Trauma Therapy II: Sitting In It

This is part II of a III part blog. If you haven’t read part I, read it first by clicking here.

After about a week of trauma therapy in PHP, the work finally began. I stopped resisting and started being honest with myself about my experiences. I stopped trying to do everything right and started trying to tell the truth. Through this, I realized that the reasons I thought I’d been hospitalized weren’t really the reasons I’d been hospitalized. The things that I thought had tipped me over the edge were only the topsoil in a deep and messy hole. And the only way out was to sit in the hole and get dirty.

Because I had been in survival mode for so long, actually feeling my emotions was exhausting. I don’t like for people to see me upset and I don’t like to be vulnerable, but trauma therapy was requiring me to do both of those things basically all the time. After a day or two of this, I told my therapist that I felt like there was a gaping wound in the middle of my chest and the only way to feel safe was to curl up in a ball. She said, “What are you afraid is going to happen? You’re safe.” I wasn’t sure what I thought was going to happen if I let go and sat in it. In retrospect, I think it was the actual letting go that I was so afraid of. I had built my life around hanging on in order to survive. I thought I would lose myself. I thought the darkness would take me over. I thought my grief and trauma and shame would eat me alive. But, in reality, it had already tried and I had escaped.

I cried for a week. I cried constantly in group even if I wasn’t the one sharing. I bought frozen and prepackaged meals at the grocery store because I could barely manage to eat, much less cook. I laid in my bed and cried myself to sleep every night, overwhelmed by the amount of emotions I was finally allowing myself to feel. Plus, the loneliness of knowing that no one else can help you with your feelings is probably the most destitute I’ve ever felt. Some days, I felt ok during PHP because I knew others around me felt the same way. It was often when I left that I felt the most overwhelmed. When it was time to go home, what was I supposed to do? The answer was: nothing. I just had to sit there and feel terrible. I felt lonely and sad and overwhelmed, and you just feel it. I felt homesick for something I couldn’t identify and entirely umoored. And when I felt like drinking or hurting myself or ending it all just to make the feelings stop, I called someone to sit with you. And kept feeling.

After about a week of feeling all of this, I remember asking my therapist, “How long do I have to sit it in? How do I know when I’m done?” She looked at me and said, “I’m still sitting in it.” There will always be things I need to sit in and feel. It will probably never be as overwhelming as the second week of trauma therapy because I aim to never get to a point again where I have decades worth of built up trauma to process, but there will always be something. No one else could tell me when I was done sitting in it. I just knew. One night, I looked at a picture of my mom and sobbed for hours. After that I knew I had reached the bottom of the cave and it was time to find my way back out.

To be continued in part III…

Trauma Therapy I: Anger and Release

When I was first released from my week in an inpatient hospitalization program, I felt better. I thought I had figured out the reasons I fell so far off the edge and believed I had the all the tools I needed to start again. My problem, I thought, was that I had failed to properly use my support system. I had plenty of people who loved me and cared for me, but my perfectionism had been preventing me from letting them in to help. While this was true, this was far from the root of the problem.

Upon my release, I agreed to attend a Partial Hospitalization Program (PHP). Literally the day after being discharged from the hospital, I had to show up at the same hospital again and keep talking about my feelings. I didn’t think I needed to be there. My first day, I thought, “I’m way more well adjusted than everyone else. I’m fine. I’ll be out of here in a snap.” (Spoiler alert: nope.) That’s the thing about trauma, though, is that it tricks us into believing we’re fine. Rather, our maladaptive coping strategies trick us into believing we’re fine because it’s the only way we know how to survive. I entered into the Women’s Trauma PHP assuming I didn’t have any work left to do. But I was about to do the hardest work of my life.

The first three days of PHP, I played my perfected role of “good student.” I didn’t disrupt, I listened, I responded when asked but only when asked, I took notes, I was friendly to the other participants. I knew all the answers. However, I had no intention of digging in, asking hard questions, or being vulnerable. I thought if I said all the right things and filled out my daily behavior log consisting of no urges to harm myself or others, I could get out of there and get back to my life. I stressed constantly about when I would be able to go back to work. The more “good” I was, the sooner I could leave. Trauma therapists, though, see right through that shit. So, around day 4, my therapist starting pushing my buttons. Our therapists often discussed how the trauma program would trigger us so we could learn how to deal with our triggers in a healthy environment, but they also emphasized that this triggering was not intentional. It just happened as a part of being vulnerable and interacting with others. However, my shell was so tightly encased, that I have a feeling my therapist had no choice but to grab a stick and poke the bear.

I’m funny when I get angry. Most people yell, become aggressive, or get physically aggitated. I sulk. I think a lot of my issues with anger come from both the fact that I’ve experienced the pain that misdirected anger can cause and also from my relentless Good Girl Syndrome. Because I’ve experienced emotional abuse, I don’t want my anger to ever feel that way to anyone else. In addition, angry outbursts seem like a form of losing control, and if I keep my anger dialed down, I’ll still be able to be perfect. It turns out, though, I’m SUPER angry. If you know anything about the Enneagram, this really shouldn’t be surprising. I’m a 1, and we’re notoriously the most angry number. But we keep our anger boxed up inside to seem measured and controlled.

This is what I did in PHP. For several days, I sat in the corner of each lecture and therapy session refusing to make eye contact and refusing to participate. The program was making me angry. The people were making me angry. My therapist was making me angry. And I was in such a delicate state that it was getting harder and harder to keep all my anger controlled. My second Friday in PHP, I told my friend in the program, “I’m never coming back here.” Later we laughed about it, but at the time I was serious. Anger is the gateway to so many other emotions, like grief and shame, so it’s where many of us start our trauma work. The minute we started to feel angry, the minute our therapist knew she was finally getting somewhere.

I finally moved past my anger the day I shared in group therapy. I had shared in group before, but never anything actually vulnerable. The longer I sat in the program, though, the more I realized that, in order to begin my true healing process, I would have to share some things that I hadn’t shared with anyone. I was terrified. Every day as I sat in group, it pressed harder and harder on me that I wasn’t going to get through this program if I didn’t start being vulnerable. I would rehearse what I wanted to say and how I wanted to say it when I was falling asleep at night. I didn’t even know how to make the words because I had spent so long trying to pretend that this particular thing hadn’t happened to me that I had started to forget about it. The fact that I had kept it shoved down for so long, though, was a huge source of my trauma.

One morning, I finally decided to share. I think, probably, I was so exhausted from being angry that I figured I had no choice but to let go and actually work the program. As I shared, I stared at the table in front of me, tears dripping off of my face, my breathing shallow, my hands clamped together in my lap. I felt no better, in fact I probably felt worse, but I had done it. Next came the worst part. The sitting in it. Our program therapist was very fond of telling us to “sit in it.” Because of my maladaptive coping strategies that I used to survive years of trauma, I had forgotten how to feel negative feelings and just feel them. Most trauma survivors, upon feeling negative feelings, use behaviors like substance abuse, self harm, avoidance, partying, or over working when we start to feel this way. We spend most of our time just trying to stay alive. In PHP, our therapist challenged us to feel without relying on these behaviors. She told us we were in a safe place to feel all of these emotions: we had mental health professionals around us all the time and we had a built in support system if we were unable to handle the feelings. The only way out was through.

(to be continued in a part II – there’s a lot to cover here, y’all. stay tuned.)

Psych Ward

*tw: mental illness, hospitalization, suicide, self harm, sexual assault*

At the end of May, I spent a week in an inpatient psychiatric hospital. While I don’t feel comfortable sharing the specifics of what led me to be admitted, I was admitted involuntarily, meaning I did not walk in off the street and decide I needed care. Instead, I had reached my saturation point for handling life’s variables and healthcare providers determined I would be safest in a hospital setting. I never thought I would need to be hospitalized, but in retrospect, I’m suprised it took me this long. I can now see warning signs in myself all over the place, but I wasn’t listening to them.

Late on the Monday night before Memorial Day, I sobbed in the car as my roommate drove me to the emergency room. I texted my boss and my therapist and called my partner, but I remember very little after that. I spent the night in Emory University’s ER, attempting to watch Sex in the City and drifting in and out of conciousness as we waited for the rotating psychiatrist to come and evaluate me. Around 5:30am, my partner left to go home and rest. Around 6:30am, the psychiatrist finally arrived. I talked with him for a few minutes, answering questions about what brought me to the ER, my medical and psychiatric history, and how I was feeling. Not long after, the attending nurse told me I was being taken to a psychiatric hospital. They assured me they would find one that would accept my insurance. I was loaded onto a stretcher and into an ambulance with no specific idea about where I was headed. I was terrified and exhausted, and I slept the whole ride.

When we arrived, I was unloaded along with my backpack I had somehow managed to bring along. Still in blue papery hospital scrubs, I sat scrunched up in an armchair alone in an intake room for what felt like hours, waiting to be processed into the hospital. Eventually, I was able to put my own clothes back on and use my phone to text a few people to tell them where I was. I wrote down important phone numbers so I would still have them after they could confiscate my phone. They took my bookbag as well, and it would be two days before I could get the rest of my things out of it. I was taken to a section of the hospital that I now know is primarily for people who are psychotic, delusional, aggressive, or paranoid. I didn’t fit any of these categories, but the women’s trauma unit I was eventually bound for was full, so I was stuck in holding until there was an open bed.

I walked around for three days in a complete fog. I’m sure the sleeping medications didn’t help, but as the reality of what was happening set in, I began to feel less and less in control of my body. I had panic attacks and cried constantly. I had no idea what was going on. I felt entirely alone. I wanted so badly to process what had happened but felt I had no one to talk to. I watched people get shots of sedatives to calm them after having raging outbursts. I watched one man try to escape twice in one day. I watched another walk around wearing only one shoe, in a psychotic daze for 48 hours until they corrected his medication and he became a completely stable person. I was scared and I had no clue how to move forward.

On day 3, I finally had visitation hours. Seeing my partner and my best friend was both jarring and comforting. They said they were surprised at how good I looked and seemed. Looking back, this is especially strange because of how out of control I felt. All of my defense mechanisms to keep my life together had finally failed. My perfectionism, my obsessive cleaning and organizing, my intellectualization of my problems, and my avoidance of conflict and difficult emotions had all worked for a long time. But the thing about defense mechanisms is that they work until they don’t. I avoided digging deeply into myself for so many decades that I started to believe I could forget that certain things had happened to me by simply not acknowledging them. (Spoiler: This does not work.) I was dishonest with myself and the people who love me about how I was really doing because I was ashamed of the pain I was actually feeling, and, at times, completely unaware of the pain I was actually feeling.

I started to unwrap all of this once I was moved from the chaotic holding unit to the women’s trauma unit. I was surrounded by women who shared my diagnoses and my life experiences. We never discussed specifics, but we just knew. It was such a relief to get hugs from other women after not having any physical contact for days in the other unit. I started to smile and laugh again. “This isn’t the psych ward!” we would yell across the table at each other, as we color pictures of mandalas and animals with dulling colored pencils. We laughed because there was no other way we could make it through. Because we were in the psych ward. And our reality pressed in from all sides as we walked around in our pants without drawstrings and shoes without laces. Our backs ached from mattresses without springs and our eyes were tired from the wellness checks every 15 minutes during the night to make sure we were breathing. It was an overwhelming week. It was a week I never thought I’d have. But it was real, and now it’s a part of my story.

Since being released, I’ve been participating in a partial hospitalization program for women’s trauma. It’s possibly the most difficult work I’ve ever done. I’m not quite ready to share my reflections on the work I’ve been doing in trauma therapy yet because it’s still so close and because I’m still doing it. But I wanted to at least share the beginning of this journey. I want to share this experience because I want to help normalize psychiatric care. Inpatient hospitalization programs are for everyone. If you feel out of control of your emotions, a situation, substance abuse, or your behaviors, admitting yourself to a program like the one I was in could be a helpful step. Inpatient programs help stabilize you in moments of crisis. Getting help before you’re in a full blown crisis is also a valid reason to seek hospitalization.

I’m getting better, but I can’t say I’m getting better every day because that would be a lie. Healing is not linear. I’m learning new ways to cope and some days I use those new coping skills effectively, but other days I don’t. I’m back at work part time, but I’m teaching my self to take it easy. I’m scared to integrate back into “real life”, but I know that I’ll be ready when it’s time. I’m still not sure what all I’m supposed to have learned from the psych ward, but I trust that I’m learning it.

Trial and Error

Last year, I wrote about my decision to go on medication for my anxiety. It was a complicated decision for me to actually seek help from a doctor. I’d never discussed my mental health with a doctor before, only my therapist, and it felt like an overwhelmingly vulnerable thing to do. My first appointment with my doctor, I sat on the examination table with sweaty palms and shortness of breath. It’s a little over a year later, and I’m still on a journey toward balance, healing, and figuring out what medications are right for me.

Unlike many physical health problems, the medications for mental health are much more of a trial and error situation. I know that some issues like autoimmune disorders, cancer, and chronic pain can feel this way, too, so I don’t want to discount those experiences. But I’d never had an experience where a doctor didn’t know exactly how to treat me. I’m rarely sick, and when I am, it’s usually with something predictable like a cold or flu, bronchitis at the worst. I’ve had a few surgeries, mainly due to routine dental procedures and sports injuries. I’ve done physical therapy countless times. However, being prescribed a medication in the spirit of “we’ll see how this goes!” is a new and somewhat scary journey.

Medications for mental health can sometimes have side effects that are worse than the thing you want them to prevent. They can cause suicidal thoughts, hallucinations, and depression. They can make you tired, dizzy, nauseated, gain weight, lose weight, hungry, not hungry, the list goes on. My body has always operated on a pretty predictable rhythm. I’ve exercised at least five days per week since I started running cross country in middle school. Growing up, fried foods, red meat, and other unhealthy options were never made available to me, a pattern I took with me into adulthood. Whenver I was experiencing something unpleasant in my body, I could usually point to exactly why that was and do something to make it stop. But these new medications are a different story.

I started out taking Zoloft. I felt like it was helping my anxiety, so we increased the dosage. After a few months, though, I was feeling exhausted and depressed. I went back to my doctor and we decided to try something else. Next, I tried Lexapro. I felt like I had more energy and experienced less side effects, but I was still feeling depressed. After talking with my therapist, I realized that maybe the depression wasn’t a side effect of the medications but was actually a symptom of mental illness. My anxiety had been my main concern for so long, and once that was quieted, my depression was free to settle back in and take control.

The past six months have been a slow trudge through day to day life. Some days were better than others, but I struggled find joy in my work and in my hobbies. Spending time with friends was exhausting, but sitting in my house alone made me feel even more worthless. There were times I had to call friends to come and sit with me because I didn’t feel safe to be alone. There were times when I had to take several days off of work. There were times when I texted the crisis hotline and thought about admitting myself to a hospital. It hasn’t been the best season. But I’m so grateful for the people who showed up for me and for my own ability to ask for help and to get up and keep trying.

So, now, not only am I taking Lexapro but also Wellbutrin. And I’m feeling the best I’ve felt in months. My insides feel less dreary and I’m excited about things instead of feeling burdened by them. I want to be creative again. I want to be spontaneous and try new things. The fog is slowly lifting. I know there will be bad days again because mental illness doesn’t just go away overnight, but I also know that my therapist and doctor will be there for me along the way. Maybe one day I’ll need to switch medications again. Maybe one day I won’t need any medications at all. But for now, the best version of me is the one that takes two pills per day, and there’s no shame in that.

Lies Religion Told Me About My Depression

CW: disordered eating, depression, religious trauma, self harm

I first struggled with depression and body image in high school. For the better part of my junior year, I restricted my eating or avoided eating altogether. I was in a theater production at school, so my evening rehearsal schedule meant I could pretend to eat all three meals at school while managing to only munch on some free oyster crackers from the cafeteria throughout the day. After several months of this, as well as constant urging from my friends, I summoned the courage to talk to someone at my church about what I was going through.

My youth leader and I went to dinner at Chik-fil-A (the classic Christian restaurant, obviously), and I confessed my hatred for my own body and general unhappiness with my life. I remember saying, “I don’t know why I’m so unhappy. I have a boyfriend. I have a lot of good friends. I’m doing well in school.” To which my youth leader responded, “Yes, but you need to be able to be happy even if you don’t have those things. That’s why we find our joy in Jesus.” Here is the first lie: If you really love Jesus, you won’t ever be unhappy.

It wasn’t until over a decade later that I realized how disturbing this was. There I sat, a fragile, 95 pound 16-year-old, and instead of getting the mental health assistance I so badly needed, I was being told that my unhappiness was directly correlated to the depth of my religious belief. If I would only pray more, read the Bible more, and be a better Christian, then I wouldn’t be having these problems. I wasn’t referred to get any outside help and instead was referred to a devotional book for teenage girls.

For whatever its worth, I did start eating again after the conversation with my youth leader. Whether it was the confession of my issue itself or my deep belief in what I’d been told, by the time I graduated from high school, I’d started eating all three meals again. But, really, that’s not the thing that matters the most. What does was my belief in my ability to be cured from mental illness simply by praying and going to church. Sure, prayer, meditation, and community can all help improve mental health and personal awareness. I don’t discount that. But my brain chemistry cannot be cured by sitting in a dark room with my eyes closed. People far more devout than I experience unhappiness and depression all of the time. And the refusal of many church communities to acknowledge the dark emotions we all face leads to a church full of shiny, happy people. When church does not allow us to be unhappy, depressed, anxious, or angry, it denies us the fullness of our human experience.

Earlier in my high school experience, I struggled with other self-harming behaviors. Like any addiction or illness, I would go through periods of recovery followed by periods of relapse. Every time I fell back into old patterns, I would spend the next spiritual retreat with my youth group reflecting on my own short comings. This is the second lie: My inability to overcome mental illness is based in my unwillingness to let God work in my life.

I spent countless high school retreats crying while participating in whatever metaphorical spiritual practice had been employed to help us “let go” of the things holding us back in our relationship with God. Sometimes this was writing down what we needed to let go of and nailing it to a cross. (Don’t get me started on the disturbing theological implications of this one.) Sometimes it was writing down our sins on a piece of paper and throwing it in the fire. Sometimes it was holding a small stone in our hands, meditating on it, and then laying it at the foot of the cross to represent our burdens. While I understand what was being attempted with these practices, for me, they did nothing but damage. Each time, I contemplated the same things. I wasn’t happy: I was depressed, self-harming, anorexic, and lonely. I believed that if I tried hard enough and really meant it, then God would take these problems away. Each time, this turned out not to be true, and each time I thought it was my own fault for not having enough faith for God to take away my burdens.

I do not believe that God magically rewards “good people” with joy, wealth, and easy lives. I do not believe that God spitefully punishes “bad people” with mental illness, sickness, and poverty. My brain chemistry has nothing to do with my actions in the world. I was born with a brain that is suceptible to anxiety and depression, and this does not make me a failure in the eyes of God. While I do what I can to maintain my mental health – exercise, healthy diet, meditation, therapy – I am the best version of myself when I’m on the right medications. This does not mean God made me incorrectly or that I’ve done something to cause God’s anger at me. It just means I have to work harder each day to find the things that ground me.

Earlier this week, my therapist asked me what things were grounding me currently. I struggled to come up with an answer. Finally, I was able to mention my partner, my cats, a vegan pot pie I made for dinner, and my new garlic plant. I certainly did not mention guilt from being unhappy or a lack of faith. Days are hard right now, but that makes me no less faithful. It does make me more grateful for the good things when they grow. I am also grateful for the people and spaces that allow be to feel all of my feelings, even when they don’t make sense, even when they are overwhelming. I am grateful for a God who honors all of my feelings, especially the ones that hurt.

Healing Old Wounds

In high school, I had no concept of self care.  I woke up at 5:52am every day, like literal clockwork.  I left my house at 7, got to school at 7:20, got coffee from the cafeteria, and met my friends in the back of the theater to finish homework or talk.  I went to class, went to cross country practice, and got home at 6.  I did homework, and went to bed by 10:00.  

Why am I telling you my daily schedule from 2004-2008? To point out that there was no time for doing what felt good. I enjoyed being on the cross country team, going to school, and spending time with my friends, but I didn’t do anything just for me.  I did what I had to do and what was required of me by others.  No one ever asked me what it would mean to do what felt good to me.  The first time I heard that question, I was 24 years old and having an emotional breakdown in graduate school.  It never occurred to me before then that I could do things for no other reason but to care for myself.  In high school, I was focused on what needed to be done to succeed in life after high school.  Studying, taking standardized tests, being captain of the cross country team, leading worship at youth group, and applying for colleges – there was no time for rest.  Rest wouldn’t help me in the future.

What I didn’t realize was that taking care of myself at the age of 16 would’ve made things much less painful 12 years later.  I never dealt with my depression and harmful behaviors in high school, so I never healed properly.  I went to a therapist in high school, but after a year of meeting, she concluded that there was nothing wrong with me and that there was no reason for me to feel so depressed. She branded herself as a Christian therapist and told me that if I only prayed enough and tried harder, I wouldn’t feel this way anymore.  I believed her and tried to move forward.  But, because I was never given any real tools to cope with what was actually a chronic mental illness, old patterns continue to resurface.

During the past five years, most of my mental illness has surfaced in the form of anxiety and panic attacks.  Medication, therapy, and learning proper self care have helped me move through the hard days.  But I was surprised when, this past September, I began to feel familiar symptoms I hadn’t felt in over a decade.  My anxiety and depression started an exhausting tug of war of apathy vs perfection.  I was paralyzed by the two extremes.  I didn’t know how to deal with both of these illness at the same time.

The only thing I know to do now is to listen to my body.  I recently heard poet and healer Jamie Lee Finch refer to her body as “She” in a podcast.  I’ve adopted that same practice, trying to personify my body in a way that gives her more value.  I try to listen to what she tells me, even when it doesn’t seem to make sense.  I let her rest so she is free to cry.  I take her on walks so she can breathe fresh air and absorb the sunshine.  I ask her, “what would feel good to you right now?” because, for decades, no one had asked her that before.