Twisty, Turny Constructive Roads

I recall doing my worksheets for the DBT skill “Turning the Mind”.  I was asked to draw two roads, one for self-destructive behavior and one for constructive behavior, and label them with thoughts, feelings, and actions that might occur along those roads.  My self-destructive road was a straight line slamming into a brick wall, and that’s exactly where I was driving last week.

Fortunately, I came to my senses and got on the twisty, turny constructive road instead.  Monday morning, I sent another job update to Joan, and this time received a reply.  Monday afternoon, I scheduled my appointment with Brent.  It’s now less than a week away, scheduled with a few days to spare before I run out of medication.  On Tuesday, I returned to DBT group despite having e-mailed Sierra to say I was quitting.  On Wednesday, I had an appointment with Sadie.

I was very nervous going into this appointment.  I knew it would be mostly, if not entirely, about the fact of my previous cancellation and the drama that ensued.  Given that my anger was fading, I was ready to sweep it under the rug and pretend it never happened.  That’s my MO in cases of conflict, but Sadie wouldn’t let me get away with it, so I was forced to talk it out.

The e-mail that angered me suddenly made much more sense when she put it in context.  Joan had forwarded the e-mail I sent her after my first day of work to Sadie and Sierra, to ask how to handle it.  She was alarmed by things I’d written that made me sound suicidal and prone to self-harm, and given that my e-mail to Sadie after the second day of work was much more positive, the assumption was that I was hiding my true feelings from Sadie for fear she’d want to send me to the inpatient unit.  The reality was that the job sucked much less after day two than it did after day one.

Since Sadie was already concerned about my safety before I cancelled my appointments, and I have never before cancelled in the year I’ve been seeing her, she was extra concerned that I cancelled not one but both scheduled appointments.  She said she worried that I was at home dying and that she was giving too much time for me to call back before sending someone for a wellness check.  Reality in this case was that I went straight from work to a friend’s shop to learn how to run the shop while she was out of town, then stopped on the way home to pick up my scrubs for work.  I wasn’t even home until after the deadline she had set.

There were some points Sadie made that I just couldn’t agree with.  First, that she actually cares about what happens to me.  She’s required to pretend she cares, not to actually do it.  Second, that I had said or done anything worth worrying about (possibly an extension of not expecting anyone to care).  Third, that we cannot accomplish any other goals if I’m not safe.  I think this is backward.  I will never be safe until my life is worth living, so we need to accomplish my other goals rather than being fixated on the idea that I could harm myself.

As a result of the first and second points, Sadie suggested that we need to add something to my treatment plan about increasing my sense of self-worth.  Why not?  It’s already full of unattainable goals.  Right now I’m failing at the one about reducing suicidal ideation.  I mean, I’m not thinking about killing myself.  However, I am thinking very much about how I wish I were not alive.

I’ve been through two weeks of my new job now, and although it’s getting easier and each day I’m able to do more independently, I still dread going.  I still count down the minutes until the end of each shift.  I have four weeks of training left before they will completely send me off on my own, and of course I can still ask questions after that point, but I don’t feel confident that I will ever be prepared to tackle the job alone.

It’s also very strange and disconcerting to work in the hospital where I was a patient so often last year.  Every day I pass the entrance to the inpatient unit at least a dozen times, and each time I have a little bit of a flashback.  Not necessarily to the unit itself, but to some related experience from last year.  The first time I walked through the ICU as an employee really freaked me out.

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