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1. I was informed I was discharging from the Psychological Institute of Washington the day after I communicated with staff that I was planning to hurt myself. I felt fear and anxiety but lashed out in anger, turning it toward myself. I began hurting myself and trying to kick the magnetic door open. The doctor told me I could choose to stop and stay calm or continue and would be restrained and given a cocktail injection to be forced to calm down. I chose to sit with the discomfort of how I felt. This was the first time in a long time I had chosen to feel my feelings. It was extremely uncomfortable, but I realized it was possible that day. And, if it were possible that day, with no foreseeable solution, it could be possible any day. It reminds me of a quote by the Buddhist Master Shantideva, “If something can be done about the situation, what need is there for dejection? And if nothing can be done about it, what use is there for being dejected?” I could do nothing but stand on my windowsill staring at the beautiful blossoms in Washington, D.C. and feeling the warmth of the sun. It was the only comfort I could find, and it made it possible to feel but not become so overwhelmed that I could not think through a solution.
2. I was ready to quit all medications and therapy one day sitting in Dr. Berger’s office at First Hospital because I did not see progress or growth. I was feeling hopeless and angry about medication that did not work and therapy that seemed pointless with a therapist who had no idea how to work with a person who experienced extreme depression and traumatic dissociation. Psychological Institute of Washington recognized my needs and the lack of progress over the course of three inpatient stays and researched trauma therapists in my area. They provided me with the name and number of a new therapist, and I agreed to go despite fear of more failure and wasted time. When I did not want to go for various reasons including feeling challenged, fear, anger, a sense of lost control, etc., I continued to show up. It has been uncomfortable, and I have run the gamut of emotions, usually the non-preferred and difficult ones to process, but I have continued with that therapist for two years and a half years.
3. I had a lot of discomfort stepping into public situations. I have spent a lot of time creating safety barriers for myself. Certain grocery stores, restaurants, parks, running paths, etc. were safe, but most other places were not. I had not communicated the intense fear of being in unfamiliar places with unfamiliar people when my therapist encouraged me to try yoga at a studio. She provided me with several local studio locations, times, and costs. Trying yoga and being close in proximity with others while trying to be in tune with my own body when overstimulated seemed terrifying. Despite the discomfort, I stayed with it for a month before deciding I was not able to continue. It seemed nearly impossible to concentrate on myself, my body, and my breathing while moving, breathing, and sweating one foot away from people I knew nothing about and ultimately did not trust. I was not quite ready to quit the attempt to tune into my body and breath though. I knew the science behind yoga and meditation and the impact it could have on someone with trauma, so I began attending mindfulness meditation class. I was able to focus my awareness on myself with much less discomfort or fear of the others around me. There was greater space, less movement, and less stimulation. The longer I attended, the more comfortable I became with the others in the sangha. There were only about five people in the mindfulness meditation class as opposed to around 25 in yoga. I was able to let my guard down enough to begin talking with the others and became comfortable with each new member who joined.
4. The shame and guilt I have felt about the decisions I have made throughout my life have made it seemingly impossible to be open about events, thoughts, and who I am as a person. I have never felt comfortable sharing and always feared judgment. I have been able to fight fear and judgment to discuss personal information about myself. Some of this was a conscious decision, albeit a decision that made me feel nauseous and like ants were crawling all over the inside of my body. The things I have shared have always been too much for me to carry on my own. It still feels as though I am wearing a backpack and carrying a canoe by myself while portaging in Canada, but I know that there are people who can grab the backside of the canoe at any time to lessen the load.
5. I have had many family therapy sessions with Tim during hospital stays but never disclosed all information about myself or allowed 100% transparency for any of those sessions to be beneficial because I did not trust therapists or case managers to share appropriately with my husband. The information I have shared with therapists and case managers is confidential, and many of those professionals did not understand the level of privacy I wanted. I recognized the need to work with my husband to address issues, so I trusted my current therapist with the details, confidentiality, and discernment in what to say and how to address issues with Tim and me. Agreeing to do therapy with Tim forced me to identify some of my needs and concerns. I was afraid of Tim getting upset and not doing things that I asked for or needed, and it took courage to accept that those things may be ignored by him. Regardless, I sat with my husband and therapist, trusting the process.
6. In the middle of June 2018, my brother called me. I ignored the call for various reasons. A few days later, I was at the Lackawanna State Park pool with my son when I received a text that made no sense to me. My sister-in-law sent a text to my sister and I telling us that if we needed anything, we could ask. I asked what was going on, and no one responded. When Ian and I came home, Tim had packed everything for us to leave for Michigan several days early. He told me that Matt was probably not going to live. I knew that if I could see him, he would pull through. I sat in the hospital every day, all day, for a week. I watched the doctors attempt multiple ways to help his body recover. I sat with my sister and other brother in his hospital room eating breakfast, our last sibling breakfast with the four of us. I ignored the reality and refused to feel what I knew was lingering in the background because of the guilt and pain. When the doctors gathered my family together to tell us that my brother’s brain was no longer producing brain waves, it took me about 30 minutes to allow myself to fully process the loss. On my way out the door of the conference room, I tried to hold in what I was feeling, but the pain was too intense. I decided to turn around and face the agony with someone. I looked at my dad, walked over to him, hugged him, and sobbed. I told him exactly what was going on in my head and heart. It was the first time in years I had been open with anyone in my family or shown any form of vulnerability, including crying in front of so many people. I was afraid of judgment or others thinking I was not as strong as I always pretended to be. I was afraid my family would ask questions. I was hurting and was afraid it was not okay to respond the way I did because it was never considered acceptable to express emotions so intensely.
7. It is common for me to experience shame especially with so many people in my life who I would consider to be in my shame web (as Brene Brown calls it). I have always allowed what others say confirm what I already believe to be true of me. I continue to struggle with replacing or changing my thoughts associated with who I think I am, but I have made huge progress in being able to speak about the shame. Admitting to feeling and experiencing shame feels exponentially more shameful, but it helps to remember the research Brene Brown has done on shame. “If we share our story with someone who responds with empathy and understanding, shame cannot survive.” Talking about shame keeps shame from growing. I have taken that dive several times in therapy and other situations. I have spoken about things that I feel intense shame about, and I have been able to say that I feel shame about those things. I have taken it a step further and spoken about the shame I feel for experiencing shame. Sometimes, when I have acknowledged intense feelings of shame and spoken about it, I have not had the desired response, and I have had to sit with that as well. Each time I experience shame, I have the choice to sit with it or react to it. I am working hard to sit with it, ride the wave, and move past.
8. I had a goal to become a peer support specialist after being discharged from the hospital May 4, 2018. In order to qualify, I needed to be out of the hospital for one year. I also discovered that I needed to volunteer or work for one year before qualifying for the position. I recognized that although I did not feel ready to work, I may be able to volunteer a few hours per week. I recognized the benefit of being a part of something and having a sense of purpose, so I began asking around for opportunities. A part time job with an understanding boss fell into my lap. My boss knew where I was in life and gave me the opportunities most other jobs would not (or could not). I stepped out on a limb to create purpose in my life and was rewarded with a boss who became a friend, a job with incredible flexibility, and the opportunity to bring my son to the office with me when I needed. I work hard to complete tasks as professionally and accurately as possible, and when I am struggling with needing a break, my boss allows me to take the time I need. I have struggled with the idea of working again because of the feelings of failure I deal with, and I have struggled to maintain a manageable stress level, but I have spent the past 15 months working toward a more balanced life.
9. Keeping razor blades has always provided me with comfort and a sense of control. Keeping them in my possession provides a sense of confidence in my ability to handle stress, frustration, anger, sadness, etc. Having razor blades has always been a fall back allowing me to know that I can harm myself if I feel that I cannot deal with my emotions in a healthier, safer way. Throwing razor blades away has always been a well-thought out and conscious decision because of the powerlessness I feel when I discard them. I have bought razor blades many more times than I should have, but I have willingly (and sometimes not so willingly) discarded them. I have chosen repeatedly to ride the wave even when it seemed much too large. I have chosen to ride the wave knowing that the wave would not only be large, but it would also last for a seemingly long period of time. Not only have I discarded razor blades repeatedly, I have reached out for help to prevent myself from using razor blades when I was unwilling to discard them/lose control. Reaching out for help, at times, was just as difficult as discarding the razor blades because I felt powerless, knew I was risking a possible hospitalization, and experienced shame.
10. I had a specific plan to die by suicide in 2019. I had the means to do it and knew how much time I would have before anyone would look for me. I was ready to do it. The day before, I reached out for help. I reached out via text message, and there was some sort of gap between sending and receiving. Because of this, the text message response came early in the morning. I knew I had received it, and I read it without processing what it said. Several hours later, and minutes before carrying out my plan, I looked at my phone. The text message was still on my screen when I turned my phone on, so I read it. Rather than put my phone away and start the process I intended; I was willing to think about what I planned on doing. I did not want to live, and I did not want to care about what others would think or feel. Nonetheless, I willingly looked at the repercussions. What would my life be like if I were not successful? What would it be like for my family if I were successful? Amid the pain and hopelessness, I chose to sit with the discomfort. I chose to do something for myself as well. I went out for coffee. I admitted to my therapist that I had intended to die by suicide understanding the possibility that I could be hospitalized, but I wanted to be transparent. I needed to be willing to be vulnerable to continue to move forward toward health.
11. I set an intention to be kind to myself for an entire year because it has been one of my greatest challenges. I tend to punish myself or hate myself; or I punish myself because I hate myself. I explored multiple avenues to treat myself with kindness and evaluated where I was, what more I could be doing, how I felt, what I needed, and any additional improvements I needed to make at regular intervals. I set goals for myself that were attainable and gave myself as much grace as I could in each moment. I made an effort to be consistent even when I felt as though I was failing. I was encouraged by the kindness I had shown myself at the six-month mark. I was discouraged by the struggle I went through for the last six months of the year, but I recognized that as an opportunity to show myself kindness as well.
12. One of my greatest desires has been to be able to take no medications. I want to live my life free from the drugs that alter who I am. Instead, I continued to take my Viibryd and Rexulti while gaining a lot of weight. Once I convinced the doctor to switch my medications so that the weight gain would stop, I remained constant on the Viibryd, Lamictal, and Ativan. I followed directions when my Lamictal was raised, and when I realized how much I was abusing Ativan, decided it would be best to stop taking it and inform the doctor. I spoke up and let my needs be known regarding medication, feelings, and urges. I engaged in discussion and willingness to try medication as a boost while in the hospital even though I was against adding more medications. I remained level-headed regarding the timeline of taking medications and have continued to remain realistic about how long I may be on the medications.
13. Maybe progress should not induce so much fear, but in many ways, I have been terrified that each success will make failure seem so much worse. Being successful and moving in the right direction feels positive but, falling down feels painful. I have also been afraid of failing at everything I try. Attempting CPT was extremely painful for that reason. Instead of being unaware of the progress I have made (for my sense of safety), I started blogging to look back at progress. It has not been a play by play shot of what I have learned or how I have changed, but it has been documentation of thoughts, struggles, intentions, etc. To be able to acknowledge movement through the process and express that for others has been a vulnerable experience, but it has also been an act of courage – to not live in fear of failure or fear others will see my progress and then see me fail.
14. I remember the feeling I had and the desire to run as far and as fast as possible when told I was going to do an EMDR session. I stayed and followed through even though I do not think I remember much about it. I was feeling afraid and vulnerable, but I was willing.
15. I was also willing to try Cognitive Processing Therapy. It took months of me fighting with myself and probably self-sabotaging before finally saying that I thought I could do the work. I ended up with the same fear as I had with EMDR. I did my best to stick with it and made an effort to work hard prior to each session. I was extremely uncomfortable reading my impact statement out loud as well as discussing various stuck points. I spoke about things I have previously kept completely silent about, even when I preferred to keep those things to myself. I continued to try to work through stuck points and thoughts while feeling frustrated, discouraged, and afraid. I felt hopeless, and I felt like I had failed another attempt to move through trauma and have alternative thoughts. Despite the frustrating and discouragement, I remain willing to try again.
16. Generally speaking, I am much more comfortable with one person or a very small group of people, but I recognized the benefits of attending the Mindfulness Based Stress Reduction course to further expand my grounding skills and increase my awareness while decreasing immediate negative reactions. I pushed myself to sign up and attend the introductory class to determine if I felt ready. I was anxious about being around so many people, especially with around 60 people at the first meeting. I was going to have to discuss my personal thoughts, emotions, and responses in a large group, and that was overwhelming. I knew that I would have extreme discomfort with my own mind and body as well, but I overcame the fear I felt and attended, participated, and shared openly. When I had a flashback, I was able to excuse myself and work through it. I was able to work through the uncomfortable sensations in my body while overcoming feelings of embarrassment, shame, and fear of returning to the class.
17. There were several reasons why I did not want to join the gym. I felt self-conscious about the weight I had gained as well as being in a public place with many people. I was afraid of falling into old habits of excessively exercising and restricting to lose weight quickly. I knew I risked the struggle of comparing myself with others and competing with anyone around me. I knew I would beat myself up if I did not think I measure up to others’ standards or my own standards. I have worked through each one of those issues, and I still work at it every time I walk into the gym. I have considered my own beliefs about myself and others as well as factors that effect performance for everyone, including myself. I started out working with Jim (my trainer) to isolate myself some and keep myself from excessive exercise. Eventually, I felt confident and more comfortable, so I signed up for the small group training sessions. I have worked through the associated social anxiety, fueling and refueling, hydration, excessive exercise, and satisfaction with my own performance in the moment.
18. I made an effort to eat and drink consistently when the only goal I had was to lose the weight I gained from the medication I had been on. At first, I was trying to maintain a calorie intake of no more than 900 calories, but Jim told me he could tell I was not eating enough based upon strength and stamina. I felt uncomfortable increasing my caloric intake to 1200, but I knew I wanted to improve my performance. Jim (my trainer) mentioned that he could tell I was eating more but not enough and asked how many calories I was taking in. He convinced me to increase my intake to at least 1600 but recommended more. I recognized on my own that I was not performing the way I wanted, so I started with April (my dietician). April advised me to no longer count calories, and she taught intuitive eating with facts about calories and fuel to fight the desire to starve myself. After several months of trying to eat and feeling uncomfortable, I started to notice a drastic change in my performance at the gym. I recognized just how much proper fueling could increase my strength and endurance. I still experience a lot of discomfort around eating, especially on days that I do not work out. I am trying to trust that eating is the healthy thing for my body.
19. When I have felt anger or shame, I have made an effort to identify the trigger so that I can work through it. I have noticed more quickly when I am feeling dysregulated or when I am beginning to feel dysregulated. I have attempted to acknowledge fear and work through it. I worked on a detailed action plan for when urges, thoughts, feelings, or dysregulation occurs. I have tried to approach things head-on rather than running or numbing every time. An approach method has been difficult to accept after years of attempting to escape overwhelming feelings that seem to activate thoughts and flashbacks.
20. Making connections with others, spending time with them, or interacting on a more personal level has always caused me to feel fear (even though I strongly dislike small talk). Relationships of any kind have made me feel uncomfortable because I do not feel as though I can trust others with my safety. I began to understand my need for connection with others because of the loneliness I felt. I analyzed the pros and cons of loneliness compared to potential loss of safety and attempted to increase interactions in a safe way. The more interactions I had with others, the more I realized I wanted to connect. I began going out and interacting in public places to have boundaries. At times, I set boundaries and held to them when questioned or pressured to do something else.
21. I had been keeping the person who sexually assaulted me as a contact in my phone, and I maintained that person as a friend/contact on social media sites. I wanted to be able to contact them sometimes, especially when feeling pissed off. I want an explanation, apology, and information about what I do not remember. I talked with my brother about some of the background and having that person as a contact, and he convinced me to block and delete all information. I cannot see or contact the person, and that person cannot see or contact me. In some ways, it has been freeing to separate completely. In other ways, I have fought an increase in flashbacks, nightmares, and fear of the unknown. The person has many connections in the area and could travel locally any time. I have found myself worrying about the person coming to Pennsylvania and running into them, but I have attempted to remind myself that it is possible but not likely. In the meantime, I continue to work through each thought and flashback as it comes.
22. While going through Cognitive Processing Therapy, I struggled with dissociation in which my mind would automatically pull me away causing me to feel lost outside of my body, and sometimes I would willingly allow myself to go to another place to feel safer. Regardless of which type, I wanted to fight the numbing and/or terror I felt while experiencing the extreme discomfort even though I also did not want to experience the emotions and actual processing of trauma. I did not want to “feel it.” I made an effort multiple times to feel, but each time I gave into the dissociation. On one occasion, I focused on everything in the present moment that I could (music, my therapist’s voice, colors, etc.). For the first time, I felt as though I could successfully move through.
23. Even though things have seemed impossible to move through at times, I have attempted to stick to the principles my brother taught me while out on a run the summer of 1996. Cognitive Processing Therapy and other challenging therapy sessions have caused me to feel as though I wanted to temporarily stop or quit therapy altogether. I have thought extensively about being able to slow down but not stop and choosing to move to the next telephone pole. My brother taught me to focus on the telephone pole and not look down because it always feels defeating when you look up. I do not always know what/where the next telephone pole is, but I have tried to continue to always move forward. When quitting has seemed easier and less painful, I have reminded myself that working through will always be more challenging at first but more rewarding. I have also reminded myself that I am not moving up the hill toward the next telephone pole by myself.
24. My 2020 intention has been to work through difficult situations by choosing courage. Courage has been demonstrated through many means/facets, and I have done quite a bit so far this year. The challenge for me has been transparency and vulnerability. Part of that was discussing honestly about where I have been with depression, self-harm, self-destructive tendencies, and suicidal thoughts with the knowledge that I was likely going to be hospitalized. I was frustrated by my inability to power through and was feeling like a failure and a burden, but I also recognized I needed help. When hospitalization was recommended, I did not fight it. I knew I would be struggling with powerlessness and shame. I knew I would be struggling with feeling as though I was a terrible wife and mom. I knew I would struggle with feeling as though I had disappointed others. I chose to take care of myself instead of allowing all those things to impact my decision negatively.
25. When I am angry, it is not usually difficult to speak up about why, but when I have felt hurt or shame, it has been much more difficult to discuss what is going on for me within any type of relationship. Not understanding seemingly sudden changes several times throughout the therapeutic relationship has left me feeling confused and upset as well as invalidated at times. It took some time, but I was able to discuss the therapeutic relationship, my concerns, my confusion, my frustrations, and my shame.