Thursday, October 19, 2017

Outpatient program, part five

You might start with Outpatient program for depression and anxiety, part one.

Seventh session (Oct. 9, 2017)
Today was weird. It was clear that at least some of the staff had read last week's blog posts and changed their behavior accordingly (on my third day there I mentioned that I blogged about mental illness, and someone on the staff looked up this blog). One facilitator was less chirpy and friendly which was good. But the one I criticized as "nervous," was friendlier and kept addressing me by name. That felt icky. Is he trying to get a "good review?" Because of this weirdness, I'll keep writing about each session, but I won't post any more of it until my final day in IOP. 

So during check-in today, I talked about the Depression Meetup I'm starting. I also mentioned that I'd had a really good date on Friday night and was feeling better than ever. And I'm continuing my daily log that I hope will reveal a pattern that correlates to my depression symptoms (sleep, exercise, meditation, stimulant consumption, meds, weather). 

The second hour we talked about triggers and how to handle them. The now-not-so-nervous facilitator led both the second and third hours, making me wonder if the director, after reading my blog, told him to get more time in group so he can get over his nervousness. He seemed a little more relaxed.

Lunch was chicken strips over a bed of lettuce with a roll. A couple of people got a vegetarian option. 

The third hour we discussed some prayers that were variations on The Serenity Prayer. One focused on relationships, one on self-forgiveness and one on love. It was another crawling conversation where it felt like people spoke up only reluctantly. 

I wonder if the lack of participation partly comes from a lack of trust. They switch facilitators on us every day, often for all three hours. It doesn't allow us to build rapport with anyone if every hour we're starting over again to reach a level of comfort with the face that's looking earnestly at us. I imagine the staff tries to evenly assign clinic duty, but it would be better if we could at least stick to just one person per day. The hourly change of facilitators does not give a sense of stability and, for me, it's a little jarring and annoying. 

The other weird thing is that people are starting to treat me, and even talk to me, as if I were a facilitator and not an outpatient. One woman has joked about my strong personality and said that when I sat down this morning I looked ready to lead the discussion. One man asked me last Friday to push him to participate more in discussion. Today sometimes people looked at me instead of the facilitator when they talked. One woman even asked if I have a degree in psychology. 

So I guess I'd better pipe down! I don't want to dominate, but as my depressive symptoms have disappeared, my natural desire to socialize has come out. I like to ask people their names and if this is their first day. During breaks I want to continue discussions we started during the last hour's activity. During lunch I like to get a conversation going with the group (we all stay in the same room for lunch). 

And sometimes during discussions I have questions for the facilitator or for the other people Maybe my ease with asking things instead of just answering them (or staying silent) makes me seems like some kind of leader? But dammit, I'm not a leader in that environment and don't want to be treated like one. In this third week, things just feel like they're getting weird, between me and the facilitators and between me and the other participants.

Two more days this week, three next week and I'm done!

Eighth session (Oct. 11, 2017)
Today the check-in hour was led by a facilitator who hadn't led a check-in yet. More newness. Each time a new facilitator does the check-in, I'm never sure how much information she has on me. I'd never told this one my story, but I've noticed that these therapists take very good notes. For instance, when someone tells therapist A something on Monday, therapist B follows up about it on Tuesday. So I figured this facilitator had information on my background.

I'm still feeling good with no symptoms, so I recounted to this new-to-me facilitator that my depression had lifted during the first week of IOP and mentioned my great Friday night date that had energized me and made me happy. While she had asked others about sleep, appetite, and if they have a support system, she didn't ask me any of those questions. She asked me if I have appointments with my therapist and psychiatrist, seemed satisfied with my good mood and moved on to the next person.

I didn't like that. Just because I feel good today doesn't mean I won't go right back down tomorrow. I deserved to be asked about my support system and how my sleep and appetite were, just like the others. In fact, I mentioned a couple of minutes later that I'd been awake for two and a half hours the night before.

The second hour we had a group discussion. It's really striking to me how much people clam up when we're in a group talking with the facilitators, as opposed to when we break down into pairs or small groups and just talk among ourselves. In fact, I wish they'd do more small group work because then we get to steer the conversation however we want to.

In fact, I wish they'd let us talk in small groups and then just leave the room. We really loosen up when facilitators aren't part of the conversation. For instance, in the third hour we filled out a handout with a series of statements to be completed such as:

I am most content when ______________
My greatest fear is______________
People think I am______________
My greatest joy in life is______________
If I let myself feel it, I'm angry that______________

Then we broke up into small groups and discussed. I relished sitting down with two other people and saying, "Okay, instead of going over these answers, what's more interesting to me is: what do you think the point of this exercise is?"

We didn't know the answer to that, so I moved on to, "One thing I had a really hard time with was the one about what my greatest joy is. I'm not even sure what joy means. What is joy? People always say their greatest joy is their kids, but I don't have kids. Did you answer that one? What did you put?"

The other two people told me what brought them joy and I sort of started to understand. Then we just picked the more interesting statements and talked about those. That led to a better discussion than going down the list of questions and reading off the page, which it would have been easy to do. I enjoyed our little talk.

I'm still trying to figure out why people don't talk with the facilitators in the room as much as we talk when it's just us. Is it about trust? Is it about not wanting to serve as some sort of example for the facilitator to pontificate on? Are authority figures just intimidating? I'm going to ask.

Oh and the best part of today was that lunch was cheese pizza! It wasn't bad, either.

Here's part six.

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