Question:
Hi, Rainbow Colors. Hi, everybody. RC, in your reply to my posting "How to deal with sense of d*nger?", one of the things you said was: In fact, I once put myself in the hospital specifically because I wanted to work on some very intense issues and I was afraid that I might lose control. I didn’t. Even at the peak of intensity, I didn’t lose control. But believe me I _felt_ like it was going to happen!
In the hospital, they actually allowed and encouraged you to work on issues that could be triggering? My experiences in hospitals was that staff wanted "pretty behavior" from all the patients if possible, and were unwilling to let a patient use the relative safety of the hospital to do work that might be too unsafe outside. In fact, one of the times I was in the hospital over a year ago, there was one patient with either PTSD or MPD (I forget which). She said that hospital staff refused to let her see her regular therapist while she was in the hospital, because they didn’t want her dealing with potentially triggering issues there. I have my own fears about losing control if I try to work on the difficult issues (and a few real-life losing control episodes that substantiate those fears). I’ve repeatedly wished I could take advantage of a safe and supportive hospital environment to do the difficult work, similar to what you were able to do. But during the several times I have been hospitalized (for recurrent depression, agitation, and suicidal ideation), staff seemed to treat me as if I was a bad, misbehaving boy, and refused to help me look at the scary PTSD issues. Can you tell me a little bit about how you and they structured the work in the hospital? What they did to help you feel safe in case you did lose control? How they made it emotionally safe enough for you to do the difficult work? I mean, if certain issues are too dangerous to work on on an outpatient basis, and hospitals are unwilling to let one do the work on an inpatient basis, then how can the work ever get done?! RC, I’m keeping in mind your ideas about slow, step-by-step work from your other posting (and starting to explore them). But I find myself envious that you found a hospital that allowed and encouraged you to work on intense issues, taking advantage of the increased safety there. Thank you again for any feedback you (and anyone else here who can relate to this situation) can offer. Wishes for peace and growth… – Phil R.
Response:
Hi, Rainbow Colors. Hi, everybody. RC, in your reply to my posting "How to deal with sense of d*nger?", one of the things you said was: In fact, I once put myself in the hospital specifically because I wanted to work on some very intense issues and I was afraid that I might lose control. I didn’t. Even at the peak of intensity, I didn’t lose control. But believe me I _felt_ like it was going to happen! In the hospital, they actually allowed and encouraged you to work on issues that could be triggering?
It was specifically set up for this very reason. Maybe it helped that I’m a t’pist myself? I called and interviewed one of the on staff t’pists and explained what I was looking for and why. My regular t’pist got temporary privileges so he could come every day and work with me. Of course I _put_ myself in the hospital so it wasn’t like I had to go regardless. If they hadn’t agreed to do what I wanted I wouldn’t have gone. The only problem I had was with some specific anger work. As I dealt with stuff I was getting very anxious and physically it was driving me batty, so I wanted to focus the anxiety into anger and work on it that way. The staff t’pist was very hesitant at first to do this because, as she said, this can get out of hand very easily. So I pointed out that a locked ward is the _best_ place for something to get out of hand, and I had my regular t’pist go over it all with her. Of course it just caused switching all over the place *grin* My experiences in hospitals was that staff wanted "pretty behavior" from all the patients if possible, and were unwilling to let a patient use the relative safety of the hospital to do work that might be too unsafe outside. In fact, one of the times I was in the hospital over a year ago, there was one patient with either PTSD or MPD (I forget which). She said that hospital staff refused to let her see her regular therapist while she was in the hospital, because they didn’t want her dealing with potentially triggering issues there.
They can’t do this if the regular t’pist can get visiting privileges. They don’t have this kind of control. Now if the t’pist can’t get temp privileges then the hospital can set these limits because of what insurance will cover and all that. It’s also kind of unethical for a t’pist to work with someone when they are really supposed to be working with someone else. So it really depends on _why_ the hospital said ‘no’. It also really depends on why the person is in the hospital in the first place. If you go in to work on depression and your goal is to get _less_ depressed then that is what you should do. Working on serious, triggering stuff might get in the way of that and if you aren’t emotionally strong enough yet to handle it, it might make the depression that much more serious. If someone is multiple it also depends on if the entire system is ready for that type of work. Oh, and of course if the staff in the hospital don’t feel qualified to work with abreactions and such then it’s _very_ wise on their part to say no! I have my own fears about losing control if I try to work on the difficult issues (and a few real-life losing control episodes that substantiate those fears). I’ve repeatedly wished I could take advantage of a safe and supportive hospital environment to do the difficult work, similar to what you were able to do. But during the several times I have been hospitalized (for recurrent depression, agitation, and suicidal ideation), staff seemed to treat me as if I was a bad, misbehaving boy, and refused to help me look at the scary PTSD issues.
Again, chances are the main focus was to keep the problems from getting any worse. Until you have that sort of emotional (ie ego) control and strength, any serious work has to wait. Can you tell me a little bit about how you and they structured the work in the hospital? What they did to help you feel safe in case you did lose control? How they made it emotionally safe enough for you to do the difficult work?
Ok, first I made it clear that I was multiple and they had to be able to handle switching. They told me their policies and such on that and it sounded like they knew how to work with that. Next I told them about specific things that I _knew_ were triggers and why (such as being restrained) and I offered options for any of them or ways to make the trigger less serious (like with restraining, if only women did it or if someone would say first ‘calm down or we will have to restain you’ this would allow my system to get in control and be safe) My t’pist and I set it up with hypnosis in advance so these words would trigger specific insiders to be strongest and able to take over the body immediately. Next, we had a standing order for 100mg of thorazine in case I or they felt I was physically out of control and in danger of hurting myself or another. I was able to ask for this or they were able to give it to me after first telling me they thought I needed it. I was there for 26 days and never needed it. I also set up a specific plan for using the quiet room and how that would happen. For example, I could ask to go in and just sit on the floor at any time. Or they could tell me I needed to go in and they would escort me without touching me. If that didn’t work then they were allowed to hold my arms (women only) and tell me I had to go in the room. If that didn’t work they were to give me the drug _before_ resorting to men holding onto me. _I_ requested to go into the room twice in 26 days. They never said I had to go in. I also made it clear to them that I was willing to follow all unit rules. I didn’t ask for any exceptions to be made. I went to all groups, followed daily schedules etc. whenever possible. There were a few days I had more trouble doing this than others and they were very good about it, but I never tried to take advantage of being ‘freaked out’ or anything to get out of something or mess up the routine. For example, I wasn’t able to eat for several days for specific triggered reasons. I didn’t make a big deal out of it just told my t’pists why and that I was able to eat x. Then I made sure I drank plenty of water and ate what I could. Most importantly I was able to be very clear in my communications with the staff so they didn’t think I was being ‘difficult’ or manipulative. I mean, if certain issues are too dangerous to work on on an outpatient basis, and hospitals are unwilling to let one do the work on an inpatient basis, then how can the work ever get done?!
Personally, I’d say that work _can’t_ get done until your system has enough ego strength and control to do that work outpatient. One of the most important things I learned in the hospital was that I didn’t need to be in the hospital to do that work. It made it easier but I could have done it outpatient too. RC, I’m keeping in mind your ideas about slow, step-by-step work from your other posting (and starting to explore them). But I find myself envious that you found a hospital that allowed and encouraged you to work on intense issues, taking advantage of the increased safety there.
I was lucky! 
Also, I was able to talk to them in their language (yes, we t’pists have a language:) which probably helped quite abit. I did have some problems right after I got there because all the staff wanted to talk to me about being multiple (I guess I’m just too good a teacher:) and I finally had to tell my staff t’pist to make them stop it. It was triggering my t’pist insider too much and she ended up outside too much for the others to get any work done. Rainbow Colors (Jill) Thank you again for any feedback you (and anyone else here who can relate to this situation) can offer. Wishes for peace and growth… – Phil R.
– The colors blend, the edges soften. Swirling and mixing we are becoming white light.
Response:
RC, thanks for taking the time to write out a well-thought-out reply to my question. I think you were fortunate to have the hospital experience you did. It seems most hospitals just want to focus on crisis stabilization: House the person until the immediate crisis subsides, then send them on their way. (I’ve seen this for most inpatients, not just me.) I don’t think many insurance companies are willing to cover hospitalization unless the need is very urgent. I’ve always been (maybe overly) preoccupied with finding external safety, since I’ve had difficulty creating internal safety. So I found it interesting that you said you could have done the work as an outpatient. That’s what I’m trying to do, and the ride is pretty rough. But maybe I’ll make some progress and feel less unsafe. Thanks. Wishes for peace and growth… – Phil R.
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