It would have been nice to end on a multiple of 5

I’ve seen more therapists than I have years that I’ve been alive. I started therapy when I was 14.

How am I? Oh well I’m emotionally dysregulated. How are you?

I’ve gone and fired therapist number 25 before I even had a chance to write an entry in here about the start of therapy with him. I met with him for 2 and 1/2 months or so.

Only a handful of sessions in I started to feel really attached to him. It terrified me, because that doesn’t usually happen and was and felt way out of proportion to how little he knew me.

That idealization was crushed shortly after. Because I felt over-attached, I rushed into some tough topics.

I think an important role of a therapist is to keep an eye on the patients level of affect and ensure that it is neither too low or too high. The optimal rage is different for everyone every day. Too low and the therapy is too superficial, but too high and it will be too overwhelming to be therapeutic. The optimal level varies based on how much time remains in the session. As the session nears its end the therapist needs to find the way to bring the affect to a level the patient can manage outside of the container of the therapeutic relationship.

I realize this can often be a difficult task, but he did about as poorly with this as possible. The session ended abruptly, leaving me in a vulnerable emotional state. This left me feeling wary about the therapy, realizing that he and I were very out of sync. I picture this session as a chart where x is time and y is affect. We both started at low affect and his line was straight across with no slope, while mine got higher and higher.

We did talk about this after, but I think he took the wrong message from it. I wanted him to be more aware of when things were escalating too far, while he took this to mean he shouldn’t press certain topics at all.

A couple of weeks ago I wasn’t feeling great. I won’t get into the reasons right now, because retrospectively I’m embarrassed about how trivial they were.
I cut in the bathroom of his building before my appointment. I felt extremely out of control. I bled through my pants leg. I spent the session with my purse held over the blood spot so he wouldn’t see.
Obviously he can’t read my mind (Although once a therapist accused me of wanting him to do that, probably with some justification) but I really resented him for not noticing something. I always keep my purse on the floor rather than holding it. Clearly I wasn’t meeting with Sherlock Holmes for therapy.
He was so focused on convincing me that I shouldn’t feel how I felt, that he didn’t get around to understanding how I felt.
He asked me if I was going to be okay over the weekend and I very unconvincingly said ‘Yes’. He didn’t question it.

That weekend I was not feeling well. I had some oxycodone left over from a medical problem I had over the summer (This is a topic for another post) I took that, some klonopin and some seroquel too.
Unfortunately I only slept for 13 hours as opposed to forever.

This is the first time I’ve ever misused prescription medications like this. I felt incredibly guilty about it. I’ve always only used over the counter medications for overdoses. I feel like doing this is betraying a level of trust between me and the perscribing doctor.

I rationalized this somewhat by not going over the daily limit for the klonopin, and only doing so with the oxycodone, because I care more about the trust between me and my psychiatrist than me and random doctor from the hospital who will never know about this.

With a lot of reluctance, I told therapist number 25 about this, but it took me two sessions to fully get out. At the time when I told him about this I wasn’t feeling suicidal any more. I came early though to that session to plan out my escape routes in case he tried to hospitalize me and I needed to bolt. I tossed a hat and sunglasses and change of clothing in my bag as well.

I brought up the idea during that session that my period may be relevant to some of my more serious mood problems. I’ve brought this up before with therapists. I never really can feel sure. Is it confirmation bias? I don’t have a good way to keep track of if my mood changes around my period. I don’t buy into those mood monthly calendars. All self report measures of mood are highly subjective and because I wouldn’t be blinded to when I have my period I question their validity.

I mentioned feeling conflicted about this due to my identity as a feminist. I don’t really have a fleshed out coherent argument about my feelings with this, just an uncomfortable feeling. Somehow I think that if I say the words feminism and menstruation enough my feelings will be clear to everyone.
The feelings have something to do with the society wanting to view women as overemotional on their periods, the medicalization of a normal process and the validity of PMDD as a diagnosis, but again I’m not good at expressing myself here. I can see both sides of an argument about PMDD.
He seemed confused about why feminism would be relevant to a discussion of PMDD. I can handle disagreement, especially since both sides of the argument are dueling it out in my brain. But I was shocked that he wouldn’t even be aware of the possible relevance of feminism to an issue involving menstruation. He seemed very perplexed and I was horrified.

He did apologize the following session without prompting, but still it was unsettling.

Then to make things even more exciting and wonderful (note the sarcasm) The therapist who kicked me out of school (I need a shorter way to refer to him) was on a major news network promoting his book.
Every bit of publicity feels like he is taunting me.

I sent him 3 angry tweets from my twitter account. This twitter account is public and associated with my real identity (not my real name, but the username I mostly use an also people I know in real like follow me there). Probably not my most brilliant idea ever, but I’m leaving them up. If any person searches for his @replies they will know that at least one person out there is very unhappy with him. They’re vague enough that if a person didn’t know the background they would know I was angry with him, but the reasons would be unclear.
This means he now has access to most of my social networking pages. That’s fine though as I put my best foot forward on those, unlike in this blog.

When I went to therapy to talk about this I was very let down. Awhile ago I made a comment about how klonopin makes me stupid, which it does. The stupidity occurs in varying degrees, but to have any relief from anxiety thoughts rushing around, some of the good smart thoughts are slowed down as well. Sometimes thoughts can even be of both types.
I commented on how I had to stop what I’d been working on (Probably for the better as is it was slightly destructive) when the klonopin kicked in, because I wasn’t able to think well enough. He decided to take this time to argue with me about wither I am on the correct dosage. I have had the dosage fiddled with to the point of adjusting it by increments of 1/4 of the smallest pill size. This is the right dose. I’ve been taking it at this dose for a couple of years. I’m not messing with it. He was convinced that there is some ideal dose where I won’t be anxious or stupid. I don’t believe this is possible, because the two are so intertwined and the impact of the same klonopin dose varies depending on the day.
The comments felt accusatory too. Like he thought I was abusing it, although I have never ever gone over my prescribed limit. In the context of previously telling him about my oxycodone and klonopin adventures I was very sensitive to this sort of comment, because I feel so guilty about it.

He was taking a super ego guilt inducing role. My super ego is super at making me feel guilty already thankyouverymuch.

I told him about something I had thought of doing, but did not do and he took his guilt induction much too far. I can’t write about the details here, but basically he took a thought of mine and turned it into a worst case scenario. I tried to protest, but he kept making it worse and worse. The things he was saying were already fears in my head. I didn’t need him to give them credibility.
I have far worse thoughts in my head that I haven’t told anyone. If he reacts with such a judgmental extreme to something less horrible then there’s no way he can handle the worst of me.

I felt like he was treating me like he thought I was a sociopath. He was playing this role of a conscious for me as if I had none.
If he had even a basic personality conceptualization of me he was working from to base his comments he’d have realized that I am already very skilled at guilt.

I stopped talking. I stared out the window for a bit.
Then, I pulled out my Nintendo DS and resumed the game I’d been playing in the waiting room. Really juvenile, but I don’t care.
My brother called while I was ignoring the therapist. I refused the call, but then he called again and I took it, upping my rudeness level by +10. He just had a quick answer to a question I’d had about the game I was playing.

After about 20 minutes of ignoring the therapist although with the occasional yes or no answer to a question I said “I think I should just leave”. And I did. He asked if I wanted to make another appointment and I said “No”.
There wasn’t anything he could say at the point that could have made me comfortable continuing therapy with him.
I hate myself already, I don’t need a therapist thinking I am awful as well.

I rushed out of the building, worried that I was going to be followed or stopped by security. Psychiatry departments are never placed near an easy exit and I think we all know this is not an accident.

I arrived home and decided to take some ibuprofen. I think the reason I am still alive after all these years is that I am awful at swallowing pills. If I were better at I’d have succeed years ago. I had liquid gel filled capsule type ibuprofen. I decided that if I dumped the liquid out and drank it that might work.
Turns out this is the worst idea ever. I tried opening one up, but it didn’t work well, so I decided to just put it in my mouth and bite it. It was extremely acidic. I ran to the sink to rinse my mouth out to stop the pain. My mouth and throat felt sore after, like I’d been vomiting.
With that method ruined, I gave up to the time being.

It’s a few days later and I’m okayish now. I’m not being very productive with school work. I’ve mostly been sleeping and eating ice cream. I don’t know what I’m going to do about the lack of a therapist situation. I hate starting over again and again.

Partial Hospitalization #1

A partial hospital program is sometimes also called a day program. You spend the day at the hospital, but then go home to sleep.

My first partial hospital program was right after my first hospitalization. I lasted two days there.
This is the program that I mentioned in my post about how they sent me someone else’s records.

The social worker in my hospitalization set up the intake at the partial hospital program for me.
I told her two requirements I had for it:
1. It needed to be an adolescent program
2. I did not want to do DBT

When the social worker informed me it was set up, she told me my requirements had been met.

When I arrived on the first day, I quickly learned neither request had been fulfilled.

I realize now that avoiding DBT in this type of program is likely an impossibility, but I’d have appreciated her being upfront with me about this. To be fair she probably didn’t know the program contained DBT. But the reason for this is probably because she didn’t put any effort to find out.

My request for an adolescent program was reasonable. I was 19. My inpatient hospitalization had been with adolescents (their cut off was age 21).

There was a group of about 6 others in the program. I was by far the youngest. Most were old enough to be my parents.
I was very uncomfortable. I listened to people complain about their children and spouses. I couldn’t relate.

At my intake meeting a ‘No Harm Contract’ was presented.
‘No way’, I said ‘I will self injure if I want to and forcing me to sign that just will force me to lie. I’d rather not need to lie.’
The contract was pushed aside to be reevaluated in the future.
I left that meeting with the understanding that I had in no way suggested I would refrain from self-injuring.

I was very angry and aggressive (verbally, not physically). Largely because I was stuck at this partial hospital program because I’d been kicked out of school and possibly also in a small part because of a bad reaction I was having to Celexa.

I was under the impression that successful completion of this program was necessary to help my return to school. Despite despising the program, I felt I needed to stick it out.

The first day was a Friday. That weekend I returned to the school to move everything out of my dorm room.
Most was removed Saturday. Sunday morning I came to retrieve the last few items and discovered another person sleeping in what had been my bed and a large bong in the bathroom.

Monday I returned to the partial hospital program. The first day I had left my sharp items at home. I wasn’t sure what I was getting into (would my items be searched?) and decided it was in my best interests to leave them at home. Monday, the second day, I came prepared with a swiss army knife in my pocket. This seemed fine based on my experience the first day.

Inpatient hospitalizations are under-structured. Too much time with nothing to do. Partial hospital programs are over-structured. One group after another. Spending the entire day dwelling on problems, because the structure prevents one from going out and doing anything enjoyable.

I was frustrated with the way the people leading the groups spoke down to us, as if the depression meant we were cognitively challenged.

During the lunch break I made a few little tiny cuts on my leg. Very minimal, close to zero blood draw.

In the afternoon I had a daily check-in meeting with a social worker. As a side note I mentioned cutting a little during lunch. I didn’t think it was a big deal to mention. I’d never agreed to the no harm contract.

I was transported into an office with another woman (someone with a higher level of authority). She demanded to see what I’d used. I handed over the knife.
A lecture proceeded in a disgusted tone, wondering how I could have possibly thought it was acceptable to bring a “weapon” (aka a small swiss army knife) into a hospital.

She demanded to see the cuts.
I refused, explaining they were minimal and did not need medical attention.
She argued that because I had done it “on the premises” she had to see them.
I continued to refuse.
“I’d have to take off my pants to show you”, I protested.
She seemed unconcerned.
I was scared and eventually intimidated into giving in.
I tried rolling up the pant leg to show the cuts, but as I’d suspected the leg wouldn’t push up far enough.
I unzipped, pulled down my pants and showed her the cuts.
I felt very violated.

“Well there’s not too much damage this time“, she huffed.

That was it. The last straw. I announced I was leaving the program.

She bombarded me with questions assessing my current suicidal risk, trying to trick me into saying something to allow them to keep me there.
I didn’t fall for it.

My knife was returned and I went home.

I still didn’t have a therapist. While making phone calls to find one, many therapists refused to see me on the basis that I’d not properly completed the partial hospital program. I only was able to get into therapy (although this was my fake therapy, because anything I said was at risk of being reported back to my school) eventually when I left out the bit about the incomplete partial program.

It won’t go away

The 3 year anniversary of when I was kicked out of school is a bit over a month away.
It’s been so much, time but it is still an incredibly touchy subject.

I can speak about suicide, self-injury, hair pulling etc in a detached, emotionless voice. When talking about my forced medical leave I struggle to get out a sentence at a time without being interrupted by crying. When upset, my verbal ability plummets.

I spoke with a researcher who is studying people who have been forced out of their school or asked to leave due to mental health issues. I’m glad someone is working to get awareness for the issue. I don’t feel I did a good job of communicating the long term difficulties I have as a result of the forced leave, but at least I did something.

School is the most important thing to me. As you can see from this blog’s name my major is a important part of my identity. Before this mess I was a different major. I defined myself by that major too. I’ve lost a part of who I am. That old identity is tainted by these happenings. I try to push that old part of my identity away and people keep throwing it back at me.

I feel so isolated about it. There are support groups for so many things. Except this one thing I could really use a support group for. I need not only someone in the same situation, but someone who also has long term problems from it.

There’s a message board I’ve been going to for support of a more general nature for nearly 5 years. Using a message board for support is tough. I spend so much time trying to give background information that I don’t feel the ability to vent freely that I really need. What I really need is a best friend and I use the Internet as a poor substitute. My most recent thread, several weeks ago, related to ways this still impacts my life. I felt very misunderstood. Feeling misunderstood feels like an attack. I tried to put on a strong front in my replies, while alternating between tearful keystrokes and slicing open my leg. I wanted to clarify and understand how I can better explain myself. I am extremely touchy about this issue.
I don’t need people to tell me to move on from it. I know I’ve been hanging onto this a long amount of time. It’s easy to tell a person to get over it and not understand why the issue is still hanging around.

Let’s look at this through Compromise Formation Theory which admittedly I don’t know a ton about, but the little I know leads me to feel it is particularly applicable here. I wouldn’t be doing something if it didn’t provide some benefit.

The negative part of this compromise is that I am still hanging onto this thing that happened nearly 3 years ago and have incredible emotional sensitivity to it.

On the other hand, hanging on to this issue is the only way I know how to feel some security. Letting it go feels like opening myself up to the possibility of it happening again. I would be too vulnerable.

My hyper-vigilance is both damaging and protective.

Periodically I do a very stupid thing and google the therapist who got me kicked out.
He’s developing quite the web presence or so he appears to think.
Up until recently, he thought it was a good idea, and not at all reminiscent of tacky 1990s websites, to include a hit counter on his blog.
I’ve taken a lot of pleasure in knowing how small his web audience is.
Yes, it’s petty, but it helps me.

In my more recent googling I learned he is publishing a book, set to come out this year.
It has a cutesy name, the same as his blog, and is about taking a trendy psychology concept and adapting it for
a young urbanite audience.
A blog I can deal with, a book is a different issue. It has the ability to reach a large audience. The thought of all these people reading his book and possibly thinking he is a great guy upsets me.
I wish I were brave enough to publicly tell everything, write my own book, so people could know the rest of the story about him.

I have these horrible images in my head of spotting his book in one of my professor’s offices. I need to keep my old world separate from my new one. A book on the wrong bookshelf would signify an invasion. The fear is almost as bad as if it were to really happen.

In reaction to this I did the only thing I could. I used my Internet knowledge for a tiny piece of vengeance, while not violating any laws.
I reported his domains to ICANN. He had blatantly false Whois info (I highly doubt his phone number is (999) 999-9999).
I got one of his domains suspended for a few days.
Again, petty, I know, but it put a smile on my face for a little bit.

I wonder if he knows I did it. Probably not.

I’m sure I’m much less on his mind than he is on mine. This is part of the problem. It hurts to see him achieving any level of success, when I still have a day to day struggle over what he did.

Within the past week, a blog post of his was featured on the front page of a highly trafficked pop-psychology website. I wonder how many people I know read his article, having no clue about our association.

I want to scream out to the world ‘Hey look what he did!’, but I can’t because what he did left me too scared.

I need to be heard

I need people to know what happened to me. I need people to know this happens. I want dialogue and awareness.

But I’m terrified of being blamed. There are people who will think this was my fault, not the fault of a flawed system.
These fears keep me silent.
There are so many things I can handle different options on, but not this. It is too personal. Defending them is an attack on me.

I don’t have the perfect way to tell my story. I have started so many drafts, saved on my computer, forgotten. I’m going to give bullet points a shot. I need to, if nothing else, get out the key points.

-A bit over 2 years ago I was feeling very depressed and suicidal.
-I felt terrified of myself and made an emergency appointment with my therapist so I could get help. He was a therapist in my college’s health center.
-He decided I should go to the hospital. I was not surprised by this and, though terrified, I agreed to go.
-When in the hospital he suggested I take the rest of the semester off. I said ‘no, school is too important to me’ and he said ‘well let’s see what the doctors at the hospital have to say’.
-I was feeling better and getting ready to be released. A meeting was held with my therapist, the hospital doctors and I. The hospital doctors said that when I was released it would be fine for me to return to school. I had decided I would drop a couple of classes, but that I wanted to return. My therapist disagreed with this.
-My therapist told me he was going to talk to the school and ask them to place me on an “involuntary medical leave”. He said he was going to talk to them whether or not I gave permission.
-After he left a hospital doctor told me “This is discrimination”
-After my therapist spoke with the school my parents spoke with a woman there to plead my case. They asked for her to please talk to the hospital doctors who had a different opinion. She refused, she was only interested in hearing what her employee (my therapist) had to say.
-The decision was made that I would be forced out of the school until they decided I could return.
-I moved out of the dorm and back in with my parents.
-One condition placed upon my return was to meet with a therapist and have that therapist speak with the school to discuss my return. On the surface this seems reasonable, but it isn’t. How can I have real therapy knowing anything I say might hurt my chances of returning to school? As a result, I had about 6 months of ‘fake therapy’.
-I stumbled upon a newspaper article telling about people who were in similar situations as myself. They had won legal cases against their school. I contacted the lawyers who had helped them.
-My case was taken pro-bono. They helped me file an OCR (office of civil rights) complaint. This was not a lawsuit. There were no financial damages. The complaint only asked for their policy to be changed, so what happened to me couldn’t happen to others.
-I won my OCR complaint and returned to school

Okay I’ll end the bullet points now.
It’s not such a happy ending though. When I returned to school things were not the same. I was a semester behind in a very small (40 people) program. It worked on a yearly cycle. The semester off put me a year behind and my absence had been noticed. People knew things. I don’t know how, but they did. No one knew the whole story, but there were rumors.
Based on these rumors I was harassed by my roommates who dug through my things and found my seroquel. From google searches they concluded that must mean I have schizophrenia ( I don’t) and that I was dangerous (I’m not) . They made demands to the RA wanting to be told why I had left the last year. In general they made my life miserable, trying to force me out. They succeeded. I not only left their room, I left the school.

In my new school now I’m paranoid. I extend a lot of energy protecting myself from the same situation repeating itself. I have trouble making friends because I worry if they get to know me too well they’ll realize how crazy I am and then the school will find out and somehow it will be used against me to kick me out. I know it’s illogical, but it shows how much this impacted me. I’m better informed now. Kicking me out would be hard if not impossible, but the thought terrifies me. It doesn’t help that I know this school did something similar to a classmate.
I have nightmares about this happening again. I see people who look like my old therapist and worry he’s gotten a job at my new school.
I love school and want to stay here.
It wasn’t damaging just from the lost semester. They kicked me when I was down. It damaged my ability to trust. It hurts me every day still.

If you know someone who is going through a similar situation send them here
http://www.bazelon.org/Where-We-Stand/Community-Integration/Campus-Mental-Health.aspx

Here’s an NPR story about this issue.

There’s also a facebook group I found today. It’s existence means so much to me.
I wish there were a support group I could go to with others who’ve experienced this. I feel like only people who’ve been through this can fully understand.

I want people to know they’re not alone and there are resources. When this happened to me I had no idea this was a widespread issue. It was a fluke I read that newspaper article.

Just to elaborate on some things:
-Justifying the schools actions by saying “I was a danger to myself” is not reasonable. If I had been a danger to myself then the hospital shouldn’t have been releasing me and it would have been an issue to take up with the hospital, not my school. School is for learning, not for judging my mental health.
-A major issue was my therapist’s duel roles. He wasn’t just my therapist, he was also an employee of the school. He was acting in the interests of the school, not for me.
-Another issue was my school refusing to talk to the hospital doctors. They couldn’t make an informed decision without hearing all sides.