Reached an impasse with treatment - feeling overwhelmed

Discussion in 'Help Me! I Need to Talk to Someone.' started by pp272, Dec 28, 2014.

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  1. pp272

    pp272 Member

    After stepping up to a partial hospitalization program, and then back down to regular therapy, I have noticed something that is troubling me. Quite a lot of the mental health profession is based on a rather superficial system of compliance. If one nods their head wisely at each directive and generally rolls along with the crowd, then doctors and other professionals label this as positive progress. However, the moment the patient pauses and says 'hang on a second, that makes no sense' or 'I don't understand' or even 'I'm not totally sure I agree with that statement - not sure that applies to me', then the patient is labelled negatively. Such labels include resisting treatment, arguementative, not following treatment plans, and such like.
    I'm getting quite frustrated and despondent at the lack of progress I'm feeling internally. If I smile and go along with everything, then I'm told that I am making great progress, even though internally I feel worse. In line with what I said above, if a start asking too many questions, then treatment tends to stall and treatment providers show some frustration, even though I feel like I have at least have some answers now.
    I have completed graduate school, so I hope that I have some vague idea about how things work, but it worries me that the social worker I also see sometimes has difficulty spelling the word 'psychiatry'.
    I am at a loss - any ideas or tips? I'm really struggling, feeling overwhelmed and heading towards having a bit of a crisis underneath the weight of it all.
    Last edited by a moderator: Dec 28, 2014
  2. JmpMster

    JmpMster Have a question? Message Me Staff Member Forum Owner ADMIN

    The reason the the labels get applied even if you feel like they are legitimate questions or objections may be based on the fact you still are not "fixed" (i am not even sure what the goal is for you or any of us- fixed / cured/ "well" really do not seem correct) and are actually feeling worse. If you admit that you are simply agreeing before that and not feeling it is actually working, and then go on to say that you are actually feeling worse, then it is a reasonable conclusion that the treatment program is not moving forward in a positive manner, and if you were essentially lying about the progress to attain the next level of care than it is reasonable to say that treatment program is not being adhered to as intended.

    That is the real impasse - you have learned how to give the correct answers to the correct questions, but they are not honest answers. This makes the foundation they are working from wrong to start with. Since the foundation that was assumed to be in place is not there to build on, they are asking or presenting things that really do not make sense to you (and probably should not- I am not implying at all that if you were "better" then you would agree and your questioning the treatment is just because you are "sick"). But if they have a course of treatment that they believe based on your responses was working well they would have no reason at all to change it and would correctly question why you suddenly wanted to change or question it. The missing piece of the puzzle is that it was not working as well as you indicated to them it was. You wanted to show progress and like every person want to get approval or positive feedback - so you answered the way one would if it was working - even though it really was not, or at least not to the extent you implied and they believed.

    I would suggest taking a step back with them and explaining where it was that you felt the program stopped being effective and try to restart at that point- and perhaps in a different direction this time to achieve the real results that your answers had suggested were achieved before.

    You have clearly made some real progress as well (or it seems that way to me and seems you believe you have made some genuine progress?) so while it is possibly disappointing to feel like you are going backwards, some of the things you have done, they have done, or that have been done together have had some positive effect. Hopefully you can use that for confidence that you can adjust the treatment programs to continue that progress.

    I also believe that ultimately the real progress comes from within. You say " even though I feel like I have at least have some answers now. " The social worker and the psychiatrist and everybody else that is involved in your treatment program can give ideas and support , meds, planning and lots of things, but real awareness comes from within you and it sounds like you really are achieving that. Perhaps more importantly, based on the tone, you have some real confidence that the answers you are finding for yourself have validity to them. Confidence and self awareness of your own issues will do more for you than 100 support workers and professionals ever could.

    As long as that is continuing to develop I would be very confident that you are making real progress and more than you are giving yourself credit for. There is often a difficult time during recovery when you have mastered much of the negative thought process but have not filled up that free space with positive things yet. perhaps you are getting to the point where the negative is somewhat under control but you still do not feel happiness, contentment or satisfaction you had expected. If you feel like you have the negative somewhat controlled but are not feeling the "happy" they seem to be implying you should feel, is it possible you just have not started engaging in things that would make you happy again at this point? Maybe try to find something to reward yourself for all the work you have done to get to the point where you can comfortably question the professional input. Think of something that might make you feel better and see if you can feel some contentment or happiness within yourself yet.

    *sorry for the wall of text here - I am really impressed with your efforts and think you deserved a little effort back
  3. pp272

    pp272 Member

    Hello NYJmpMaster,

    Thank you very much for your reply. I really appreciate it, especially the detail, and it helped to put a few things into perspective. One positive takeaway is perhaps the reason for my feeling like the treatment plan isn't working anymore, is that I have possibly progressed and moved beyond the current stage of treatment (?). I thought a lot about what you said, took a step back, and agree that maybe I have developed more of a degree of self-awareness. Perhaps I have reached a point where feelings and thoughts are being identified a little better (rather than just a jumble and mess of emotion), and therefore, I need to focus on engaging in more positives. I will do as you suggest and try and identify the point when I felt like the plan stopped working quite as well as it once was, and see if a couple of changes can be made from that point in order to move forward. Just to clarify, initially I did agree with everything I was told at the beginning of my treatment plan, and felt like it was all good, solid stuff, but perhaps I have moved/evolved beyond it now.

    Once again, I really appreciate your reply, as well as the time it must have taken to type all of that. It helps me enormously when I get jammed into a corner, regarding the progress of treatment, just to see someone else who is not part of the treatment team put a little perspective on things. I sometimes forget that I used to be (very recently) in a significantly worse place than I am now. It all gets a little confusing sometimes, since I like to be as well-read and informed as possible on potential diagnoses in order to help with the treatment 'conversation'. While there is definite PTSD from a difficult childhood, borderline personality disorder has been thrown around, as well as some patterns associated with alexithymia. All seem to be interlinked, but then I have personality traits that seem to cancel some of these things out. Plus, the more I become aware of my feelings and thoughts, my emotional content and personality shifts around making it more muddled and difficult to identify a straight diagnosis.
    However, like you said, I have to look at the positives. At least now, I can identify and control some of my moods, thoughts, and feelings in a more emotionally balanced way, rather than applying a logical plan to everything I say and do, which I didn't even realize. Unfortunately, when I did run out of pre-determined actions and logical plans which controlled my every word and action, my mind used to just hit the brakes and all of the natural emotions and feelings all exploded out at once, usually in the form of self-destrutive behaviors. Not fun.
    I just need to remember to take a deep breath sometimes, not get too carried away with the excitement of good progress in order to avoid moments of utter despondency when things stall. Yes, having thought about this with a clearer head, things are getting better!

    Thanks once again - it helped!
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