I’ve been searching for the right words to explain my experience here. It’s been immersive and all consuming. I’ve tried chronicalling the daily struggles and successes, but that hasn’t done the experience justice. I’ve gathered lots of information and am now in charge of figuring our how to sort and categorize it all.
I’ll start with the basics. On October 23rd I was admitted to a residential DBT treatment facility following a severe and prolonged depressive episode. The facility I’m at specializes in the treatment of Mood and Personality disorders with Dialectical Behavioral Therapy primarily with supplemental therapies such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Behavioral Activation, and Art Therapy.
I work with therapists in a group setting for the equivalent of an entire work day, for an entire work week. I see a psychiatrist and an individual therapist several times a week. I have, over the course of a few weeks here, dissected my life and identified a good deal of the damaged parts. I entered this program with my “documented diagnosis” as Major Depressive disorder and Generalized Anxiety Disorder. My new “documented diagnosis” as I leave here is Bipolar 1 disorder, Borderline Personality Disorder, and Generalized Anxiety disorder. These diagnosises aren’t completely new information to me, but going over what they are and how they have potentially been affecting my life has been a hard pill to swallow.
My medication rollercoaster has continued. My lithium dose was raised again and, after a week, I was almost sent to the hospital. They lowered my dose back to what I was initially taking, and I still feel like shit, but not to the point where I feel like I’m dying. Welbutrin is the latest addition to my ever growing list of attempted solutions. I can honestly say, I feel closer to my baseline than I have in months, despite still feeling like I’m slowing being poisoned.
The facility I’m in is ran out of a building that used to be a convent. A nunery. The therapist offices are old bedrooms and the programming rooms range from regular auxiliary rooms to the chapel to the dining room. The house I’m living in is right next door. It’s a massive house that feels like one would imagine living in a model home would feel like. It’s cozy, but has glimpses of industrial bits. Almost like a hotel that has been cleverly disguised as a singular house. I live with seven other women at this point. Some are newer to the house and some have been here longer than I’ve been here and will stay long after I’m gone as well.
Now, this setting seems highly appropriate for the programs ran within it, because what they’re doing here feels close to, and slightly short of, being a cult. There is a certain dialect that is spoken that I don’t believe exists anywhere else. Everything is neutral. There is a list of forbidden items that are not to be spoken of. The STAT list. And the staff…..they corral us from place to place with a firm hand and half smile. Everyone that works here seems very kind, but they all have a level of clinical detachment among them. Like they’ve been brainwashed. Back to my cult theory…. what cult would be complete without it’s fearless leader. For us, that is Marsha Linehan. The people around here talk about this woman like she is god. Marsha is the creator of DBT and the author of the DBT manual that we are studying ever so diligently. Now, I’m not knocking the program, just the way we are being systematically indoctrinated with it.
The program has been quite eye opening. Dialectical Behavioral Therapy is composed of four main modules: Mindfulness, Emotional Regulation, Interpersonal Effectiveness and Distress Tolerance. The main focus with all of these areas is to be mindful in your actions and interactions. There are also teachings about acting in line with your values that are a main focus as well. The mantra I keep hearing is about “a life worth living.” That’s the goal for us. Not necessarily happiness, but contentment and the will to continue. Personally, a lot of the work I’ve done here is about getting honest with myself and others. Expressing my thoughts and feelings without fear of judgement or rejection. Early on here, I figured out that I’ve been living in a constant state of denial and avoidance. Denial and avoidance of my feelings. Rejection of my feelings as valid. Denial of blatant truths about situations in my life that I’ve spun to fit my vision. Denial of reality as it sits in front of my eyes. Mindfulness and validation have been my strongest tools. It’s all a work in progress, but I feel like I’ve found my footing here and I have been able to identify and outline areas that need work.
This grueling day to day work would be impossible without the support of my peers here. I felt very lonely when I first landed in this place and was resigned to not making any connections for fear of the inevitable departure down the road. That failed very quickly and I effortlessly bonded with a handful of the women here.
The first one was easy. We instantly clicked over our matching WuTang shirts. As days passed and I learned more about her, she struck a blinding resemblance to my younger sister. And suprise, suprise…. they’re the exact same age down to the day. We would spend the late evening hours outside, talking about all the things we weren’t allowed to talk about during the day. Sex, drugs, diagnosis, harm habits, the other clients stories, life stories that led us here and so on. She was a fountain of knowledge and gossip. At one point we went on a shark movie binge for several days. Most nights we could be found in the living room, laughing maniacally as people on TV were devoured by horrible CGI sharks. I grew to admire this stranger in a short period of time and I’m dreading the impending departure and the fact that I will never see her again once I leave this place.
I guess that’s a problem that I have with settings like this. Open honesty and vulnerability are expected and those circumstances generally create bonds between those that share those experiences. Attachment is as inevitable as later departure. These environments cultivate these connections, specifically between people that are prone to deep and fast emotional bonds, that feel genuine and comforting in the face of every other thing around being clinical and cold. We form these bonds for survival, only to shortly after have them ripped from us.
I’ve had to learn brutal honesty here and how to be honest when I don’t want to be. Several times a day we were asked about our emotions and distress level and then shuffled through course information and exercises that require full disclosure to be effective. That hadn’t bothered me so much. The part that severely got under my skin was that each day, I had to fill out a card for tracking my daily habits and urges. Every day I had to write on this piece of paper whether or not I was experiencing suicide ideation or self harm urges. Every. Single. Day. And I was honest when it came time to explain my answers to my therapist. But it deeply bothered me that it was something I had to do. I wasn’t allowed to forget that these were factors in my life. It felt a little dehumanizing. I wasn’t allowed to posses items such as tweezers or a pencil sharpener. Razors were completely out of the question. No nail clippers. No hair straightener. No aerosol products. I had my knitting needles temporarily revoked at one point. One girl had her jump rope taken away. If I wanted to use any of these items, I had to do a “check in” that basically meant I had to tell them that I was not in distress and was not experiencing and self harm urges. I gave up on asking to use any “sharps” because, to be honest, I couldn’t pass that check in on some days.
I learned how to be honest with others when my feelings were involved. I learned to express appreciation and gratitude to people that were virtually strangers to me. I learned how to be comfortable with verbally expressing love to other humans. I learned how to be honest with myself about what i was feeling. I learned how to be vulnerable in times that I usually wouldn’t be. I learned to be okay with whatever emotion I was feeling and sharing that and not feeling like I was going to be judged or looked down upon for it. I learned how to tell people to fuck off and get out of my space in a polite and effective, yet assertive, way.
I learned a lot in my 30 days of treatment, but I still have so much more to learn. I’ve caught my footing and have gained enough stability to start taking life on again: one step at a time. I’m fucking terrified and my constant state of emotion for the last day or so has been *screams internally* with a side of anxiety, terror, panic, fear and somewhere in there is a shred of hope. Hope is what I’ve been holding onto for the last year since this mission to better mental health commenced and it’s what I will continue to hold onto into the foreseeable future.