Putting the Libra to Sleep

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I’ve completed six days in the Lutheran Hospital outpatient program, and I can’t tell yet if it’s making me better or worse.

There are two designations—IOP (Intensive Outpatient Program) 1 and 2.  None of the literature explains the difference between the groups, but, basically IOP1 is for more functional, more acutely symptomatic folk.  IOP2 is for more severely ill folk who maybe require other services (home care, rehab, medical, etc.).

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The first two days I attended IOP1.  The group was HUGE, 14-18 people with the usual one or two who dominated every conversation and folks talking over each other.  I thought I would lose what little mind I had left.

I watched my intolerance and irritation skyrocket.  My Libra penchant for fairness blew up into a neurotic need to silence the blabbermouths so that the silent suffers might get a second to squeak out a comment.  But I also realized this was all my shit.  If the facilitators felt no need to shut down the usurpers or redirect the tangential wanderers, then it wasn’t my place to step in.  Instead I clutched my purse to my chest and took deep breaths.

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After the second day (and no sleep that night), I knew I needed to talk to my designated handler.  I told her through bitey, frantic, tear-and-snot laden spew that I couldn’t take another day of it.  She listened with a beatific smile and commented in a gentle don’t-spook-the-Tasmanian Devil voice.  Perhaps I should move to the other group.  And feel free to find a quiet place to breathe whenever the desire to punch a talky-talker in the face arose.

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My first day at “the other end of the hall” felt restful in comparison.  There were only five of us in group, and I learned things about PTSD—one of my diagnoses, though something my therapist and I have never really explored.  We usually have other immediate shinola to deal with, so we’ve only ever just touched on it.  THIS was what I was hoping for—some new information, some new tools, a direction.

But, the next day the group expanded to 13, and the whole issue of blatherers and time-sucks reappeared on a crazier level.  I tried to be compassionate, but that well seems to be dry at the moment.  I know folks talk out of nervousness, insecurity, etc., so I tried to reason with myself.  I still ended up out in the hall with my earbuds firmly in place, listening to Billy Joel sing “Innocent Man.”

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I blame the insurance industry and our butt-head Governor, Terry Branstad.  Most insurance coverage only allows three days a week in outpatient care, so Mondays, Wednesdays and Fridays end up with twice the group size as Tuesdays and Thursdays.  It’s stressful to go from a small, intimate group where folks feel safe enough to open up, to a mob where everyone talks at the same time.

And because our Governor closed most of the mental health hospitals, took away funding for behavioral services, and basically told folks with mental illness to “get over it,” the programs that are left are bursting at the seams.

I watch the kind and knowledgable staff at Lutheran run around like headless chickens, trying to accommodate everyone’s needs, shore up folks enough to leave so that those who have been waiting a month for an opening in the program can take their place.  The nurse practitioner who talked to me about medication laughed long and loud when I called it “a three-ring shit show.”  This seems to be my new favorite phrase.

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I came home every day more exhausted and people-avoidant than ever.  I feel like an Introvert In Extremis, only able to function after hours of silent cat time, a couple episodes of Fringe and a frozen pizza from Costco (they have the best thin crust sausage pizzas…).  Even then, “functional” may mean taking a four-hour nap or washing the dishes.

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Yesterday I did my laundry at 3:00 in the morning, because I couldn’t stand the thought of going to the laundromat on the weekend when everyone else goes there.  So, because I was already awake at 3:00, I did laundry for the first time in my apartment complex’s washer/dryer.  Granted, one is not supposed to use the machines until 8:00 out of respect for the tenants who live next to the Common Room.  But since I hate people right now, I didn’t care.  And I tried to be quiet.  No one came after me with a knife, and no one slashed my tires later, so I think I got away with it.

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In between tippy-toeing, I sat at the nice dining table and worked on my journal.  Along with my wheeled laundry hamper, I brought my traveling studio (everything should be on wheels) and a big mug of hot chai.  I sat at my own little coffee shop with my earbuds in and the smell of clean wafting around me, and even through the itchy buzz of being up at 3:00 doing something illicit, I could feel my mind smooth out.

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The same nurse practitioner who laughed so hard with me suggested a new strategy for next week.  Bring my wheely cart and when group bugs me too much, take it to this out-of-the-way lounge I found and do art until I feel like coming back.  I tried that on Friday, and I left the hospital less drained.  I met my two meditation buddies for lunch and lasted about 30 minutes before I completely faded.  My well is dry.  That’s all there is to it.

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I think the trick is to not panic.  I feel myself considering the new drugs this kindly nurse practitioner suggests, even though I sat with my own NP before I started IOP and recounted my long list of Drugs Tried and why they didn’t work.  She reminded me that there really is nothing new in psychotropics, just tweaks to the same old formulas.  If they didn’t work then, they won’t now.

I’m grateful that the Lutheran staff is so willing to work with me.  It’s ironic that the adaptability and flexibility I need from them is part of what makes me so irritable there.  It’s a very loose, laissez-faire set-up for people who have different special needs.  I must try to give my Libran craving for fairness, order and rules a rest.  Maybe I can give her a Xanax.

The Hot Itch

Say Hi to the PopeLast week I met my new primary care provider.  I’ve been searching for a doc for a couple of years since the Best Doctor in the Whole World retired.  I try not to hold everyone to his standard.  I got spoiled.

So, everyone who’s anyone has recommended this OB/GYN nurse practitioner.  Great, I thought.  I was a nurse.  We can relate.

And, indeed, she was vivacious, and friendly, and practical (gotta love that).  Then, we took a sharp turn into The Twilight Zone.

I would characterize this NP as an evangelical Christian, which would normally be a non-issue for me.  As a self-proclaimed mystical atheist, I’m always interested in what other people believe.  I told her that.  She laughed and said she wouldn’t try to convert me.  I laughed and said it wasn’t possible.

So, with that bit of self-disclosure out of the way, she asked if I ever had thoughts of harming myself.  I gave my standard Psych History answer—”I tried to kill myself once.  I still have suicidal thoughts, but I recognize them as symptoms and a signal to get help.”

She said, “We all have bad thoughts, and most people go through some period of depression.”

(Okay, I thought.  She’s not a psychiatric nurse practitioner.  She may not know the difference between clinical and situational depression.  Just go with it.)

“Where do those bad thoughts come from?” she asked (rhetorically).  “If you believe in God, then you have to believe in the Devil…”

I must have gotten a LOOK on my face, because she stuttered to a stop and started talking about vaginal health.  Was I imagining things, or was this educated, medical professional about to tell me mental illness was caused by the Devil?  I was so shocked, I don’t remember what else she said, just that we wrapped it up pretty quick, and I was shuffling to my car in a daze.

The daze turned to anger before I left the parking lot.  Are we in the Middle Ages, I fumed.  What was next?  Burning at the stake?  Dousing?

Rage fueled a deep hopelessness.  I missed my old doctor.  Did I have to choose between the cold, condescending woman who took over his practice or this kind-hearted religioso?  Did I have to start the search all over again?

I met with my meditation group later in the day and felt righteous satisfaction in their outrage as I told the story.  It’s a hot itch, indignation.  It gets under the skin and festers.

AbsinthineSo, as we sat together in silence, I took a step back from what I was feeling.  I called up the part of me that observes my thrashing around with gentle curiosity.  What happened?

I saw that I’m not as tolerant as I like to believe.  I don’t like people pushing their religion at me.  I don’t like the blank stares when I say I’m an atheist.  As the pastor at the First Unitarian Church in Des Moines said on Sunday, I’m more than willing to share my faith with people who are genuinely interested, curious and open-minded.  But, that happens rarely.  It’s just easier to keep my mouth shut.

What does it matter anyway?  I tried to look a little deeper.

My ego hates to be misunderstood.  It hates to be dismissed or categorized.  And it really hates to be discredited.  I’m proud of how hard I’ve worked to regain some functioning in the world.  Proud.

Ah.

I looked at my choices again.  Cold, Condescending Beeyatch or Evangelist?  I tried CCB the last time I got bronchitis, so I knew what to expect.  I had a feeling the Evangelist would be kind and thorough.  I suspected she would take very good care of my body.  And that’s what I needed her to do.  I might have to set some boundaries.  If I could nudge my ego aside, there might even be A Teaching Moment.

Coming home from meditation with my friends, I turned up the music and sang down the highway.  The ego is a stubborn little cuss.  Mine can be paranoid and hysterical if the mood is right.  Anything can offend it, and it defends itself with teeth and claws.  But, like a mediocre poker player, it has a tell—that hot itch of indignation.  When I feel that under my skin, I know it’s time to back up and look again.

I’m glad for that signal, and I’m glad I know what to do with it.

Thanks, Ego-Girl.  Keep raging.

 

 

Our Town

One People

Today I watched a police officer escort a homeless family out of HyVee’s café.    They had been in the booth behind me, so quiet I never even knew they were there—a mother, a father, a little boy about six and a baby in a stroller.  I didn’t see them bother anyone or cause a disturbance.  They were just resting, watching the big screen TV.

The young officer wasn’t mean, but he wasn’t kind either.  He asked what they were doing.  He asked if they were staying at The House of Compassion (our homeless shelter), then he got them up and out the door.

I don’t blame him—he was doing his job, I guess.  But I’m furious at whoever made the call to the police in the first place.  The family looked poor, but clean.  They didn’t smell drunk or seem high on street drugs.  The breakfast rush was over, so taking up space for paying customers couldn’t have been the issue.  Maybe the sight of the sleeping mother was offensive.  Maybe the whole idea of homeless people in plain sight was offensive.

I’m sure it never occurred to the complainant to ask if the family needed help or breakfast.  Or to call their pastor instead of the police (because anyone who needed to call the police must own a strong sense of morality and, thus, have a pastor).  And I’m positive they didn’t understand that a homeless shelter is far from restful, especially for adults who must protect their children.  Leaving a shelter exhausted in the morning is the norm.  Poverty is exhausting.

When I left HyVee, I spotted them far down the road—the dad pushing the stroller, the mom lagging behind with the little boy.  Even at 9:30, the morning was hot and humid.  I wondered where they would find a welcoming place to rest.  I wondered if that was possible in this town.

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