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.)

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.

Why and How to Make a Mental Health Safety Plan

*tw* suicide, abuse, assault, anxiety, depression, substance abuse, eating disorders

I once thought that mental health safety plans were only for people who were “really suffering”, only to be used right on the verge of self harm or suicide.  But recently, I realized that once someone reaches a place that urgent, it’s too late to make a plan.  Asking for help should happen much sooner, immediately after symptoms and warning signs start to appear.  Many of us, myself included, think our symptoms aren’t “bad enough” to get any serious help from a hospital or a helpline, but the truth is that it’s much better to ask for help too early than too late.  So, based on my limited experience (DISCLAIMER: I am not a mental health professional), here are some helpful insights into creating a mental health safety plan.

  1. Know your triggers.  Do you have something really stressful coming up at work?  Are you going to have to have a difficult conversation with someone you love?  Are you going to be interacting with someone who makes you feel unsafe?  Have you been looking at literally anything on the news? Be able to identify the things that trigger your anxiety and depression (or whatever it is you experience) so you can make sure to have a plan ready before the triggers are present.
  2. Make a plan while you’re feeling helathy. By the time you find yourself in a hole of panic or depression or suicidal thoughts or substance abuse, you’re not able to make a cohesive plan.  Have you been feel good lately?  Now is the time to make a plan.  Every office building and hotel I’ve ever been in has an emergency evacuation plan posted on each floor.  They don’t wait for the building to catch on fire to make an emergency plan.  They make the plan while things are still safe and functioning well.  Once the emergency begins, the chaos makes logical thinking impossible.  It’s important to be thinking clearly when you make a plan for yourself.
  3. Know your warning signs.  Know what to look for within yourself so you’re aware of when you should start to reference the plan you’ve made.  If you can stop yourself from spiraling deeper by implementing your plan early on, that’s a huge victory.  Knowing yourself and how you respond to triggers is crucial.  If you can identify what you’re feeling and understand your symptoms, that’s honestly half the battle.
  4. Plan for the worst case scenario.  As an anxious person, this is not always something I would suggest.  When I’m getting on an airplane, I should not imagine the worst case scenario because I’ll find myself in a panic spiral about my plane falling out of the sky in flames.  However, when it comes to imaging what you might do at your worst, you need to be prepared.  Even if you’ve never harmed yourself or attempted suicide or abused substances or developed disordered eating, mental health can be an unpredictable monster.  Know which hotlines to call, even if you’ve never needed them before.  Know what resources are available at hospitals near you.  Know your therapist’s phone number.  It’s not overkill to have the resources at hand.
  5. Have a support system.  Don’t be afraid to ask for help.  This is huge for me.  I hate asking for help.  I’m an #indepedentwoman and I don’t like having to depend on others.  But I promise that your friends would much rather get a call at 2am or have you ask them to come sit on the couch with you in silence than know you were suffering and didn’t reach out.  List a few people you can call when you’re struggling.  If you’re not good at saying how you’re feeling, develop code words with your partner or best friends so you don’t have to do the emotional labor of explaining what’s going on.

RESOURCES

This is all fairly new to me, so if you have any suggestions of your own or things that have worked for you, please share them!  Also, here are a few resources I’ve found helpful:

  1. Check out the My 3 app (not sponsored, just a great resource).  It’s available for Android and iPhone and provides a place for your safety plan that’s always in your pocket.  You can choose friends to contact, list resources for yourself, keep track of your warning signs and coping skills, and make a plan to keep yourself safe all in one spot.  10/10 would recommend.
  2. If you’re more of a “write it down” type of person, the National Suicide Prevention Lifeline has a great Patient Safety Plan you can print out.
  3. Lastly, here is a template that I made based on personal experiences.  I had trouble finding a template related to interacting with your abuser, so I made my own.  Check it out here: Assault/Abuse Survivor Safety Plan Template.

Stay safe out there, friends.  It’s a crazy world, and we have to take care of ourselves in order to fight the good fight!

If you are having thoughts of suicide (or if you are concerned about someone), there is help available right now. A trained counselor is ready to talk to you and provide help. Call the National Suicide Prevention Lifeline at 1-800-273-8255. This is a free 24-hour hotline. (Press 1 for a dedicated line for Veterans and their families. Para español, oprima 2.) If emergency medical care is needed, call 9-1-1 or go to the emergency room of the nearest hospital.