12 October 2012

The Road to Somewhere

I'm really struggling to positively summarize the past six weeks of my life (spent in an inpatient treatment facility for PTSD in Salt Lake City) after gaining a reputation of being overly negative. I'm not so sure that's actually the problem. I'm far more confident that the reason I'm struggling for words is that I'm absolutely heartbroken that I used every chip in my power to come to a center that became (or that I allowed to become) a disappointment. Or maybe it wasn't. I'm hurting in ways I've never hurt before, I've excavated deep-seeded emotions I'd buried for years and years, and most significantly I fear I've let myself, my command and even Tricare down for costing them such a huge fortune (over $2,200 a day) for me to receive care over the past few weeks.

Unlike the girls whose final statements (their parting words before leaving the treatment program) I heard a week or two after I arrived here, mine is incredibly unsupportive and untrustworthy of "the process" of treatment (how me) and much more determined that the only way I survived in a flawed institution was to rely on my own internal strength and to allow myself push like crazy.

To force myself not to give up. In this all-female military unit, I dug into my reservoir of internal strength to ignore the "teenage drama queens," constantly passing notes during the 8 daily hours of classes. I wish I could have learned from them. Instead I learned that when military women are wounded early in their careers, they respond by acting out like children, and it breaks my heart to be an audience to such sadness.

I watched an over-tasked program director take the same feedback from us, her patients, for the past five weeks (the treadmill's broken, we can't call Germany, and how much is this "treatment" actually costing my government, plus about 20 more...) and not solve or follow-up on a single one of them. The person in whose care the Department of Defense has placed me in my most vulnerable state did not make any visible effort to show that she genuinely cared about what we, the girls who brought in almost $40,000 a day to her program, begged her to address. Another round of heartbreak.

That's a tough cookie to swallow for me, a girl wounded by war, sexual trauma, and finally willing to face some long-lingering abandonment issues. To feel forgotten in a hospital with absolutely no way to leave was scary and isolating to an extreme I'd never envisioned. Or felt. To be dumped by my best friend while I've been here (by email, of course, saying that our 18 year friendship interfered with his marriage) and to sign final divorce papers after a very tumultuous past few months. And to be willing to rip my heart open every day in class only to re-discover each day that the program didn't have (or want to have) the resources I so desperately wanted to put myself back together into anything resembling an organized fashion.

I can now recognize that good things have happened here, and I truly believe they happened as a result of the Cognitive Processing Therapy (the fancy name for teaching PTSD patients to change their thinking patterns) and because of Amy, my therapist's, unrelenting determination to push me past every limit I thought I had. How I never ran out of tears blows my mind. That goodness happened in spite of the broken system in which she works. It's all out on the table now. I know. I believe my trauma is no better (or worse) than any one else's. But it is mine. And I guess now it's wrapped in a package with a nicer bow.

I came here feeling like a failure, and there are certainly still hints of that. But just hints. Looking back, there are times in the past when I wish I would have been stronger. Or weaker. Or cried. Or just let it go. I started doing that here. There have been times (even here) when I've felt defective, like every patient (all 17 of them) was "getting it" (whatever "it" was, anyway) and I was stuck alone in a dark, empty place. Perhaps by choice.

There were times here when I slept for hours, somehow allowing the burden of the past 10 years or so slide through my toes and out from under my thin, white institutional bed sheets. Or when I've been in yoga, holding downward facing dog or shavasana, tears streaming down my face, knowing that it's not strength that's kept these feelings of hurt, betrayal, sadness and frustration buried so deep. It's been fear. Fear of not knowing how to deal with feelings in a constructive way. Fear of allowing...maybe even inviting...someone to love me unconditionally. Fear that when I admitted to signing divorce paperwork served to me by a man I may always love for his good intentions, I would be viewed as a failure (a two time failure) in everyone's eyes. Thinking. Always thinking that the opinions of other are more important than my own.

I've let that go. That stays in Salt Lake City, a place that after this Friday (today), I never plan to re-visit. I want my hurt and sadness to stay here. I'm done being chased by sadness.

I didn't come here to change my life. I came here to match the me I felt in Afghanistan, living simply and loving every second of my job, to the me I want to feel every day in the future. I'm leaving here confirming what I knew when  had my first post-Afghanistan panic attack...that going to Afghanistan was the best thing that ever happened to me...and also the scariest. ("It won't ever feel worse than this" Amy said to me over and over...and I hope she's right).

It is in this moment that I've reached (rather, allowed myself to reach) a turning point in my life. Learning to live with the scars, the emotions, the regrets and the fear I accumulated both pre-and post-Afghanistan. Making that connection was my goal in Salt Lake City. I wasn't here to make friends or help others. Because I feared if I took that approach, I'd stay here for years and never talk about myself. I came here to challenge the unhealthy beliefs I've clung to for months, years and even decades...I came here with a dream to live a healthier life. To put even a two inch gap in the door jam (therapy-speak for slowing down my immediate response to an outside stimulant). To at least take a brief mental pause when my brain tells me "I don't deserve to receive benefits from the military" merely because my war scars are internal and others had it far worse. If I can think to myself at least 1% of the time that "I deserve compensation for the unique and dangerous service I performed in Afghanistan and my resulting PTSD" than maybe six weeks of fighting my own guttural reaction was worth my time. No, it was surely worth it. I have to learn not to resent the system for trying to help me after it's failed me in so many ways.

If I can accept "Medication will help me through this rough patch and then my life has the potential to be so much happier" or "If I forgive myself for past mistakes, those who care about me are apt to do the same." If I believe those statements can ever be true (whereas when I arrived here, I believed they were always false), then I've made progress. And even an inch is progress.

I found my voice again. I never, ever thought it could be so cathartic to drag and actual pencil across an actual piece of paper, cut off from the internet for six weeks. I cry when I write, not out of fear of the description and circumstances of the situation, but because I've learned to attach emotion and feeling to  situations. On paper. The true test...the next step...is to give myself permission to speak the way I now allow myself to write.

Physically, I judge myself and think I've had an atrocious and infuriating stay here. With no access to physical activity, I've gained weight, I've eaten a lifetime's worth of fried institutional cafeteria food, and I've felt the wrath of condescending nurse technicians threaten me if I didn't behave in their directed way. I'll leave all that crap here. And hopefully I can leave most of these 10 new pounds here as well. Or somewhere.

But again physically, this institution, this tall building, locked doors, void of any aerobic exercise capacity, has taught me more about how to survive in the "real" world than perhaps I even learned in Afghanistan. I've literally lived like a snared wild animal learning to survive in captivity. Each night, I sat at my desk either reading or watching the sun set over the glorious Rocky Mountains. Trapped in a cage with up to 17 other overly-restless-pseudo-prisoners with little to no official programming from the time we returned from dinner at 5.45pm until we started to drift into a highly-medicated slumber around 9pm. There was no avoiding noise. Or crowds. Or stray hairs all over the floor. Shoes strewn across the living room. Class books tucked frantically into every nook and cranny on the ward.

Physically, there is no safe, quiet place for me here. There is no escape. I've felt trapped, overwhelmed and anxious to all new levels, generously reflected in the new medications I've been prescribed and the new symptoms I've developed in treatment. And the difference, the magical difference now, is my extremely well-honed ability to mentally slip out from the walls of hell to find myself performing the 12-count cleansing breaths that begin every Bikram Yoga practice in any language in any country in the world.

I'll spend the next three-and-a-half days driving through Salt Lake City, with 25 notecards listing my most troubling stuck points (again, therapy-speak for negative patterns of thinking that magnify my PTSD and depression) tucked into my purse. The big ones. The thoughts that haunt me the most and that have haunted me here. The ones that seem to force me to feel isolated, frustrated, ashamed, scared and confused. And I'll do my best to leave my evil stuck point cards all over the city. In coffee shops. Yoga studios. Restaurants, Hiking trails. National Parks. Churches. Temples. I won't litter them...I'll mindfully place them in locations best suited for such a purpose...garbage cans.

I'm giving myself time to do that, and I used many of my remaining chips to transition back to work in such a unique way. To continue healing myself now that I think the hospital itself has given me all it's capable of giving. And maybe I'm not sad about that after all. I'm sad that getting a mental institution to do the right thing (focus on patient care) felt like a huge struggle. It was an extra brick on my already overbearing load. But even that was a great lesson to me. I picked fewer battles than I usually do.

I've admitted before to expecting this hospital to "fix" me one delicious bite at a time. Such a thing...a dream...is completely unreasonable for any institution. But there were also a few people here (and at home) who cared so deeply that I now feel an overwhelming desire to make my best attempt to go live an amazing, happy life because I've been so inspired. Their joy was contagious. They know who they are.

Six weeks is not enough to alone change the trajectory of my future. But six weeks, ugliness and all, has been enough to awaken me from my self-loathing pity party and to get me marching in the direction of a happier future. And for the first time in as long as I can remember, I believe in the idea of a happier future. I have a backup plan. And a backup to the backup plan. And I guess in the end if I lose my compass, I'll just try to remember ow the old version of me would have responded, and I'll run like hell in the opposite direction.

** This is the first entry in a retrospective series of life in a mental health institution. A special thanks to Keith Hudson Photography for perfectly capturing my post-Afghanistan self.