On the “Bad Days”

I’m going to be completely honest with you: I’m struggling today. I’m struggling in just about every area, actually. I’ve been trying to write a post for about 4 hours and I keep just erasing and ending up staring at a frustratingly blank, glowing screen. My day has been all over the place – I started out energetic and unfocused and am now a ball of irritation and negative self-talk. And I almost used that as an excuse to avoid posting. I actually almost used it as an excuse to avoid just about everything today. But here’s the thing about emotions – they are information.

If you’ve ever done cognitive therapy, maybe you’ve heard that before. Emotions are neither good nor bad, they are just information. IN reality, this is the cycle that occurs whenever we feel anything. Something happens (internal or external – some event occurs), we interpret the event, have thoughts about the event which cause emotions, which then lead to action. Often the line is blurred or the thoughts turn to emotions which turn to behavior so quickly, we don’t have time to process what’s happening, so we just link an event directly to an action and label all thoughts and feelings that happened between the two “good” or “bad.”

One behavior with which I struggle a lot is “shutting down.” I start to feel angry or threatened or hopeless or overwhelmed and I just say “fuck it” and stop engaging with people. This is problematic when you’re in crisis treatment, because you kind of have to engage both with your treatment team and the “natural supports” in your life if you want to get stabilized, and then stay well.

A friend called me earlier and left me a voicemail saying she “just wanted to check in”, I didn’t return the call. (Sorry!) My Uncle texted me to see if I was available for a phone call. I didn’t text back. (Again, I’m sorry.)

See, I’ve been struggling with this thing that might seem a little obvious – crisis stabilization treatment is, by nature, short term. It’s not establishing a long-term working relationship with therapists you’ll be seeing for months or years. For me, it was a week in the hospital with one team, a week of partial hospitalization with one case manager, three weeks of partial hospitalization with another case manager, and now I’m nearing the end of my intensive outpatient treatment with, you guessed it, another case manager. Now, I knew all of this from the outset. So, my initial reaction was to just buckle down, do the homework, and not get too invested in “trusting” the providers. (That’s Trauma Brain 101.)

The thing is, my second case manager in the partial hospitalization wasn’t having it. She called me on my shit. She interacted with me in a way that built trust almost immediately. And I started to open up. I don’t want to overstate this, but it was the first relationship, professional or not, in which I felt absolutely no need to sensor myself. There was no judgement, not even a distorted perception of judgement on my part. This woman is, truly, phenomenal at what she does. Once I started being open with her in our one-on-one meetings, that trust bled over into the groups she was facilitating, which then built trust in the other participants and allowed me to be open and honest in every group. Here’s the thing about being honest and making progress in crisis stabilization, though – it means you “graduate” and move on to the next phase of treatment quickly. Which, while objectively is “good”, means an end to that very short lived but incredibly impactful professional relationship.

Now, Trauma Brain says “What the FUCK? I trusted you and I opened up to you and now you’re gone!” (Even though I knew the relationship would end quickly before it even started.) And then Trauma Brain says, “IOP is even shorter than PHP, why would I engage fully with this new case manager?” Because Trauma Brain is a pain in the ass and doesn’t want to get better because the walls that are up, the habits that are now maladaptive, once kept me feeling safe in what was a very chaotic and dangerous environment. And Trauma Brain thinks these walls and protective measures are still necessary even though they are messing up my ability to be a fully functioning human.

So, the “event” for my struggles today was realizing how quickly I’d be moving on from this wrap-around support I’ve had for the past month and a half. My interpretation of that is “Well, I’m never going to have a long term relationship that actually allows for trust and safety” and “These case managers don’t actually give a damn about me anyway.” (this is, objectively, not true, but it’s where Trauma Brain goes, and sometimes, with Trauma Brain, so goes my Nation). Then begins the spiral. The negative self-talk: “I don’t deserve support.” “I’ve never had support in my life, why would I have it now?” “I’m a piece of shit and I will always be on my own because of that.” “I’m better off on my own, anyway.” The emotions: feeling neglected, hurt, angry, scared, defeated, etc. The behavior: shutting down.

So my job is two-fold. In the immediate, I need to challenge that spiral of self-defeating thoughts which lead to me shutting down and not even wanting to write a blog post (which is exactly why I’m writing a blog post). In the long-term, I need to challenge Trauma Brain. To acknowledge it, but gently explain that we’re not living in that chaos anymore. Because Trauma Brain is really just the scared little kid inside of me who never got the reassurance and stability and consistency she needed to feel safe and secure. It’s now my job, as an adult, who’s starting to recognize these patterns, to hold that little girl’s hand and tell her “Everything’s going to be ok. You can trust people. You are not ‘bad’. You do not deserve punishment. You are as valid as anyone else.” It’s the idea of parenting your inner child. It’s way easier said than done, of course.

It’s being mindful or my thoughts and feelings, but not giving them control over my actions. It’s being willing to be curious about them. It’s recognizing that I’m angry and I don’t know why, but rather than throwing a chair across the room and screaming “Fuck it!” and dis-empowering myself by giving that emotion free range to dictate my actions and outlook, sitting with it (even though it’s uncomfortable) and being curious about it and digging into it to see exactly where it is coming from and what it’s trying to tell me.

It’s telling myself that, yes, I will be finished with Intensive Outpatient in as soon as 5 days, but that doesn’t mean I shouldn’t be open and honest with my case manager there. It’s reminding myself that I have, now, for the first time ever, felt what it’s like to be able to be completely honest and open without holding back anything out of shame or fear, and that means I can do it again. In my personal relationships as well as in the longer-standing professional relationships I will develop with therapists and doctors. It’s being willing to look at myself instead of my environment and recognizing that I have the power to react as I want, that I have autonomy, that I have control over myself and that I don’t need to be at the constant whim of my emotions. And that, my friends, is where the true healing and empowerment lies.

 

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