Wise Mind is Silent

This week I tried the Tuesday DBT group. For several days prior, I was obsessing anxiously over what to do. I had agreed with Sierra, the group therapist, that I would try this group and skip the Monday group I usually attend. Up until 15 minutes before Monday group started, I was thinking I might show up for it and tell her I changed my mind about trying the Tuesday group. I managed to keep myself in the house until after that group started, thus forcing me to either go on Tuesday or skip it entirely.

When I showed up on Tuesday, I had to sit in a waiting room until Sierra showed up to escort me to the room where this group meets. As the time approached, I was worrying that she would not remember to come get me and wondered how long I should wait before fleeing the building. Then she showed up. As we walked to her office to pick up her materials (and coffee), I told her that I had nearly changed my mind and come to Monday’s group. She mentioned that she’d realized coming to a different group might be really hard for me.

Hard it was. The group was much larger than Monday’s, and half the members were men. My anxiety was through the roof. I didn’t know what to share when it came to diary cards, so I followed along with the rest of the group and just read off a list of the skills I used, despite thinking that this does not really show the therapists whether I used the skills correctly or if they helped. I was then silent the rest of the group. There were plenty of times I had things to say, but other people leaped in with the talking (and talking over each other) and there was never a gap long enough for me to feel comfortable saying anything.

Our mindfulness exercise was to do a forest visualization. I’ve never done this one, as the other group prefers the beach. It didn’t work out well. I was so anxious and made more so by closing my eyes. I could barely breathe. I spent the whole exercise fighting off tears. That was the only other thing I shared in group, that I was too anxious to benefit from the exercise.

When the group ended, Sierra was busy talking to another member, so the other therapist, Nadia, showed me how to get out of the building. She told me how to get back to that room next week. I bit my tongue and didn’t say that I probably wouldn’t be back next week.

Reasonable Mind tells me that I should change to the Tuesday group. They spent much less time rambling incessantly about their lives. They covered a lot of material in those 2 hours. Review of the ACCEPTS and Self-Soothe skills from the previous week, plus doing the IMPROVE and Pros & Cons skills (complete with filling in a sample Pros & Cons sheet). The Monday group would have reviewed one skill and gotten part way through starting another.

Emotional Mind tells me that I should stick with the Monday group. The only reason I even would consider the Tuesday group is that it turned out I knew one of the members from one of my inpatient stays. In Monday group I’m becoming comfortable with the people, and changing will set me back 2 months in terms of my comfort level.

Wise Mind has been annoyingly silent on the whole issue. To be fair to the Tuesday group, I have to admit that I came into it in a bad place, emotionally. Not only was I extremely anxious, but I had spent the previous day obsessing over suicide. I couldn’t stop thinking about overdosing on mom’s pills (my own are all hidden from me). This went on for hours, with me unable to find a suitable distraction, until I finally managed to fall asleep.

I spent the next few days worrying that these thoughts would persist and that I would have a crisis just days before making it 2 months between psych APRN appointments. I’ve never successfully made it 2 months yet. Mom and I went to Steak ‘n’ Shake and I was hit by a flashback to our last meal there. It was the day before my overdose. I’d been obsessing about suicide for days. When I declined to order anything but a shake, mom asked, “What am I going to feed you?” I said, “You could feed me all my pills.” She asked if she needed to hide them and I said no. The next night, I nearly died.

I went into this week’s therapy appointment and handed Sadie my diary card notes, complete with one that said I was worried about being sent back to inpatient. I was so relieved when she said, “You don’t need inpatient.” She was careful to make sure that my other negative urges that week weren’t suicidal urges in disguise, but seemed to be reassured by the fact that I had planned to call the emergency hotline if I reached the point of researching which of mom’s pills would kill me. She told me not to worry about inpatient unless I was in immediate danger (at which point, get to the hospital), and if I was just having thoughts and needed to talk she would find a way to squeeze me in for an extra appointment.

There are 2 days left until I see the psych APRN. My notes for him are ready and I plan to emphasize that I am still depressed and something needs to be changed. I know this not just because I’m still struggling with suicidal thoughts, but for a more subtle reason as well. I’ve been grumbling about taking my medication for a week, and that’s always a sign that it needs to be adjusted.

The plan for next week is to see psych APRN on Monday, give the Tuesday DBT group another chance, and see Sadie on Thursday. At some point before Thursday, I also need to work on the crisis plan she requested that I create. I’ve printed out half a dozen templates, but don’t love any of them, so I’ll probably overachieve and design my own.

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