Intensive Care

Collage art, greeting card artSince July, I’ve been in a program called Intensive Psychiatric Rehabilitation.  It’s Medicaid-funded and designed to help those of us with “serious and persistent mental illness to achieve goals that improve success and satisfaction in living, learning, working and socializing.”

It’s like nothing I’ve ever experienced in any kind of health care service—thorough, gentle, involved, deep.  For these first six months, I’ve met with my IPR Facilitator (Aly) two to three times a week just gauging my motivation and willingness to go through the process—doing lots of assessments, looking at self-awareness and life satisfaction, and meeting in a small group to hear how others are doing the same.

I believe my participation in IPR is a big reason for my greater stability during the last half of 2014, but maybe not because of the actual work I do in the program.  I get to spend four to six hours a week with a caring professional, talking about my life and my illness, who gives me useful feedback.  Considering that I see my therapist weekly, that gives me up to seven hours a week of therapeutic support.

I can’t begin to explain how lovely that is, to have somewhere to go every several days a week where I feel safe, heard, challenged, and successful all at the same time.  I have felt parts of me relaxing that have been clenched for years.  The notion that I could be kinder and gentler to myself grew naturally from this place of safety and care.  The outrageous idea that everything about my life—the wild and warp-speed mood swings, the practical struggles with money and relationships, my weight, my compulsions, my delusions, my mistakes and mis-steps—could be accepted and given a place at my internal table became my new mantra.  “Yes, that, too.”

This increase in professional support prodded me to start searching in different ways for more natural support.  I found a wonderful, active community at the Des Moines Unitarian Church, signed-up for a class there in SoulCollage®, met some interesting people and sang.  I started reaching out to my old friends in Minnesota.  I joined Facebook, fer cripes sake.

World She InhabitsOver the last few weeks, my work in IPR has taken me on a new journey of discovery.  My focus in the program is on my Living Environment, to assess and eventually set a goal about where I live.  This could also include a “Staying” goal if my current home turns out to be best for me.  We looked at all the places I’ve ever lived, which ones I liked most and least and why.  Aly asked me to imagine my perfect space, perfect neighborhood, perfect part of the country—to dream big and with extravagance.  We’ve spent time tweezing out my values and preferences and laying them over my ideas about home.

One of the many assessment parameters Aly used was to imagine what the significant people in my life would say about my current living environment, about the idea of moving elsewhere, and what their concerns might be.  I try hard not to presume what others think about me, so I wasn’t sure.  But I thought in general they considered me successful  (This is an IPR term.  It means that you generally stay out of jail and the hospital, that you can perform self-care, do basic housekeeping, and partake in enjoyable activities in your home.  Luckily, I rock at being successful).

This exercise made me curious to know what my friends and family really thought, so I started asking them.  It’s always a little scary to ask people what they think of me.  They all carry memories that I’ve lost, things I’ve said in the past, events and experiences fried out of existence by ECT.  Plus, an outsider’s view of my often-times incomprehensible behavior can carry an emotional charge for them.  I’ve done a lot of weird and hurtful things in my bipolarness, and turning over those rocks can be deadly.  But, getting that outside perspective is valuable for someone with mental illness.  We get trapped in our own faulty musings.  Someone else’s reality can be shocking, but life-saving.

As it turned out, they do think I’m successful, but another theme started appearing.  As I’ve reached out to my friends in Minnesota, they all to a person have said, “We don’t know why you moved in the first place.  It never made sense to us.  This is your home.”  And even my sister, who orchestrated my exodus from Minneapolis, said, “You’ve worked hard, made friends and have a routine in Marshalltown, but Minnesota is home…”

My compulsive side would do something with this information.  I’m choosing to just add it to my IPR file along with all the other assessments and data.  It will be a while yet before I actually choose a goal in my Living Environment.  In the meantime, I want to keep practicing this kinder, gentler attitude.  I want to keep attending UU services on Sunday.  I want to schedule my next visit to Minneapolis and spend time with those people who still love me and remember me.  I want to spend time with the people here in Iowa who love and support me, too.  I want to keep an open mind, explore, evaluate.  I want to keep being successful.

Because, you know, I’m on an Adventure.

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