Category Archives: group therapy

It Comes From Inside

I went to see my therapist yesterday and I have to say that, quite frankly, she pissed me off!  I sat in the waiting room with my chest out and my shoulders back and a quiet smile on my face.  For reasons outside of my control it had been quite some time since I’d seen my therapist and I was so excited to tell her that I’d been winning the battle with my bipolar disorder daily, posting to my blog; I’d started it in 2013 but hadn’t done much with it until this year, and I was still celebrating having a year clean and sober.  I was all bubbles and sunshine inside while I waited to see that door open and her pop her head out and call me into her office.  For the first time in forever I was really ready for therapy.  Then it happened.  She did call me back and on the way to her office she asked, “How’s it going?”  I was beside myself with glee waiting to get started on how good life was going for me and how happy I’d been lately and then…she blew it.

I’d decided to downplay the sobriety thing and start with my mood.  I told her that things had been quite good for me where my mood is concerned.  I’d been able to use my CBT and DBT skills to keep me grounded and I’d been more positive than I’d been in a very long time.  She looked at me with a blank stare, shook her head and that was it.  Really?  Maybe she didn’t hear me.  Maybe her mind was someplace else, I don’t know.  This wasn’t what I expected or what I’d planned on.  This was supposed to just floor her and instead she just looked at me.  Fine. Okay. I decided to talk about my blogging.

I went into detail about how I’d been putting my feelings into the blogosphere about my bipolar disorder and treatment and my recovery from drugs and alcohol.  I knew she’d be impressed with me because I’d been in a horrible slump for so long not able to do much of anything and this was monumental for me.  I kept looking at her face waiting for the big smile to open up and let me know she was proud of me.  Nothing.  She just shook her head and turned around to her computer and began making notes.  Are you fucking kidding me!  What the hell is her problem; clearly she did have a problem.  Well, the last thing I had in my arsenal was my sober birthday and I knew this was going to get her.

After no response to my rambling about my good mood and my blog I was jumping up and down inside to tell my therapist I’d finally reached my first year of sobriety.  And I was right, that got a response.  “How did you feel about that?”  That’s what I got; a question.  As far as I was concerned it was a stupid question.  Wasn’t sobriety like this the goal of hours of therapy and training?  Anyway, I decided to bring attention to my blogging again and explain how I’d blogged about the bittersweet feeling of my year being sober.  I went into detail and made a very important point; at least I thought it was, about mourning my addiction like a good friend.  I thought this was really big and I thought that being able to verbalize it in such a way would surely impress her.  Nope.  What did she do?  I’ll tell you what she did.  She took the wind out of my sail like her certification gave her the right to just cut me down at the knees.  How dare she!  “Well, you’ve been mourning this for months, what makes it any different now?”  That was it; I needed to do some quick mental checking because I was on the verge of losing my cool.

In my head this woman was every name in the book but a child of god.  I thought about getting up and just telling her never mind for the session and walking out, she’d touched something in me that I knew wasn’t good.  My inner demon was coming to life and that never ends well.  In an instant I had to jerk myself back to a happy place because I was quickly going down the wrong road.  I could envision her calling security just like the social worker did in the ER when I came to the defense of my partner; I just hoped my eyes hadn’t turned the least bit red.  This just wasn’t going the way I’d envisioned and I was totally thrown off by her nonchalance.  Right then I had to decide whether to take the high road or to just show my ass.  Trust me, it was a hard decision.  All of this took place in a split second.

And then I came to the realization that, as much as I wanted my therapist to be happy for me and give me some sort of accolade, the most important thing is how I feel about what I’ve done and how far I’ve come.  My therapist’s job is to guide me down the road to being able to manage my mental illness and staying sober.  She’s not responsible for giving me my self-worth; that’s my job.

happy balls

So after I had this internal dialogue with myself I decided to let my therapist off the hook and go on with our session.  I reminded myself that I was there for therapy not ego stroking and, surprisingly, I was okay with that.

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Mental Illness and Two Types of Therapy

I have been in and out of treatment for my bipolar disorder and substance abuse for nearly fifteen years and I have gained a lot of knowledge about different treatment therapies.  Most recently I have been exposed to two types of therapy that have helped me tremendously. Following is a brief summary of each one of these therapy models.  I encourage further research on both.

The first of these is DBT (Dialectical Behavioral Therapy). DBT was developed by Marsha Linehan to help people suffering severely with BPD (Borderline Personality Disorder). DBT deals with helping to reshape detrimental behaviors that can stand in the way of effectively living with BPD and, over the course of its history; it has been expanded to treat other mental illnesses and recovery from a number of addictions and disorders.

DBT is made up of four specific skill sets being taught that help with the stabilization of extreme moods and addictive behaviors.  These skill sets are mindfulness; being fully present and aware in the moment, distress tolerance; how to tolerate uncomfortable situations without the need to change them, interpersonal effectiveness; how to ask for what you want and learn to say no while maintaining positive relationships and emotion regulation; how to change emotions that need to be changed when you want to change them.

The dialectic module of treatment focuses on self-acceptance but also realizing that some behaviors need to change in order to facilitate mood stabilization and recovery.

The second therapy I have been in is CBT (Cognitive Behavioral Therapy).  This was developed by Dr. Aaron T. Beck and it deals with helping people with depression combat “automatic [negative] thoughts” that can increase this depression.  CBT helps patients to realize that how we see the world will affect how we feel; this, in turn, can increase or decrease depression.  Therapists help patients with anticipated challenging situations that may arise, and they help them to come up with a plan to combat these situations in a positive way.

Of all the different types of therapy and groups I have been a part of I would have to say that these two have been the most beneficial to my current journey towards recovery.  They have also helped me to develop skills that help me to deal with everyday life situations with bipolar disorder.  I highly recommend these therapy models to anyone suffering from mental illness and substance addiction.

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Back To The Drawing Board

Back in IOP (Intensive Outpatient) therapy…oh joy.  This will be my lot three days a week for the next sixteen to twenty weeks.    I walk in the room and come face to face with a motley crew of alcoholics and addicts who have committed to staying sober and working The Steps.  The facilitator is a slight red-head who reminds me of Shirley MacLaine but she is slightly disheveled and majorly unorganized.  I have to correct her about my name and that immediately makes me feel some kind of way.  My initial reaction is that I’m in the wrong place.  I’m a bit anxious and I feel out of place but, ironically, I start using DBT (Dialectical Behavioral Therapy)  exercises; the nature of the group, to calm myself and find my niche in this space.  Twice we are interrupted from getting things going by the late arrival of two people and this aggravates me like nails on a chalkboard.   After everyone has finally settled in Teacher, what I’ll call her, announces that there is a binder of information we are responsible for and she hands me a white binder with a stack of papers that go inside.  She apologizes for the incompleteness of this wealth of information, none of the papers have holes punched in them, telling me that there is no three- hole punch in the building.  Ugh.  Really?  I’m at a loss for words.  This isn’t starting out good at all.  I keep telling myself to give this all a chance because I know the routine all too well; I’ve been in four other groups over the course of nearly a year.

Group begins with a check-in consisting of going around the circle and giving our names, announcing our addiction(s), how much clean time we have and what kind of mood we’re in.  Surprisingly I’m calm with the fact that I will soon give my story to a new group of strangers.  The eye contact that I get from the other group members as we go around the circle puts me more at ease and when it’s my time to introduce myself I’m confident and strong.  Teacher starts things off and my apprehension starts to creep back to the surface.  She’s speaking but it’s as if she really doesn’t know what she’s supposed to be doing.  I feel like I’m balancing on the edge of my seat in anticipation of her next word or instruction because she just seems so hesitant to take control of the meeting.  I want to jump out of my seat and snatch up her papers and her spiral guidebook and just teach the class myself.   Finally the ball gets rolling, albeit slowly, and we dive into the skill for the day.  Not even five minutes into this I discover that my stack of papers is missing the literature for the topic.   This is yet another speed bump to slow our momentum.  Teacher apologizes profusely and excuses herself to go make the necessary copies having to get originals from one of the other attendees.   She returns and we try this once again.

Class seems to creep by so slowly and I feel like I’m in another state of consciousness.  The information is helpful and informative but Teacher just seems a bit off-key to me.  Everyone else seems to be comfortable in a homey kind of way and I envy the way they seem to be able to abandon any judgement of the entire situation, they seem to be completely at ease.  Am I missing something?  We keep it moving and finally one of the other people speaks out of turn and asks Teacher isn’t she ready for a break.  A collective sigh of relief goes around the room and we all start putting down papers and heading for the door even before we hear how long break is going to be.  Maybe my observation was wrong about how the other groupies feel about the whole thing.

We all return from break grateful that there’s only thirty minutes left of this haphazardly conducted meeting.  Though we trudge along and play the game I can tell that I’m not the only one frustrated with how things go here.  I try to keep from watching the clock when one of the gentlemen brings to our attention the time and I perk up and see that time’s up and group is over.  Before Teacher is able to fully give ending instructions we begin packing up our things and preparing for our ending circle to recite the Serenity Prayer.

Wow, it’s over and I made it through and I’m actually glad I came.

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