DIY PHP

November 23, 2021 7:14 PM

I am really stressed and would like to go for a stay on an inpatient unit but that's not feasible for many reasons. How would you provide yourself the resources a person could get on an inpatient stay? (A quality, reparative one not one that just adds to your trauma)

I don't want to really say much except I'm having a really hard time. I have overwhelming self loathing for appropriate reasons (not saying the self loathing is appropriate but it is based on wrongs I have objectively done). I'm not suicidal or self harming or anything like that just really stressed and overwhelmed.

I don't want to burden someone with my concerns as ultimately I need to deal with myself and find solutions for myself and nobody can do that for me. But even if I wanted to, I don't really have anyone in my life I can go to for something like this besides the therapist I pay to support me.

My therapist doesn't do crisis and I'm not really in a crisis anyway. I just hate myself and wish I could become a different person. Where do people without real friends go when they need help? How do I give myself permission to receive warmth, care, understanding, when I don't believe I deserve those things or feel like I must keep things "fair" by also helping (even when I'm in no condition to be helpful to anyone)? How do you build authentic connection with other people when you feel like nobody wants you around?

My self care is trash, I'm not sleeping and I can't tolerate most meds that help with that. Crisis lines are not very helpful usually, as it's clear that I am receiving a formulaic response. I'm writing this from a mini spa day type of setup with tools for grounding etc.

I need to belong, and I don't belong anywhere, and grounding skills don't really fix that. Distress tolerance just teaches you to feel ok even in a situation where maybe you shouldn't, and I don't know if that would be useful. I just need to feel like I'm not alone and I don't know where to get that in a way that is genuine when I am such an anxious, avoidant person so that I have no true friends.

(Side note: I don't really know what it's like to be inpatient as I've never done it. In my head it's like a vacation except you àlso don't have to plan anything and you get to experience emotional intimacy with others because everyone is open about their stuff. No planning, just show up and you're fed and taken care of and don't have to think about your responsibilities while you are there.)

posted by crunchy potato to Health & Fitness (16 answers total)

Response by poster: Forgot to mention I also take medication prescribed by a psychiatrist.
posted by crunchy potato at 7:20 PM on November 23, 2021

That sounds like a lot. I totally get what you mean about needing a break from an overwhelming time.

What resources do you have? Can you take some time off of work? Maybe consider going on a sort of staycation but at a nice local hotel?

I've struggled with a lot of similar things. The book Mindful Self Compassion.Workbook by Christopher Germer and Kristin Neff has helped with working through feeling unhappy about myself and life. It's probably one of the best self help books I've ever read.

If you like your therapist, have you gotten a chance to tell them how overwhelmed you are? If I was trying to overcome this, they might be helpful. I've been working through the self compassion workbook with my therapist and it's good because it gives me support outside of therapy.

Good luck ✨ I hope you can get some rest and care.
posted by starlybri at 7:31 PM on November 23, 2021 [6 favorites]

You mention distress tolerance, and I think that lots of the DBT skills can be helpful. I'd take a staycation, one with a pool. But that is me. Bunch of good books. Are the sensory skills in DBT any help to you, soft velvet/fur, nice scents?
I've been doing EMDR for about a year, and it helps not just with trauma, but with everything it seems. I mean things bother me less.
I hope you feel better.
posted by intrepid_simpleton at 7:37 PM on November 23, 2021 [1 favorite]

Ask your therapist about process-oriented group therapy. Many groups are skill based - show up, they teach you a skill to practice at home, come back the next week and share how it went, learn another skill. Process groups use the interactions between group members to learn how to share and connect with people and to get real feedback on how others are reacting to you as well learning more about you react to others. It's not a quick fix but it could give you something that you wouldn't be able to get anywhere else.
posted by metahawk at 7:42 PM on November 23, 2021 [3 favorites]

Also, if addiction of others played any part in your trauma (and it almost always does, one way or another) I know several people who have found support, community and a new way to respect themselves via Ala-non. If you are interested, be sure to check out several different groups - each one has its own personality. It's not the same a therapy but it might give you a different kind of support from people that you aren't paying while also giving you a chance to volunteer to give back to the group and be of service to others.
posted by metahawk at 7:46 PM on November 23, 2021 [4 favorites]

FWIW, my experience with inpatient programs has been that you don't get as much emotional intimacy as you might want. Lots of people only stay for a few days. (In most parts of the US, three days is the default stay for someone who doesn't want to be there but isn't a serious danger.) Also, lots of people spend those few days too overwhelmed, homesick, and angry about being confined to really connect to anyone else.

I've gotten more emotional connection out of (1) outpatient group therapy and (2) partial hospitalization programs.

Outpatient therapy groups — therapy, not support, that's important in my experience — usually meet weekly and have a pretty stable membership, and you can really get to know the other patients. Often therapy groups have a theme: you can find men's groups, women's groups, groups for specific diagnoses, groups for parents or teenagers or queer people or people of color or etc, which raises the odds you'll be able to connect to people. Different groups have different rules, but in some groups you can stay and keep participating for years as long as you follow the rules and attend regularly.

In a partial hospitalization program, you show up every day, do recovery-type activities, and then go home at night. They're like inpatient programs for people who don't actually need to be on a locked ward. The activities can include group therapy, discussion on recovery-related topics, and sometimes also fun stuff to help keep people's spirits up. People tend to spend more time in them at a stretch, compared to inpatient: often a few weeks rather than a few days. Because they're less traumatic than being locked up, and because there's less rapid turnover, my experience is that people in them are more able to be emotionally available than in inpatient programs. I've made genuine friends in partial that I've stayed in touch with for years afterwards.
posted by nebulawindphone at 7:51 PM on November 23, 2021 [17 favorites]

Respectfully, this does kind of sound like a crisis. Perhaps your therapist can refer you to someone who does do crisis treatment, at least for a short term?

(Seconding that inpatient is...not like what you're fantasizing about. There is zero privacy and little to no rest due to nighttime checks, a lot of the people there are in deep crisis and in no position to be capable of being intimate or open, there is little time to go deep in any therapy sessions, the whole experience seems to be about getting on stabilizing medication to be discharged as quickly as possible. It is hectic and feels very out of control. I agree that partial hospitalization or outpatient therapy groups would be a better option for you, or even, like, a stay at a monastic retreat or something. Inpatient is traumatic.)

Good luck to you.
posted by peanut_mcgillicuty at 7:59 PM on November 23, 2021 [8 favorites]

Response by poster: A couple clarifying points.
I guess in describing my idyllic locked ward experience, I was referring to residential treatment vs inpatient. I assumed (wrongly) that anything less than six months wouldn't be called residential.

Had EMDR off and on for about ten years. Current therapist is looking at Brainspotting for me in lieu of EMDR.

I suppose it's the social aspects of the situation that I'm especially struggling with and did not articulate very well. I can take a weekend away with my favorite hobbies but it won't heal the wounds that cause the shame attacks, rejection or assumed rejection which leads to behavior to confirm the rejection, etc.

Thanks for the process group suggestion. My T mentioned it before but local ones are full. Your suggestion reminded me to check for alternatives and I found a kind of loophole situation that sounds like the same thing. Still paying for acceptance and belonging but at least in a group space I can maybe translate it into real life better.
posted by crunchy potato at 8:19 PM on November 23, 2021 [2 favorites]

One of the way people do this is through spiritual/religious groups. Regular attendance promotes connection and it is fairly normalized in many circles to talk about your problems and struggles in that context, there are some formalized ways of looking for support. Some people don't tolerate this at all, but it is something to consider if there is a group of people with like minded values around you. Ymmv.

Partial hospitalization or Intensive Outpatient sounds like the way to go, if you have a decent program nearby.

There are inpatient programs that specialize in specific types in trauma and such, but unless you live near one it requires travel and associated costs. In general they are still inpatient programs and come with many of the downsides of inpatient but can be more focused and have more quality groups on the things you would recieve on a generalized inpatient floor.
posted by AlexiaSky at 8:44 PM on November 23, 2021 [4 favorites]

I know that at least if you are in the US, there are 12-step meetings for all sorts of issues––not just AA or Al-Anon. You can also go to 'open' meetings even if you don't have that specific problem, just to sit and observe if you want. You don't really have to say anything if you don't feel comfortable but I think generally they expect newcomers to at least introduce themselves with a name. If you think any of this could be stemming from childhood trauma, check out Adult Children of Alcoholics (and Dysfunctional Families). It's only nominally about alcoholism in the family. I have a friend who is severely traumatized by their childhood with their 'mostly normal' parents, but one parent is probably mentally ill, and I feel that they would feel heard and maybe connected to others at these meetings. It's worth a shot or two or three, because each meeting has a different vibe. They're totally free and if you live in or near a city, there are probably multiple meetings happening every day nearby. There are people who go to different meetings in the same day, or go to a meeting every single night of the week. That's what they're there for. It's a community of people who might understand you. Even if it's ultimately not a good fit for you, it might be a good thing to observe how you react to these meetings.
posted by saturday sun at 8:54 PM on November 23, 2021 [4 favorites]

Your question (and clarification) made me think of this place, which was (and remains!) wildly outside my price range but would have been amazing at a time where I could have written a question very similar to yours.

Instead, I found an ashram near me that provided self-guided retreats, and booked two weeks there for a few hundred bucks. No phones, no computers, I brought books and a journal and committed to showing up to the daily programs that were open to all (meditation, light yoga, meals, farm work). It gave me something concrete to do in a non-judgemental space, and allowed me to create some space from the self-loathing so I could rest. By chance I connected very well to the other people living there, but it could have gone either way.
posted by third word on a random page at 10:19 PM on November 23, 2021 [4 favorites]

Don’t know where you are — are crisis houses a thing locally?
posted by lokta at 1:58 AM on November 24, 2021 [1 favorite]

Don't know where you are -- are crisis houses a thing locally?

I think that OP is in the US, where, unfortunately, there are not crisis houses as defined in the UK: places that offer "intensive, short-term support to help you manage a mental health crisis in a residential setting rather than in a hospital."

I am thinking of several occasions in my own life when an overnight in a crisis house would have helped me manage my anxiety (which is part of my mental health picture, along with depression, for which I am prescribed medication).
posted by virago at 6:56 AM on November 24, 2021 [1 favorite]

Reading the others, have you thought of a monastery? Quiet and peaceful and about $50 a day including meals. You don't have to be religious either. Most have libraries and grounds for walking.
posted by intrepid_simpleton at 10:08 AM on November 24, 2021 [2 favorites]

Oh, and the secret words are, "private retreat", as in, "I would like to make a private retreat."
posted by intrepid_simpleton at 11:48 AM on November 24, 2021 [2 favorites]

no internet + lots of coloring books + grippy socks
posted by Jacqueline at 2:26 PM on November 25, 2021 [1 favorite]