My concluding thoughts on in-patient for DID and PTSD

In two earlier posts (here and here), I wrote about my initial research for in-patient programs for DID. I took this list to both my therapist and meds doc and was met with mixed results. Both offered some pros and cons. I walked away unsure what to think.

Pros – Both said that in-patient work had helped some of their clients.

Cons – Cost, disconnect with your current therapy team, inability to customize the program, and inability to choose your peers. Let’s talk about each.

1) Cha-ching. Check your insurance or be prepared to lay out a lot of cash (remember the “leave your $35,000 at the door for your first 20 days” from a previous post?). But some programs did mention taking several types of insurance. But then your insurance carrier knows your DX. A tough decision to weigh.

2) Disconnect with your current therapy team. These programs don’t tend to involve your current therapist in the in-patient treatment regimen. They have their own psychiatrists/psychologists, they perform their own “comprehensive assessment” that MAY include consultation with the referring individual, and they design their own treatment plans. They may also ignore your previous (or current) experiences with meds, and start you on something new.

No programs I see indicate they work with your current therapist BEYOND your therapist filling out a pre-admission information form. The closest “outside their in-patient setting” communication is “patient and family education” and a phone call on release for “assured continuity of care.”

While I appreciate that many of these folks are excellent at what they do, my therapist told me that her experience is that the programs don’t call and don’t communicate.

That complete disconnect makes no sense to me. Especially for those of us with DXs involving dissociation and switching…we are trying to re-establish continuity between/among different facets/selves in our lives, and the us-vs-them attitudes of in-patient facilities reinforces that disconnect?

You basically start over from the beginning on their program.

Like your current therapist is some sort of idiot whose work they have to undo and fix.

Insert Kate’s standard response here, which I have felt building for several paragraphs.

<Fck that.>

3) Inability to focus on specific short-term treatment needs.

I have a very specific need for the program I am looking for – I want short-term in-patient to deal with some flashbacks and rage that I have hidden for a long time, and I want to do it in a safe environment. Where I feel safe enough that I will not be a threat to myself or my caregivers.

I am not not interested in touchy-feely group therapy or life skills stuff. I get that from my own treatment team. Besides, my therapist feels that group therapy is not the best for me at this time.

Some programs have dual-diagnosis tracks, which refer to the need for a 12-step program to address some sort of addictive behavior that has occurred as a result of attempting to cope with the original trauma. I am not interested in 12-step, and I don’t want to be in an environment with others dealing with their addiction issues. No offense to anyone with a dual diagnosis that involves addition to drugs or alcohol. Just does not fit my needs.

4) Clientèle. My therapist gently suggested I consider who I would be living with during my in-patient time. “Several have been committed against their will. Many are not your ‘peers’. There is a real drug/alcohol issue here.” I understand her concern. It is somewhat discriminatory, but at the same time, realistic. And I mean no disrespect – it would be in extremely poor taste for me to suggest that MY needs are better/different/somehow-more-special than anyone else who has been raped and traumatized.

Perhaps my vent (see #10 here) about the Princeton “Retreat” for “Inpatient Alcohol and Drug Treatment for Executives and Professionals” sums this up better. I am very high functioning. <When I am not thinking about jumping off a bridge.> Without giving details that may make it easier to figure out who I am in real life, I have a boatload of serious accomplishments that I threw myself into to run from the trauma.

I am looking for a program I can customize, like this one. If I am going to do the touchy-feely group crap, I’d like it to be with women who are like me professionally. That would help ME more, and that is what is most important to me. Finding a program that best fits me.

And that should be the logic that everyone follows.

Finding what is right for you.

And sadly, for many of us, there just isn’t anything appropriate.

Advertisements

2 Comments»

  Tigerweave wrote @

we are trying to re-establish continuity between/among different facets/selves in our lives, and the us-vs-them attitudes of in-patient facilities reinforces that disconnect?

Yep… kinda like rule #1 I learnt for PTSD “Don’t retraumatise!” Rule # 1 for DID has been “Don’t throw myself into situations that encourage me to dissociate.” At least until I have learnt other skills to take the place of the dissociation that recognise and address the reason I was dissociating in the first place.

My experience fwiw!

I like the idea of a safe place to be able to address the more acute stuff. I really like the idea! But none of these places (iirc) mention DID? So without DID-specific treatment, I would presume you/whoever might end up in a situation where you yourself are the one working to maintain the equilibrium of the system in an environment that may simply trigger the ones in need to disappear.

Hmmm, not sure if I expressed my thoughts properly. Just that, thinking of myself I wouldn’t want to be dealing with the DID on my own in such a situation. And the treatment for DID is so specialist they may or may not be able to help me – and if they can, why isn’t it mentioned?

  emilylonelygirl wrote @

Tigerweave

I found no place that would let you work just on the tough stuff in collaboration with your therapist. The closest seems to be EMDR sessions, but not good enough because if they don’t stop in time…

Several of these places mention DID, but not specifically how they treat it. However, I did find a website for “alumni” of the WIIT program, and some of the articles from the “graduates” mention things that they did at the center. The link is here. http://www.enlightenedchoices.com/index.htm


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s