One flew East, one flew West, one flew over the Cuckoo’s Nest. ~ Ken Kesey
If you have been following the last few days here at Lemons, you know that I:
- Just returned from a wonderful 3 week stay in Arizona at an amazing in-patient facility.
- Enrolled in a PHP (partial hospitalization program) here at home as a transition or step down tool.
- Was disappointed (understatement!) with the outpatient PHP.
So, let me just fill in the blanks and lay out the full story.
I entolled in this PHP which is purported to be a six hour per day, Monday thru Friday intense outpatient program to transition from in-patient care to normal daily living. To continue the positive life changes made in an in-patient environment while still allowing a focus on healing and education with a emphasis on women’s trauma. Sounds just about perfect right? WRONG!
Wednesday March 23, 2016
7:30 am. I arrive at the facility a half hour early, 8:00-2:00 are the program hours, as requested to complete some admin paperwork. I am given a two page questionnaire regarding insurance and an brief outline of program rules (don’t be late, no drugs or alcohol, dress appropriately etc)
7:35 am. Paperwork complete, I am asked to wait for the nurse.
8:40 am. A nurse (?) comes and takes me into another room and takes my vitals, tells me my blood pressure is high, has me complete another stack of papers including release of information forms, a liability waiver and more insurance stuff.
8:50 am. Paperwork completed, I am taken back to the waiting room and told someone will come and get me soon.
9:30 am. The same nurse (?) comes back and gets me. She takes me upstairs and to an office with three techs who are sitting at desks drinking coffee. They look up when I walk in. No one smiles or says hello. The nurse(?) says, “This is our new admit for PHP” That’s it. No name. Nothing. She turns and leaves. The techs are still sitting there…staring at me. I break the awkwardness and introduce myself.
9:45 am. After one of the techs, Tammi, finally gets out of her chair and makes a chart for me, she hands me my workbook and takes me down the hall to my “group” pointing out the fact that I shouldn’t have parked where I did and I MUST park in a designated parking lot from now on. She points out the stairs to the cafeteria and the fire escape. I ask her where the restroom is. My “group” has just let out for a break so I go into the group room and sit by myself and wait.
10:00 am. Random patients start coming in and plunking down in chairs around an oval table kind of thing. I am getting some looks and I smile trying to connect with someone. This is clearly not a women’s group. There are about 12 people. A bearded man in his 30’s comes in and sits down. I think he’s another patient. Turns out he is the therapist. He does not acknowledge me. He begins a discussion about the limbic system. He tries to turn on the projector but at that point, the power in the building goes out. One patient says, “Here we go again,” like this is a regular occurrence. The therapist, who the others are calling Aaron, turns to the whiteboard and continues with the lecture. Apparently this is the status quo.
11:15 am. Lunch break. It is included with the cost of the program! I walk down to the cafeteria and the menu is cheeseburgers with onion rings or fries. I think, no…I would rather have a salad. I look at the “salad bar” …. I get a cheeseburger. With water because the juice machine is out of order. I sit by myself because everyone has taken their food and disappeared. I am the only one in the lunch room. I read my workbook and discover The Big List of Pleasurable Activities. 🙄
12:10 pm. Back to the group room. One of the patients asks Aaron if they we can go around the room for introductions and discuss group goals before we break again. He says sure and we continue our topic discussion on the brain.
1:00 pm. Time for break. Oops…forgot intros..will do it when we get back.
1:15 pm. Waiting for Aaron.
1:20 pm. Start with intros and group goals and expectations. Aaron starts and adds that his pet peeve is tardiness (!!!) 😳 Most people are military, most are young, most seem incapable of completing a sentence not riddled with the f-bomb or worse. When it is my turn, I say that my goal is to transition after a three week in-patient and that my diagnosis is CPTSD. I get no “welcome to the group,” no “happy you are here,” not even a “thank you for sharing.” I think, “What is it with these people??”
2:00 pm. I go home and think that it will get better. It was just me. My perception. I was just nervous and out of my element. Tomorrow it will be much better….
Thursday March 24, 2016
7:45 am. I arrive early so that I can ask questions about the program. I look for someone to ask. Nobody else is there. No, really…nobody. I take a seat in the group room and wait.
8:05 am. People start rolling in. Aaron is there again. I try to ask him if there is a schedule or if he knows anything about a woman’s trauma group. Another patient interrupts him and says there usually is a group but that the therapist who runs it didn’t show up. Maybe she will come in today. We start group with a check in and then meditation. Several people begin to snore…loudly.
8:45 am. Break.
9:00 am. Tammi the tech comes in to facilitate a discussion on Anger. She is not a therapist or a clinician. She does have a GED though so I guess that is a qualifier. The discussion is chaotic, patients are talking over one another and advising one another and doing a lot of what Pia Mellody calls, “shoulding all over each other.” I remain silent because I am a little in disbelief. It is at this point, I believe, that I realize that I am in the Cuckoo’s Nest.
9:45 am. Break. There is a rumor that Amy, the women’s group therapist came to work today! Then, I see another female patient speaking to someone who looks like she might be in charge….of…something. The patient comes towards me and I ask if she was speaking to the women’s group therapist. She says yes so I go and try to speak with her as well. I tell her my name and ask if I am to join her group. She snaps back, “I don’t know, I just got here!” Well, then. I take my seat back in the group room.
10:05 am. People start filing back in from break. Amy, the therapist, pokes her head in, finds me and says, “Well? Are you coming or not?” I grab my things and go out into the hall. She is not there…nobody is. I follow the sound of voices and peek my head into a room…relief! I see some of the women (girls) from my group. I go in and take a seat. Again, no acknowledgement of my presence. They are reading aloud from a book I do not have.
10:15 am. Amy opens a discussion on shame from Patrick Carnes’ book, “The Betrayal Bond.” She says she will get me a copy and I tell her I already have one and I have read it. To that she replied, “Hmmmpf” (I am NOT making this up!) A patient started talking about how her husband always twisted things around in arguments so that she began to doubt her own perceptions. I respectfully raised my hand and told her that this was called gaslighting and that sometimes they don’t even realize they do it etc….Amy interupted me and said, “It doesn’t have to have a fancy name. It’s just called crazy-making and they know damned well they are doing it.” Another patient began discussing how bad she feels if others don’t like her. I said to her with a smile, “Remember, it’s none of my business what other people think of me.” She smiled and said she would try to remember that. Then when one other person started talking about how she tried so hard to get others to like her and accept her and even tried to change for them, I asked her if that had worked. She smiled and said no. I smiled back and just shrugged. At that point, Amy lost it. Really. She broke into the conversation and said, “Evidently, we are in need of a review of group therapy rules of communication. When people who have never been to group therapy before come in, they don’t know that they are not allowed to judge others, give unwanted advice, or belittle any one else’s situation.” She continued in this vein while looking straight at me. She said, “Silly little sayings and big words are not appropriate to deal with real problems.” I was furious. I had done none of those things and knew from my own experience that information and mantras can do a great deal to help in trauma. I knew that her own perception was skewed. She concluded by saying, “Is that understood by everyone?” I said no. I then engaged her as she did me, in front of the group. I said the following. “I came here straight from a world renowned treatment center who basically wrote the book on group therapies and boundaries within them. I crossed none of those. Your organization and your own behavior, on the other hand have been unprofessional and have crossed every boundary imaginable. I came here to continue my own care and healing and nothing I have seen is facilitating that thus far.” She interrupted me and said, “What I am hearing is that you are leaving the program?” (Um……?? Where did those words appear in my previous statement???) I responded, “No, I did not say that. What I said is that no one has bothered to answer any of my questions, provide any schedules of care, set out expectations or guidelines etc. Then you “open” a discussion and are seemingly offended when healthy discussion takes place. You have crossed all of your own so-called boundaries.” At that point, she told the room to take a break. I expected her to sit down with me like a functional adult to discuss what had happened. Nope. She left the room. So much for the open discussion on SHAME. Oh, the irony……
10:30 am. Shaking my head in utter and complete disbelief, I gathered my things and left.
10:35 am. On my way home I called the Intake office to advise them that I was dis-enrolling. They took note and transferred me to medical records to revoke my ROI.
10:45 am. I contacted my therapist and told her what had happened. I sent her a picture of the famous list. She replied that she was rarely at a loss for words…..
Friday March 25, 2016
8:30 am. I get a call from Carlos, a tech at the PHP asking if I am coming to group today?!?!? Trust me when I say that it took Herculean strength not to use several of the f-bomb variants I learned in the last few days to tell him that I had dis-enrolled already. He asked why. I simply told him that the program did not fit my needs. 😇
So, people, I chose to fly out of that Cuckoo’s Nest and I feel very, very empowered and strong for doing so. I am not sure that I would have been able to do that just a few months ago. I may have kept going and taking the abuse because the so-called professionals who were in charge pretended to know what was right for me. The truth is, nobody knows what is right for me, except me. My story is MY story and nobody else can distort my reality unless I let them. I owned my reality with this whole nightmare of the last few days. I know in my heart and mind what is right and what is wrong, just as I did with Will for all these decades. The difference is now that I will not go blindly into the deception of others or willingly ignore my own truth. I know all too painfully where that has gotten me. That is a road I will not willingly travel again.
Between my therapists and myself, we have worked out an aftercare plan that we believe will be the most beneficial for me and maintain the immense progress I have made. There is always a solution and feeling stuck is no longer an option for me. In this case, I accepted the things I couldn’t change and had the courage to change the things I could. Just as with Will. I cannot change him. I cannot change the past. I cannot change the hurt. What I can do is change me, change my circumstances, change my future. My future includes a healthy me, a hopeful me, a courageous me.