of a good start. Since that fateful day, I have been forced to live on the fine line of being totally understood and an object of misinterpretation. In every circumstance, I’m met with an elephant (or, perhaps I am the elephant) in the room. The constant stares, the people not knowing what to say . . . heck, sometimes I don’t know what to say . . . It’s hard for anyone to deal with thoughts of suicide, but when you’re forced to walk around with a label slapped across your forehead reading: “high risk,” it makes you start thinking maybe, just maybe, suicide is a valid answer after all.

Though it may be a valid answer, I’m going to fight like hell until it isn’t mine. If there is one thing I have learned these past few weeks, it’s that the only way you’re ever truly getting saved is if you get up off your ass and do it yourself. There has to be a point where you realize enough is enough – there needs to be a desire somewhere inside to get better. You can’t simply rely on other people to guide your healing, especially if they aren’t aware of the depths of your hurt. You need to find a want to get better, and you need to do it on your own.

One of the best pieces of advice I received this week came in the form of a self-care booklet placed in the waiting room of the clinic where I have been receiving my intense outpatient services. The front cover read:

“I lied and said I was busy. I was busy; but not in a way most people understand. I was busy taking deeper breaths. I was busy silencing irrational thoughts. I was busy calming a racing heart. I was busy telling myself I am okay. Sometimes, this is my busy, and I will not apologize for it.” 

This has been my “busy” for quite a long time, and will probably remain such until I’m able to look back and say I’ve finally won. Until then, I’m going to do what I have to do to stay alive, no apologies needed. This is me; I will survive.

Looking Back, Moving Forward

I don’t believe in the celebration of New Years. 

Call me crazy, but I just don’t understand the hype behind watching a ball drop in symbolism of what many falsely believe is a “new start” – an opportunity to leave the past in the past. As I scroll through social media, it is filled with people ‘hoping’ for a new year better than the previous, and it takes everything in me not to comment some passive aggressive comment telling them unless they work for it, hoping won’t do much to bring them the health and happiness they feel they rightfully deserve as members of the human race. 

Sure, there are those who take steps toward change and at least devise a resolution, but how many of those same people actually follow through…? I’ll save you the trouble and tell you that an estimated eight percent of people who make a resolution each New Year’s Eve actually go on to achieve their goals. That’s right, only eight percent of people who recognize a need for refining in their way of life actually go on to make the desired modifications. Why, though, is it so hard for us to commit to this goal for ourselves, when we so effortlessly commit to all the things we’re better off without? 

My theory is simple: timing. 

I wasn’t always such a grouch around this holiday. Up until the past few years, I used to really enjoy the idea of ringing in a year of new opportunities. The thought of a fresh start was healing to me as I was first beginning to explore the depth of my anxiety and depression, eager to overcome obstacles quickly, and return to a normal lifestyle. I made resolutions each year ranging from being honest about how much I was struggling to actually attempting the medication I had been refusing for months, and like many others around the globe, I lasted just shy of a week every year. It was frustrating. Each year I felt more and more like a failure for not meeting my goals, when in reality I should have beaten myself up less about that, and more about spending 3/4 of the year sulking, waiting for another ball to drop from the sky and tell me I need to make a change in my life. 

Up until this past year, I’m not so sure I knew a fresh start doesn’t always begin on that first day of the year. It wasn’t until a heavy resolution to not attempt suicide came crashing down at my feet that I realized I couldn’t live like that – that I needed to make that promise to myself as something more prominent than a half-hearted attempt at making a change, if not for myself, than for my friends and family. That realization came after an attempt on January 9th, just nine days after I had vowed, under a shiny ball dropping from the sky, to carry out that very same promise. . . So what, in that moment where I had the choice between life and death, made me choose life? What made that decision suddenly make so much sense? What made making that promise to myself suddenly have meaning? 

It’s all about timing. Just as a person wishing to lose weight doesn’t have the drive to do so until they step up on the scale, I never really saw a reason to fight for life until I saw how easy it was to die. A week after the festivities had ended, my promise to myself was just beginning; an undertaking I truly needed to hit my lowest point in order to find my own motivation to fight back – and I’m glad I did, because, yeah, I’ve made my fair share of mistakes this year, some worse than others, but with each one I found the courage to get back up, dust myself off, and learn from it. This year, the extent of my progress in the content area of self-growth was exponential. I’ve done so much I never imagined possible, and probably wouldn’t have been, had I not taken the innitative to refine and improve my life, even after screwing up my initial resolution. 

So, no, I don’t celebrate New Years by making a half-hearted goal for the coming year, or hoping it will bring me all the health and happiness I deserve. For me, tonight is just any other night – tomorrow is just any other day; and, when the time is right, I’ll be here, ready to make a change in my life. 

Happy New Year. 

Healing the World

One of the first things people tell you when you have any illness is that they are “there for you” and “you won’t have to go through this alone.” These people, they mean well. So badly, they wish to rid you of the unbearable weight you have been forced to carry. Some may go as far as believing they would, if granted the opportunity, open themselves to carrying some or all of your load because they can’t stand to see how weighed down this life has made you. 

I’ve found, however, with every encounter with these phrases, a diminish in their value. It may be because the stigma of mental illness makes one who has never experienced it doubt its validity as a cause of excruciating pain, or simply it may appear an endless battle which they are unwilling to commit themselves to watching someone struggle with day in and day out, for as long as it may take to retain control of their minds to a point where they’re in the driver’s seat. 

Regardless of the reasoning, or intended motives, behind the meaningless words mumbled in the face of the uncomfortable encounter, there is still a living, breathing, individual putting themselves, and their inner struggles, out there – asking for help – looking for understanding. I wish more people would see this starting of a truly difficult conversation as more of a privilege, and less of a burden. I don’t understand how you could take for granted this opportunity to instill even the smallest bit of hope, trust, compassion, and love in another human being. I don’t understand how one can allow themselves to sit passively as another weeps the sorrows of their heart. I don’t understand how your heart doesn’t break in the least bit when you hear of how cruel this world can be. I just don’t understand. 

So, how do we fix this? How do we take a world of people hardened at the core and breath love in their bones? How do we teach compassion and empathy to generations who were bred with the survival of the fittest mentality? How do we bring the broken back to life? Can we…? Or are we all to far gone? 

We need a miracle, and we need to be a miracle to others. We need to adopt the ways of our youngest civilians – living with child-like faith and a belief in the power of never ending love. We need to look within the darkest parts of our own beings, and find the power to forgive and move on. We need to find the path to honesty with ourselves, and with those around us. We need to find out who’s lives we were put on this earth to touch, and we have to live out our divine purpose of this life. We need to get over our self-centered ways; we need to come together. We need to get through this. 

This is beyond my own struggles, or those of the mental health community. This surpasses that of the sick, the grieving, and the broken-hearted. This is about seven billion people simultaneously taking off their blinders to see what life is really like. . . To see how broken we have become. This is about a world of people choosing to “love your neighbor as yourself.” This is about growth; this is about change; but, most importantly, this is about healing. 

And, it’s about time we do. 

Breathing in the Sunrise

I woke up on my eighteenth birthday to watch the sunrise from the front of the ship. I sat, wind pressing hard against my face, dark ringlets blowing in the wind. My eyes got heavy with tears; I couldn’t help but smile. 

I never thought I would make it to that moment. I never truly believed I would make it as far as to celebrate eighteen years of life on this earth, but, somehow, I did. A small feat compared to the uphill battle I am to face on the road to many more; yet, in that moment, I felt for the first time in a long time a sudden urge to keep going. If only to see the beautiful paintings of the rising sun, I found something worth fighting for – I found a reason to keep on living. 

Cracking through the darkness, streams of purple fill the open skies. Quickly overtaken by a bright light in the distance, they form a beautiful swirl of stunning shades of violet and orange. 

After countless years of living in a constant shadow of who I was expected to be, I’ve become so accustomed to the gloom of disappointment, of never being enough. Blinded by a past I believed defined me, never could I imagine a future for myself beyond the pain of the temporary. In the extraordinary, I found no hope. Before that morning, the pastels of the early morning sky fell to my ignorance, little did I know what symbolism blossomed in that breathtaking tye-dye sky. 

I sat silently, watching as the sky erupted with color before me. Just as quickly as it came, the color faded, leaving only a calm blue in it’s place. 

Life is like a sunrise in that living in darkness is always a choice. You can choose to live your life with the ideal that there is nothing to look forward to, or you can go out there and fight to find something you’re passionate about – something so captivating you can find strength to fight another day through the darkness just to have another opportunity to reach that point where you’re able to find purpose in this life – in your life. 

I closed my eyes, and placed my hand on my chest. Listening to the beat of my heart, all I could muster was a soft: “I survived.”

One year; one month; one week; one day; one sunrise at a time . . . I survived. 

An Open Letter to My Abuser

To the man who changed my life:

Condemned to silence for far too long, I’ve begun to investigate the broken pieces you left behind all those years ago. The aspects of an eight year old girl that were ripped from my grasp – taken too soon – leaving me so empty, devoid of any purpose in this world. 

Consequent to your actions, I have lost not only faith in human kind, but all these years to my life spent struggling to overcome the engulfing affliction your egocentric manipulation has left on my once innocent heart. I have experienced a beytrayal of trust in the most indecent of ways; to confide in others is implausible. Braving each obstacle as would an unaccompanied soldier rushing into unfamiliar territory, I have become indubitably well-versed in concealing the parts of me which ache deep in my bones with both remorse and trepidation.

In behalf of your self-pride, my own has taken a spin for the worst. You saw me as an entity for your indulgence; a mere object of recreation. You dissipated the purity I embodied, and managed to diminish my value in the process. Debilitated and weary, I fight to advance to a place in this life where the trauma I have endured at the hands of your selfish ego is no longer the tag line. 

I have spent the last ten years aspiring to consign to oblivion. To believe that it simply didn’t happen to me – that this ghastly abuse could not have possibly taken place. And, every once in awhile, I still contemplate my minds ability to fantasize such a cruel course of thought, though I know what occurred is very much real, and therefore a significant component to the development of my often cumbersome anxiety.

The most considerable of burdens I have been left to bear is you. I cower at the thought of your living a life unobstructed by the consequences, or even guilt, of your crime. I find bewilderment in knowing that my decision to neglect closure for the sake of my own prosperity could ultimately be the cause of the victimization of others’. 

I anathematize you. 

Mr. Abuser, you ruined me. Beyond damaged, You’ve annihilated my childhood, and infringed on my future. You’ve broken my trust, and rid me of any and all courage and poise. In the course of one year, you’ve createdan upheaval continuing to unravel nearly ten years later. I’m hoping that I will one day look back on this situation as a blessing in disguise, but, please remember that one who forgives will never forget. . .

I will always have your name etched in my brain as the man who changed my life forever. 

Never again yours,

A distraught victim 

To You. . . 

You’re lonely. You’re sad. You’re angry at the world.

Misunderstood is an understatement.

To the you who watches as the days pass, and the seasons turn; to the you who watches this life slip through your fingertips like quicksand; to the you who is waiting on a sign – something, anything, that will sooth the pain. This is to you.

Day after day, the heartache builds. The weight of a life of hardship weighs heavily on your already burnt out body. Forced to tip-toe around your life, unsure of what may be around the corner, you find yourself craving recklessness for the control it bears. It starts off innocent; you find satisfaction in “beating” depression and anxiety in their own game. You realize that by becoming your own worst enemy, no one can hurt you worse than that which you inflict on yourself. Over time, the harmless name calling in the mirror turns to self-inflicted harm, and eventually to thoughts of the world being better off without you, and actions which reflect this. 

The world would not be the same without you in it.

You beat yourself up. You let your illness pummel you around like a punching bag; but, I’m here to tell you it’s time to fight back. 

I know you’re tired and you’re frustrated and you’re sad. . . I know some days just breathing takes more energy than one would like to admit. . . I know you want to wave your magic wand and make your sufferings fade away. . . It’s tough, I know. . . 

But, you are strong; you are loved; and, you are worthy of your future beyond the realms of suffering with mental illness. 

Please know, if no one else, I believe in you. You and I, we are the fighters; together we will conquer this battle – we will earn the life we so desperately deserve. 

Six Hours

It was 11:27 when I climbed in my SUV, and slammed the door shut before pulling away from the curb. At about 11:28 I found myself sitting at a red light – screaming obscenities, tears flowing like waterfalls down my cheeks, my thoughts so clouded I couldn’t take a breath. 

I walked in the door to my mother’s sternly pointed finger directed straight at me as she yelled for what felt like an eternity , but her words remained transparent to my already racing mind. I stood there motionless, emotionless. My body and mind conflict as I draw the covers over my body, shaking fiercely to the rapid beat of my heart, while my mind remains of such ease. 

I don’t remember how I made it home last night, or what exactly triggered the panic attack which created such an emotional upheaval. I wish I could say this hasn’t become my normal, that I have become strong enough to deal with the scary thoughts on my own without reacting in such a juvenile manner. I wish  I could say I have the power to “just snap out of it.” I wish I had the words to explain what’s going on in my head when my body breaks down, piece by piece. I wish… I wish I knew why. I wish I knew why me? Why now? 

I woke up this morning: circles around my eyes, a stuffy nose, and an exhaustion running from head to toe. Six hours earlier, I believed the overwhelming emotions who told me I don’t deserve to live. Six hours earlier, I honestly saw no reason to keep going. Six hours earlier, I almost made the decision to succumb to the lies depression and anxiety have told me. But, ultimately, six hours earlier, I decided to live. 

Six hours. 

Breaking the Silence 

My mom called me a liar, and my dad had no words at all. They both looked at me with fear-stricken faces, eyes welled up with tears. 

In the two months since, I often find myself thinking back to this moment – the moment I finally told my parents about the sexual assault their then seven year old daughter fell victim to ten years prior. I had always imagined this would be the moment I would rip off the bandage and sport a fresh scar as a small reminder of a wound now healed, but it had quite the opposite affect when it instead revealed a wound which remained  very much open and uncleansed. 

Having only been seven when it happened, I never quite processed the magnitude of what occurred until years later; Still, I subconsciously felt the effects from that day forward. The dismissing of physical affection, the lack of emotion, the fear of men, the inability to trust, and maintain a relationship at even the most basic levels. My abuse robbed me of my childhood, and turned me into the tin man no one would have ever expected. 

Ten years I went without telling a soul, but when an unexpected trigger brought about flashbacks from the worst time in my life, I couldn’t keep it in any longer. Telling people made me feel dirty. It made me feel like I did something wrong by letting this happen to me, and as if I was hurting those around me by waiting so long to bring it up. One moment I had all these emotions bottled up inside, and next thing I know they’re overflowing all around me. I was drowning, but all everyone around me cared about was that I take the man responsible down with me. 

My mom called me a liar, and my dad had no words at all when I told them what had happened that night. I remember his eyes welling up with tears, and the shear terror spread across her face. I remember the disbelief and the uncomfortable silence which ensued for the weeks to follow. Sometimes I wonder if I should have remained silent just a little bit longer. . . 

National Day on Writing 

Writing saved my life. 

I was 14. Barely a teenager, and not yet in high school, I had already endured more than I would ever wish on anyone. My parents recently divorced, I fell victim to the isolation associated with having narcissistic parents. I sat at my mom’s bedside after a series of car accidents left her dibilitated, and I cried and I prayed that she would take her survival as a sign, and choose life. So may times I saw and experienced things no innocent child wants to believe is real. But that’s just it, at 14, I wasn’t really a kid anymore. . . I had to become the person my family needed me to be. . . I had to grow up too fast. 

The first time I ever picked up a pencil to write about my life was after my mom’s second car accident. I remember walking in the room to see her and she bluntly told me she wished she had died that night. I still can feel my stomach drop every time I think of that moment – the moment Suicide became an answer to a question I didn’t even realize I had been asking myself.

I remember the picture on the wall, and the ways it’s colors blended together when my eyes welled with tears. That night, and every night since, those colors are what I see before I fall asleep. The deep greens and oranges of the limitless field of flowers blending into the pale blue sky. I’ve drawn and re-drawn this image over and over in my head, every new sketch more realisitic than the last. 

That night, I sat in my bed totally numb. I hadn’t anymore tears to cry, and not enough energy to give a damn about another day.

I wanted to die.

At about 3am that night, I started drafting my Suicide note. I never imagined it being so difficult to say goodbye considering how difficult it is to live every day through the pain, but I couldn’t find the right words. I started off by saying how much pain I was in – explaining the heartache of watching your own parent lose the will to live. I wrote about my own suffering from a past I’ve kept masked for much too long. I poured my heart into this – I wanted people to know how much I had been suffering in silence while everyone demanded their own attention. And, when I crossed all my t’s and dotted my i’s, I looked it over and realized all I had written is in the past. Writing was like releasing a debilitating burden from my shoulders, and it became an addiction. 

From that day forward, I’ve kept journal after journal of filled pages. Of stories of heartache, loss, sadness, and hopelessness, but also of hope, triumph, and happiness. 

I’d like to say that writing made me better; that it took the scary thoughts away. I want to say I haven’t attempted, and I’m recovering from the mental scars. I want to say that I’m O.K. now – so desperately, I wait for the day I’ll be O.K. . . . 

Four years ago, writing saved my life; and, today, it’s still helping me to fight to keep on living.

Happy National Day on Writing.