Facing An Important Decision

Today, I find myself reflecting on a past decision to leave mental health treatment back in 2008, ultimately the decision that cost me SSDI and Medicare health coverage in January 2013. Granted, it wasn’t exactly a “conscious decision” to leave treatment. A series of events led to a state of overwhelm and dissociation that prevented me from leaving my home — a state of agoraphobia that lasted from mid-2008 up until the time KR and I moved to Cookeville, TN, in May 2010.

I still struggle with this today; but by June 2008, one missed appointment left me in the precarious position of walking away from treatment altogether. I never returned to Centerstone where I received care from 1998 through 2008.

I never even considered the consequences. I just didn’t go back (much like the last time I was employed, a coincidence that only occurred to me today). I was so frustrated with the roller coaster ride that was (and still is) mental health treatment that I simply gave up.

Today’s reflection was triggered by a phone call from my disability advocate. It was over a year ago when we last met to discuss appealing the judge’s unfavorable decision. Honestly, I thought my disability advocate and I had agreed to drop the claim because the entire process was triggering way too much for me. He apparently filed it anyway because I received another denial letter from SSA in regard to that appeal around the end of February. He finally called about that denial letter today.

The only other options would be to either take my case to Federal Court with the help of an attorney, which he basically led me to believe is impossible, or to file a completely new claim.

No.

I’m done.

It’s OVER.

Before we said our goodbyes, he reiterated something I heard him say in the courtroom. He said that I’ve ordered my life within certain boundaries to maintain my mental health; but he feels that I would not be able to consistently maintain employment within those boundaries while at the same time managing my mental health. He knows that as well as I do, as well as KR does, yet convincing a judge of that when my own treatment team doesn’t even believe it… well, that’s another story.

My present situation with regard to treatment at PMHC is no better than Centerstone in 2008. I’ve basically put myself through hell again for the last 4 years… for what?

I’ve made no progress. Far too many of my symptoms have only worsened over these last 4 years rather than improved.

PMHC has me so confused that I don’t know what to make of it. I don’t understand the practices of this facility. I’ve met with the new counselor 4 times. I don’t feel like I’m building a rapport with her. Appointments are brief and feel rushed. This last appointment on Friday barely lasted 20 minutes, and we didn’t talk about anything of substance. My bad. That connection isn’t there. I’ve lost trust and faith in this treatment facility. It’s not like I had much trust and faith in it to begin with.

At the end of that appointment, my counselor told me I needed to meet with a care coordinator.

“Wait, what?”

She explained that care coordinators are there to “check-in” with clients while at the facility. I thought that’s what case management was for! Why is my case manager visiting my house every month if not for this reason? My frustration bordered on rancorous spite.

“Remain calm. Jump through their hoops.”

She ushered me into this nameless man’s office. Neither my counselor nor the care coordinator told me his name — no introduction of any kind.

“Yep, manners are a thing of the past.”

“Lose the sarcasm.”

“Nope.”

I felt stubborn, deciding then and there that I had no desire whatsoever to cooperate and zero patience left for idle chit-chat.

“Short answers. Don’t bother hiding your indignation.”

After he finally finished asking all his questions, I asked if I would be meeting with him regularly in addition to meeting with my case manager. After all, they basically have the same exact job, except my case manager meets with me at home. He said, “Nope, I’m just for check ups,” whatever that means. It feels redundant and unnecessary. It seems like a waste of time and money.

Maybe all of it is.

Throughout 9 different counselors and therapists over more than 22 years, I’ve questioned the process of therapy relentlessly — wondering how is this supposed to work, wondering what exactly am I supposed to be talking about? I need direction from a counselor. I need a little push every now and then. I avoid anything that’s uncomfortable. It’s how I cope with life. Give me homework. Give me art prompts. Give me writing assignments. Give me something, anything, we can actually discuss that moves me forward and helps me face what I’m actually there to work on!

I’m out of patience. I’m frustrated. I’m contemplating walking away from treatment again because I have no desire to continue wasting my time. I know I am ultimately responsible for efficiently making use of my time in the counseling room; but counselors also have the responsibility for directing clients in the most productive use of our time.

Maybe I’m just triggered from today’s conversation with the disability advocate, but I have to decide what is best for me and my mental health. I’m just not sure what that is anymore, and I’m definitely not convinced that the facility where I receive care is even a “good” choice, let alone the best choice.

Patience Is Not a Virtue I Possess

Perhaps the thoughts I’m going to share tonight are best left unsaid. Then again, it could be said that anything we share, whether verbally or through writing or on the internet, with others has the potential to create a ripple effect that causes even the slightest change for the better. Who knows? And does it really matter, anyway? What is, is.

I could have written about this earlier, but I chose not to because I give 3 chances to people before I make a judgement call. My case manager has missed our last 3 scheduled appointments, in a row. The first, she said, was due to a crisis emergency of another client. That’s understandable, though, I have to admit that even with the first missed appointment I felt like a courtesy phone call would have been more responsible than having just not shown up at all.

The second missed appointment was the rescheduled appointment after the first missed appointment. This second one, I gave her the benefit of the doubt because when she called, she woke me up. Since I wasn’t quite awake yet, I thought I could have simply mis-heard or not remembered properly the date on which she rescheduled our appointment. I called her the following Friday and left her a voice mail to find out what was up. When she called me back, she told me she had our appointment written down for the following Wednesday, even though I seem to remember her saying during that wake-up-call, “How about next Wednesday at 3:00?” (Not two weeks away.) However, she did come to see me after that phone call that day.

And then, there was today. Again, our appointment was set for 3:00 pm today; but she didn’t show up. No phone call, nothing. There’s no disputing the fact that my appointment card says 6-6-14 at 3:00 pm. I waited around my house until around 4:15 pm. I had to run a couple of errands and felt that waiting any longer was a waste of my time. No missed phone calls; no messages when I got home. Fine. Whatever.

Should I say something? To whom? Would it even do any good?

I’ve been at that “why bother” level of frustration for so many months now that I fail to see the point in complaining or even bothering to stand up for myself. I’m struggling to understand: Is it just me? Is this the “normal” level of care by this facility or case management, in general? I had case management once before in Clarksville, TN, briefly; but it was so different from what I’m experiencing here in rural “‘Merica.” Should I be upset over these missed appointments? Or am I overreacting?

Yes, I’m angry. Yes, I’m frustrated. Don’t schedule an appointment with me and then, not show up or even call to let me know that you can’t make it. That’s unprofessional! It’s irresponsible. How am I supposed to take this case manager seriously after 3  missed appointments? I’m trying very hard not to take this personally, but why shouldn’t I? Dammit, this is the 3rd time (in a row)! This does not feel like a coincidence. This feels like a test. A test of my will. A test of my character as a person. A test of my patience.

And right now, I have very little PATIENCE! I have no patience for games. I have no patience for drama. Drama is for TV shows and movies, NOT “real” life. I’m seriously at the point of dropping out of treatment again because – this – is not helping.