Recently in Hospital Category

Ready to Go

| By Paul | | Comments (3)

Exactly a month ago, I wrote about the perspective of my entire life, all in one neat package. The only way that was possible was because I did so from a totally honest place. I had never been able to do that before quite in that way. I read it aloud in therapy that same day, and we both were full of emotion, with some tears of joy.

It was certainly a huge healing step for me, yet it was also an internal risk. I did not consider that at the time. I have no regrets. It was necessary. I needed to know it, feel it, and write it.

I quickly found that having all that perspective has nothing to do with arriving at any particular destination. While it may have sounded "feel good", it led to a chain of realizations and internal acceptances as well as some massive conflicts. From a purely human psychological perspective, it was kind of astounding to me how that happened.

A lot started coming at me quickly and I tried my best to hold onto the entire perspective all along. It was not easy. There were a myriad of inputs reverberating throughout.

All parts of me were listening—indeed trusting—and they were all over the place. There were onslaughts of memories from different periods which were coming at me and hitting me in different ways. Parts of me were railing against everything in quite dramatic ways. There was massive acceptance, but also massive denial.

Some of the perspective was about being suicidal and the ways in which I had tried to kill myself long ago. Some was about the ways in which I have hurt myself. So, while there was a total dedication to safety all throughout, there was also a constant internal chatter about suicide and self-harming. Some was also about abusive events I felt I "should" have had control over, which led to guilt and shame.

I kept my focus on containing everything and keeping what was happening somewhat balanced by paying close attention and reality checking. I was constantly trying to assess my safety, which is never easy. When guilt and shame came up, I challenged that through an internal message of forgiveness. When denial took hold, I tried to focus on simple truths. And I practiced self-care all the time.

However, the containment only worked for so long as the internal stressors became greater and greater. It became clear that the containment was at odds with the perspective.

Containment was winning out, so it was decided to face the perspective head on. I pushed. Hard.

Less than a week later, I found myself in the hospital. I got here safely and I knew precisely what the job was I was here to do: "we" had to push harder.

Since I have been coming to the same inpatient unit for over 20 years, and know so many of the incredible people who work here, it was not difficult to get back to perspective. I did it in a very direct way. I was able to focus on trust with others and within. I spent nights in the "quiet room", the room one goes to for a "time out" but also the room ones goes to when "losing it" and needing to be physically restrained. Not all great memories.

I struggled some with opening up enough to where I felt I was close to losing control. It was not really a struggle of willingness but rather a struggle of how to do it. And while I did feel like I lost some control, it was never like it used to be, and I was really in control the whole time. I let rage pour over me. I touched immense sadness. I laughed harder than I had in a long time too, which may sound weird, but sometimes it is better to laugh hard if the alternative is to sob. There were "volcanos" erupting inside me. Physical pain. Mental exhaustion. Inability to ground.

While it may sound odd to some, a significant piece of the work here has been about changing the name of what has always been perceived as the scariest part. This had been something in my consciousness for a while. It has happened once before a few years ago. It is not an easy process. It is not just "done". The goal was to achieve a new name for this part which more accurately reflected the healing that has been accomplished over the past few years as well as the part's true essence. It took 7 days, but it was done. It felt like a part of me was reborn; that I had given all of me a new direction or at least a stronger path.

Then the perspective took on new meaning because of the hard work. Then there were a few more days of settling that in inside. Sort of like the glue drying.

This has been amongst my most healing (and most difficult) hospital stays. And now, I am ready to go.

My apologies to those who posted a comment here. The site has been having spam problems. Comments are not working.

Categories:

Halloween, Part III

| By Paul | | Comments (17)

The centered space I found myself in the morning after Halloween did not last. I hoped that maybe the difficulty would recede and that the safety risk would lessen. But it did not turn out that way. Instead it became more rocky. I was oscillating between functional and non-functional and safe and unsafe and cohesive and fragmented (which was orders of magnitude beyond frazzled or scattered). It was a roller coaster and had become too much of a risk.

I held on to see my therapist Thursday evening, the day after Halloween. That, in an of itself, was a strong indicator of how tenuous a situation I was in. Holding on like that is not all that common these days for me. When we met, I told her that if this escalates to what it was like on Halloween the night before, then I was not able to go through that level of distress on my own. I said once was enough. Plus I assumed the risks would be greater because I would be weakened by the other night. That was our agreement.

My time with her helped. I had a spurt of being functional that evening. At that point, I thought maybe that I was on a positive trajectory. But after my functional Friday morning at work, I started falling apart dramatically in the afternoon when I got home. I knew clearly that I rallied simply to do get through my responsibilities. I so quickly knew that it was serious and that I could not solve it by adding more and more responsibilities or tasks to my schedule.

The "plan" from the other night on Halloween was coming up again, but with greater force, just as I had feared. I was certain it was not just an expression or idle threat, and I knew I had to get help while I still was able. There was too much at stake.

I was remarkably decisive. I had to be. At 3 pm I texted my psychiatrist: "Can you find out if Proctor 2 has a bed?"

It was a struggle to tell and allow my wife to drive me. I knew that meant the option of serious self-harm was removed, though I never told her that was the issue. She knew I was having a hard time, and mostly, that is all she needed to know. So, I made it past that hurdle. As we were leaving, I told my kids who took the news in stride.

My wife was stressed about it all, and I promptly changed my mind on the drive in. I wanted to go back home and try harder. But by this point, despite my growing panic, the decision had been made. The admission was all arranged. They were expecting me. Changing my mind was not an option.

Just a couple hours later I made it through admissions and was on McLean's Proctor 2. There are few words to describe how it feels to be in your home and then a few hours later on the same psychiatric unit I have been coming to for over 20 years. It is surreal and, as always, conflicted. While I felt safe from self-harm or worse, I did not feel safe "in my head." I know coming here means I have a lot of work to do so I can leave in a place where I am grounded and confident in my ability to stay safe and live the life I have built for myself.

Because it was all surreal, I needed to reality check and assess what got me here.

First, is that I was able to get to the hospital without actually hurting myself. It does not usually happen that way.

Second, is that I was able to have the accomplishment of getting through Halloween on my own, whereas in the past that kind of experience would have landed me in the hospital, and many times in restraints. Being able to prove that I could get through that kind of off-scale internal response was enormous for me.

Third, and perhaps the most important, is about trust. I wrote this in my journal:

"Do you realize how much awareness I had to have and how much presence I had to maintain in order to make all the decisions I did safely? I think parts of me know that there could not have been a more perfect chain of events. Parts of me were majorly triggered. I held on, even though it didn't feel like I had much control over the "internal slider." The threats of imminent self harm would have happened and would have been extremely serious. I think part of it was that we had had enough."

"Internal slider" is a new analogy to help me think about and experience the active process of staying centered. Last January, in a post titled Unity, I wrote about thinking about my psyche in terms of "parts on left" and "parts on the right", and how my challenge is to find a bridge between them. The real world experience is of sliding back and forth. Sometimes there is more activation of parts on the right and it becomes harder to stay safe and live in the present. Sometimes the focus is on "work" and I lose touch with everything from the past and enter denial. A visual image of a slider and a bridge is realistic, and it is consistent with the view that dissociation exists on a scale. Where someone is on that scale is different from person to person, and also different for a person over time.

Coming here does not mean that certain parts need to go nuts or dump a lot of memories or any of that. In other words, they do not have to continue the trajectory I was on. I came here precisely to change that trajectory.

I knew how to get all of me to safety. I knew when the time was right. I knew it had to be after Halloween and not before. That has to have created a huge amount of internal trust.

I know this past week or more was very dicey. I get that. But the payoff has been enormous.

And now my work here begins.

Categories:

Halloween, Part II

| By Paul | | Comments (2)

On the day of Halloween, I was very much on edge. While I had planned for weeks and dealt with a steady stream of internal messages, I was still not prepared for what was to come.

A conflict had been building for days about staying safe. That is not particularly unusual. However, I knew the level of risk was. Even with seeing both my psychiatrist and therapist that day, which were both helpful, I did not have a real grip on staying safe.

My first order of business was to get back to my house. That was a battle in itself. I made the decision to go home not because I pushed parts of me away or ignored what was coming up or issued an ultimatum. I have learned that none of that works. I got home because I kept my hand on the "steering column" even though the amount of actual control felt minimal.

I like to use metaphors. Felix Baumgartner jumped last month from 24 miles above Earth and in the process he broke the sound barrier. What interested me the most was his press conference after his landing. When he jumped, he almost immediately ended up in a uncontrollable spin. It wasn't clear to him what to do. He said he reached out with one hand and it made it worse. He then reached out with the other and it made it better. All the while he stayed the course and kept trying.

Now, I'm not equating was was to come during my Halloween evening to this historic jump. But, for me personally, there are similarities. The similarity was that the risk was so great and it was not clear that what I was doing was enough to get me through without serious harm.

I have not often shared writings taken directly from my journal, but as I am trying to get across my experience, this seems to be the best way to give some context for what was going on:

5:58 pm: "It's getting very loud inside. It's ramping up big time. Having hard time staying home."

8:11 pm: "The night has taken a nasty and dramatic turn. All the internal struggle to keep contained what was beneath the surface is gone. It's as if that content is gone. It now has nothing to do with Halloween or anything of the sort. It's now just about getting hurt. That whole dynamic seems to have replaced everything that has been the struggle up to now."

9:09 pm: "It's not going well. Drive to get hurt is huge. It's dwarfing any ability to see what's really going on. I'm flipping about trick or treating and the Halloween party being now Sunday. This feels like an eternity."

9:14 pm: "I'm now in bed. Starting to be more in touch. I'm aware of huge physiological swings: hot cold hot cold, searing pain no pain, loud noise and silence. I'm way too overloaded. This is too much even for me."

9:15 pm: "I am adamant about no medicine. I know that stance is not helping me."

9:21 pm: "It's now escalating."

9:26 pm: "Enormous ringing in ears. Feels a lot like when I've taken massive overdoses. It's some physiologic chaos mirroring mental chaos. It's got to be a good barometer. This doesn't happen that often. This is akin to a medical crisis. It's clear cut now."

Here "clear cut" refers to needing the hospital. The discussion I had with my psychiatrist that morning was about why it is often clear cut for going to an emergency room for a medical crisis, but not for a mental health one. The reality, we both agreed, is that I have been able to get through many mental health crises safely without needing to go to the hospital. But there is always a safety risk. There are many mental health crises I have not navigated safely. Despite those realities, I felt strongly that trying to get through on my own was what I needed to do.

The closest parallels I can think of to this experience are the times I have lost control in the hospital, was not safe, and had to be restrained in the "quiet room." But I was not in the hospital. So my safety was totally up to me. What happened then was that my journal entries got more sparse and, at the same time, much more bizarre.

Because I do not have a "memory" which corresponds to these entries, I will not share them here. I do not think that is fair to me. But suffice it to say that my reading through them is extremely difficult. They were off scale.

But at 6:01 am the next morning I made this post:

"I woke up moaning. I am not leaving house today. Not going to work. Last night was too hard. I need to recover. I can't believe how hard last night was. It was so risky because in the midst of all that was going on, there was a parallel planning to get hurt very seriously. My body feels wrecked. Like I have been beat up. Everything hurts."

At 10 am I wrote:

"Despite how wrecked I feel, there was a huge sense of accomplishment about having stayed safe last night. It was not just that we went through something really hard and came through it, though that is a piece of it. It's way more than just suffering through with all of me. Maybe it was a sense of internal trust. But I haven't been able to hold onto it. The gains from last night are not enough. This is not over. Not by a long shot. I'm way overstimulated. I'm jumpy. Hypervigilant. I'm not settled down. It's only continuing."

Just a few minutes later, four to be exact, I wrote: "I have found my way back to center."

I have a policy to avoid language specific to self-harm or suicidal behaviors. In this post, 'safety' refers mostly towards the latter end of that spectrum (i.e., suicide). Tomorrow's Part III post will focus solely on the aftermath.

Categories:

Unity

| By Paul | | Comments (12)

I am still working at trying to find ways to deal with what I have termed a psychological suicide attempt. I keep telling myself that if one is lucky to survive such attempts, there is the opportunity for recovery and healing.

After my pre-Christmas hospital stay, I arrived at a solution that I needed something new in therapy. I felt I needed new forms of expression, that I had outgrown the art and music and writing and now needed to focus on physical means of expression.

I find myself back in the hospital again prompted by a similar "attempt." The fact that I only managed to stay out of the hospital for three days has compelled me to take a close look inside.

On the surface, it seems that I am doing all the right things. So, it was natural for me to seek an additional tool or pursue a new direction.

I quite quickly found here that I had not at all outgrown art and music and writing as expressions that lead to learning and healing, but that I was doing them in an isolation of sorts. I would not at all go so far as to say I was merely going through the motions. But it has been something akin to that. I thought I could get all the healing benefits from what I used to do, but with significantly less effort. What made it hard for me was that it was rather easy to convince myself that there was no decrease at all in effort.

I will take my paper journals as an example. I have done art (and writing) in paper-based journals for years, but my output has dropped to nearly zero for well over a year. I had found a new tool. I used electronic system maps. Additionally, the monthly word counts in my private electronic journal began to jump significantly. Looking at this globally, the effort was merely shifted. But, really, what had found an easier way to work that gave me far less information and was far less helpful and far less healing.

My therapist brought me a couple of my older journals from a few years ago, and I was just immediately floored. The 120 pages in each were filled in a matter of weeks, with art, with statements, with dialog, questions, answers, pain, joy, anger. There was a huge amount of information and expression. Most of it was extremely hard to see and read. And every page was eye opening.

I realized that I was not doing that now. So, I decided to dedicate more of myself to this type of work. I know that means not just here in the hospital, but out in my regular life. And I also know that may require some sacrifices.

Yesterday, on a weekend day without any groups, I was here with a friend I have known for a long time. We were talking about using art as a means of expression and healing. We decided to do an "art therapy" group together. I came up with the directive: "Draw about your major obstacle facing you right now."

I drew about the divide between the two "camps" of me.

In the "left camp" are the parts of me who are very comfortable with all the healing language. We know what those words are. We use them all the time in therapy. The left has seen enormous growth. There has been a huge surge in functionality. I am able to juggle work and family and therapy. I have achieved major accomplishments at work that I thought I would never achieve again. I have become completely reliable at home, and taken on more and more in my community. Who can have a problem with that? The left paints a very nice picture for the world that is "socially acceptable" and "socially appreciated." Of course, it is very appealing for me and easy to use that growth as the measure of my progress.

If the "left camp" was the totality of who I am or even the great majority of who I am, there would really not be a problem. But, it is a fact of my life that there is an enormous "right camp" that needs to be attended to at least as much as the left. And it has not been. The result of such complete focus on the "left camp" lead to huge jealousy and anger from the right camp, and that lead to a serious lack of safety.

The obstacle, for me, is getting some communication and collaboration over that divide and over that bridge. The path is the art. The expression.

In the image, the "right camp" is straining against the river. Overflowing. Looking for a way across. Trying to communicate. There is huge effort from the right. I know it is easy to say that the actions of this camp are so harmful and hard to imagine that they want any help. Our focus has become only about stopping the actions. But that is an approach they cannot understand. It is a mismatch of language.

The only way to heal is to give the "right camp" a path. A new outlet. Or a new lease on old outlets. By the "left camp" being more accepting and understanding that the "right camp" is as much a part of us as any other. The irony in all of this, is that the "left camp" fully knows life is not perfect. The left expends so much energy to keep everything contained and looking good and strong.

Balance was my word for 2011. In many ways, there has been balance this year. But the balance has been so precarious. The balance came at a huge cost as it was achieved merely through division.

For 2012, we need a new word. Balance is still the goal, it always will be, but we will achieve it through unity. For me, unity does not mean we will all be one. Unity means more about being on the same team. United. Working on the same goal. Supporting each other. Harmony.

Categories:

Compassion Destroyed

| By Paul | | Comments (17)

I have hurt myself, sometimes quite seriously, many times. It is difficult to rank serious self-harm and suicidal events because one must take into account both the physical and psychological damage. But while there is a good deal of subjectivity involved, there is no question that what I did to myself last week ranks up there as among the most serious in my lifetime.

Physical damage is what most use to rank such events because it is quantifiable. Like many others, I have taken dozens of overdoses over the years. Two of them were objectively different from all the rest. They were the ones which were especially calculated. They involved taking many times the lethal dose. And they were preceded by taking sedatives so that I would not be able to change my mind and go to anyone for help afterwards. Those were obviously serious physically and I was lucky to have survived them many years ago.

Hurting myself in the present often involves recreating past abuse. This has gone on for years, is often an instinctive response, and is something I am ashamed of. It has been damaging because I have perpetuated the abuse done to me and has led to all sorts of problems. What makes it difficult is that most of the problems are psychological and comparatively easier to hide.

As I have healed, the more I appreciate the extent of the psychological damage of this kind of self harm. To put it into some context, long ago when my psyche was much more separated, these self harm events were more isolated. While it undoubtedly caused psychological damage, hurt aspects of me had little or no understanding of where their distress was coming from.

Without question, increased awareness and internal communication—whatever level one dissociates—are necessary components to healing and tools to help keep us safe. But there are no guarantees of safety. When safety is breached, the increased awareness leads to a totally different perspective of the effects of self abuse.

What happened last week was arguably, for me by my own scale, the most serious event of its kind ever by many measures. To call it self harm or self abuse is not even adequate. Self harm was the terminology I used a decade ago. Self abuse is the terminology I began using a few years ago. What happened last week was a psychological suicide attempt. I think it is important for me to be as precise as possible and not cloak what happened with more sanitized terminology.

A couple days ago, I did an analysis of both the events and feelings which has led me to label what happened in such a unambiguous way. While a lot of the actual events are lost or in flashes, I have enough information to know that what happened was in a totally different class from past events. I also have hard data, which was able to give me a perspective that is much clearer than any similar event before.

But the saddest piece comes not from the actual harmful events. Not from what was done to my body or done to my psyche.

The plan from the night before was to be admitted to the hospital, where I am now. I had become too unstable, too fragmented, and too much at risk. I told my therapist I needed some time to tie up some loose ends at work and do some last minute preparations.I was supposed to be in hospital admissions by 6 pm. That was the agreement I made.

It turned out that I was not grounded enough to be trusted with such an agreement or such an amount of time on my own.

I know there was internal conflict about getting hurt that day. That conflict usually is what keeps me safe. But there was very little sense of reality and no sense of ground. And, so, "safety" and "getting hurt" existed as their own isolated parallel threads. That dynamic of polar opposites existing simultaneously increased the safety risk manyfold.

At one point, I was at a tibetan arts store to get my wife, who is into yoga, a Christmas gift. Amidst all the confusion and fragmentation, at 1:45 pm I wrote these words in my journal: "Healing. Went to the tibetan store for a present. Big shift now towards safety. But confusion and conflict too." That nearly led to a change of course to not get hurt. But it was not enough.

At the store, I also searched for a gift for my therapist, my "healing guide". I thoroughly explored the shop and what I found for her was a compassion stone. It is a small stone from India with the "Om mani padme hum" mantra on compassion in Tibetan script . This is sad because it is proof that there were enormous coexisting efforts to be safe and also to be hurt.

While it certainly feels like my "gift" to my therapist is tainted, I hope we can take from this something positive.

This stone, then, obviously has critical significance. It perhaps should sit in my therapist's office, or be accessible to us. We should use it as a reminder of how the desperate effort to be safe and compassionate was destroyed—within minutes.

For me, that stone will probably be my most important icon in the world. It is something tangible from that horrible day. It will mean more to me than the medical records I have from the major overdoses. More than poems I have written from long ago about sad events and abuse. More than any art work I have made. Even more than records I have from the Catholic Church.

That stone represents the fact that I made a choice. That stone embodied all of my hope. It embodied all of my compassion. And I, and I alone, made the choice to destroy all of that.

I will never forget that.

And now I have to pick up the pieces and recreate what I have destroyed.

Categories:

Living and Perspective

| By Paul | | Comments (26)

This is the point at which this blog takes a decidedly personal turn. I am probably going to start writing about things that are more about my day-to-day life, though I will always try to tie it into a broader picture on healing.

The last four weeks have gone like this: I had an enormous trigger in the middle of February. I handled it well initially, but it eventually led to an internal breakdown and huge disconnect internally. I landed up in the hospital and truly thought I was set back two decades ago. I was certain it was going to take a long time to turn things around and would need to cancel my obligations for the next several weeks. But, I am not in the same place I was two decades ago, one decade ago, or even a year ago. I was able to turn the incapacitating disconnect into a total connect which propelled me forward in just a couple days. I learned that my "resilience" is probably here to stay. And that knowledge gave me confidence.

I did not have to cancel any of my obligations. After I got out of the hospital, I had to prepare for a big elementary school "lip sync" show I was co-leading for the following weekend. That went super well. All 150 kids loved it. They got a taste of being on a real stage with real sound, lights, props and costumes. I dressed up as the school mascot, a "penguin" and danced a final act before all the kids came up on stage and we closed out the show with the traditional "Cotten Eyed Joe" dance. I had enormous satisfaction for having a big role in making it happen.

The following week, I had to meet a work deadline of a large research proposal that had been in discussion and preparation for many months. It was a single-spaced 15 page main narrative document with a whole host of ancillary materials. I was not happy with the quality of the main narrative initially, but I had some people contributing pieces to it, and eventually I was able to pull it all together and submit something I was proud of.

Traditionally, there have been total collapses after these work proposals. I have done many dozens of them over the years, but relatively few over the past several years. Even with the last one that was due middle of January, I had a decent sized collapse and I only wrote one part of the proposal. But I did not collapse this time. Instead, the next day I went to the championship swim meet for my youngest daughter and photographed the whole event.

There was definitely a worry of collapse after that. I struggled quite a bit the beginning part of last week, and last Tuesday I started to write a post titled "System Disconnect" but did not get very far as I was too mired in difficulty. I found myself run down. I cancelled some obligations.

But if I had to describe what it felt like, it was as if there was a little something extra in my "tank" that I could call upon. In the not-too-distant past, I could easily find myself in bed for days, unable to do practically anything. Instead, by Wednesday I was back on schedule. Thursday was St. Patrick's Day and I photographed a town event. Friday I went to work and attended an evening social function for work. Saturday I cleaned the house and then went to my youngest daughter's swim banquet where she won a trophy for "Most Improved Swimmer" for her age group. Sunday I was out hiking with the kids most of the day while my wife was in bed sick with a flu. Monday I spent most of the day volunteering in our town's elementary school—more on this in another post. Tuesday, today, I was at work by 6 am and was busy until I left for therapy at 4 pm.

So, what is the problem? Well, on one level there really is no problem at all. I know that to the outside observer my life has looked incredibly smooth. I have been navigating everything perfectly. My wife is the happiest she has been in a long time, because I have been very engaged with the family for a long time now and my engagement is only increasing with time. To me, on one level it feels like things are also very smooth.

But what I do not quite understand is why I am not at all connected to the past week or two or more. It feels like the proposal was a lifetime ago (or really didn't happen). It feels like all the stuff at the end of last week and this weekend was a lifetime ago too, even though I can recount the days and everything. Being able to recount the events though doesn't feel so natural. If never pressed, I would have no need to recount them. But, yet, they are all on my electronic calendar. And they are in email records. And they are in my journal. All of those things I did not have a few years ago or even a decade or two ago—at least in this way and so accessible. All are tools I have now that seem to help me in so many ways.

The last week or so has not just been about "doing things." I know that there has been a really unusual quality to my piano playing that is a step or two or three beyond where I normally am at even when I am playing really well. There have been expressions about religion and Easter and possibly going back to the church that I went back to for the first time last year with "My Healing Guide." I seem to know exactly what to say to my kids, without really getting irritated with them. I have even been more open about what I struggle with, telling certain people some things that seem to naturally come up in conversation, but saying just enough so it feels safe and appropriate. If I were just "disconnected", none of these would be possible. So, it is not the normal disconnection which leads to problems with safety and lands me in the hospital.

The reality is that life has not really been so smooth. "My Healing Guide" brought up her assessment that my ability to tolerate distress is extremely high. And if I think about it, I know that in between all this wonderful "functionality," there have been some massive panics. I know after my proposal was done a week and a half ago, there was a huge conflict about getting home safely and I actually needed help to get home. I know there has been a lot of pain and that I have not taken heavy duty pain pills, but instead Tylenol and Advil.

What I do not quite understand is how there can be so much connection and flow that must require most all parts of me, yet there is a huge degree of disconnection (for me).

After spending time in therapy today, then writing about all of this in my journal, then writing about it here, there actually does not seem to be that much disconnect anymore. So, maybe all that I need to do is allow myself to "live" (which is what I have been doing) but merely stop now and again to assess where I am at and maintain perspective.

Categories:

Reflections on 2010

| By Paul | | Comments (35)

Last year in Looking Back and Ahead, I tried to make sense of my long healing journey as well as identified my gains for the year. I think it is probably good practice for all of us to reflect on the past year and use it as an opportunity to celebrate the gains, validate the tribulations, and set goals for the upcoming year.

For me, this year has been filled with at least as many ups and downs as the last one. Most of what follows is based on a discussion with "My Healing Guide" a couple of days ago. Whenever I talk about short-term gains, she likes to frame them in a larger context, as being built on the accumulated efforts of the entire journey. She says it is like I have already built a foundation, and our task is to add floors and rooms. I do like that metaphor.

I do believe that the Contract of a year ago was the launching point for what I was able to accomplish this past year. The entire Contract is really based on just a few basic principles (summarized by single words): trust, acceptance, and validation. Everything flows from this. While I don't read the Contract much these days, I don't really need to; its creation came from a place of near complete common ground and all of me knows its essential elements to the core. Yes, the Contract has stood up well this past year. All of me has understood its significance.

While I know our therapy work this past year was a true collaboration, it was important for me to tell "My Healing Guide" that she played a huge role in helping me continue to heal. I absolutely do not take that help for granted. None of my gains would have been possible without her help, without her willingness to be there for me, to walk with me, to listen to me, to promote trust, acceptance, and validation.

I also have an appreciation for the fact that healing is really about living. It is not all about therapy. The work we have done has helped me live more of the life I want to live. Yes, there have been some really low lows this year. But there have also been new connections inside, with my children and, to some extent, with my wife.

The 2010 year started out horribly with the Our Family Crisis, which blew up in our faces. This family "friend" was truly distorting my relationship with my wife and driving a huge wedge between us. This situation had been ongoing for years, but I think it came to a head because the "friend" saw an opening partly because I was in the hospital so often. It is astonishing to me that I was able to solve it. I stood up for my family. I took charge. I reestablished boundaries. The result was that my wife and I became closer and that set us up for what was to come.

In Holy Week, Church Visit, Scandal, and Miracles, I wrote about how "My Healing Guide" went with me to the church where a good deal of my childhood abuse took place. I never imagined that would have been possible, and I still cannot believe we did it! It was initially all completely validating and healing, but it did stir things up inside which caused us to eventually question whether it was the right thing to do after all.

There were gains made, however, which helped us realize it was definitely the right decision. Those gains came at a cost, though, because of internal instability that landed me inpatient quite a bit this past year; five hospitalization for 59 total days. I knew Easter was going to be really tough. In The Word of the Lord?, I wrote about some of the issues I faced during Easter and how I tried to put into perspective the stream of news coming out of Rome.

We then addressed directly an aspect of me key to the self-abuse. Inside, we were all certain this part was the embodiment of evil. We were all afraid of what seemed like unlimited power. In Inside, an art piece done in the hospital, this part stepped forward and joined in the healing process. That was a huge leap forward for all of me.

Not all was safe, though. That huge shift led to additional instability in my system. There was a long period of continued self-abuse from other parts who were newly activated. I wrote about this, mainly from an intellectual perspective, in Sex Injury: Past and Present. I recreated situations that would lead to my own abuse which kept fueling feelings of worthlessness. I do think, now, that I have come out the other side. I firmly believe that kind of self-abuse is permanently behind me. I am continually being reminded of what it was about (through flashbacks) and know it cannot ever happen again.

There were two occurrences that led to this resolution.

First, was when my wife found out about my self-abuse by my accidentally leaving my electronic journal open to a particularly sensitive entry. That she now knows about what has been my life's deepest secret—though she does not know details—is incredulous to me. Even more surprising is that while she had immense trouble with this new knowledge, I think it has made us stronger. The cards were put on the table. She finally learned that there are truly dark aspects to what I have to deal with.

Second, was that I physically got hurt from the self-abuse itself. After I wrote Taking Care When Physically Sick, I found out the illness was a result of the self-abuse. Getting hurt in this way ushered in a whole new sense of what the consequences really are, a reality that acting out parts had no concept of before. It brought self-abuse parts together with more healthy parts and is causing yet another reordering inside.

I have the sense that this new internal reordering will be what 2011 will be about. I know it will not be painless and I do not know what the months ahead will bring. But I hope the reordering and focus on safety will allow certain aspects of my life to flourish. I expect work and my relationships with my kids and wife will be where new gains will be made.

Already, the new reordering inside is leading me to come face-to-face with how to achieve balance in my life. How can I be successful at work, for example, while practicing good self-care? Or, said more broadly: How can I participate more fully in life and still practice self-care? 2011 will be about finding and maintaining this balance. Whereas 2010 was about acceptance.

Balance partly comes from being in touch with feelings. And this is why I have been proactive lately about getting in touch with feelings as a kid and connecting the past to the present. I have watched movies and television shows and read books which are validating and asked my Mom for old pictures of me as a kid. This is one way I know of to achieve balance. It is more difficult to get lost in a single part of me if I am also reminding myself of feelings. I have to always remember that balance is key now. Yes, I know I am being very proactive. I know I am forcing myself to feel feelings. This is one major aspect of self-care. And this is the one area I know I focused on when I started this new healing path a couple of years ago.

I also know that self-abuse was one way to solve internal problems, even though it was definitely harmful and dysfunctional. I talked with "My Healing Guide" about it not only being about making myself feel worthless. But also about recreating abusive events so that I could come out the other side and prove that I was "not really hurt" and could go on and be functional. I am not sure how much was which. But I do not think it needs to be my job to figure out what the relative weights were. We are all on a new course now.

If part of the self-abuse was to feel worthless, I have to challenge that now and do deeds that heal that way of thinking. If part of it was about control and recreation, I can challenge those by practicing my skills at balancing and validation.

What is important for me to keep in mind is that I know I have skills and a plan in place to help keep my life balanced and safe.

Yes, 2010 was a year of great accomplishment. And I know 2011 will be equally great if not better.

Happy New Year to all of you!

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In Self Assessment, Part Deux, I talked about how disengaged I felt in the hospital. I had been trying to do what I knew always works. But something was holding me back. I was not making progress.

I found out I am physically sick.

I have known I had been running a low-grade temperature since the beginning of the month. And I have felt achy and run down. Up until this past week, I attributed it all to what was going on mentally. But my symptoms worsened and my temperature went up to over 102F a few days ago. What little energy I did have went away completely and I found myself practically unable to do anything except sleep.

What I want to bring up here is the question: How do we attend to our mental wellbeing when we are physically sick?

My own current situation has increased my appreciation for how truly difficult it is. Paying attention internally when one is severely dissociative is a hard enough task even under the best of circumstances. For me, I have noticed that because of being sick, there is an expected hunkering down of sorts, which means my internal awareness is reduced. My internal parts do not operate in the same way as they do normally. I am not sure how exactly this is all happening. It is as if my system does not have enough total energy for parts to be as active and accessible as they are normally.

The best I can do is be as gentle as possible with myself. And to be "on call" when I feel better so that I can cultivate the internal awareness I know is necessary for "normal" living. For me, that time will come when I am out of the hospital. I see no point staying here any longer if all I am able to do is be physically sick.

I find myself also thinking about those who struggle with chronic physical problems. I have a better understanding of how difficult a road it is for them. I find myself asking how they navigate the rough waters of healing?

Then I started asking how I would be able to attend to my mental wellbeing if I still had current depression or anxiety or suicidality? The reality is I do not have any of those symptoms in any kind of ongoing way anymore. I realize this makes things so much easier. I realize this also means I would not be where I am in my healing. This site would not exist, at least in the manner that it does; its content, messages, and focus would be far different.

Because I know what it is like to struggle with these debilitating issues and deal with ongoing dissociation and trauma difficulties, I try to bring that perspective to my writings here. My being physically sick, helps me appreciate that for many, a lot of what I write here may seem out of reach (or that I am out of touch).

I write to show that while the healing journey can be painfully long, healing is very possible. Anyone can heal. Do not let anyone, including yourself, tell you you cannot. As I have said before, one of my main mantras is: Anything is possible. I believe those words.

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Self Assessment, Part Deux

| By Paul | | Comments (8)

Dissociative Identity Disorder Self Assessment Art Therapy

To say that I have not been very engaged here in the hospital would be a major understatement. Yes, I did 10 pieces of art over the weekend and had shift in acceptance Monday evening. But that was ephemeral. There has been one distraction after another since coming here, all meant, I think, to deflect against dealing with specific memories.

First, there was the not eating and drinking, which I truly thought was going to take me over, and has not gone away completely by any means. Then there have been troubles with an increasing fever for a week; for me, all physical ailments are a distraction! And yesterday, I deliberately allowed the comments on my last post, a mistake on my part, to distract me for most of the afternoon and evening.

But, in the midst of all of this was the sole group I have been to, I think, since I have been here. Well, it was a combination deal of talk-based self-assessment followed by art therapy self assessment. So, two groups really.

Back in May, I posted Self Assessment, where we used art therapy in group to "represent body sensations, thoughts and emotions contained in a circle." Yesterday we repeated that directive.

I have said before that I believe art therapy is one of the mental health community's greatest inventions for trauma healing. And while I have done many art pieces over the years, I never attempted anything with such vigor as in this piece. I started with the circle, the black circle. Then I put the typical angry colors of red and black to represent surging emotions (a whole host of them) and body sensations (physical pain).

I put gray in there to represent me, the responsible adult (or "coach" if you will) of all of me. I have recently been asked to put myself in artwork. But I did not ever have a color. I chose gray a couple months ago, and it made its way into this image. All the while, I was going back and forth between laying down the interior colors and angrily making the black circle thicker and thicker.

I have heard artists talk about getting into their work and using the medium as a conduit for emotions, and have seen this in movies. That has never really been an experience I have much had, until yesterday. I can certainly say that I have the experience quite often when performing on the piano. I absolutely find it thrilling!

The second part of the assessment was to draw healing colors outside of the circle. The healing colors that are very specific to me are purple, pink and brown. During this whole process, which took only about 15 minutes, I was using the oil pastels so hard that I broke several. Then I immediately grabbed the bits and smashed them into the paper. And, as usual with oil pastels, I used my fingers to blend all the colors. My hands were completely covered in color when I was done.

I think this is the first art piece I have done where I have completely filled the page with color. It was very important for me to do that. I do not know why it was important and do not know what that means.

I rather like the result. And maybe I am more engaged than I think.

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The Aftermath

| By Paul | | Comments (45)

Eating Disorder Polyvore

In Blending, I talked about how I navigated through Halloween and a short hospital stay which led to increasing my level of acceptance. I almost never leave the hospital so quickly. And probably for good reason. I ended up back inpatient in exactly a week.

What I believed was acceptance was more a mirage. I asked to leave based on what was really only a minute amount of internal communication. It was not enough to leave here confidently. But I did anyway.

While I did well for several days, everything collapsed in a matter of hours. The memories that came to the fore on Halloween, the ones I thought were attended to, came rushing back with a force greater than I could have ever imagined.

As I wrote in the earlier posts, I had been trying to do the work I knew I needed to as an outpatient, but just today I realized why that is so hard. Being a Dad, husband, and working has to be protected on the "outside." This means simply that I am not that willing to allow myself to be vulnerable as an outpatient. While normally this is a good boundary, it can get in the way when a step forward in healing work needs to be done.

This is why I have always used the hospital to help me with these big pieces of work. My time in the hospital has been hard. This is more normal for me here. Physical pain ramps up. I get memory flooding. I lose time. I have difficulty maintaining control. I get little to no night sleep (or sleep all the time).

Stopping eating and drinking, an old coping strategy, seemed like the only way out. The only way to control things. After several days, today I made the decision to begin eating and drinking again. The cost was just too high. And, deep inside, I knew I was just postponing facing things.

Over the weekend, I did a good deal of art. I made 10 important pieces (one of them is shown above). Today with "My Healing Guide," I tried to make sense of them and put them into context. As I did, everything kind of started to fall into place. I saw the 10 art pieces as telling a story. A story I could never tell with words alone. And a story I could never tell outpatient.

We went through the images quickly because we were short on time. And she clearly tried to help me move towards a place of acceptance. This was truly hard for me. It has not been at all easy to accept that some of the abuse was at the hands of multiple bad people (or "organized torture" to use my doctor's words that sent me over the edge on Friday). While, I have always known bits and pieces of these memories since the early 90s, it was always much easier for me to cast them aside. To say that I make them up. To deny.

But one of the biggest lessons I have learned over the past couple years of healing is that to deny sets up massive internal conflicts, and leads to self-abuse that recreates it all. So, really the only path to healing is to accept the truths we hold inside. Today I was telling myself that I would not be going through so much internal struggle and pain and self-abuse if there was not truth to the memories which have haunted me for years.

This afternoon, I did not go to any groups. Instead, I stayed in a sort of sleep-awake state. Processing. I was getting titrated memories and there was some kind of communication going on internally. Most of it was about acceptance. It was interesting that I was not flooded with memories. I cannot even say for sure what the images were. But I am certain I was trying to put everything in its place.

Normally, when I make this kind of progress like today, I say I have done enough in the hospital and start to advocate to leave. But I do not have the sense I am over any hump. As soon as I moved towards acceptance, and started taking in liquids again, the physical pain came back. I will give myself more time here. And I am not certain where this stay will take me. So much has happened already in such a short time.

What I will work on now is to be gentle with myself. To continue to try to eat and drink enough. To accept as much as I can. To not push the memories away, but to contain them safely. I will continue to express myself through art and writing in my journals.

I also know I need to find a way to talk about the overwhelming material outside of the hospital. I know how to do a lot of things. But this is one skill I have not quite mastered. The question for me is: How do I handle the responsibilities of life while at the same time make progress on what is held in parts of me and needs to be addressed and healed?

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