by Karen Najarian, 4-16-2021
So, I promised I’d write about my out-patient experience at John Muir Behavioral Health (the out-patient program for folks at their wit’s end).
Having only been incarcerated 48 hours, I was released from my seventy-two hour hold in the looney bin at noon on Thanksgiving Day (paroled for good behavior, I guess). Weather permitting, I had planned a nice afternoon Thanksgiving repast properly Covid distanced with our neighbors on the back deck. The turkey was already roasting. I was grateful for my freedom and the decreased despair provided by the anti-depressant prescription, which was the whole reason why I went willingly. But, I still felt fragile. In the passenger seat of the car, I felt like I’d just gotten off of a backpack trip: cars and people were moving too fast, colors were too bright, noises were too loud. In forty-eight hours I’d lost my desensitization to the jarring pace of the modern world. I’d been floating on a cloud wrapped in eiderdown for forty-eight hours and I came to like it. I came to make it a baseline, a default. I came to call it home. Now in my house, I looked around: shelves full of stuff I could live without, a mess of magazines on the coffee table, Abby the Dog jumping on me. In the kitchen, veggies were chopped for stuffing, potatoes peeled for mashed potatoes, and my office – I couldn’t even open the door to that chaos. Dinner was to be at two, so I did what I’d always done – I jumped into gear, but very mindful of the serenity I was leaving behind.
As it turned out, our neighbor was having her own emergency in the hospital ER. Having also been released at noon, she, too, jumped into gear and assembled her part of the dinner. At four o’clock the four of us plopped into our respective chairs on the back deck like ball players siding into home base and took a deep breath and a moment of thanks. “Yep, it’s a 2020 Thanksgiving,” said Brian.
On Friday I waited, expecting a call to set up my entry into the out-patient program. Too late, I noticed I missed the call. They were closed for the weekend and I found myself teary and anxious that I had to sign up on Monday when I thought I’d be starting on Monday. I found myself hungering for a program that I didn’t even know anything about. Later, I discovered that it wasn’t necessarily the program I hungered for, but the human connection I’d found at the in-patient program. The isolation of Covid made everything worse.
On Saturday we had our young friends, Banning and Regina, over for a socially distanced lunch on the back deck. At the mention of my 5150, Banning lowered his head and looked over his glasses at me. Unlike Banning’s experience as a fifteen year old, unlawfully locked up for eleven months in the largest insurance fraud case in the United States, my stay was nurturing and helpful. I missed the spare contained environment where all I could see of the outside world were the green crowns of trees through the top windows, the lower windows, frosted, emitting a soft glow. All the surfaces were smooth, no door knobs, nothing to hang yourself by, where all our needs were met and we could just focus on us.
I yearned to arrive at some steady state that I could live with or at least know what to expect. Or maybe I needed to learn to ride the waves, to accept that the waves ARE my new steady state. With nothing to do that weekend and the misery still going on with my feet and eyes, I wrote to God in my journal:
God, Godforce, Great Mystery: What am I to do? I’m lost without my feet and eyes. And I’m tired and teary.
My pen answered: This is a time for that.
Me: OK. I guess I have no choice but to accept it.
MY pen: Yes.
Me: Why? What good is this?
My pen: It just is.
Me: My ego likes reasons and answers and timelines and schedules and certainty.
My pen: This is not that place.
Me: So, I’m in this alternate plane while the rest of the world spins productively?
My Pen: Yes.
Me: I feel a rift between me and my friends that can hike and do and see. I feel separate and more than a little bit less than.
My pen: It’s OK. It’s just your ego. Your ego thinks it’s running the show. It is not.
Me: The world tells me otherwise. The world honors doing and accomplishing.
My pen: Let that go. It’s an illusion.
Me: It feels like a convincing illusion.
My pen: It is just an illusion.
Me: So how do I navigate this realm?
My pen: Write.
Me: OK. You said so. I am left with little choice, anyway. Do you mind if I share this conversation?
My pen: No. I don’t mind. More people need to know this. This is your job.
So, getting orders from The Great Somewhere, here I am.
On Tuesday I got up, showered, and got dressed, all within an hour. That was a first during Covid. I put on a top I hadn’t worn in nine months and wrapped a pretty scarf around my neck. It was cold outside so I grabbed my coral colored down jacket, as opposed to the black puffy I wore backpacking. I had somewhere to go – somewhere to BE, at 8:30. It felt great.
At the door of the big box-shaped building next to the green lawns of a golf course, I got a new mask, gelled up, and had my temp scanned. Upstairs there were papers to fill out, cards to show, and signatures to make. Then I was off downstairs to the big meeting room where things were already in motion. The sign on the door read, “Cafeteria.” Opening the door, I quickly scanned the room. It was full of chairs all six feet apart lined up like little soldiers on parade. Later, I would count forty of them. They were all filled except for one chair, front and center. Years ago I would have wilted at the conspicuousness of interrupting a big room full of people and then have to sit in front of everyone. On this day I welcomed the human energy in the room and was excited to join them, even if at one time they all wanted to off themselves.
Written on a white board in cerulean felt pen was the schedule for the day. Basically, forty-five minutes to one-and-a-quarter-hour sessions by therapists, a chaplain, and an art therapist. In these sessions I learned about Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Cognitive Distortions, Metacognition, Acceptance and Commitment Therapy, neuroscience of addiction, coping vs fixing – a lot of fancy words asking you to look at your life differently. At 11:15 all forty of us would break off into smaller groups in separate rooms and meet with a therapist to talk about what was going on with each of us on a more personal level. There was also time for a fifteen minute one-on-one session with an assigned therapist.
Having had a ton of therapy, I knew a lot of these suggestions and devices to massage my brain to go in the direction I wanted it to go. But the hands raised and answers given in response to group brainstorming were validating, helpful, and made it feel like we were all soldiers in an army fighting a common battle, even though we could not be more diverse.
And even though we spent five hours a day together, it was hard to really get to know anyone. Due to Covid we were instructed to stay six feet apart. Break apart sessions in the big room, were loud and noisy with our six-foot distanced shareings. I mentioned to my therapist in a one-on-one session that I had a blog that was pretty honest and raw. She responded that “we don’t want that here. It might trigger someone.” I was astounded. How does one heal without learning new ways to respond to triggers? How do we connect without showing our wounds?
Being depressed, no one was excited to talk. We introduced ourselves daily (new people came, others graduated) with an answer to a question, like what’s your favorite pizza topping, and your name. Two weeks into the program the art therapist suggested we make some kind of a sound followed with our name. She modeled it making a funny squeaking noise. Then, in unison everyone was to mimic the sound. Wrong approach. A room full of forty depressed suicidal people mostly responded with “eh” as their sound. I decided to liven it up and, when my turn came, I held up both my arms, swayed them left to right overhead, and sang over the crowd, “Aaaaaaaa Ooooo,” like Freddie Mercury at a Queen concert. Yep. I had my own stadium following along. The therapist looked at me with wide eyed wonder. I grinned like Jack Nicholson.
After a week of this, from 8:30 until 1:30, with no lunch but fifteen minute breaks between sessions where the smokers were the only ones who chatted together in the cold, windy parking lot, I was sensing that this was simply a program to gain techniques to keep you out of crisis – to keep you alive. I was not seeing a lot of progress in my fellow inmates. I mentioned to my therapist that there was no deep work being done. She said, “No, this isn’t that, and everyone is supposed to have their own private therapist, as well.” This program was all designed to manage thoughts and behavior, not the why that makes you respond to life the way you do. After a week of listening, in our small group to an obviously very smart and accomplished middle-aged woman, struggle, overwhelmed and paralyzed with the stacks of ever accumulating papers on her kitchen counter and hearing the therapist suggest for the umpteenth time that she file just five pieces a day, I’d had it. I raised my hand. “I don’t know, but I think this has nothing to do with the papers.” I was afraid I had upset the apple cart, overstepped my bounds, and maybe even violated a HIPPA statute. Sitting six feet to my left, she swiveled her bowed head, looked directly into my eyes, and said, “I think you’re right.” Hallelujah! We were making progress.
I learned that in addition to the help I found by being in the presence of others, their contributions, and the daily classes, I gained meaning, purpose, and a lightness of being by bringing my true wild and natural self to the party. I disregarded the therapists warning to not trigger anyone. I spoke of my past, my childhood, how I had conquered old destructive thoughts and behaviors. The therapist in our small group leaned forward and implored, “How did you get this way?” “I took a leap. I prepared myself to die, because that‘s how doing the new behaviors felt, and I found that I didn’t.” People started coming up to me during the breaks saying how everything I said helped them. Women would talk about their over-bearing mothers, their verbally abusive husbands. Men would talk child abuse from their abusive drug addicted or alcoholic parents. I had the same unsolicited response; “Drop kick them.” Pretty soon all I had to do was kick my foot out and they knew my answer. One gal crumpled up a letter she’d written to her ex and literally drop kicked it across the room.
On my last day, after ignoring, “You’ll have time to do that in your small group,” I addressed the whole class with a heartfelt thank you for being part of my journey and a good bye. I read a letter to my small group:
The situation that brought me here was in response to a medical condition magnified in my mind by the powerlessness, hopelessness, and despair I felt as a child.
While each of our journeys is unique and special, I think they all require immense courage. You’ve shown your courage just by being here. This work requires feeling feelings you think you might die from. I encourage each of you to gather more courage, either from an armful of stars gathered from a clear night sky or form it from the mud of the riverbank. However you do it, open that door to that dark room. Bring the light of your heart. Shine it on the remnant memories of your past. Clean it out, even if you need a pick and a shovel, or even a blow torch. Shine your light into the dark corners and find in each corner, a child of a different age who’s been cowering behind the trauma. Kneel down. Open your arms and gather them to your heart and promise that you will be their advocate… always. They will inspire your strength. They won’t believe you at first until you show them with your actions. Gradually, with their building trust, the cloak of depression you’ve felt safe in will lift and they will show you the lightness of joy and ways to find connection and fulfillment. With your heart for a compass and your soul for a pair of wings, hold their hands and follow their dancing footsteps down a new sparkling path paved with diamonds. It’s time. You were born for this.
The biggest lesson learned: We need each other. We need to be open to hearing each other’s stories and courageous enough to tell our own. More people need to know this.
PS. Yesterday’s PET Scan showed “no clear evidence of cancer.” It may still be lurking and it may very well return but for now, this is good news. I don’t know what this means as far as drug regimens which are still kicking my ass but right now I’m happy to share the good news.