Tuesday, September 20, 2016

Intensive Outpatient Notes

It's no surprise that I would find my self after 2 hospitalizations in another but at least this time it's outpatient!! So I can actually post about my experiences.

A little update. I have moved home and the move went find but the finding a job part has been stressful. I still after a month don't have a job but, at the same time my mood has dipped. I became frustrated with the system and decided to reach out for help to find providers. That was a smart decision. I still don't have providers but I'm getting help and information.

This place that I was at was based on Cognitive Behavioral Therapy. Which takes a lot of effort... but so does life!!

Today we discussed Relapse Prevention. I identified some of my triggers from guilt, shame, depression, anger, Automatic Negative Thinking (ANTs), feeling sexually stimulated, feeling like I'm nothing, stress and the feeling of "why try", all of these are internal triggers for me. External ranged from, texts from people that I have used with, seeing a device that I used, Location, attractive people, feeling others stress, loud noises, messages on Kik, and certain websites. And that was just the first page..... I found more triggers on the back. Anniversary date of July 4th when this depressed mood started, too much to do, feeling overwhelmed, family friction, end of or start of relationship, spending time alone, being judged criticized teased or put done by self or others, financial stress, physical illness, being yelled at, being around someone who has treated me badly, frightening news events, and certain people, places, and events. Anther trigger is feeling like I am different. Then I had to come up with a plan for some of these. for the ANTs I can try and flip them after identifying them. If I am mistreated then I can leave or learn how to speak up. Boredom, I can find something to do, write as much as I have to learn something, go to the library. If I get stuck in thought then I can blog or write in a journal.  One way to get SOBER is to Stop, Observe body Breath, Expand my awareness, Respond in a healthy way.  I can also meditate or focus on my breathing or a scent to find calm and safety.

Thought Record of the primary problem.

WARNING Only read if you are safe, and in a good spot. This was a long day for me and I had to use some relaxation methods to de-stress.

Situation: Voices telling me to die.
Automatic Thoughts: I am never going to get better; I am worthless; I am doomed; I should have done something different; I don't desire to live; If people knew they would place me inpatient; I can't tell no one, no one can help; I must die; I hate myself.
Feelings. and how intense: Alarmed 10, impatient 5; concerned 10, perturbed 8 provoked 7
Thought Distortions present: all or nothing thinking, Jumping to conclusions, emotional reasoning, rationalization, unfair social comparisons.
Adapted/ Realistic thoughts: I will work to get better; others see my worth; I feel hope; I can do more today It's in the past; I deserve to live and thrive; I can tell people as long as I don't have an exact plan and they can help; People can relate; I feel like I can try; I feel loved and accepted; I have something to offer. After going through this again it's helping.....

As for feelings I fell repulsed by the automatic thoughts. Justified, rejected, discarded, troubled, foggy, unsure, skeptical, shaken and anxious. But no after typing this up I feel more relaxed.

Then again this is the THIRD time I am going through this. I did the back of the worksheet and discovered a few new things. When I asked some questions I found out that I have no boundaries, and that I need to change and the desire to change is low. Voices think I am worthless, and getting bullied and the boom scares are what's caused all these feelings of self doubt. I did realize that the voices are not me.  I now feel Uplifted, Perplexed and hateful of voices.

At the end they have us reflect on the day and now after writing this my mood has gone up. I have hope that as long as I say these realistic thoughts more then I can rewire my mind.
                         

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