Talking Is Overrated

Three trigger dates fell within the same week this year in April. Easter is a kind of “floating” trigger date as it isn’t one of those holidays that’s nailed down to one particular day. I managed. I got through them. As always, I avoided as much as I could, distracted when I couldn’t, and coped when reminders triggered flashbacks or panic or whatever else. I’m told that’s all I can do. I feel numb, emotionless, and detached — not surprising for this time of year, especially not surprising for the month of April.

I’m convinced this is as good as it gets.

The final trigger date at the end of April passed much the same. I was supposed to meet with my case manager that day, but she called the day before to cancel again. I had an appointment with my counselor this past Friday — the day after that trigger date; but I didn’t even mention my son’s birthday. My biggest problem is that I avoid discussing these events in my life even when I know I need to. Rather, I opt to talk about trivial matters or anything else. This causes me to feel even more frustrated with myself as well as mental health treatment (obviously, considering my last post).

“Is there anything else major you think we need to talk about?” That open-ended question is daunting. It fills me with dread and panic, signaling the end of a session. Immediately an inner conflict arises as some parts express a desperation to be heard, demanding with urgency the chance to speak up, while others caution against saying too much. The fatalist cynic reminds me of the pointlessness of therapy as the paranoid social phobic sounds the sirens of compulsive distrust. All within seconds of each other, the final word comes down to the inner critic who demands silence, effectively shutting me up.

What actually comes out of my mouth in response is resigned exasperation of yet another wasted chance to talk with another human being about something more meaningful than the weather. What actually comes out of my mouth in response is the minimization of how I feel. Detracting from the complexity of my inner world protects it, protects each part of who I am from further humiliation.

What I don’t say keeps it locked safely inside, guarded against criticism of being overly sensitive or crazy or weird or any other judgement I’ve heard time and time again throughout my life because I know it sounds absurd. I know it sounds completely insane. Worse yet would be no one believing me should I disclose such an intimate detail of how I experience my life. The conversations within my mind have more value to me than conversations with other people. I’m convinced other people don’t listen anyway, whether it’s family, friends, or those within the profession of “paid-listener.”

I get that it “takes a while” to work through particularly difficult issues like what I’ve faced in my life. I know there is no simple, easy solution to working through past trauma or present difficulties. I need no one to remind me of that. It doesn’t help matters any to be shuffled from counselor to counselor to counselor or having no consistency in a treatment schedule whatsoever. The hopelessness of this situation was triggered at the end of my last counseling session when my counselor suggested that I switch to yet another counselor — someone I don’t want to see, someone I already know I don’t “click” with because she and I have met before.

After our session, my counselor asked me to wait in the lobby to meet with one of the care coordinators. As I was sitting there waiting, the conversation in my head debated wildly about the prospect of having to find a trauma therapist elsewhere. Starting over completely at a different facility entails a bigger change than simply giving up on treatment altogether. I waited until my counselor called her next client back and they disappeared behind the door. Feeling the familiarity of that trance-like disconnect, I impulsively gave in to the argument within my mind.

I impulsively gave in to the urge to flee and simply walked out — left the building, got into my car, and drove away.

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.

No One Believes Me

The disability hearing last Tuesday was terrifying. From the moment I walked in the door to the waiting area, it was all I could do to keep myself from hyperventilating. KR took the entire week off of work last week. He needed a vacation from his job, so he took it. This also meant he was able to attend the hearing with me. My disability advocate decided to use KR as a witness for my case at the last-minute after speaking with him privately before the hearing. I was asked to leave the courtroom during his testimony, so I have no idea what was said other than a couple of brief comments KR shared with me. Feeling a full-blown panic attack coming on as I sat in the waiting area while KR was in the hearing room, I retreated to the restroom to calm myself in privacy.

My disability advocate did a good job in working with what he had as far as evidence of my condition, but I got the distinct impression from the judge that she didn’t believe anything I had to say. She seemed exasperated, as if I was wasting her time. I struggled to answer the questions asked of me, fumbling over words, stuttering, and feeling so “on guard” that I failed to articulate clearly and concisely exactly what I intended to say.

I had no good answer for why I left treatment back in 2008 while previously on SSDI. I don’t quite understand it myself. I agree. It was a stupid mistake. When asked, I stated that at that time I was struggling to leave my apartment at all, let alone get to therapy appointments. I should have said that I took the break from therapy that I felt I needed to regain my bearings, but I didn’t. I couldn’t think straight. I told the judge that it was never my intent to leave treatment altogether. It just happened that way.

The agoraphobia and severe anxiety I developed while living in Nashville didn’t completely, magically disappear when we moved to Cookeville, either. I still struggled with these issues greatly after the move. It took me until July 2013 to work up enough courage just to seek out treatment again. Even though I had asked around prior to that for help in finding a treatment center, it wasn’t until then that someone at DHS told me where I needed to go. I’m fairly certain that neither the judge nor my disability advocate believed me when I told them I began treatment at PMHC in July 2013 (specifically, July 17, 2013 was my intake appointment). The records the court received began in November 2013, a full 3 months later! The discrepancy in records made me look like a liar.

Also, the judge questioned why my counselor and I agreed to terminate therapy in January of this year if I was still struggling so much. I interrupted her at that point (not a good idea, but no such agreement took place, and I panicked) telling her, “NO! I did not agree to anything. My counselor simply dismissed me from therapy with no further contact.” I also told her that I tried for months to get another therapist through my case manager to no avail. No one was listening to me then, just as I felt no one was listening in that hearing room.

And THIS is probably the main reason why I left treatment to begin with in May 2008 — feeling re-victimized and unheard by a screwed up mental health system. The worst part is I don’t know what would make it any better.

The fact of the matter is that the most damning piece of evidence against me in my attempt to get back on SSDI is that I failed to remain in treatment, regardless of the reasons. It feels hopeless that this judge saw anything other than that. It feels hopeless that neither the judge nor my counselor nor KR recognize that I am seriously struggling right now to keep my head above water in the kiddie pool, let alone swim out in the ocean with everyone else! Even if I did get back on SSDI, there’s always the possibility that I could simply be rejected from treatment again like this past January, causing me to lose the SSDI yet again.

STOP!

My disability advocate made a few good observations in his closing statement. I don’t do well under pressure or with change. Feeling pressure causes me to shut down, retreat to my mind for solace. Change sends me into a panic, causes everything to feel out of control and overwhelming. He said that I have managed to create a home environment that feels safe and manageable, where I am able to do what I need to when I need to in order to manage the symptoms of my illness and to maintain, at least, some control over my mental health.

I was only able to do this by taking the time I needed while on disability to figure this out for myself — without the influence of constant pressure and feeling bombarded by outside sources. Receiving SSDI gave me the chance to catch my breath after years of chaos and constant overwhelm. I haven’t figured out how to do that in the “outside world” yet. I need more time to figure out exactly what will work for me so that I can use my talents and abilities to the best of my ability and provide an employer with a stable work flow. I’m just not there yet. I apologize for being so slow, but pressuring me to “hurry up and get better” sure as hell isn’t helping. The pressure I’m feeling from everyone around me is only making matters much worse!

Right now, my self-confidence is shot. I’m coping to the best of my ability, perhaps not in the most healthy manner, but coping nonetheless. I feel helpless, like my life is in the hands of people who couldn’t possibly give a rat’s ass about my well-being. I’m scared. I’m frustrated. I’m overwhelmed. And as always, I don’t know what to do with any of it except block it out, distract myself, or self-soothe.

— C’est la vie. —