what to do when you feel trapped

[Jaquta]

I haven't been wanting to engage and when I have felt like reaching out I heven't know what to say.  Is there any point in saying anything anyway.
It's been nearly two years and two months since I had any psychological support.  I thought the psych review may have helped (offered some direction, some input, possibly even some hope).  The doctor indicated that the report would be ready in two weeks, it is now six.
There doesn't seem any point in accessing the psych services as they seem pretty incompetent when dealing with me.  I wonder about the usefulness of seeing my GP.  That doesn't seem to be helping much either at the moment and if anything is leaving me feeling more angry, frustrated and hurt.  I fought my emotions to see him today but the consult has left me feeling even more withdrawn and determined not to go back.

I have split things off in an effort to cope and have used that to start running.  In all honesty I don't want to run either and just want avoid everything by sleeping all day.

My pregnant sister and her partner are home for a short period.  While it is OK having them home it is also a stressor.  Mentally, emotionally, financially, etc.

I feel that there is considerable stress at home.  Two days ago my mother said that she wished she had a gun so that she could shoot my father.  I expect if she had one she may have done so.  In some ways I think that we are all trapped here at home.

When things get bad as they have been I sometimes turn to reading my old medical records.  I can't be bothered going there though.

I have been having nightmares again.  Regularly stuff is coming up from my past which I can't seem to deal with.  Not sure what aspects of it need resolving.

I feel like running away.  No time ever seems a good time.  There is always some family thing that gets in the way.

I don't think I could even engage in support at the moment.  Being so cynical of support isn't helping.

My GP has said that the psych services won't help

[Peter Forster]

It sounds as though there was a disconnection in the relationship, I know from personal experience that that can be associated with a lot of helplessness and anger. My usual inclination when that happened in my therapy was to want to cancel an appointment or create distance. Not sure whether that was the right thing to do. What does the Wise Jaquta think?

[Peter Forster]

I am glad of that. Mindfulness is not quite the same as DBT... I know plenty of folks who have been irritated by Marsha Linehan's program who have found a very comfortable practice of some kind of mindfulness...

And it can be combined with sport - mindful running or walking gives you two benefits.

Try listening to a few MP3's by Kabat Zinn. Or others.

And glad that talking helped.

[Jaquta]

The site feels a little lonely but I don't mind one on one time or advice from an expert.
I'm not sure where everyone went.  There were truck loads of people posting on the mental health expert forum before the doctor left.  I think that not having access drove them to other forums.  Sad really.  I guess coming up to Christmas people may find their way back here.  It's disappointing not to see people accessing your talents.

I think I am more likely to term the experience as excruciating.  I was kind of scoffing at the idea of being prescribed pain killers.  I generally don't take pain relief except occasionally for severe menstrual cramping, etc.  Anyway, I'm happy to be a little bit compliant this time.  I can't wait til I can stand up straight again.
I'm sure I'd rather be outside going for my 80 minute run than writhing around in pain inside.

I guess it was good that those people had the confidence to back themselves and their service (although it probably would have been nice had they known and communicated their limitations).

I think I'll stay away from surgeons if at all possible.  Last time I was over-anesthetized and took ages to recover.  I then developed an abscess and spent six weeks being treated at a wound clinic by nurses who would poke and prod and say, this is deep, does this hurt.

If stuff is important, I think we make the time.  Even with the time I doubt I would be motivated to do that number of sets.

Several years ago I had physio for a shoulder impingement injury.  I think all those exercises get a bit tedious after a while.  It could have been that I was distracted though as I just got a big shock off one of our electrical cables.  Thankfully the cord fell out of my hand but I still ended up with cardiac arrhythmia's for a bit.

I thought you weren't suppose to fall to pieces until after age 30?  I feel, and look , like an ancient old lady already.

It sounds like it could have been a postural or core strength problem.

I'll have physio for my back (if I can deal with the pain and with someone touching me).  I don't always trust the medical literature.  dbt for bpd -didn't work for me.

A back injury probably gives me permission not to beat myself up for not running, etc.  Kind of reminds me when the oncologist said that running would be against medical advice.  That seemed more mental than physical -in my opinion anyway.

When I once contacted my local psych emergency team (pet team) in a crisis one of the staff were telling me how they were divined.  Like how they divine for water.  Maybe that's a very, very long way off that beaten path.

Thanks for your time and patience and input.

[Peter Forster]

Chronic back pain is almost as complicated as mental health. I have had it myself. Fascinating experience...

Went to see a chiropractor, who said I needed chiropractic, tried it but it didn't work. Went to see an accupuncturist who said I needed accupuncture, tried it but it didn't work. Went to see a back surgeon who said I should be seen by his physical therapist, tried it but it didn't work. Started to feel that it was odd how everyone I went to see recommended their services as the most appropriate for my problem.

Went online and started looking at the medical evidence - turns out that for chronic back pain the relationship between MRI results and pain is pretty unclear... which then makes you wonder about surgery. Finally I found a physical therapist who was willing to be realistic (didn't insist that I do 15 repetitions of 6 exercises 5 times a day - when would I fit that in to my schedule?) and although sometimes physical therapy exercises made the pain briefly worse, it slowly got better.

Then I stumbled upon something that really helped - an inversion table which allowed me to do stomach crunches while upside down (I know that sounds weird, but it prevented me from "cheating" on the crunches and twisting while doing them - which really made my back worse when I did them right side up).

Lessons learned for me - use reliable sources of information to understand what the medical literature has to say about a chronic condition - search for someone to work with who seems willing to work with you collaboratively - keep your eye out for things that might be worth trying that are a little bit off the beaten path, but don't spend too much time on those things...

Oh, and get support so that you remain hopeful.

Glad you are here on this site.

[Jaquta]

I gave up and went to an after hours medical facility.  It's Saturday here today.  The doctor said I have a prolapsed lumbar disc.

Not sure about what I'm going to do about seeing my GP.  He told me to exercise.  This other doctor told me to rest.  I will see him sometime but ... can I trust him?  Dilemma or excuses??

[Jaquta]

I think those feelings were due to anxiety and stress.  I don't feel as though I am connecting with what I write (some of the time).  It feels split off.

I think helplessness, anger and frustration.  I guess rather than taking responsibility for what has happened I am looking to attribute blame.  I feel somewhat confused by the role health professionals are expected to take in health care.  I feel as though I have been directed towards a service with the idea of help which hasn't been available.  I let down defenses to allow people in and as a result I feel overly dependent on services that aren't available.  I feel accessing services and people has been harmful vs helpful.  I guess the main problem is that I don't feel confident in myself or my own ability to make significant improvements.
I was discussing attachment with another member recently and wonder if I will ever be able to have healthy relationships.  Get married, have kids, have a career, pursue education.  Just be normal which so many people take for granted.

I feel that my doctor hasn't been hearing me.  I think he feels as helpless as I do sometimes.  
Two plus years seems like a long time to find a replacement therapist (especially when my last T insisted I have three therapy sessions per week).  I guess it has now averaged out at less than one session per week.  Something the mhs must be grateful for.

I think that perhaps I am getting anxious about the outcome of the review and the need to enter into new therapeutic relationships.  The need to stop seeing my GP.  
I think I also have issues with engulfment/ abandonment stuff.  I think I have had to deal with so much alone over the past few years and opening up and trusting these people again feels threatening and hurtful.

Creating distance can feel like the safe thing to do emotionally.  I think on the triangle of relating that would be equivalent to reacting in the child state.

I think I need to talk to my doctor.  At least I can justify a visit because I have a sore back (?slipped disc).

Sorry for taking up so much of everybodies time.  Thank you for helping me to work through all this.

[whitecat78]

If you were brain dead, you wouldn't be able to write as well as you do.

[Jaquta]

Mention of the psych emergency services triggered a lot of thoughts.  Someone I know through medhelp said that they would commit suicide tomorrow if a particular decision was made by a government agency.  I have spoken to the person and trust that they will be OK.  I hope they will be.
Suicide has been mentioned at home, this time because my sister's tenants moved out due to a family member (not my family) attempting suicide and being a vegetable.  I have been feeling somewhat brain dead lately and was wondering if this was due to my history.  The effects are likely to be immediate aren't they and not come on gradually?  Talk of dementia and vegetable-like states have got me stressed.  I can't take back that 2000 mg of prozac, x many mg of respiridone and 300+ mg of cipramil -discharge meds.
I also just read an article about Shapelle Corby (Australian imprisoned in Indonesia for drug smuggling).  It mentioned her being mentally unwell and not being able to reverse any damage if continued.  I think they mentioned psychosis.
How much damage is being done by untreated anxiety and depression?  I think I'm a little depressed, I'm not sure.
(Her story is only of interest because another Australian was hung for drug trafficking into Bali.  It was the hanging that was of interest.  Actually the judges comments were a deterrent for me  ... way too much information here.  Everything is kind of connected anyway.  This connects back to dbt by me looking up proana sites and coming across other harmful sites and an online dbt class one.)
Our neighbor stopped me the other day and was saying how her son killed himself last year and how she was feeling bored and lonely and still grieving.
It is nearly a year since my cousin hung himself too.

Maybe the head thing is just due to stress and anxiety.  I didn't make another appointment to see my doctor.  I guess it is hard talking about some of this stuff because he once said that he was blunted to it.  I guess it would be a different story if he had to live with it or manage it.  I don't like carrying this stuff.
I thought my doctor may take stuff for granted because I see him so regularly.  I just felt that things were different this week.  Maybe he was under additional pressure because he had to do a home visit and prepare a speech for a seminar.  ??  It doesn't help when one doesn't feel as though they are being listened too though.
He said he would contact me when the report from the review came through so I thought the distance would help me gain some semblance of control.

[Jaquta]

It must be exciting meeting with people at the forefront of their respective fields.

I think those toxic interactions still exist.  I have experienced those toxic interactions.  I expect these interactions are affected and influenced by many variables though.

For me the difference in clinicians attitudes between a diagnosis of severe depression and bpd was vastly different.  People are more sympathetic towards those with depression and much less tolerant towards those with bpd.  I expect I probably perceived this difference as rejecting too which perpetuated the cycle.
My doctor also once made a comment that I'd been denied appropriate medical treatment and this was due to the presence of the bpd diagnosis.

I expect dbt has helped many people.  I have benefited somewhat from the skills although I am reluctant to admit that.

I sometimes feel frustrated by my GP's previous lack of knowledge about bpd.  I expect when he was at medical school though there was very little information about the treatment of this disorder.

I'm not sure why exactly I feel so invalidated by Marsha Linehan's work.  I tried reading her text but found that extremely triggering.
I don't have the same reaction to others work.  I find John Gunderson's texts very clinical and I like that.  CAT and mentalization based stuff seems OK.  I like Kernberg's and Clarkin's stuff on transference best.  That seems most helpful to me.

My last therapist suggested that dbt wasn't such a good fit for me because my issues stemmed from early childhood which meant I couldn't utilize the skills.  ??
I copied out her letter on one of the forums (along with another T's).
My T also said that dbt isn't implemented in this country as it was intended too, at least not in our local mhs.

Maybe subconsciously I hold Marsha Linehan's work responsible for me being so stuck.  If it worked maybe I wouldn't be in this position.  That sounds pretty cynical and naive.  I'm sure it is more about my feelings towards my T than about her.

[Peter Forster]

I had a couple of opportunities to meet with Marsha and she is, as you say, a bit of a character. But I think that her influence in the area has mostly been positive. I remember working in the psychiatric emergency service in the days before DBT and the toxicity of the interactions with folks who were labelled (I use that term because it felt more like labelling than diagnosis) as "borderline" was mind-boggling.
And yes, Marsha's DBT is "just" a compilation of techniques from others with a little bit of new material.... However, she had the chutzpah to do the research to show that her treatment worked at a time when psychotherapy outcomes research was not as advanced as it is now.
And, yes, mental health systems have tended to implement DBT in ways that are not particularly "user friendly".... but good clinicians using DBT can be really helpful and her compilation of the best techniques has withstood the test of time.
Also there are now books from New Harbinger (a publisher) that are I think much more accessible ways of using DBT - Workbooks on DBT for bipolar, for borderline, and for anxiety.

[Jaquta]

I think my resistance to dbt comes from its arbitrary implementation by health professionals here.  I also associate it with a lot of negative emotions which have arisen through diagnosis, etc.

I do however feel somewhat irritated that someone can take a bunch of life skills and put their name to them.  Maybe that's a skewed perception but that is how I currently feel.

I have spoken to several people who have known Marsha Linehan and feel somewhat validated when they say they feel she is a bit strange.  I'm not sure how grateful those with bpd should be for her efforts.  Possibly she has done some to advance treatment and awareness of the disorder.

I joined an online bpd support group several years ago which had a strong focus on meditation.  I liked some of the excerpts and teaching stories they posted.  I was banned after some comments I made though.  I jeopardized a persons recovery by saying that I didn't think that they would recover.  I had no right to say that and was way out of line.  I guess in a world where you and others are struggling to survive anything can happen.  Emotions are so raw and insight is so limited.  I have come a long way since then.  It was a hard, and potentially costly, way to learn valuable lessons.  

I usually like being in the moment when I run but because I have only just started to get back into it and have a lot of other stuff going on I tend to use the negativity as a motivator.  My GP once read a psychiatrist's letter to me as he thought I had a right to know what was being said about me.  He mentioned fatiguability.  I use all this past stuff a lot.  Running punishes me and memories of them.  I am pushing too hard at the moment but are afraid to back off.  Mentally I will see that as a huge failure.  Either way, at this rate, I am going to crash and burn rather badly.

I can't feel at the moment.  If I could I expect I would stop and think before I spoke (or wrote).

I don't get this.

Hopefully I don't have dementia to look forward to either.  I was wondering whether that was pseudo dementia though.  That feels so familiar.
I caught five minutes of the news tonight and they said that research done at Otago University said that cells after a stroke weren't dead but dormant.  

[Jaquta]

If I were advising someone else I would most likely tell them to talk to a health professional.  Tell them to get help.  It is a dilemma though when those health professionals, in my opinion, have created and contributed to the problem.  There are only so many times when I feel I can tolerate being told that there is nothing they can do to help, to have calls unanswered and I guess to sum it up by the director of mental health to be told that I don't matter.

I guess I have become quite phobic about asking for that assistance when I feel it is most needed.  It is devastating to be made the problem and to have that negativity documented in exchange for further put downs.

The basics?
I'm easily getting light exposure.  It is coming up summer here.  Our house comprises of a lot of windows so regardless of activity I will still be exposed.
I have been running most days.  I was wondering about doing a marathon next year.  An off-road half feels more me though.  I feel like I need exercise to prove to others that I can achieve and that I am OK as a person.  Exercise is often punitive for me.  It is usually more about weight and body image.  I have trouble staying with anything for longer than six or seven weeks (and then that is usually because something has happened with a member of my treatment team).  I often find myself starting things over and over and this becomes extremely demoralizing (especially when others achieve and progress).

My basic social contact for the week (other than a good morning or good night from my parents) is my contact with my GP.  I sometimes meet the neighbors when I am out walking and will wave to them and occasionally they will stop and talk.
I live out in the country and currently can't afford to drive into town, etc.

I probably don't do mindfulness meditation very often.  I have had some negative experiences with dbt and can still be resistant.  I bought a copy of the skills training manual several years ago but after my last therapist and her asking me not to read stuff and to allow her to treat me I have been reluctant to take anything in.  I was trying to read Otto Kernberg's book on T-F-P.  I thought it was helpful but it can be hard to treat yourself.
I did buy one of Jon Kabit-Zinn's mindfulness meditation cd's.  I have been using it in my brothers car.  At the moment I prefer listening to several of the songs on the bush fire appeal cd.  (Don't give up and look around you, everyone you see, everyone you know is going to die.)  ??  We don't have music in the house.

Exercise used to be enjoyable.  My coach gave me a rope and told me to hang myself from the rope by a branch of the tree.
I currently have a sore back and sore neck so exercise perhaps isn't as pleasurable as it use to be.  Nor is it when it makes me feel sick.  It could just be due to anxiety.  ??

I've backed away from posting.  There have been others who have been struggling, feeling suicidal, etc and I feel guilty for not being there emotionally for them.  Not being there at all for them really.

All evidence based.  Exposure to sun has the potential to increase my biological age though.  I did one of those questionnaires on biological aging and due to stress, etc my life expectancy is 53 years.

Thank you for you support.

I can relate to that too.  No money.  Also I got a bike puncture and couldn't afford to repair that.  My doctor said he would give me a puncture repair kit.  He said they can be picked up from the $2 shop.  When I can afford to fill the car up with petrol I will go and investigate.
I feel pretty close to losing the plot too and that is without the help of magic mushrooms, etc.  I was thinking about dissolving all my lorazepam tablets in alcohol and injecting them (I live on a farm so have access to needles and syringes, etc) but it perhaps isn't the best solution to my problems, even if it feels like it.

It's good that you're feeling better.  Perhaps you could discuss your feelings about meds with a psychotherapist or doctor.

Sport is something I regularly fall back on.  I sometimes feel like I live in a museum with all my dead relatives stuff.  I wish my parents would biff some of it.

Thank you for all your support.

I think talking has made me feel less alone in all this.  Thank you.

[whitecat78]

I have that trapped feeling too. I have a problem avoiding people just because they stress me out. I feel like I am becoming a schizoid.  I am trapped in a annoying environment, I have no money, my car tire is flat, I got so scary depressed to the point I felt psychosis coming on, caused by mushrooms.  I had to go back on SSRIs, I am feeling much better now. I keep changing my mind about how I feel about medication.
Do you have any hobbies? I find lots of joy in painting, making crafts and collages, anyone can do it. I find it very therapeutic. I also love buying weird collectible antiques. These are the things that get me up in the morning. Like Peter said you give very good advice on these forums.

[Peter Forster]

There is this wonderful and thoughtful person who has been such a help on this forum called Jaquta, and I find myself wondering what she would say in this situation. I imagine it would be something wise and thoughtful.
Even though I have only known her for a short time I feel I do know her voice, and perhaps even a little bit about her.

Finding and engaging help is not an easy thing... but not altogether impossible either. Let's see if we can figure out how to get you up to the task...

How are you doing with what I call the basics of good mental health -
1. Morning light - getting exposure to bright light (30 - 45 minutes per day) before 9 am (either getting a light therapy light or getting outdoors).
2. Aerobic activity - 30 minutes of activity that raises the heart rate (brisk walking is perfect)
3. Regular social contact in the morning - what I call cafe therapy. Nothing meaningful, just the reassurance that life goes on.
4. Mindfulness - mindfulness meditation practice.
5. Health pleasure - doing one healthy thing that is or, at least, used to be pleasurable per day.
6. Mastery - noticing one thing that you do well each day - for instance the posts that you put up here.

This seems like an overwhelming list. Two observations - you don't have to do everything, but the more the do the better you will feel. And you can combine several - for instance, a mindful walk to the coffee shop in the morning could get you four in one fell swoop.

These are, by the way, all evidence based recommendations.

Keep in touch. We want to help you just as you have helped us.

[Jaquta]

because I'm not self-harming or in hospital.

I exceeded the character limit so that meant deleting half my post.  Too self-loathing to even bother with communicating the rest.