Recently in Hospital Category

It was a decade that began, for me as a survivor, with the public airing of the clergy abuse scandal in January 2002. I had thought that was all behind me. I had dealt with all of that a decade earlier, surviving some tortuous "healing" years in and out of the hospital in the early '90s.

By the mid '90s, I filed suit with the church, settled, and then completely distanced myself from therapy and the hospital. I wanted nothing to do with all of that. I was very clear that my DID (dissociative identity disorder) or multiple personality disorder was made up. While that was a huge piece of denial, and I know that now, somehow that allowed me the space to get married, buy a house, build up my career, and twice become a father. But, really, while many good things happened during those years, my life was severely partitioned. I just wasn't aware. Hurting myself would happen in its own box. Being petrified would happen in its own box. Everything went back to the way it was in the '80s, except I now had built a life for myself, which was very real but also somewhat of a facade, something I could hide behind.

It collapsed like a house of cards in 2002. It's shocking to me how quickly it all happened. The more functional parts of me thought they could handle things; the talking to reporters and details of my abuse being in the big daily papers. But something strange happened. I started to realize that my life really was a bunch of partitions or rooms and that things not only were not right in 2002, but they weren't right all along. I was kidding myself about how much I had healed. The depression, the switching, the suicidality, the eating; these all were back again.

After a series of false starts with various random therapists, I called my old therapist, I like to call him Freud, and asked if I could go back to see him. We started working together again. It was hard. I became increasingly symptomatic. I became more fragmented. I acted out in self-harm a lot. And I ended up in the hospital again. And again. And again. But it was different from the '90s and I can't quite put my finger on how. We worked hard. But it was slow progress.

Then things changed. In 2008 I started working with an art therapist. By late 2008, I stopped working with Freud as my main therapist and switched to the art therapist as my main therapist. And things took off, like I was shot out of a cannon. I was not used to working in this new way. The old way was to intellectualize everything. The new way was to explore feelings, draw and paint, hug each other when leaving, and use all those healing words and phrases. The new way acknowledged internal parts in a much more direct way. She wanted to know what they felt too. We started paying attention to everything. I started taking journaling very seriously and now use it to keep connected to my life, no matter how chaotic and confusing. Also, this website was born.

Here's what I accomplished in 2009 (in rough chronological order):

Whew! I've done a lot. And luckily I did a lot in this decade. So, when I refer to the "2000's", it will be known that there were many highs and many lows, but lots of healing, and it ended in a bang.

I do give up sometimes. I cannot deny that. In fact just a few hours before I wrote the "contract" a few weeks ago, I wrote to my therapist that I was giving up. But now, looking back, on this decade and a little bit on the decade before, I must know that I can never give up. Too much has been gained. I am a different person. I have healed in more ways than I could have ever imagined. And I look forward to the next decade, even though I know that there will be lots of hard work ahead of me. It will all be worth it!

Happy New Year to all of you!

My time in the hospital has been marked, so far, by an unbelievable lack of internal cohesion and a nearly constant state of internal fragmentation. For the five plus days here, I have been all over the dissociative map, spending hours upon hours sitting out in front of the "safe" Nurses' Station, using my basic set of learned grounding skills along with the few other patients who also are at various states away from ground. I try not to judge too harshly my needing to do these basic grounding skills. I know the judgements do not solve anything. I use the iPhone games quite a bit, sticking to ones that are most helpful when dissociative: Peggle, Cross me Not, Cross Fingers, and MLB Baseball. I have listened to a little bit of classical music. I write. I draw. I talk. I don't sleep much. I try to participate in groups, but it has been really difficult for me this time.

There are some pressing issues here. The first is eating. I know eating is a form of control. I also know that it was hugely prominent back in the 90s and has been brewing for a while now. I am now at a 20 pound weight loss over the past couple months. And the hospital has exacerbated this issue. With DID, though, it's not uncommon to be in a part of yourself who has no trouble eating. But this often triggers parts of the system who do have these problems, makes them feel out of control, and the result is almost always more dissociation (and more trips to the Nurses' Station). Usually, I find that my best bet is to eat when I am able to maintain somewhat of a sense of core control, make negotiations, eat very small portions in a very deliberate manner, and all the while respect the difficulties that parts of me have.

Other parts have trouble with physical pain and it is severe enough to necessitate narcotic pain medications at times. The pain is always much worse in the hospital. It is always perceived as a complex of body memories. But maybe that is too easy an explanation. Medications are a bit tricky. There are two sides. I cannot rely on the medications as a first response, because they remove my first obligation to attempt to utilize the grounding skills (and may become a crutch). On the other hand, sometimes the grounding skills simply will not yield relief and at a certain point my doctor says, "There is no purpose in being a Marine when dealing with this". So the medication certainly can play a role; although my response to pain medications varies widely.

Yesterday, Monday, was almost totally lost time and this has been par for the course. My journal entry from 4:55PM reads:

In a short span, by 7PM, there was a sea change. I knew what this meant; that I was on the fast track to leaving the hospital. It is hard not to like me this way. I immediately developed a sense of humor, ironically made jokes about eating (there is a nurse who loves to talk about food), felt super strong and confident, and ultra-grounded. Usually I then quickly begin to get irritated about being here, and do nothing but advocate for leaving.

But I made an agreement when I first came in. It is documented in my private journal. I came in because I went into a functional state, denied parts, and kept pushing onward. I did not go into denial about parts consciously over the past few months. I did it for survival in order to achieve life tasks that needed to be done (e.g., work and home). To achieve this level of functionality, I sometimes have to do the equivalent of putting all the parts in a virtual "dungeon". In fact, often my perception is that parts cease to exist.

When I came in here, I said I cannot use the same tactics I generally use in the hospital, where I get recharged some, reconstitute myself, and leave. I know I will end up going back to the same life-threatening safety issues that are front and center in my life right now. The part of me who is focused on the serious self-harming needs to be addressed and the work needs to start in the hospital. This kind of work with similar acting out parts in the past all began in the hospital. I understand this part needs to be communicated with if I am to achieve any sense of real safety and stability at home.

So, I quickly became determined not to let this new "awakening" get in the way of what I knew I must do. The "awakening", though, felt amazingly good, but it was not long before everything started shifting yet again. By 8PM, I started to act out the normal script; I have been in the hospital too many times to not see it. Oh, there was a temptation to keep telling staff "Things are fine, I feel great, I'm okay." I started to do some of that. But this is not a game, and this is life and death serious. I was up front with them. When I tell that them that I know there is more to what is going on right in the moment, they get it. When I tell that that my safety has been off-scale jeopardized and life-threatening, they get it. When I tell them that I do not have any evidence at all that the motivations of this dangerous part have changed one bit, they get it. The nurse said (paraphrasing): "Not to worry; we will not let you go until the big safety issue is addressed head on."

At 10:28PM, the steps I had taken had again changed things inside. The cohesion started lessening and I wrote in my private journal:

At 10:40PM, I wrote:

Tonight, I slept for a mere 1.5 hours and was not phased by the second round of sleep medications. I do not know where all this will take me. Doctors, nurses, and friends are basically telling me to "keep working and see what happens". I am working super hard. I am being given time and space. For that I am grateful and determined.

You may be interested in these related posts:

• Mental States (May 2009; visually represents different mental states)
• Awakenings: An Extreme Example (September 2009; discusses an experience similar to the "awakening" discussed above)
• Making Sense of Nonsense (December 2009; talks about what led to the place I'm at now)

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My life is quite chaotic right now and a little bit out of control. By the way, I do know how to minimize!

As a system, "I" am cognizant of the fact that there is an extremely delicate balance between all the facets of my life. We cannot be too much in any one area for any protracted period of time. We all know that inside even though many of us will deny it if asked outright. This balance is crucial for my internal life as well as external life. On Thursday, hopefully, I'll write more about this from a neuroscience perspective. But now I'll focus on what my experiences have been lately.

Balance is what all of us strive for, whether dissociative or not. But there are extra challenges for those of us who dissociate, and as a general rule, the more dissociative we are, the more difficulty we have finding that balance. While there is certainly a concept of a dissociative continuum, and normal dissociation for "normal people", there is without question a different scale for some of us.

Another way of looking at the problem from an astronomical analogy is that most people stay within the context of their own psychological solar system. For the dissociative, we can be in the solar system, in the galaxy, in the Universe, in some parallel Universe, in a singularity point, or in any combination of the above, at any timescale.

For me, lately, I am experiencing more of the extremes of dissociation, where it's difficult, if not impossible, to distinguish between reality and fantasy, between present and past, between safety and danger, and even to know who I am and what "me" means.

Yesterday, I was not that in touch and already somewhat unstable inside. Yet, I was able to shift things to be what I needed to be. I volunteered at my daughter's school, helped my wife fix her computer at work, got some work chores done, cleaned the bathrooms, told my daughter an awesome story about fairies, and more. But there was something missing. I was able to be functional in all those ways at the expense of loss of control. I have been oscillating between extremes and this is not sustainable.

Not only have I been functional over the past week (or longer), I have had some really amazing experiences. I was in the "zone" for a newspaper photography shoot of a parade. I freed myself from the usual "thinking" associated with playing piano and created some wonderful recordings. I was able to teach my daughter, who is somewhat new to the violin, how to improvise, create and feel music. This was an "Aha!" moment for her and it was so gratifying for me. These are examples of how dissociation can be a very wonderful gift and "healthy".

But there has been too much else going on and too many external and internal triggers. I know that parts have freaked out at night and sought out my wife (minutes or hours after some of these great experiences). I nearly lost my daughter at a hockey game (also minutes after a great experience). And I was unable to keep myself safe today. Plus, I am having an onslaught of memories and nightmares I cannot even remember.

This is not unknown territory for me. I've been struggling with a dissociative disorder for a long time, and have been diagnosed with dissociative identity disorder (DID) since back in the early 90s. Many of the feelings and experiences now are quite similar to back then. But what makes the present different is that I try as best I can to pay attention to what's going on and document everything I can. That effort is usually what makes the difference and keeps me safe.

Right now, that effort to document is keeping me out of the hospital and allowing me to "make sense of nonsense" or at least document the nonsense. I have kept a private electronic journal for the past 16 months, and I write at an average clip of 30,000 words a month. I'm usually around a computer and can write to it whenever I need to. As a bit of an aside, about a month ago, I wrote a handy little script for my iPhone that allows me to be virtually anywhere and write to the journal (as long as I have a 3G or Edge ssh connection). As I've written before, I use the journal (as well as this blog) to help me track of my crazy life and learn from the range of experiences I have. It's certainly not a linear healing process, but it absolutely does help.

One post to my journal stands out. At 3:43PM yesterday I wrote: "I also think something very bad happened inside just a little while ago. But I don't seem to know about it now. It was purely an inside thing." This, I think, had nothing at all to do with planning to be hurt or anything like that. It was just a knowing that something happened inside and I documented it as soon as possible. I cannot explain it. If I didn't take such care to document, these awarenesses would probably be lost in the noise.

But, despite the documentation, I still have been unable to guarantee my safety. And I am not stable internally to the degree I need to be. I believe some of the functional stuff and good experiences and successes threw me off a bit. I kept using those as signs of hope that things would change. I really cannot assess the chances of things changing and becoming more stable if I keep going without some sort of intervention.

The reason why I am on the fence about going into the hospital is because of those successes and good experiences. The hospital removes that. The other times I have been to the hospital, as far as I can remember, were because of complete loss of functionality. That has not happened now. I am wondering if I can build in safety more explicitly and tell my wife and boss that I need to be home for the time being. My wife already knows that I have not been well. She can tell. She has told me she knows this. She doesn't know how to act about the eating, whether to be happy or upset about my weight loss. She doesn't know how to react to parts flipping out at night and then me being completely functional and on the ball in the morning. I acted incredulous with her about it, because when she brought it up that she knows I've been having a hard time, I was in a completely different state.

I want to see how this explicit safety plan goes. If I cannot make it work, and home falls apart and everything breaks down, then I will know I need to be in the hospital. I am not there yet though. For now, I will push ahead, keep documenting, and trying to make sense of the "nonsense" and hope that I take a trip back to our solar system and stay there for a while.

I have written about many of these issues in the past. One advantage to the blog is that it distills a lot of the things I write about in my private journal. It's important for me to know what happens moment to moment, day to day. But it's equally important to know how those experiences fit into the larger picture. The blog serves that purpose. So, while I am glad that people read the blog, it truly is more for me than for anyone else. My apologies for being so selfish!

If you find this post interesting, you may want to take a look at some related posts from the past several months:

• Does Dissociation Make Us Special? (June 2009)
• From Chaos to Control (June 2009)
• Moving Past the "Band-Aid" Approach (July 2009)
• Acceptance (August 2009)
• My Take on What Healing Means (September 2009)
• Giving Up Rant (September 2009)
• The Boat is Sinking or Is There Even a Boat? (October 2009)

So, I'm in a particularly delicate position right now. Well, actually that's the problem. The position I'm in seems to change. From one extreme reality to another extreme reality. That's another post all to itself, which I will get to soon. But, the extreme changes have got me thinking...

Last week I posted my Giving Up Rant. I really was at rock bottom there and kind of stayed in this place. I guess I'm still there. Well, that's not true. I had a breakthrough on Saturday and then another this morning. But, I cannot easily keep track.

The week before that I posted My Take on What Healing Means. That was one of those "You can do it!" cheerleader posts. And just before that I posted Awakenings, which was that transformative experience when everything seemed to fit together just so perfectly.

So, I'm sort of taking stock of where I'm at. And I went through and looked at pretty much all of my previous posts dating back to April of this year when I started blogging. With the exception of some stray posts, they were all pretty much about the positive aspects of healing and, more or less, had to do with acceptance or working to get to that place of acceptance. Indeed, I wrote the Acceptance post upon leaving the hospital in August. I can easily see how I would be quite unhappy about all these posts when I am in the depths of despair.

It is precisely this "dichotomy" that has me taking stock.

I have been struggling a bit with whether the blog is really helpful for me. I think it is. The wonderfully supportive comments from all of you kind and caring people helped me stay in this place of acceptance. I appreciate them all for their validation and ability to get me to think. I especially like it when people offer alternative views. Largely, the blog allows me to synthesize my healing journey and put a good face on it, so to speak. I think that's good. But it's not enough. It doesn't fully respect the parts of me who really aren't on board with this process and fight against it. And it presents a sort of unitary voice, the sort of intellectual voice.

I know that for me, framing things in an intellectual kind of way is self-protective. I want to appear coherent and as least mentally fragmented as possible. Of course, this sort of gets in the way of acceptance. And along the way I sort of think I end up minimizing the struggle.

My private journal, which has many entries per day, contains far too much minutia for anyone to make sense of (usually myself included). And far too many extreme situations. Drama, some would say. So, that's where this blog has a real role in my healing. The blog is an at least twice a week healing exercise for me. And, usually, I write my posts at the tail end of a couple hour grounding process before or after therapy.

My hope is that I will start to change a bit how I put myself out here on the blog. I may start to include more of what the struggles are. I want to be able to talk about the scary parts. The parts that don't want to heal. I think that's the next evolution for the site. I think it will make the site more real, and in the process be more helpful to more of me.

Somewhat unrelated, but in keeping with the "blog carnival" theme, I wanted to point your browsers to Dr. Gudrun Frerichs' recently posted articles:

• Achieving Co-Consciousness
• Self-Acceptance and Love
• Healing Narcissistic Self-Parts
• Trauma Work

I found them to be quite in line with the language I use myself and how I understand where I want to go and what healing is all about. I hope you find them helpful too. I may look at them more closely and write about them in the coming days and weeks to come.

Some in my life say I'm strong.

Some in my life say I'm weak.

The signs are that I'm much more able to keep myself safe, that I pay attention on the inside, that I try to communicate, that I am making an effort to understand some of the darker parts of myself, and on and on. Those are strengths. That is the healing mission I've been on for the past year.

But the healing comes at a cost. The cost is what I alluded to when I told the people in the hospital that I thought I suffered depression because I couldn't get my home life on track. At home, I am somewhat ineffectual. I am clearly not consistent. I am in bed a lot. I am unable to carry out my duties in any regular way. I cannot follow through on vacation plans, thereby upsetting most of the family. I let people down. At work, I'm not nearly half as good as I used to be. I don't go that often. When I do, it's carefully controlled.

The cost looks like weakness.

And I am left asking "What is the measure of a man?"

In the hospital, I learned that I am where I am right now, going through what I'm going through, and doing the best I can. Period. Healing is not pretty. In fact it's quite messy.

I can pine away for those days when I was super functional Dad and husband and worker, but to do that I would have to neglect considering all the self-harm that was going on to make that possible.

I am trying to remake myself so that I can set myself up for the rest of my life. I know I cannot live the way I have lived. That way has no future.

But the question is how to make my life more functional? Maybe the way things are right now is something I have to accept as part of healing. Maybe I have to accept that the reworking I am doing inside is hard and is not bearing fruit in the ways I would like right now. I cannot do everything at once.

In the future, I hope it does more. But, realistically, what can I expect? I honestly don't know.

And now for some context. For several months, we had a 1-week vacation planned at a small zero amenities cabin in the middle of a forest, 7.5 hours away. All I knew was that it had 4 cots. I had planned this. It was to begin tomorrow. Only a couple days ago did I realize that, as planned, this was not something I was able to do because it didn't feel safe. I proposed an alternate plan, to a place closer to home that I was familiar with, for a shorter period of time, and to a more furnished cabin (with it's own shower and bathroom and pillows and bedding). I felt like that was doable for me. The alternate plan didn't go over so well with 1/2 of the family. But, unlike the past, I am standing by my decision of personal safety over family happiness. In the distant past, I would be able to follow through on the original plans without any problem and perhaps pay the price somewhere down the road. In the more recent past, I would have to struggle through miserably. Where I am right now, with being in touch with what's going on inside, I cannot do either to myself. So, I look like I'm being selfish and weak to some. But I've made a compromise. I'm still giving them the vacation, it's just configured differently. On the inside, it's about protection. And if that's considered selfish, then so be it.

On February 1, 2003, the space shuttle Columbia broke up over Texas on re-entry into the Earth's atmosphere.

That is almost exactly how I view coming out of the hospital and re-entering the "real world".

The hospital is a protected ultra-safe environment. The doors are locked. The windows have thick locked mesh screens covering them. Staff checks on you all the time. In fact, every 5 to 30 minutes, depending on how well you are. You cannot use kids scissors unless supervised. No plastic bags.

When you come home, everyone expects that you are better. That is, after all, what hospitals are supposed to do, right? In a certain sense, you are better. I wrote in my last post about how my "acceptance" battery got recharged. That was good.

But there are, of course, other batteries. And the one that gets recharged with rest and relaxation did not get any juice added to it at all. Coming back from the psychiatric hospital is also like coming out of a medical hospital after surgery. It's the same kind of recovery. I've been exhausted.

I finally explained this to my wife yesterday, using the surgery analogy, when she wondered why I ended up in bed all day.

But the re-entry analogy is also apt. In the hospital, you are in a confined space. When you are out of the hospital, there's a rush of sensing. The world seems enormous. This takes a bit of getting used to. I don't think anyone can understand it unless they've experienced it.

Then there's the processing. What was actually done in the hospital over the course of those 15 days? I don't even know. I'm confused about it all. I don't know how to make sense of it. I suppose it will all make sense soon enough.

Image courtesy of NASA.

First, a very appreciative thank you to everyone who sent me well wishes while I have been in the hospital for what will be a 15 day stay. I am pleased to report that I will be leaving tomorrow and am very much looking forward to being with my family in my home.

My main accomplishment here was coming to terms with acceptance. Acceptance doesn't mean you are a quitter or that you have lost the battle (whatever that battle may be). Acceptance is about freeing yourself from burdens and allowing yourself to focus on healing.

For those who struggle with severe dissociation, we are constantly getting messages that what we experience is not real, that we make it up, or that we are addicted to drama. It's difficult to be understood because our experiences are not like the masses and we are often isolated.

My doctor here tried to impress upon me that these are mere distractions. We have to look past all of that. What we all need to learn to do is accept who we are, however complicated our internal structures may be, and navigate through life to create as much happiness along the way as we can.

One example of this is that I struggled in the hospital with long-lasting dissociation. I had not been used to the timescale of these experiences lasting on the order of days. For me, these experiences at this point in my life usually last on the order of minutes or hours. All the grounding skills I was used to working, really didn't. And I sort of began to panic. My doctor said something like: "Paul, you have to accept that it is what it is, but you know that these experiences do have an end because they always do."

Another example was this perception that a certain part of me was pure evil. I have struggled with this for many years mainly by ignoring and shutting out. I was in a battle that didn't need to be. When I accepted this part as me and made an effort to communicate, this part told me that their job was to protect younger parts in a very specific way. That was huge for me, this new communication.

Coming to the hospital is about recharging my "battery" which contains acceptance. When it drains to zero, that is when I end up here. If I didn't have DID, then I would perhaps be able to get support through normal life experiences, like work colleagues, friends, etc. But how do you talk to your friends and neighbors about having DID? Having this blog does help with that, but not completely. When I come here and I am surrounded by people who accept what I go through and can understand and can help me. When my battery is charged, I leave. It doesn't mean I feel great. It just means I accept and can go on with my life.

I finally understood that I have depression. The first tip off was that when I was admitted to the hospital on Friday, I happened to notice the intake sheet that the doctor was writing on. The alphabet soup jumped out at me: PTSD, DID, MDD. I knew the first two, but filed away the last one. A few minutes later, "major depressive disorder" came to mind and I thought that they were perhaps just pulling out old diagnoses from old charts. Well, sure, they were doing that. But it actually turns out to be valid.

I've now confronted a problem. My wife has been telling me for a while now that I really haven't been there for the family in the ways she would like. Since she hasn't said that in the most tactful way, I've kind of been in defense mode about it. I'm not sure if it was a change in her tone yesterday or just the reality setting in, but I've suddenly realized she has some very valid points.

I quickly considered depression a couple months ago. The warmer weather was here in New England and I didn't seem motivated in the things I was motivated by last year, mainly having to do with my landscaping efforts. This extended to other areas of family life. Yet I was able to have periods of full interest. These are my "rallies". One could say these were like mood swings, and through some lens they probably are.

I now think this is depression masked by dissociative coping strategies. Certain areas of my life, dominated by certain parts of my self, are very rich and active. Certain other areas of my life aren't so lively. My initial thought was that this wasn't the same depression I had several years ago. It wasn't that all encompassing heavy depression that permeates every aspect of one's life. I brought this up with my psychiatrist, wondering if this needed to be treated. But he, too, brought up the fact that, according to my reports, this wasn't an overpowering depression.

But, I am different now than I was a few years ago. A few years ago, even though I knew I had parts, all of me was more or less lumped together. Now, I can imagine the thought of parts of me not being depressed and parts of me being depressed.

So, as I enter the second day of being inpatient, this is what I learned. On Monday I will ask the treatment team about all of this and have them consult with my psychiatrist. Unless someone gives me a reason otherwise, I'm planning on asking to start an antidepressant.

I'm not sure how much I'll post about the current hospitalization. Given how I need to focus on myself, I may not post much since this site is not really about my day-to-day experiences as it is about the broader picture of trauma and dissociation. It's very hard being here. There's a great deal of activation of parts and I'm working very hard at staying grounded and present. But I'm okay. Every hospitalization is so completely different and I learn so much about myself from each. So, while it's immensely difficult, I'm looking forward to, in the words of my therapist, "having an authentic experience".

In an earlier image of a cobblestone path, I was reminded of internal order that is sometimes needed in order for many of us to move forward. Several of you remarked that the image was too "regimented", "trapped" and "constrained". So, I followed up that image with one showing masts and rigging from a tall ship. That didn't sit very well with me.

The other day, I saw the Japanese film "Departures" which won this year's Oscar for best foreign film. It was extraordinary on so many levels. I guess I was feeling particularly "open" while watching it. In the beginning, the hero was playing cello in a small orchestra. They were playing Beethoven's 9th Symphony, the one which ends with the famous majestic chorus. If you listen to the whole symphony, you will know that the main melody of 15 simple notes is present throughout the entire piece and only in the end are you treated to the full glory and majesty of that simple melody.

I was sitting there and thinking to myself, "This is the metaphor I want to use for my parts!" It's better than cobblestones and better than sailing rigging.

There are two components to the metaphor. The first is the majesty of the piece and the choral crescendo towards the end. This is a celebration! It's saying, you have this very simple set of 15 parts (notes) and you work with it (or play with it) throughout the 55 or so minutes of the entire symphony, exploring every possible combination of what these 15 parts can do. In the end, quite suddenly, you are treated to something quite remarkable. Who would ever imagine that ending? Who would ever imagine that 15 simple notes would yield such beauty and power?

The other component has to do with the members of the orchestra and chorus. There are so many, and each contributes to the glory of what this piece is about. They each play their own part, but when put together they create beautiful music.

I was out in my garden today, thinking about this musical metaphor and wondering what kind of image I could put with it, when I happened on these "annabelle" hydrangeas. They look, more or less, like an orchestra to me, a "symphony of parts."

The past few days have been horrible for me. I had planned to go into the hospital. But I decided against it today. Instead, this was what I did. I thought of the symphony. I looked around me. I listened. And I felt better.

I've also included a high resolution (1920 px) image. Technical information: Nikon D300 camera with Tamron 90mm/2.8 lens, 1/200s and f/10.

I have been in trouble for a while now. The past couple of weeks have been quite difficult. I am at a point now in my healing where I have much more awareness and control of my internal parts and my life. When I start to lose that awareness and control, this is destabilizing for me. I have kept myself safe, but it's been rather dicey.

I won't bore you with the details, but I had planned to get admitted to the hospital today. I figured this was getting a bit out of control and I needed help. This is also the day before a big trip to another part of the country to my wife's family with her and my two young daughters. Given what's been happening, the difficulty I've had pushing through, and the increasing suicidal thoughts I've been having, I made the decision that it was safest for me to go into the hospital. Truth be told, I waffled on that decision a bit. But in the end I made it. All the arrangements were made. I had packed and was ready to go right after my kids got home from school and I told them. My wife was incredibly unhappy with me, which is putting it mildly. She can't understand. But I'll talk about spouses in another post.

I don't want this blog to become my private journal, but the reason I am writing this is that I did want to share something you may identify with.

When my kids got off the bus and met me at the front porch, I told them I was going to the hospital and not on our plane trip. My oldest daughter was completely devastated. For weeks I had been having immense trouble pulling myself together, the switching was getting out of control, and my safety was becoming difficult to maintain. I had a little rally this past weekend (on another little one night trip), but I didn't think I could pull it together for a big trip to another state for five days.

So my 10 year old daughter pleaded with me. Tears were streaming down her face. I kept telling her I had to go to the hospital. That I didn't feel well and I had to do this. This went on for a long five minutes. But I was firm. We ended our conversation and she went inside.

I sat there for a few minutes. Just sat there. Then suddenly there was a "rally cry". Everyone inside came together and agreed we could go on the trip. I asked inside. I wanted to make sure. At that moment, the decision was reversed.

My therapist keeps telling me about how when you are on an airplane, they teach you that in case of emergency you have to put the oxygen mask on you first before you put it on your children. I understand that. I really do.

But there are times in life when it doesn't quite work that way. Sometimes you really can find the strength inside and do "it" for your children. And that's what happened today.

I'm not expecting my trip tomorrow to cure anything. I still have my bags packed for the hospital. I'm prepared that when we come back I may need to go in. But I will have done this for my children. And, right now, that means more to me than anything.

I've been in a psychiatric hospital many times over the years. Every single admission is so completely different, in part because each admission has a different cause. I have taken lately to writing appreciation letters to the staff because it always amazes me what happens there. I reprint here the majority of my letter from a couple months ago.

I reprint this letter here because I think it's important for people to realize that psychiatric hospitals do have a real role to play in helping those in crisis. I understand that many are petrified of hospitals, as we've all heard some horror stories. But there are many good hospitals and many good therapists ready to assist. One important requirement is that you have to meet them halfway and be open to receiving help.

This article appeared in the April 2009 newsletter Many Voices.

I have read Many Voices off and on for the past 18 years. Wow! That means for at least 18 years I have been on some sort of healing journey. That's a little less than half my life. Mind boggling when I think about it because sometimes it feels like I've accomplished absolutely nothing. I still have flashbacks, body memories, I switch and struggle with self-harm, but rarely act on the urges. However, everything is different now.

The biggest change is that I've made a commitment to be alive. When you can honestly make that level of commitment, you will know you are on a different, more sturdier path to healing. Suddenly you are forced to deal with the pain of all of you (yourself and your parts). You are forced to find healthier ways to push through, like breathing or drawing or writing or crying. You are forced to learn about all the parts of you and not just push them away. And you do it because you know it's the only way!

Healing from trauma, though, is kind of like learning. You don't start out knowing how it is that F=ma, you build up to it. I have had many helpful people tell me that if I just do this or that, things will get better. But none of that made any sense until I found my own way. I didn't used to think I could communicate with parts of me. I never really believed I was in it with some of the darker parts. A lot of times I didn't even believe in parts or that I was abused.

Flashbacks and body memories are sometimes more debilitating now that I don't "act out" and because they are attached to feelings. But I have new skills. I can sometimes say to myself that this is a memory and not be too caught up in it as much as I used to. I can curl up with my stuffed animals. Be comforted by loved ones. I can change my plans and say to myself that it's okay.

The largest area of growth is how I deal with my somewhat fragmented internal structure. I often denied that my "system" existed. I still do that to a degree, but I am beginning to empathize with parts and the result is increased sharing and communication and trust. The barriers, I am finding, don't need to always be so severe. So while I ask myself why, if I am getting better, do I have to experience so many bad and painful feelings that used to stay with the parts? My answer is that I am stronger now and able to experience them in a more whole way and not be destroyed. I guess that means I'm healing. This is why it's important to take a step back and assess. My knowledge that I am healing gives me the strength to go on.

Healing, though, goes hand in hand with safety, which is the topic of this issue. I have done more over the past year to create internal and external safety than at any other time in my life. I have finally been able to recognize triggers and take steps to keep myself safe. I recognize my awesome responsibility to my wife and two young children (and to myself and the children within). I do things now that I never would conceive of doing. I let my parts have time to experience what makes them feel comforted. This could be playing piano or writing or drawing or talking. And I take my internal work and therapy much more seriously now. I don't go back to work after therapy. I sit in the safe library for a few hours before therapy to write and draw and to figure out where all of me is at.

All of this change has come quite quickly for me. And this is what I want to tell all you MV readers. Only recently did I find a new therapist who was able to work with me in a very different way. This therapist works with all of me and she uses a range of methods, from talk to drawing to music. It's not been easy. The commitment is huge! But I now know everything is about safety. I finally found a safe place inside, after many years of being "told" to do so. Last September, I experienced an incredible state of consciousness, not unlike I suppose what people hope to achieve through meditation or yoga. I saw and experienced the infinite nature of the universe and my whole being was bathed for several weeks in a rich energy. That experience was my awakening. A gift, I said, for all the hard effort I had made and for the way in which I shifted my healing focus. I have not stayed at that place, but have achieved glimpses of it since. I now have something to reach for.

A few weeks ago, in a dream, my inner family took me on a journey to show me their safe place. It is a wonderfully rich place not unlike "Camelot". Now when I meditate with myself, in a safe place, I can close my eyes and go back to this place and stand alongside my parts who have finally let me in. Sometimes I do it by being quiet. Sometimes soothing music helps me get there. This is not, by any means, the end of my journey. In fact, in many ways, it's only the beginning. My parts inside are finally trusting me enough to share. We are beginning to gain a sense of family. Even darker parts that I have wished away many times are being accepted and accepting others in return.

It can be remarkably healing to accept your inner structure. But you cannot just stop there. You have to accept and make an effort to change. Only then can you experience healing.

Many Voices has been a reality check for me over the years. I have read about survivors who have immense struggles. And survivors who have integrated. Sometimes I cannot understand what I read. And often I say "These people aren't me!" But I am here to say that you are me! You are my sisters and brothers. I, like many of you, have suffered inexplicable childhood trauma. Denying is such a barrier. And today I am not ashamed to even say I have parts inside.

I also want Many Voices readers to know that, if you haven't already, you can find a path to healing. My awakening experiences were gifts that come with a responsibility. I am here to tell you that there is a safe place. You can find it. Trust yourself, work hard, and open your heart. It's right in front of you and it's incredible.

The drawing above represents my internal safe place. The striations represent energy flow from right to left and show how the safe place deflects everything and keeps the inside protected.

Epilogue

Shortly after I wrote this contribution, I had to go inpatient for nearly two weeks.  My hospitalization was extremely difficult for me as I began to come to terms with the body memories and the pain.  The words I had written above finally sunk in and I realized that sometimes you need to ask for help.  Sometimes the pain is too much and you need pain medication in order to just keep going.  But above all, I came to fully accept that the abuse I suffered has had a major impact on me and I sustained a major life threatening injury.  My work is about healing from that massive injury, by keeping me safe, my parts inside me safe, and those loved ones around me safe.   Then quite suddenly, I began to grieve for the first time ever.  My therapist said this is "monumental".   I now am truly healing.

If you've read any of the posts here, you know that I advocate multiple approaches to healing from trauma. Expressive writing is one such approach. This was written at an inpatient group in about 10 minutes. The directive was to "write about an object you treasure." Earlier that morning, my therapist brought the sticks, along with other rhythm instruments, to a group where we explored rhythm and sound. I found that group to be healing and I was thankful she brought the sticks.

Such writing does not need to occur in a hospital. You can do these directives and explore multiple approaches in therapy or on your own. The goal is to find what works for you.

I backdated this post because it happened a while ago. As I'm new to doing this blog (reworking it from the static site it used to be), I'm pulling some material I think may be useful from my private journal entries and posting them here. This is one of those posts. I will talk more about all the issues I'm raising here on the blog.

One issue I'd like to raise is expanding what is traditionally thought of as "therapy". For many years I've done traditional "talking" psychotherapy and, every time I was in the hospital, I was exposed to "art therapy". I always found it helpful. Somehow the process allowed more of me to speak of our experiences. I began to realize that creating pictures is at least as valid as using words to describe experiences. I then began working with a therapist who encouraged me to do both: talk and art (and music). This shift led to the great change in my healing. Suddenly, the barriers were dropped and the parts of me who didn't do well with words had a place at the table.

Anyway, art therapy is all about a powerful experience for me. In the hospital, it begins with a directive by the therapist. Several patients sit around the room, think about the directive, choose their media, and then get 20 minutes or so draw on a large piece of paper. After the time is up, everyone hangs their art on a board and we go around and say something about what it means and about our process and we get feedback from others. It's really quite an experience.

For this particular group, the directive was to: (1) draw a container and (2) draw emotions, body sensations, and thoughts.

I had already been to Tai Chi that morning and, for a long time, I had been sitting and relaxing and finding that inner peace. So, I was in such a good state when it came time for art.

Unfortunately my scanner is smaller than I thought. But I captured most of the image. The container is a heart. I wanted to make the color pink for a certain part, but the closest I could find was a redish color. The container had to be a heart... for that's exactly what I felt. Originally I didn't want any container because I felt so connected to everything outside of me. But if there was to be a container, a heart would be more than adequate. My "mind's eye" is at the bottom. Simply observing. At top is a crude representation of how I visualize the flow of thoughts. I did make one fundamental error. The flow of thoughts is really right to left. But I forgot that until just after I put in the arrow. And this was not drawn with an erasable pencil. It was drawn with my charcoal pencil. Thoughts are kind of like waves. The waves serve to separate them. Really, it would be nice if I could find some way to put a space between each thought to separate further. But what I drew is more than an adequate representation.

Then, emotions and body sensations. When I am troubled, emotions and body sensations become very separate. The emotions take on a life of their own. And the body hurts. This was not the case yesterday. Nor today. I represented the emotions as also outside of me, as rays from the sun (which themselves are physically made of particles and waves). They are bathing my whole body, hence the yellow surrounding all around me. Note that the space the energy from the sun takes up is larger than my body. This is the sense that I am radiating energy. It exists in me and outside of me. The experience of a few weeks ago could be interpreted as the yellow in this image becoming so enormous that it filled up the whole universe. I chose the Sun because I needed to find something that people in the room could relate to. I couldn't draw a picture of the universe or of God or "consciousness".

I guess the moral of my post is that dealing with trauma and dealing with dissociated internal structures may require a more varied approach than just talk therapy.

I'd love to hear about what's worked for you.