Saturday, February 27, 2010

Get up outta my dreams, Bi-atch!

Not having a great evening. Time for distraction from the gremlins rampaging in my head. Sleep over with (S) was good. Just chilled out and watched movies, ate junk food...all the good stuff. This morning we awoke to some pretty shoddy weather, so quick change of plans and horse riding was replaced by ice skating. Now keep in mind I have not ice skated in, oh, about 12 or 13 years, and in that time I have sustained damage to my vestibular system, so balance is still a wee bit of an issue at times. But, (S) was terrified, having never had much success in the skating arena, and I promised to teach her how, so I overcame my own qualms, and found it really is much like riding a bike. Once I got out on the ice, I pretty much got my groove back. And I managed to not only teach (S) to skate, but to get her off the wall in the first five minutes, skating without holding my hand after the first 20 minutes, and getting quite a speed up by the end of the two hours. And she didn't fall over once! So she was pretty chuffed with herself and her fantastic teacher. Of course, having not been on skates in a number of years, my legs and particularly my ankles are covered in ice gel at the moment, and hurt like a motherf*cker! After skating we returned to my place, with an Indian takeaway, and chilled out for a little while before I packed (S) off home to spend some time with her significant other. Which leaves me, an empty house and the gremlins in my head....sigh.

My therapist (D) wants me to start writing down dreams as I remember them. Now, part of the PTSD is that I do have a number of recurrent nightmares, and she knows the contents of these, but she is more interested in the 'other' dreams now. Just looking for another way to burrow into the dark abyss that is my mind. I find this a little confronting, and paradoxically kind of stupid. Because the 'other' dreams I have, are not ones that I believe offer any real insight into my psyche. They tend to be quite short, usually if I have them at all, it will be in that period between half asleep-half awake, and it will usually just be some random bit of info from the previous day. I truly believe that the purpose of these types of dreams is to function much the way a de-frag does on a computer. To group like information together, and get rid of excess stuff, creating more room for the inevitable new information of the next day. For instance: The other night (morning really) I was dreaming I was wandering through rooms trying to put out spot fires that were erupting in closets and up curtains ect. Now one could over analyse this and suggest...I dunno... perhaps that I was feeling the burden of trying to deal with multiple crisises at once, and feeling like I wasn't doing a good enough job dousing each individual 'fire', because there were so many to douse...... OR once could take into account that I was watching Rescue Me, (a tv drama based on firefighters) the night before. Hrrrmmmm.... Anyways, (D) acknowledged that I thought it was bollocks unlikely to be helpful, but she asked me to give her the benefit of the doubt on this. So being the good client I am *snark, snark*, I have been dutifully recording my dreams when I wake the last few mornings.

Anyhow, in order to prepare myself for any nefarious plans she may have for this information, I went to my dear friend google to tell me a little about dream analysis. First, I looked at it from the Jungian model, because I know this is a particular area of interest for her.

Like Freud, Jung believed that dreams are important gateways to unknown parts of ourself. After this point of agreement the approaches of the two men differed considerably in their theories and approaches to dream analysis.

For Jung dreams are an expression of the personal unconscious through the archetypes of the collective unconscious. Whereas Freud believed that dreams were frequently distorted in a subconscious attempt at repression, Jung believed that any such distortion was usually unintentional. The dream was a direct message from the personal unconscious- Here be dreams
In more modern times, my dreams "some are just rubbish stance" takes yet another hit.

A multitude of sleep laboratory and clinical studies have suggested that the dream and/or REM sleep is an inborn biological phenomenon designed to facilitate memory processing, problem-solving, mood regulation, and psychological adaptability
Neurophysiological studies indicate that dreaming occurs when the brain is activated during REM sleep. This consists of excitation of forebrain circuits due to activation of the pontine and midbrain reticular activating systems. In addition, there is selective activation of occipital, parietal, and limbic regions along with excitation of cholinergic neurons and inhibition of noradrenergic as well as serotonergic neurons.
I do however, remain correct in my assertion that this dream analysis malarkey, is just a sneaky way for her to gain access into parts of my psyche that I may or may not be ready to share with her just yet
Although careful history-taking and assessment of mental status remain the foundations of clinical evaluation, dream material may provide additional information and insight into the patient's psychodynamic and diagnostic status. For example, dreams may serve as early warning signals of suicidality, homicidality, ego-disintegration, psychosis, and impending acting-out behavior The Dream- A psychodynamically informative instrument
Sneaky (D), very sneaky! Of course, I could just avoid this blatent intrusion into my psyche, grab my crystals, tarot cards, and other new age paraphenalia, as I get these handy dream interpretations myself from the internets. Don't need your analysis (D) cos with one click of my mouse, I can discover that the fire in my dream means

Fire-Depending on the context of your dream, to see fire in your dream can symbolize destruction, passion, desire, illumination, transformation, enlightenment, or anger. It may suggest that something old is passing and something new is entering into your life. Your thoughts and views are changing. In particular, if the fire is under control or contained in one area, then it is a metaphor of your own internal fire and inner transformation. It also represents your drive, motivation, and creative energy. Alternatively, the dream may be warning you of your dangerous or risky activities. You are literally "playing with fire".
And furthermore, just in case it comes up in future dreams...
False Teeth-
To dream that you are wearing false teeth, indicates that you are not being completely honest in some waking matter.
Farting-To dream that you are farting, suggests that you are being passive aggressive. You need to express your feelings in a more direct manner.
Fakir-To see a fakir in your dream, foretells of phenomenal changes in your life. (Am not exactly sure what a fakir is, but sounds exciting, no? Will definately be on the lookout for one of those dreams!) Dream Moods
Sigh. I guess I should just share the damn dreams with her, huh?

Thursday, February 25, 2010

Time to make good choices

Today's therapy session was craptastic less than ideal. I'm not really sure what was going on with me, but I spent the whole session quite defensive and a little bit sulky, if I am to be honest.  I blocked (D) at every possible turn, preventing her from really being able to dig into any subject, and behaved, generally in a narky and antagonistic manner, because I'm mature like that! I don't know whether it was because I knew I had the whole weekend to get through by myself, or maybe, with some of the stuff swirling around my head about the suicide attempt anniversary, coming up next week, I just really didn't want to dig into anything to confronting.

I started the session, telling her I was fine, everything was fine, FINE! And that pretty much was my catch phrase for the entire session. Bad dreams? Not important. Weird crazy issues with bio dad? Not bothered! I'm fine, and nothing you can say or do is going to make me admit otherwise, woman, so get up and outta my grill! Word.

But the truth is, I'm not fine. And when I got home, and started contemplating the weekend stretched out in front of me, with all the temptations that come when lil sis goes away for the weekend, I realised I was heading towards danger zone. As much as I am trying to push anniversary stuff out of my mind, and pretend it doesn't matter, it is still starting to worm its little gremlin way into my psyche.

So, (fairy claps for me) I decided to take a action. I rang my friend (S) and told her what was going on, cos I'm proactive like that! :P Together we devised a plan. Tomorrow, I am going to busy myself cleaning the house, and catching up on some other errands I've been putting off. (S) has banished her bf to a boy's night tomorrow night, and she is going to come over after work for a girly sleepover. Chick flicks, chocolate, face masks and a mattress on the living room floor, just like high school. On Saturday, we are hopefully going to go for a trailride at some stables just outside the city. (K) was talking about having done it at our coffee yesterday, and it reminded me of how much I enjoyed it last time (S) and I went back in September. Something very zen and peaceful about, sitting atop these giant beasts, and meandering your way through the Aussie bushland. On Sunday, I'm working a double shift at the Ronald McDonald House. By Monday, Uni will have started up, and of course therapy will have rolled around again.

Obviously, I need to come clean to (D) about what next thursday represents to me. I shut her down today when she spoke about a contact call on saturday afternoon, but maybe I should take her up on it.

Its hard work. *Yes, that's kind of whiney, but still....* Its so much easier just to let the bleurghiness take over and pull you down. It takes so much energy to make sure you are doing these tiny things to combat it. But I can't keep crashing. Even though there is a lot I have no control over, I still have to take responsibilty for my own choices. So today, I am feeling a little ashamed of my juvenile behaviour, but proud that I finally pulled it together enough to make healthy plans to support my well being.

Wednesday, February 24, 2010

Suicide Anniversary

Another "anniversary" is fastly approaching. I think thus far, I am doing a pretty good job of keeping myself engaged and not allowing myself to slide back into the more comfortable (if somewhat terrifying) depression I have experienced over the last few months. Am slowly clawing my way out.

Was speaking to (K) at coffee this afternoon about it. I feel as though, I am unreasonably putting a whole lot of emphasis on a day, which is essentially just the same as any other, because something bad happened on this day a few years ago. Like, if I didn't insist of putting such meaning into it, it wouldn't be a problem. I'm trying not to, but as (K) pointed out if I am thinking about it, down to the precise day, then, yeah, its probably not so much a case of intentionally focussing on it. I guess its somewhat embedded into my psyche. The other reason I feel stupid, is because its not an anniversary of something someone else did to me, or some terrible accident or disaster. Its the anniversary of my very serious suicide attempt. I explained to (K) that in someways, I still feel as though I never really went back to "living". I mean, they got me breathing again, I learnt how to walk and talk again. I interact with people. And even when my concious is not open to exploring the possibility of the 'future', I am still making steps towards it, with my uni, with the recovery process, with relationships. I feel like its just a lame excuse for me to wallow for a day. (K) pointed out that if it was someone that I loved who had died, the anniversary would throw up stuff. She also pointed out, that from our conversation that day, it was pretty clear that I was grieving what I had lost still. We had talked about my upcoming high school reunion and how I didn't want to go, because I was not the person that my quite successful 17 year old self should have been 10 years later.

Anyway. As usual, when I feel unsure about whether I'm overreacting or whatever, I turned to the internet to see what the literature has to say. I didn't actually find a lot. But what I did find was a whole lot of links to blogs and forums, with people facing the same feelings, some 6 or 7 years after the event...

It has been noted that :
People who attempt suicide must not only have the desire to die, but must also have developed the capacity to enact lethal self-injury. Those who have made a suicide attempt have overcome their instinct of self-preservation
That in itself, without taking into account the reasons or trauma behind the event is traumatising, in and of itself. You become the perpetrator of violence against your own body. And in doing so you go against nature, which should instinctively inbed in one, a sense of self-preservation. (Note: I am not saying unnatural in a judgemental way...)

Anyway. It has brought up a whole lot of mixed feelings. And although I am trying to keep myself as even keeled as possible in the lead up to next Thursday, I do think it would be wise, to just let a few of my support people know, just in case.

Tuesday, February 23, 2010


Today was my first additional session. I'll now be seeing (D) on Tuesdays as well as Mondays and Thursdays. I'm still not 100% sure on the third session schizzle, but it has already begun to show some positives, I think. (D) explained to me, that she often doesn't know how hard to push me, because the minute that the conversation turns to uncomfortable topics, I will say I don't want to talk about it right now. But I'll also say that about things that I truly am not ready to talk about at all, and that may very well cause a meltdown. Quite snarkily, I asked her what conclusion she reached, and she replied that she thinks its probably best to push me. As much as I hate it, she is probably right. I think that is partially why progress has stalled, because she lets me get out of talking about a lot of stuff I should be talking about. So yesterday and today, she would not let me deflect or change the topic. And yes, it was horribly uncomfortable and somewhat upsetting at times, but, because I knew it would only be a day or two at most before I would see her again, I was able to leave those feelings somewhat in therapy, rather than take them with me. So, yeah, "Containment 2010", is working...sigh

Tomorrow, I am catching up with Consumer Advocate (K) for coffee, and then back to therapy on Thursday, so the week is pretty structured. My friend (S) has been coming around a fair bit too, just to watch TV or eat dinner after work, because she knows that I need a little bit of company at the moment to stop me from withdrawing back inside.

Next week the Uni Semester starts up again, and I'm once again enrolled in two subjects. One is a prac subject (5 weeks of teaching). At this point I am unsure whether I will be able to make it through 5 weeks of full time work (more actually if you count the huge amounts of prep work) The Disability Officer at the Uni is trying to negotiate so that I can have one day off in the middle of each week, and just do an additional week at the end. But the faculty is resisting. Will just have to see how it goes. Still pulling together the necessary paperwork to get the uncompleted subjects from last semester dropped without academic or financial penalty. Is quite the process!

In that mode, have been trying to get a hold of Case Manager (M) since the end of last week, to get some paperwork from the psychiatrist for my claim at the uni. Finally got a call this afternoon, and as I understand it she had been out of the centre for most of the afternoon, and it was quite close to leaving time, but felt somewhat brushed off. I'm probably being unreasonable, and I know in part, I am overly sensitive to picking up "signs" that people are obviously sick of having to deal with me, pissed off with me etc. I tend to find problems where there aren't any. And realistically, she knows I am seeing (D) three times a week, and thus fairly well taken care of. It doesn't even matter really that it has taken her a while to get back to me, on a few occasion over the last few weeks because essentially my questions have either been "household stuff" like letters or scripts, or else, I have figured out ways to deal with whatever little emotional blow-out I am having myself. And I never specify my messages as urgent, because I don't really think there are. It just makes me feel a bit uneasy that if it was urgent, I still might have trouble getting a hold of her. Which is once again, probably unfair, because she has always gotten back to me quickly on urgent matters, and it would be my responsability to make sure it was clear if it was an urgent call. Anyway. Just makes me a little nervous, but I'm being silly.

Got two new appointments in the mail today, one for the Psych in about a fortnight and one for the Neuro at the end of the month.

I'm doing ok-ish at the moment. Starting to make tiny moves into going back into the world, I hope it lasts a bit longer this time!

Monday, February 22, 2010

On the ward and out of my mind- what were the designers thinking?

To read the rest of the series, read here, here, here, here and here

So, just a short one tonight.

In Ward B, the decor was not to awful. Lot's of soothing pastels, and watercolour paintings of old fashioned women sitting by a lake but as a whole not to terrible. It was reasonably new, and quite fresh and clean looking. I did have a few questions though...Why create a beautiful peaceful garden, complete with benches, flowers and a fountain, in an atrium in the middle of the that all of the patients could see through the glass wall running length-wise down each side...a spot that looks blissfully calm, and then refuse to allow those who need the bliss the most (ie the patients) access? Sure we had the smokers courtyard, and the gardens were not too bad out there, but seriously this atrium looked like a little paradise, but was strictly out of bounds, wtf? Second, if you are going to have glass windows running floor to ceiling on two sides of the tv room, in a city that is known for having some of the coldest weather in our state, don't ya think double glazing might have been a good idea...I'm just saying! And finally, if you are going to shut down a paediatric psych ward (shame on you!) and convert it for use as part of the adult psych ward, please take down the cartoon characters on the walls, and the signs reminding us to "Stop. Think. Revise". Its creepy and patronises the shit out of us.

BCH was not so great. For a start the nurses office was right down the end of the corridor, you know away from where all those annoying patients are...wouldn't want to actually have to interact with them!  Whilst the rooms had carpet the majority of the ward was linoleum, which made the whole setting very 'hospitalised' looking. The courtyard had but a strip of what had been grass, but was now mostly dirt, and one lonely, failing to thrive tree sapling. The rest was concrete. Grey concrete. Someone had tried to try and paint a 'soothing' mural on the wall...a sort of Tuscan garden, if you will. But rather than soothe, it just served to remind you there was no living things in your surrounding environment at all! Bathrooms, were tiny, and there was no shelf in the shower, so you had a choice of putting your soap etc either on the floor, or closing the lid on the toilet which was right next to it, and putting your stuff on top of took me a while to decide definitavely which was more unhygienic. At Ward B, my bedroom window looked out on a garden, at BCH it looked out on a shipping container. The whole air of BCH, was just very fusty, old and worn. The whole building just felt like it was giving a big sigh of fatigue. And I don't think it was built that long ago.....Oh and lets not forget the bright orange bedspreads....purty!

Of course I have mentioned before, the eyesore that is the Public Mental Health building, I attend as an outpatient. A giant, purple-grey, amorpheous sludge of depression. What were they thinking?

Now skip to the websites my mother has been looking at of private psych hospitals in the area. Just in case I need to be admitted again. Aside from the seemingly superior therapeutic interventions and alternative therapies, these places also look like they would be more soothing to the soul to be in. Each room looks like a moderately priced hotel room. The gardens are landscaped and gorgeous. One I'm recalling in particular had access to bushwalks and a swimming pool.

Obviously the user pays system is always going to have more money for cosmetics than the Public system. But you really do wonder, these designers who create the buildings for government departments and get paid quite a bit of money, the staff who are responisble for the general interiors (posters, murals etc)...what are they thinking? Do they think if they just make the environment as unpleasant and depressing as possible, we'll leave sooner?


Dear Bachelor Number One,
Whilst I am completely fucking in shock pleasantly suprised by your supportive reaction to me finally coming clean about some of my mentalism (after over 6 months of dating, the last month of which was spent avoiding your calls, because I didn't know what to say). A handy little hint would be not to take your completely loco slightly mentally unwell girlfriend to see "Shutter Island" at the cinemas, after she has opened her heart and told you everything you needed to know. Better planning on the movie choices needed, I'm just saying....
Your beloved Crazy One.

Note: For those who don't know (and I was one of those) Shutter Island is a thriller/mystery based in...wait for it..... a mental institution in the 1950's...yup lobotomies, patient experimentation...the whole shebang!
And yes,
Bachelor Number One and I are back together (not that we ever officially broke up, I just kind of dropped off the face of the earth) I'm trying to be a bit more honest with him, rather than trying to hide 'my crazy in a box' We'll see how that goes!

Sunday, February 21, 2010

Absentee Dads and heart attacks.

So, just because my life wasn't already weird and drama-filled enough, my absentee father has been making his presence known again. Big Sis has had contact with him over the last few years, but I've really not had much contact at all since he walked out of our lives 27 years ago. Anyhow, he has been trying over the last six months or so, to open the lines of communication back up, and I have been, well, less then receptive. He did come and see me, on my birthday, which I spent in the local mental health unit about a month back.

He had some health issues a few months back, and whilst my sis told me about it, I did not feel the need to go and see him in hospital or call him. On Thursday, I recieved a call from him, which I screened and promptly forgot about. Later when checking my voicemail, I retrieved the message telling me, he had had a heart attack and was going in for surgery. I can say without a whole lot of shame my first internal response was "So what?". Not because I wished for anything bad to happen to him, but because it really didn't mean any more to me than if it had been a random stranger off the street. I went about my business, went to my therapy session that afternoon, but there was this constant niggling in the back of my mind. "What if he dies?" I couldn't help but wonder if this was something I would look back on in 15 or 20 years time, and think "I should have seen him, I should have opened my heart a little, I should have had closure".

I spoke about it briefly at the end of therapy with (D). We didn't really have a lot of time to speak on it, as we had to sort the mess of Monday's session out, and 50 minutes can go both excrutiatingly slowly and in the blink of an eye, at the same time. She queried whether I could find out what the actual risk was, whether I had some time to mull it over or not. I couldn't think of a way to do that. It was not like I could ring his relatives up and say "What up? What are the chances the geezers actually gonna croak?". And my Big Sis, Bless her cotton socks, is a drama queen like no other, so he could have a hang nail and she would present it like he was at death's door, shaking hands with the reaper.

I spoke to Big Sis anyway, later that night, and she told me that he had had surgery (a stent (?) placed) and was doing ok. So, I just pushed it to the back of my mind to deal with later. He was discharged the next day. Apparently they don't keep you very long after this particular type of surgery as long as you have relatives willling to keep an eye on you.

Today my sister rang again asking if I wanted to come visit him. She had rung yesterday but I was able to get out of it by pleading prior plans. Today I went. It was ok. He looked like shite. And he is in some serious denial coming to terms with the changes he needs to make. He sat with us for about 20 minutes and then went back to bed. I stayed and kept my sister company for a few hours, playing scrabble and yahtzee. And then I went home. I'm not sure how I feel about it still, to be honest. Does this mean I need to start having regular contact? Do I wait till the next time he's on death's door step? Do I have a moral obligation or an obligation to myself to even care? I don't know. For now I'm just going to stick my head back in the sand

On the ward and out of my mind: You are nurses, right?

Back to On the Ward and out of my mind, you may also want to read this, this, this and this.

I was diagnosed with epilepsy quite a few years ago. Juvenile Myoclonic Epilepsy to be specific. As I have, moaned about incessantly alluded to on this blog, this has been a bit hard to manage at times because of my PTSD encouraged insomnia. I tend to have a lot of myoclonic episodes (aka petite mals or weird little jerks that make me look freaky) and less of the tonic-clonic seizures (aka grand mals or randomly dropping to the floor unconciously in a break-dance type fashion) At the moment with sleep being completely f*cked less than ideal, I am averaging about 1 or 2 tonic-clonics a month.

Anyhow... when I was admitted to Ward B, I had a plethora of medical health issues as well as the quite obvious fuck-uppery, what with me trying to kill myself and all. I was still recovering from aspiric (sp?) pneumonia, from being extubated, I had  a little damage to my cerbellum (a fairly important bit of grey matter when it comes to motor skills and some cognitive processes) and some pretty major damage to my vestibular system (fairly important for staying upright and balanced) and finally I had the pre-exisiting condition of epilepsy.

Upon admission to the ward, the nurses freaked the frack out. I wasn't supposed to overhear these conversations, but meh, if you are going to talk right outside more door what do you expect? Basically, they didn't feel equipped to handle my medical needs, didn't have time to do the extra time with me for the rehab exercises I needed to do twice a day, blah blah blah. Ultimately in the end, they didn't do to badly that first admission. They managed to find time for my exercises, the pneumonia resolved with antibiotics, and although I had a number of seizures they would generally just help me to bed, or if in bed change the sheets if necessary, only calling the doctor in on one occasion where the seizure was longer than average.

However on my second admission about three months later, things were not quite so straightforward. It took four days just to get the necessary equipment (shower chair and toilet chair) brought down, which resulted in some very unsafe practices. (I was using a zimmer frame at this point). And there was one old bitch nurse who decided unilaterally, and without consultation with doctors or any other nurse, that my seizures were in my head. Had she read my medical notes she would have quickly been dissuaded from this notion... or maybe not, she was pretty old school, and seemed to hold the opinion that all people with mental health issues were merely naughty children needing attention. On particular day, I went back to bed, feeling quite dizzy and unwell. This nurse (not even my designated nurse) took umbrance to me being in bed in the middle of the day. I tried to explain I was feeling poorly and possibly might have a seizure coming on. I hadn't had the aura yet, but generally in the hours leading up to a seizure I can feel a bit poorly, and either way a nap would either resolve it, or else I would be in a reasonably safe place if I had a seizure. She basically told me it was nonsense and frogmarched me back to the tv room. After 10 or 15 minutes I felt decidedly worse, and got up to tell her I needed to be in my room (I also didn't want to have a seizure with a whole room of strangers gawping) but one look at her face told me she wasn't going to listen, so as my aura kicked in I made my way to the bathroom, where I promptly fell face first onto the tiles, smashing in my front teeth and bloodying my nose, having...suprise suprise... a seizure. By the time I properly came out of the post-ictal state, she had gone home and was not back on shift for the rest of my stay. I had smashed in teeth and a swollen nose, to remember our time together though. They took me to the dental hospital and got caps for the broken teeth, which subsequently crumbled, as there was not enough tooth to adhere too. Lucky me also got to endure four root canals about 6 months later, due to the nerve damage done. My teeth are still a mess, and it will likely cost me a great deal of money out of my own pocket to fix them (there is a possibility I can get them fixed through a referral program with new mental health service district... appointment is in March) My mother hit the roof when she found out, but unfortunately we were a bit to busy trying to keep me sane-ish over the next little while, to follow through and make sure my complaint was dealt with adequately.

Other than that, my immune was rather inept at this point, due to lack of sleep and a significant weight drop, and particularly during my first stay I seemed to catch every flu and cold that patients and nurses alike carried in on the germ infested little bodies.

Nothing quite so problematic at Big City Hospital. I did have a few seizures during my stays there. One rather humiliating one in the shower, however in general they did a pretty good job responding. The only gripe I have, is that during one such seizure, I not only voided (not all that unusual), but also threw up (quite unusual). They did help me to change (embarassed much?...yup!) but they left me to sleep it off with some rather unpleasant regurgitated matter in my hair. Fair enough, they were probably allowing me to rest, but running a damp wash cloth over my face and hair... basic nursing 101. I also vaguely recall my designated nurse delegating her student nurse to clean the vomit from the floor, because she could not handle vomit. Possibly why she became a MH nurse?

In my opinion, a nurse is a nurse here in Australia. Yes, Mental Health Nurses are a skilled subset, but that doesn't mean that they should let the basics of patient care go.

End result for the most part, if you are going to be in a mental health ward, you are better off to have no pre-existing medical ailments.

NB: That being said, from a Community Mental Health perspective, both my Case Managers have been super-duper in supporting my other medical issues. CM from my time in Ward B, would drop me off to Outpatient Rehab and Physio, organised to have a safety belt custom made for me so that I could do additional rehab safely at my Gym, and also came to a number of individual assessments with me to to keep abreast of my progress, and see what ways she could help facilitate it. CM from BCH, has made sure I was getting my appointments with NeuroDoc, and has also been the one to get me the referral for aforementioned Dental Appointment in March.

Saturday, February 20, 2010

Shut up

Movie goers of the world

If you are going to go and see the same movie as I am, on the one day I manage to make myself go out and do something 'normal', and then proceed to laugh, talk and poke each other in front of me for the entire last third of the movie, you had better be under the age of 15, not grown goddamned adults who should know better...... I'm just saying....

Sorry, did that swift kick to the back of your chair make you spill your drink over your ugly-ass boyfriend? What can I say, I'm crazzzzzzzzzy, ya know?

Friday, February 19, 2010


Lil Sis turned to me this afternoon and said "You know, Crazyboy is going to be here soon...." Crazyboy, is her new...erm...Bf? Fling? Bit on the side?... its all still a bit unclear. He lives on the coast, about an hour and a half away. She has been heading down there every weekend recently to spend time with him. I guess, after four months of living with her ex AFTER THEY HAD BROKEN UP, she now feels free to pursue something different. I can just hope that she doesn't rush into things. Anyway, I've only met CrazyBoy once when he came down the other weekend to go to the waterpark with us. I'm sure he is a nice guy, but he is soooo full of energy, its drives me insane. He never stops talking. He acts and speaks on impulse. Its like he is the re-incarnation of a Golden Retriever. But.... he makes her happy, and its been a while since she has been happy. And anyways, she usually goes to stay with him.

But this afternoon he was on his way to spend the weekend at our house. Sigh. She tried again "He's going to be here in 15 minutes..." And left that hanging in the air, as she looked me up and down meaningfully. I paused, and did inventory. Last shower, two days ago. Hair stringy and pulled back with a headband. Attire, pajamas with a chocolate stain on the top. "Right, so you want me to have a shower then?". "Well, maybe even just put on a bra?" she replied hopefully. Grudgingly, I made my way to the bathroom to human-ify myself again.

I get it, I do. I mean, that's one of the good things about living with family. When I'm not at my best, and schlepping around unwashed, in pajamas, she accepts it. When I am incommunicative and lying in bed for hours staring at the well, she knows its because I'm having one of my bad days. On the days that I HAVE to go out and face the world, I have to make some effort, but at home, I can just schlep if I don't have the energy. But Crazyboy doesn't know me. And in the bloom of a new relationship, slovenly, depressed sisters aren't high on the romance scales.

I get it. And really, showering and wearing day clothes is not that much of an ask. It's what normal people do. But there is a tiny part of me, that is ever so resentful that for the near future, I am going to have to put on "Game Face" in my own home.

Thursday, February 18, 2010

I'm not very good at psychotherapy

I am a thinker. By no means the most intelligent person in the room, but I appproach the world analytically. I have an innate need to find reasons and explainations. I thrive on finding the rational and logical reasons behind other people's and my own actions. In some ways, it has been my greatest defense throughout my life. As a child my intelligence protected me on two levels. First, as a precocious child, who learnt the rudiments of reading and writing at around age 3 (according to family history) I used these skills to escape from the turmolt of my early life. I wrote stories, and later discovered the catharsis of poetry and journal writing. I read ferociously (easily plowing through the 15 books we were allowed to borrow from the library each fortnight) to escape into worlds that were anywhere but mine. Second, I used my ability to analyse situations in order to predict what was going to happen, in a very unpredictable home. I was highly in tune with my surroundings, people's emotional states and motivations. And thirdly, I used this understanding to allow myself to retain relationships, I could find a reasonable and rational explanation to excuse any behaviour on others behalf, so that I could accept and live with those behaviours over which I had not influence. This pattern continued well into adulthood. I am doing it right now! :)

This defense was, like most defenses, bothe protective and destructive. The need for rationality and logic got in the way of my ability to just experience life as it was. To feel and accept emotions, without considering whether they were valid or not.

I'm not very good at psychotherapy. I was very good at CBT, in some ways. I was able to dissect my thoughts like a scientist dissects a frog, to identify and label each thought and its purpose. I was even able to integrate some of the ideas at times. It helped, somewhat. It was exhausting though. I felt dragged under by the past, and what I managed to control in my day to day consciousness, through extreme hypervigilance, always having to be ready to pounce on that next cognitive distortion, I was unable to keep at bay when my unconscious took over during sleep or horrific flashbacks. I felt like I was barely managing the symptoms, but underneath there was an untreated infection of 'feelings' just waiting to go septic and kill me.

So, I started psychotherapy. And I suck at it.

Feelings throw me through a loop. They are neither logical, nor rational a lot of the time. They don't stand up to close examination. They are maurauding rebels without a cause, determined to occupy my brain and do whatever the hell they want. In psychotherapy, I am to accept these feelings, to embrace them, to try and understand those parts of me, not analytically, but empathically. I am finding this incredibly difficult.

I went into therapy today, nervous, but reasonably sure that I had managed to find a logical reason for my behaviour in the past couple of sessions, and why I thought therapy was stalling. I was validated by discussing this earlier in the day with my Case Manager (who seems to use more CBT/DBT orientated interventions) that I was showing good insight, and showing signs of things starting to click into place. Therapist (D) was somewhat less affirming. She did congratulate me on my ability to step away and think about the way my mind was processing things, and acknowledged I made some very valid points. She has two major issues with it. First, she felt that I had found away to analyse away any responsability on her behalf. That she had made mistakes within the conflict too, but that I was too scared of the emotions that came with that (fear, dissapointment, anger) to allow them in. So I bludgeoned them to near death with logic and over analysis, so I wouldn't have to deal with them. Second, as much as she was interested in what I thought intellectually about what was going on, she was more interested in how I felt about it. I found that incredibly difficult to answer. Emotions are just not a strong part of my personal vocabulary. I don't know how to speak of them. Sigh. I've got a long way to go. I'm not very good at psychotherapy.

We also had a brief but horrifying talk about the therapeutic relationship. At one point I was focussed on breathing shallowly to prevent myself from throwing up. She explained that due to the nature of the relationship I was going to have feelings for her "the therapist". I was going to feel hatred and dissapointment. I was going to feel love and sometimes just like. Arggggggggggggggh! I just kept quiet hoping she would get this little talk out of her head and move on. Thinking about it now, I have to acknowledge (stomach churning again) I do have feelings that reside somewhat closer to love (platonic) than like. And it horrifies me. She is somebody who knows more about me than most people, who has shown herself to be consistent and trustworthy, who appears to care about me, who I can share a laugh with, she is nuturing and protective.... it is much like the relationship between best friends, or even approaching a maternal type relationship.... but its not. I remain aware of the limitations and reality of what it is. But still, there remains this strong attachment, that the very thought of her leaving sickens me. I hate it. And yes, there are times, when my feelings move beyond annoyance with her, to a deep, visceral rage that I have yet to fully understand.

We spoke at some length (rather she spoke) about how it was not my job to protect her from any of this. Link back to her (forced) admission that I could be exhausting. She stated firmly, that if she was beginning to experience feelings of exhaustion or burn out, it was her job to be mindful of this and remedy it...not mine. My only comment was, that it scared me to not be aware of this, because if I didn't know where she was 'at', I couldn't be prepared. She reflected that this is how I must of felt growing up in an environment where one had to constantly, be in tuned, to be prepared. How difficult a responsability for a little girl, how heavy a burden. She reported counter-transference feelings of immense sadness. I wasn't ready to go there today.

On the way out the door, she told me she would call on the weekend and she had put aside a third session for me on Tuesday. I paused. "Haven't you had enough yet?". She replied gently, "No, Ophelia, I haven't.

Wednesday, February 17, 2010


So, I have avoided blogging about my session on Monday, a) because I am kind of ashamed of my regressive behaviour and b) because I just needed some time to really think about the issues and decide where I stood. But times running out. I have therapy tomorrow, and it will have to be addressed.

In line with my strategy of avoidance, I have avoided phone or email contact with (D) for the last couple of days, but she caught me this morning by calling while I was on my way home from another appointment. You know how sometimes, when you are out and about and your mobile rings, you just grab for it and automatically answer it.... shit... it's her. Very immature, I know, but I would rather have just let it go to message bank. Sigh. The conversation I had with her was quite immature too. "How are you?" Fine. "I was just worried about you after Mondays session and wanted to check in" There's nothing to talk about. I'm fine. "Well, I don't think that's true, we need to talk about this" Oh, dear, bad reception...gotta go.

But tomorrow, its time to man up and face it. You of course, have no idea what I'm talking about yet.

So the session mostly focussed on how we can better "contain" me as we move through this next more uncomfortable stage of therapy. Should we introduce a third session? I talked about my reservations a little...finances, power dynamics, dependency etc. And then she said something about how she was really suprised that I was considering it, as she thought when she put it on the table I would shoot it down. This pissed me off and I quite snarkily asked "Why would you bother asking then?". She also said something along the lines of, she wasn't sure if it was the right thing to do either, she just put it out there for discussion. To which the "Interpreter" in my brain heard "I'm not even sure if I want to do this". I got angrier. I wanted her to be sure, before she suggested such things. I wanted her to have clearly though out and justifiable reasons for her suggestions. She clarified that what she meant was, she wasn't sure if it was the right thing for me, because she was mindful of the issues it would bring up for me. Sigh. I didn't really hear her in the moment... it took a few days for that to sink in. I think the issue is, I don't trust my own opinion much, so I am relying on her to know what the best step forward is. I need her to be a rock, in a world where there is so much uncertainty and instability. I need to trust that she knows the right things to do. But, in retrospect, I am also aware that she is just a human being, that there is no magic formula, that some of this process will inherently be hit and miss. I think it feeds into the control issues. I need the sense of rules and procedures to make me feel safe, nebulous concepts and strategies make me want to run and hide, its too risky. But in order to continue this process, I have to find a way to move forward through the risks. To trust that she will catch me, or better yet, help me land on my own two feet.

The other issue this all brought up was abandoment issues, which I never really factored in as much of an issue for me (and makes me cringe, as it brings me one step closer to fullfilling the criteria for a BPD diagnosis... not that there is anything inherently wrong with the diagnosis itself, but more because that is an additional stigma I'd like to avoid...sorry if that makes me weak) I worry that with additional demands on her, session wise, (and at a reduced rate) she is eventually going to get fed up, and leave me to deal with this mess unfinished. She has stated unequivocally that is not her intention, and the suggestion for increased contact was hers... but then to hear her sound not so sure about it rattled me, and let those gremlins start gnawing at my brain. She mentioned something about how maybe I was worried that my family was right, that she was just trying to 'milk me dry'...(ludicrous, I am not that profitable a patient) I told her that was not the case, but I did wonder why? What does she get out of it? I can see the pitfalls...a client that requires more time, seems to have more crisises at the moment and makes her less money, for the time investment. So what does she actually get out of it? I guess I partly figured if I could figure out her motivations, I could better assess whether she was safe or not. But on a deeper level, I just wanted to put her in a double bind, so I could justify the fear I was feeling, that she was just going to leave. I pushed her on the issue, pushed her to answer the question, boxed her into a corner until I got something out of her I could misconstrue for my own purposes. She said she could tell me about how much of a privilege it was to be able to take this journey and help people, but that I wouldn't believe her. She acknowledged that while it can be exhausting, it was infintely rewarding... ah-ha! Gotcha. My mind stuck on the word, exhausting. Of course she is trying to subtly tell me something she is not allowed to verbalise directly. I am a burdensome, tiring, draining, exhausting waste of space. I pushed further,  "Am I exhausting?". Double bind. She could lie and say no, but I would not trust her if she was a liar. She could hedge and try the old..."I hear that its important to you to hear the impact you have on me...why do you think that is?" But this tactic cause me to shutdown and then go into tailspins. Or she could be honest. "Yes, sometimes, but....." I didn't hear anything really from there. Just a roaring in my head, and the hollow victory of being proved right. It was nearing the end of session, and I think she was concerned at sending me out, and having me decompensate. Quite a valid concern, as that is exactly what I did. She tried to talk to me about tactics to keep myself safe, asked me to email her. I sat silently. I was NOT going to email her. I was NOT going to see her again. I was NOT setting myself up for that kind of fall again. Eventually I got up and walked out without a word, and got my little self-destructive actions under way.

Sigh. When you read this, it seems like such minor things. But particularly when you are peeled raw in therapy, it seems huge and insurmountable. So, I have had my tantrum, and I have had time to think about things, and really examine my own motivations. Now its time to go and face the very uncomfortable music.

Tuesday, February 16, 2010

On the ward and out of my mind- Therapeutic or Babysitting?

Continuing on from here, here and here

One cannot expect to go into a mental health ward (at least in the public system) and experience any real therapy. There are several reasons. The focus on providing treatment in the least restrictive environment (and lets face it, also the lack of financial resources to have enough bed space) mean that all but the most severe cases of psychosis or the forensic cases are discharged in quite a short amount of time. In my experience, most people are there between 2-14 days at most. The emphasis is quite heavily on containment whilst the worst of psychotic symptoms/ suicidal ideations pass and medication adjustments.

I was first admitted to Ward B in 2006. My first admission was quite a lengthy one, in part due to the additional medical issues I experienced as a result of my overdose. I was in hospital for about 2 and a half months. Over the next two years, I was admitted on four other occasions, for periods ranging from 5 days to two weeks. Whilst in hospital there were a number of people I could theoretically talk to, in order to process what I was going through and experiencing.

Consultant Psychiatrist
Generally, I saw this guy maybe once a week at most. Usually it would be him, a Student, my assigned nurse for the shift and I. Occasionally members from my medical team were invited to participate. Not quite like the horrible ward rounds that you guys in the UK have described. But still somewhat intimidating. The focus of these meetings was primarily to establish where I was at, mental health wise and to adjust medications. They usually only lasted five minutes or so, and there was generally no suggestion on how I might deal with some of the symptoms I was experiencing, other than to suggest I ask my nurse for a prn when needed. The consultant changed over the two years that I was in and out, but the one thing that did remain the same was that he was male, usually quite authoritarian and foriegn. I found myself getting quite upset when having to go through my history with these guys, as a) I wasn't really comfortable with men b) several things on Doctor said to me about my family made me feel quite judged (I think it was due to significant cultural differences in the ideas surrounding parents and respect) and finally, as English was not their first language, it was near impossible to talk in the idioms and metaphors, we would generally engage to soften the impact of telling a trauma. They simply did not understand. Language had to be clear cut and brutally to the point. Raw and stark. Being the passive personality I am, I usually just accepted it, but one occasion it got too much for me and I got up and stormed out of the treatment room. Unfortunately, anyone who has ever needed a walking stick before can tell you it is near on impossible to "storm off" and I ended up going arse up in front of the nurses station and all the patients. I then promptly burst into tears, which the nurses responded to quite quickly, as I am known to be a non-crier. Bundled off to my room, the nurse could do little more than pat my shoulder as I howled for the next 15 minutes. That's why I don't cry. Once I do, I can't stop. Anyways....
As I mentioned, you got an assigned Nurse at the beginning of each shift, who was supposed to check in with you for that shift, and if you had any additional problems you were to find them. The one thing all the nurses had in common was that they were OVERWORKED. The bulk of their time by necessity had to be spent caring for the geriatric patients. They weren't normally sitting in the office ignoring us (it was a cramped, uncomfortable space anyway), they were working hard. That's where the similarities ended. Some nurses were so burnt out from the demands of "general nursing" on the ward that they had no energy left for mental health nursing. A brief "How are you today?" was sufficient to their requirements and if you did approach them with an issue, they would try to listen but you could see that harried look in their eye of someone who knows they have 1001 things to do before their shift ends. Some were burnt out by the demands, but made the effort anyway. Spent the time developing rapport with the patients. Back in the days before somking restrictions came into full force, they may sit in the courtyard and have a smoke with a group of patients, always observing, in a non-confrontational way that is so much better than "How are you today?". They may be too busy to deal with you straight away but they will tell you when they can see you, and they will keep their promise. They had the skills to turn subjects that we had in common into ways of exploring the patients issues. For instance one nurse, who was also a professional photographer, would always want to see what was new in my portfolio, and we would discuss how it was representative of the way I saw the world..... and finally there was the last kind of nurse....relatively rare, thankfully. The ones who hated mental health patients, thought we were all just lazy sods who were bunging it on for attention. Mind you, the community had its share of acopic personalities that made their way to Ward B, but no excuse for the nastiness these women exuded. If its not a field you want to work in, that interests you...then why the hell work there!  I met some wonderful nurses in Ward B. As a gimpy, little long term patient, who wasn't violent or particularly demanding, I was out of the ordinary for them. Most patients were gone too quickly for them to develop rapport and the ones that remained (in Ward B at least) were pretty far gone to dementia. So, I guess in a way I became their little mascot. But for those majority of nurses who did the best they could in an under-resourced area, there were 3 or 4 nurses, whose callous actions or words remain with me today
Case Manager
I didn't get introduced to my first Case Manager until I was about a week away from discharge. Their focus is generally Ccmmunity Care. My first Case Manager (Y) was fantastic. She found away to relate to her clients, she made sure to make the meeting spaces somewhere comfortable, whether it be a park or a coffeespot, and she firmly believed in talking and doing.. in other words, by all means talk about what was going on, but at the same time go for a walk as part of my PT or go and check out a second hand book store. Anyways she was my Case Manager for most of the time I was in that area... and whilst I was in hospital she did check-in on me, she would drive me to and from my private psychiatrist appointments, when I had permission to leave the hospital. She was less of presence than out in the 'real world', I guess because she knew while I was in there I was relatively safe and contained.
Anyone who has spent time in a mental health facility will know that it is the patients that you spend the most time talking to. And often the ones you turn to, for advice or comfort. There are some inherent difficulties in this. You have to be concious of the fact that a) some of them will not be entirely truthful with you, and b) some of them will have issues that may end up impacting on your own mental health. This is particularly important to keep in mind if you decide to keep in contact outside of the ward. But the benefits are they are usually extremely judgmental, and even though no person has exactly the same experiences as you they do have a greater understanding than the average person. The other thing they bring to the table is some comraderie and humor in a dark time in your life. There is a suprising amount of laughter in a Mental Health Ward. The downside to this, is many of the 'acopic' patients, went from this comraderie and support back to their isolated and lonely existences, felt the void, and so would make a suicidal gesture just to be re-admitted for a few days to a world where they felt accepted.
Other hospital staff
Being a longer term patient, the housekeeping staff got to know me quite well, and would often stop for a quick chat. It was all very light, but it was always nice for them to compliment me on how well my walking was coming along, or as one old duck said to me "Some meat on your skin and those dark circles away from your eyes, you're starting to look quite bonny" :) In addition, (S) my physiotherapist was a fantastic support. She worked really hard to keep me goal focussed on the future, to give me hope, but on the few occasions I did fall apart, she was lovely too. I guess she didn't have to adhere to boundaries as strongly as the MH professionals do, and in those times when I was wondering if I was ever going to walk, read and talk properly again, she would take my hand and let me cry. She also provided me ample opportunites to get out the pent up anger inside me and direct it into my rehab sessions, knowing when to push my buttons to get me to push myself just that little bit further out of anger. She was a big reason why I recovered physically as well as I did, but I also believe she was a big reason why I made the steps forward with my mental health too.
Private Psychiatrist
By this stage I had been seeing Dr B for a little over a year. As soon as I was allowed out on leave, I began to go to my appointments with her twice a week, first on escorted leave with either my mum or Case Manager, and then by myself. I found it quite surreal that I was signing out of a psychiatric hospital to get psychiatric help, but the reality was, in order to get the containment I needed to go outside of the Public System.

There were some differences and some similarities at Big City Hospital.
Consultant Psychiatrist
Usually there was just you, him and  the junior doc. Not quite as confronting as at Ward B, but also it meant that there was no nurse to explain things to you when you left. I often found it hard to absorb what was being said. The consultations were the same length, about 5 minutes, but seemed to be more regular than on Ward B. Every 2-3 days. He is also the guy who heads the team the Junior Doctor and Case Manager assigned to me in community care are apart of. This means he is kept more regulalry apprised of what is going on with me, and is generally consulted in CM thinks I might need an admission. So there is a lot less repeating myself. And quite often they will do a direct admit rather than make you endure a horrible A&E admit.
Now this is one that I do get quite cranky about. I understand that we live in a world of paperwork, back-up paper work and back up, backup paperwork, but the amount of time the nurses spent even out of the office, let alone actually engaged with patients was abysmal. They did not have the same geriatric workload as Ward B nurses. WHAT ARE THEY DOING?? I believe a small part of it can be attributed to the system of medication hand outs. In Ward B, three times a day you lined up outside a window for your medication, this took two nurses about an hour to do. Of course, they had to track down the odd non-compliant patient, but it worked pretty well. Assigned nurses gave out any prns or the odd medication that fell outside these times. In BCH, each assigned nurse, prepares the meds for each of their patients and then runs around the ward like a headless chook with a dixie cup of pills and another of water, trying to find their patient. As there is a bunch of nurse all trying to do this at the same time, the tiny meds room gets quite jammed up, which slows the process further. I've watched an individual nurse take two hours to get through all her meds. It seems to be a waste of time that could be better spent with patients. In BCH, I quite often went an entire shift without talking to my assigned nurse, or even knowing who is was until they came to give me meds. A common phrase was "Ive been measning to come and see you. Just let me finish these meds". And then you never see them again... I am not a squeaky wheel in hospital, so I am easy to overlook. Additionally, I have had a nurse tell my private psychologist who rang, that I was doing very well, and that she has spoken with me that morning....and she had not even seen me! Most of them are good nurses I think, but there is a culture of inefficiency and a tendency to migrate to the nurses station where its comfy. The nurses station in addition, is nowhere near the middle of the ward, so they had no idea what was actually going on (i.e patients smoking dope in the corner (I witnessed this!), there was gossip about patients getting it on in the laundry (not sure if that's true) If you did need to see your nurse, it would take a lot of banging on the door just to get anybody to respond. Massive Fails in my opinion.
Case Manager
Unlike in Ward B, my Case Manager in BCH was housed in a separate location from the hospital. I think she only came to the hospital once, when I was first admitted to introduce herself. However she does always make sure to let them know if I am coming etc and checks on me when I am discharged.
Other staff
Consumer Advocate (K) came and saw me twice during my last incarceration   admit. She also arranged for her counterpart to check in on me on my birthday, which was sweet.
Similar to Ward B, but have had a few bad experiences this time round. One of the girls I befriended in there ended up taking me on a bit of a roller coaster ride outside of the hospital. But I will always be grateful for the few months of friendship we did have. And I truly hope she manages to work through her issues. Unfortunately, I had to distance myself to preserve my own mental health.
Private Psychologist
I began seeing (D) about two months before I landed in BCH the first time, over the next 6 months I had two subsequent admissions. I cannot emphasize how much of a support she has been when i have been hospitalised, and I really need to remember that at times like now, when I am pissed off at her. I was really reluctant to go in my first admission. I had stayed out of hospital for nearly two years, I didn't want to go back to that. I didn't want to admit to how far things had gotten out of control. She did not push hospital, in fact she is in many ways anti-hospital, but eventually we both had to admit we were out of options. The first admit, she sat in the ER with me for hours, waiting for admittance. She also did a lot of the talking (background history stuff) that I was unable to do. I don't think I would have stayed and waited if she hadn't have been there. She also rang me pretty much everyday to check how I was going. At the end of the admission, the Consultant Psych told me, that if I was admitted again, (which I think he suspected I would be, with D-day anniversary coming up) that I was to go to my bi-weekly session with her, for continuity. So on the subsequent stays, I was faced with the surreal prospect of leaving a mental health ward on leave, to go and get mental health help. Seems ludicrous! But it helped.

Ultimately, I can see that Public Mental Health Facilities are not meant to be therapeutic communities, I can see the arguements for least restrictive environments etc BUT if the patients are going to be in the hospital anyway, you would think that there should be some attempts to provide an environment more conducive to processing whatever emotions etc they are feeling. I don't know exactly what the answer is, but I suspect a big part of it, particularly in BCH is getting the nurses off their arses, out of the nursing station and into the messy melee that is a psych ward. That's what they signed up for after all.

The second thing I have become aware of in retrospect, is how lucky I have been to have other people, (private practitioners, physiotherapist, auxilary staff ect) step into to fill the void left by the lack of involvement of behalf of the nurses.

Monday, February 15, 2010

On the ward and out of my mind- I'm Bored!!!!!

Ok.. well it appears I won't be sleeping any time soon, so I might as well continue with these posts. See part one here and part two here.

Once you are confined to a MH ward there is not a lot to do, other than sit and think. And the last thing they want you doing is thinking! So they have a little schedule they run through each day to keep the crazies happy. Ward B "OT" time was not run by a qualified OT, rather two Recreation Officers, ( read nurse who got sick of nursing and decided to spend the rest of her career beading and sum dood with no neck who liked to take the male patients down to the gym to bond and got sulky if a female patient, say, thought she might like to go for a run on the treadmill.)

Morning meetings started at 8.30am every morning. The R.O. would first take meal orders, introduce new patients, and take care of housekeeping. It was also an opportunity for patients air minor grievances. The R.O. would then write the schedule for the day, and take names for excursions and banking, as well as the Centrelink lady who came in once a week to help clients sort their benefits out. We would then do the Petal Puzzle from the paper (word puzzle) together and then scatter back out to the courtyard to smoke. Some people were very vocal in these meetings, a great deal of us were pretty quiet. The only time I really spoke was during the Petal Puzzle, the only real form of intellectual stimulation I was getting.

Some activities were regular. Gentle exercise on Monday and Thursdays, which I had to attend because my lovely Physio (S) came down to run it, and she thought it would be good for my physical rehab. Of course, to rub in the humiliation of being the only one under 50 doing it (the younger patients pissed off outside for a smoke, and spent the whole hour staring through the glass and laughing) I also had to wear the belt. The belt is a thick canvas thing that velcro's and buckles around your waist with handles on the side or at the back. Its used in Rehab for patients who are learning to balance and walk again, so the physios have something solid and strong to grab if you start to fall. On Wednesday lunch they took the bus to a local Mental Health Clubhouse that hosted a wednesday lunch for $2. The idea was to introduce patients to other service users and the facility, so that when they were discharged they had community support. I think its a great concept, just not for me.. I found it kind of creepy and depressing.

Other activities during the morning might include escorts to the gym, morning sing along (yeah... I said it...sing along!) Volleyball tournaments against Ward A. In the afternoon while male RO did shopping/banking for patients female RO did art, sewing, beading, trivia games. I must admit I actually did enjoy beading, not elaborate stuff, the precisness of it just appealed to my slightly OCD side.

This schedule was repeated week in, week out . Which was great if like most people on Ward B you were there for a short stay. (2 days average for an OD, 4-7 days for most other stuff) The only long termers like me were the geriatrics and one woman who I never found out what was wrong with. She was in her 30's but literally would not move or look at anyone. She just stayed where she was put and stared off into whatever world she was in. She was pretty, her husband came to visit her regulalry and I always felt quite sorry for him....and her too, of course. The point is Ward B was a temporary stop for most people, the long termers ended up on Ward A. But somehow, I, as a long termer, ended up on Ward B. And there is only so much beading one can do!

Occasionally, the week would be shaken up by an exciting once off activity. BBQ in the park, bus trip to local national park and dam (they drove us through mcdonalds drive through and got us soft serve cones on the way back...giggle...) Other times we would head over to Ward A for social time and a bbq

Interspersed with 'activities' were workshops. Patients were 'strongly encouraged' to attend ones that the nurse or doctor thought relevant to their current issue. I got shoulder tapped for the anxiety one. I also got bullied into the relaxation class, which I walked out of after a few minutes. I find a lot of relaxation strategies to actually be quite triggering and make me quite agitated. The workshops were all very short, language aimed at the lowest common denominator and of course had a very heavy CBT bent. Out of boredom, I believe I probably attended all of the workshops over the course of the two months (they cycled through on a two week rotation) including ones that were clearly not apllicable to me at times. the staff tolerated this as I sat quietly and they didn't really know what else to do with me.

After a month or so it hit me, that no matter how lame the activity was, if i just grinned and beared it, it looked good in my notes and put me closer to discharge, so I threw myself in, barely concealing my disdain and trying not to ark up at the patronising undertones. Even (I'm ashamed to admit it) the sing alongs. I learnt that you had to play the game. Paint happy pictures, sing "You are my sunshine" and look damn well excited to be doing it.

Even with the reasonably full weekly activites, the weekends stretched on for ever, as there were no RO's on. I accumulated a plethora of art supplies (with sketch pads I didn't have to show anybody, I took up crocheting (also recommended as part of my "Fine Motor" rehab. I wore my MP3 player constantly. I spent weekends using a collection of Dr Seuss books that I had borrowed from the kids I used to nanny for, to try and prod my brain into remembering how to read again. I practiced writing with the sheets the OT from my rehab team supplied for me, as well as worksheets to improve my 'scanning' capabilities.

In addition to the activites on the ward, I was also doing a lot of rehab work. Aside from the stuff I mentioned above. I would have an individual session with (S) the Physio every day or two, as well as attending Balance and Movement group classes and Fine Motor Classed (mostly populated by patients who had suffered a stroke or had a hip replacement. I had speech and OT every few days. My designated nurse for each shift would also come and run through a series of exercise designed by (S) for 10 minutes or so each shift. They particularly liked the ones where they got to try and push me over (while sitting on a bed) so that I could practise using my core muscles. Some got a little over enthusiastic with this one! I think perhaps working out the frustration of their shift.

During my time in hospital and even as an outpatient (S) was my lifeline. She didn't take any bullshit. When I yelled at her, she yelled right on back. But she also seemed to know where my breaking point was, how hard to push me. She was honest about what she thought my recovery time would be (two years... she was pretty close, I last used my walking stick 22 months later) And she gave me something to focus on. I couldn't do anything to 'fix' my mind, but if I worked hard I could undo the damage I had done to my body. She was never judgemental, even when I complained, despite the fact I had done it to myself. I pretty devastated when a year into my physio she went off early on maternity leave. But I am eternally thankful for compassion and firmness she demonstrated in that first year. She was also a great advocate. When she found out that the room I was in had not been equipped with the necessary equipment she has requested she got it sorted straight away. Within 10 minutes I had the toilet chair, shower bench and transfer chair I needed in my room.

Ok. So moving onto Big City Hospital Program. I have been hospitalised there three times for periods from one week to two and a half weeks. And there activity program includes....erm... not a lot. They do have an RO, but she tends to set random activities up in the dining room, without letting people know she's doing it, so unless you happen to walk through you don't know its on. These activites are mainly arts and craft, beading, sewing and once cooking. So not a lot for the average male to do. But I'm a girl and I liked beading. I just managed to miss it most days. They also occasionally brought a Wii out to play. Other than that, no morning meetings, no real scheduled activities, no workshops, no trips. Just hours of sitting in a depressing, concrete courtyard chain smoking. Once again, my MP3 player was my friend. My own art supplies. And a stack of books. (Yes, I did get the hang of reading again). There aren't even any books or bookshelves in the ward, just hideously out of date, lame women's mags. I wanted to dontate some books, but there is no shelf.

Anyways. Next I will probably talk about MH professionals. When I have the energy to write it up.

Sunday, February 14, 2010

On the ward and out of my mind- You are what you eat....

So, I started bloggin about my experiences in Mental Health wards here yesterday.

It continues...

Body image was never much of an issue to me (not until the last 6 months or so), but weight has always been an issue. When depressed, I restrict, not to lose weight, but because eating seems like too much effort and too life affirming. When I was first admitted to hospital in 2006, I was 38kg (about 84 pounds for those across the pond), which is about 10kg under my optimal weight. I found out later that a Doctor in the ICU told my mother that I must have either anorexia or bulimia to be this weight. Sigh. This suspicion was not helped by the fact that when I started to be offered solid foods, I rejected a lot of them because I truly had no appetite, and well... the food is just gross. They didn't really push it, but I was subsisting on icecream, soup and toast.

Shortly before I went down to the MH ward, my mother shared what the doctor had told her. To her suprise, I laughed. I explained that I didn't have the discipline for anorexia and I couldn't stand throwing up, so no, I had neither of these conditions. I knew I was too thin, I just didn't care. But obviously, the doctors did. So, it was time to watch myself.

Ward B had a dining room with a small kitchenette attached. Breakfast was continental style, with one or two nurses in charge of toasting bread in the kitchenette. Lunch and Dinner were ordered at Morning meeting. If you missed morning meeting then you got what ever the Rec Officer chose for you. At lunch and dinner time a big trolley was pushed through by one of the Hospital Auxilaries, and then you lined up and had your name marked off and your tray handed to you. There was another nurse who served soup. Of course, there was only plastic crockery, and the nurses monitered the dump tray, to make sure you returned your cutlery. Armed with the knowledge that I was probably being monitered for an ED, I dutifully attended all meals for the first week or two and then ate whatever slop they put in front of me. I made sure to stay in a common area and avoid the bathroom for a while after eating to avoid any unfounded suspician. Eventually, they were satisfied it was not an ED, but for some reason still could not wrap their heads around the fact I jsut didn't eat becuase I couldn't be arsed. I was subsequently tested for all manner of diseases and disorders that can cause significant weight loss, and all tests came back clear. Once the spotlight was shifted somewhat from my eating habits.I began to order sandwiches for lunch and dinner, as these were generally palatable, as was the soup. In addition, due to the brain injury, I developed quite a bad tremor, and found eating with cutlery quite difficult, so I was forced to on a couple of occasions have a staff member feed me. I was quite keen to avoid this humilitation. The staff did get frustrated with my rather restricted eating, and referred me to a nutritionist, but nobody really forced the issue. After more than two and a half months of nothing but sandwiches, I began to really hate them!!

The first thing I noticed walking into the dining room that first day, was the high portion of elderly patients. I mean patients with severe dementia, who could not mobilise, feed, shower or dress themselves. All the nurses who were not performing other dinner tasks, were sitting feeding one or two of these patients. I would come to find out, that with no dedicated geriatric ward, Ward B became a dumping ground for all elderly people for whom an appropriate nursing home placement could not be found. They were often sent in as "Violent and aggressive" and a few of them were, due to the dementia, but most of them were as close as you could get to being vegetative. According to the nurses, and patients who caused Nursing Homes too much work, or resisted in anyway, were, often inappropriately shunted off to Ward B.

Years later, when I was admitted to Big City Hospital, there was of course a small population of elderly patients, but none who needed the kind of intensive care, that more than 50% of Ward B's patients did. These nurses were run off their feet, doing geriatric nursing, instead of the Mental Health Nursing they were trained to do. They resented it. And the other patients on their load suffered from the inordinate amount of time that needed to be dedicated to this one patient population.

In Big City Hospital, the dining room set up was in many ways similar. But instead of ordering meals from the kitchen, you lined up at a dedicated kitchen in the dining hall, where one of the kitchen staff would allow you to choose from two options of pre-cooked meals, in a servery or sandwiches and soup. The nursing staff had little responsibility other than to moniter the dining hall, much like a school yard moniter. The one patient I saw who required such attention.. help with feeding, mobility, showering etc, was regarded with much resentment from the staff (He was a cantankerous old bastard who seemed to enjoy winding them up) I remember thinking. You only have one of him, and you share him as a patient. Nurses in Ward B would often have two or three such patients on their  individual shift load, as well as a couple of the more standard patients. Funnily enough, despite being more overworked, as a whole I would say nurses on Ward B spent a lot more time with their patients, despite this heavy workload, than staff at BCH did, despite the fact they essentially had more time. But more on that in another post.

At BCH I was never on an ITO, so was mostly free to (with permission) walk across to the shopping centre across the road to get the food I liked, if I felt like it. There was also a number of vending machines on the ward (Got's to have my diet coke), as well as snacks put out quite regularly. A lot of patients seemed to do nothing but eat all day long. If you didn't show up to a meal, you weren't questioned, unlike in Ward B, where you would be basically manhadled out into the dining room if necessary. On a few occasions at BCH I missed breakfast, and once dinner because nobody came to tell me it was on, and I was to distracted with internal stuff, to be aware of time.

The one arsey thing I saw quite regulalry on BCH was younger patients getting hungry after ridiculously early dinner and ordering a pizza, which the nurses would generally allow in. It was always amusing to watch the expression on the poor pizza delivery guys face.

Next time, I might talk about OT... the patroning schmucks....

On the ward and out of my mind

OK. It's nearly 2am and I need some distraction. Twice today I have heard/read about somebody elses experience with Mental Health wards. One, was through a phone call I had with friend (C) in another state, who just spent a few days in what sounds like the MH ward from hell. And then I read MadSadGirl's latest installment in her "Tackling the Mental Health Minefield" series. So I thought I would write a little about some of my experiences.

As my regular readers would know, I hail from the other side of the equator. Here in Australia, we run off what I guess would be called a two-tiered health system. Pretty comprehensive universal hospital cover in the public system (but with pretty long waiting periods for non-emergent stuff, and overworked, underfunded hospitals). And for those who opt into Private Health Insurance or are prepared to pay out of pocket, a number of private hospitals. I acquired private health insurance, when I was diagnosed with epilespy, because if I had to go to hospital for any length of time, then I wanted it to be somewhere my Private Neurologist had treating rights. I haven't needed to use it for that. Its also a good idea to get Private Health Cover here before you turn 30, otherwise you lose out on the tax-rebate. So pretty much, I just used it for covering basic dental, optometry etc. 

The first time I was admitted to a MH ward, was back in 06, post OD. It was a public hospital in large regional hospital. I spent some time in the ICU while I was at my worst. After a few days (its hazy... a week at most) they attempted to move me down to a MH ward. But I was still actively hallucinating as a result of the medication I had taken, my heart rate and blood pressure went through the roof, and after about 12 hours (and my mum pleading with them to get me onto a medical floor) they decided I was to medically unstable and transferred me back up stairs. As, they had begun to notice some of the effect of the brain injury I had acquired, I went up to the Rehab ward, so once I was stabilised my Physiotherapy, Speech therapy and Occupational therapy could commence. Once up there, they also realised I had developed Aspiric Pneumonia from being extubated, so they got started on treating that as well. I was place on 1:1, which basically meant as they didn't have me in the 'safe' confines of the ward, and I had (apparently) at some point verbalised that I had every intention of finishing what I started as soon as they all left me the hell alone, I had to have a Mental Nurse, who had me in sight all the time, as well as the regular floor nurse who looked after me medically. For the first two days, this was probably somewhat unnecessary, as I drifted in and out of consciousness, and was not able to walk or even get out of bed by myself anyway, due to the brain injury. But after that, as necessary as I see the 1:1 was now, it was a pain in the ass. I could not talk to friends or family without a stranger listening in, I could not take the time to process what had happened, as I had someone taking nots on my every move. And, although for the first week or so, I could not mobilise to the shower or toilet by myself, once in there, I was afforded no privacy, as they could not leave the room. Necessary, yes. Consquence of my own actions, yes. Pain in the ass, yes yes yes! For the most part of the, oh, two weeks, that I was on the Rehab floor, my 1:1 nurse had a pretty easy shift. Once I was not actively hallucinating, I was pretty quiet. And I was resigned to the fact that I wouldn't be able to do anything in hospital anyway. Plus my mum was there everyday, helping to feed and shower me (grimace) And all the medical stuff, obs, meds etc was done by the floor nurse. So pretty much they just sat there reading Women's Day. A few, given that 1:1 time with a patient, a luxury they did not normally get, did try to talk to me about what was going on with me, what had led up to the OD, where my mind was at now. But I wasn't really in a place where I was willing to talk yet. One tried to convert me to accept Jesus Christ as my Saviour. The whole Let Go, Let God shite... which was very unprofessional. But for the most part they were ok. I began my rehab with my wonderful physio (S) and her lovely assistent (lilS). Got taught how to transition from bed to chair, and then later down the track from chair to walking stick or zimmer-frame. By the time I left to go down to the ward two weeks later, I was mostly using frame or stick, with the wheel chair only when I left hospital on day leave with my mum or when the nurses had to escort me back up to rehab floor for my sessions (otherwise would have taken me half an hour to get there) So once my medical issues had somewhat resolved, they made the decsion to move me back down to the MH floor. Was probably still a bit too soon, medically, but is very expensive to have to dedicate nurse to one person, or else they just take them off the ward floor, and it becomes understaffed.

One nurse, explained the MH wards to me, one night shift. She explained I was going to Ward B, which was a lower security ward, than Ward A, where they put the floridly psychotic and forensic patients. I was still on an Involuntary Treatment Order, which meant I could not leave ward without supervision, but the ward was only locked at night. So, I could try to leave if I wanted, but security and police would be called to bring me back, and then I would be transferred to Ward A. She also told me I could smoke in the courtyard in Ward B... that was enough for me after three weeks without a cigarette. I was brought down and shown to my room. The ward was laid out in a T shape. The Dining room/ Kitchenette/Common Room were in the middle, with small nurses station running along side it. From there, there was three corridors, to the left and right were "adult" beds, and down the centre a partition opened up what used to be the adolescent ward, to allow for more bed space still. At the very end of the corridor on the left (males), was another small tv room, with the requisite MH ward piano. I was taken down the right (females) corridor to a private room. There were 8 private rooms down one side of the corridor, with every two rooms sharing a bathroom. And four dorm rooms down the other side, with four patients sharing a room. I was happy to be given a private room, which I was later told was because I still had complex medical needs. They left me to settle in the room a minute, while they went to grab my paperwork. I took the opportunity to hobble my way to the bathroom to enjoy a bit of privacy for the first time in two weeks. Bliss. Once I got the hang of the weird bathrrom locks, that had to lock both the door from mine and the adjacent bedrooms access into the bathroom.

I was still sitting there 10 minutes later, when, let's call her Nicole, came back in to check on me. She knew I was dying for a cigarette, so she took me out to the courtyard, handed me my cigarettes, introduced me to a few of the younger patients, and told me she would be back in a few minutes to go through my paper work with me. I smiled hesitantly at the other patients, and then sidled away (as much as one can sidle with a walking stick) to sit on a bench and chain smoke seriously. I hate to admit it, (I think this is the case of a lot of people on their first admit) my immediate thought was.... I can't talk to them, they're crazy! Never mind out of all of them I was the one who just came off 1:1 and was still on an ITO. It was then it began to dawn on me what I had done, or more to the point, where I had landed myself.

Nicole came back out and took me around to a table on the other side of the courtyard, out of ear shot. She asked if I wanted to do this in my room, but I wanted to continue smoking, so I said outside was fine. Still she took care to speak softly, to protect my privacy. "This" turned out to be a patient intake form and a the first of what would be one of the many risk assessments forms I had done over the next four years and various inpatient stays. Mood leading up to the OD?... very low. Sleep?...had been bad for months but am told I didn't sleep at all for four days before OD. Have no memory of this week at all, although I was later told I did go to work for the first two days (Mon, Tues....OD on Sun), but I didn't have this info yet. Just one big missing chunk of time. Self Harm? No point denying, they had seen my scars and cuts. Eating? I was 38kg at 161cm at the time, so obviously not great. Current level of suicidality? Hmm...hesitant to answer that. Did I think I could come talk to a nurse if suicidal or self harm urges got to much? What am I going to do about it if they do...I'm in a MH Ward, I'm guessing they don't leave blades lying around. Did I have a plan? Like I'm going to tell you. Then she spoke about my life before OD. Professional Care? Yes, Psychiatrist for two years. Diagnosis? PTSD. History of sexual, physical, verbal abuse? Yes, yes and yes. Drug and Alchohol abuse? No. Psychosis? Apart from the OD induced hallucinations, no. Family support? Well.......... Housing? Not sure. Currently rent by myself, but mother insisting I come and live with her.

Nicole stopped and gathered up the paper work. And then suprised me, by pulling a packet of cigarettes from her pocket and lighting one up. She looked at me and said "I bet you are just feeling pretty shit about the way things have gone, huh?". I nod, dumbly. She went on to say "This place really isn't so bad... just think of it as a chance to take a break and focus on yourself" I say nothing. She smiles sympathetically (or is it empathetically) She goes onto explain the rules. Meals in the dining room at 7.30am, 12.30pm and 5.30pm. Meal selection is done at Morning meeting, which everyone is expected to attend in Common room at 8.30am. Courtyard open at 6am, closed at 9pm. No smoking inside. Permission (and for me supervision) required to leave the ward. Checks every hour (15 minutes for me, for the time being)

She walks me back inside pointing out things as she goes. Kitchenette is for staff to serve only. Coffee/Tea and snacks available for Morning Tea and Supper at 10.30am and 7pm, respectively. She points out the patient board. My first name has been written up there, next to my room number, and my dedicated nurse, which for this shift is Nicole. I am to find her if I need anything. We head back to my room. We both shiver as we walk in. I am to find out, my room is inexplicably colder than the rest of the ward, even the nurses say so. I will have to use four blankets at nights. My room contains a single bed, a laundry hamper and a built-in unit with a cupboard, shelves and a desk. There is barely enough room to get my zimmer frame in, so I will have to become more proficient with my stick. My bags have arrived. Friend (Miss G) has packed what she thought I would need, as mother is not ready to face apartment yet. She has included my Journals, thinking that I wouldn't want then left at home where prying eyes could see. I don't want them here either, content could keep me locked up for a lot longer than I was planning on staying. (I later give them to Miss G to keep at her house until I get out) Nicole goes through my bags, looking for contraband.... she finds it, disguised in ways that even I don't see the potential danger until she points them out and starts giving me ideas. Perfume (glass bottle, alcohol) Razor (obviously) Phone Cord (OK...hang on what???) Belt (I guess...) Shoe laces (Just take the shoes, I'll wear my thongs) ad infinitum. Lighter (Apparently I can probably get this back later) She eyes the journals curiously, but just gives them a cursory shake. She wraps a patient ID sticker around the back of my phone to cover the camera lens...for privacy reasons.

Any Questions? When do I get to go home??? Sigh. "That's for the doctors to decide, but it will probably be a little while, you're not well, physically or emotionally". She goes on to explain that they normally don't get patients with complex needs like mine. Most people either take a non-lethal OD, and are well enough to come down from A&E or CCU within a day or two. Or else they take the lethal dose, and well, they don't end up here. She said that (S) would be coming down for a meeting with the rest of my "team" and I, later on that day, to discuss my rehabilitation and the Psych Doc would come up with a plan for putting me back on meds... I hadn't had any since the OD, apart from my epilepsy meds, because they wanted to give my system time to recover.

She pats my shoulder and gets up to leave. At the doorway she turns and smiles. "You just have a bit of relax" Lunch is in 10 minutes, I will come and get you. If you need anything come and find me. If you start to feel dizzy, hit the call button" I notice the red button nestled next to the bed head. She turns and leaves shutting the door softly behind her. I lean back, clasping my childhood comfort object to my chest, and look around. And I think "What the hell have I gotten myself into?"

To be continued at some point.....

Friday, February 12, 2010

I got what I wanted and I don't want it anymore

I got what I wanted. Finally, after all the drama and crowding and  visitors staying, for the first time since I got out of hospital, I got the house to myself. Lil Sis is away down the coast until Monday. Big Sis is away for the night and should be going home on Sunday anyway. I spent all day, counting down the hours until they left, fantasising about the peace and quiet, tuning into the classical stations, maybe lounging around watching tv or doing some painting, blissfully and wonderfully alone.

But... they left, and I got some company to replace them. The 'Voice" kicked into overdrive. Freedom and an empty house was apparently too much of a temptation. I can cut without having to worry about anyone walking in on me, I can drink without worrying about detecting, all in the vain hopes of ignoring the central message from the "Voice". "Now is your chance, nobody home for the next day at least, nobody to accidentally find you, to call an ambulance. Do it now" Strong suicidal ideation, flirting with visions of a fistfuls of medication, swigs of vodka and full bathtub.

I don't know why. I mean, no, these thoughts and feelings didn't magically dissappear after "Horrible Thursday". But I guess, I had so much else that needed to be dealt with, that there wasn't so much time to stew. I honestly, was just looking forward to a nice quiet evening alone, and then bam! it all hits me, seemingly from nowhere. I suppose a big part of it on a subconcious level at least, is that I literally haven't been alone in over two weeks now, so limits the opportunities. So, I am viewing this a knee jerk reaction and trying to ride the waves as best I can. There has been some minimal SI and a little drinking. I tried to call therapist earlier, but could not get through. I left a message explaining the issue, but have not heard back. We have a planned check in phone call tomorrow, so I guess I'll just hold out for that. Problem is, I left a message, which means she'll be apprised of the issue, and ask me how I managed to work through it without support. And I don't really want to tell her I resorted to some unhealthy coping strategies. I feel like if I tell her that, it kind of sounds like, "I couldn't reach you, so I decided to slash myself" Which I guess is partially the truth, but makes it sound like "Why weren't you available when I needed you?" when in reality, I have always been fully aware that as a solo practioner, unless we have prearranged a contact time, and it is generally within business hours, she may not be available all the time by phone. I understand that. That's why we got Public Mental Health involved. But Case Manager (M) is of course only available 9-5, Mon - Fri. And although there is a Triage Line, it is staffed by people I don't know, who don't know me..and I find it incredibly difficult to talk in this situation. Naturally, the times when I am most likely to crack up, are evenings and nights, when the MH support I am comfortable with, is for the most part unavailable.

Anyway. It does kind of validate one thing that she said, about containment, and phone calls providing me with less of a feeling of having to struggle through on my own. I may not have got a hold of her tonight, but I know she will be calling tomorrow, so I just have to hold out until then. By that point I'll either feel a bit better, or I can talk to her about it. 12-14 hours isn't that far off. But if I had to wait until Monday at 3.30pm, it would be a lot harder to keep myself together.

My biggest fear, is that this is my knee jerk reaction, not just to being alone, but to being alone for a long enough period, that I can act on impulses without any risk of discovery. Up until this point lil sis was usually in the house most evenings and nights, or else her ex and his brother were, which was somewhat of a discouraging factor. Now it looks like little sis will probably head to the coast most weekends, which leaves me with a lot of opportunity, at least until we get a housemate. Sigh. So, hanging in there. I got what I wanted...not so sure I want it anymore.