The Shifting Image of My Care

In September of 2006, when I was still blogging on DiaryLand, I wrote an entry about seeing my life in black and white. I meant not just my life in general, but my care needs in particular. I wrote said post in response to a meeting I’d had with a psychologist several weeks earlier because my behavior at the training home I lived in at the time was spiraling out of control. The psychologist asked me where I saw myself in three years’ time, referring to care needs.

In my response on my blog, I said that I constantly had two images in my mind about what my life would be like, one positive and one negative. These were represented by the two most important alter personalities I had at the time, Carol and Jane.

Jane was fiercely independent. She wanted to live completely on her own without any support, except for maybe a weekly visit from a person to read her mail and the occasional help with deep cleaning.

Carol, on the other hand, saw herself as needing more support. I, at the time, made a point of clarifying that my “negative” image didn’t mean I needed 24-hour care, but that I needed significant help beyond that considered “normal” for someone who’s just blind.

Six months later, I had already discovered that the positive image wasn’t going to come true, yet I shifted my two images. I started to believe that the “good” outcome would be the situation I would live in at my student apartment, which included sixteen hours of support a week. The “bad” image, then, became needing 24-hour care.

You all probably know that the “bad” image eventually came to be true. When I wrote about the 2006 post on my original WordPress blog in 2009, I said that the situation couldn’t get much worse than it had been already at the locked unit. If another three years later, it was worse, I reckoned that’d mean I was in prison or a homeless shelter and hence wouldn’t have access to the Internet.

It didn’t get worse, of course, right? Or did it? I mean, I lived with my husband for some years, but eventually got admitted into long-term care. I now have one-on-one support most of the day. And yet the images are still there.

Jane is still saying I should live independently. Not with my husband, mind you, but fully on my own. Then at least I can’t manipulate people into giving me more and more care and, by extension, cannot drive people away.

There’s another image haunting me. This image wasn’t in my mind back in 2006, or at least I wasn’t aware of it. It is the image of a girl, aged around sixteen, who was a patient in a psychiatric hospital in the late 1990s, where she had been restrained for weeks on end until her parents sought media attention. This is the true worst-case scenario I see in my mind now. But the worst part isn’t the restraints: it’s the fact that the girl was often left completely alone.

I had a few incidents of physical aggression towards staff recently. The staff keep reminding me that they realize that I don’t mean to be aggressive and that they won’t leave me if I am. I hope the worst-image alter, whom I call Rachelle, won’t prove them wrong.

Recovering From Autistic Burnout

Today, the prompt for Reena’s Exploration Challenge is one word: burnout. This word evokes so many thoughts, feelings and memories in me! After all, though I was never diagnosed as suffering with actual burnout, the reason is more that burnout isn’t a DSM-IV or DSM-5 diagnosis than my not having suffered it.

That is, I did indeed not suffer the classic shutdown-type burnout where people are too exhausted to function. Rather, my burnout was more of the meltdown type, where I got so irritable and dysregulated that I couldn’t function anymore.

In 2007, I suffered autistic burnout. This is an actual thing and is more and more recognized by autism professionals too. It involves an inability to function in daily life as a whole, not just work, due to the experience of being overloaded, being autistic in a neurotypical society.

I have shared my experience of landing in a mental crisis in 2007 many times before. I was at the time living independently (though with a lot of community support) and going to university. That all changed within a matter of days: on Tuesday, I was sitting an exam, while the following Saturday, I was a patient on the locked unit of a psychiatric hospital. First, while there, I had to stabilize. I had to get back into a normal sleep/wake rhythm and regain my will to live.

Once I was no longer nonfunctioning and suicidal, however, I had to get my life back on track. My social worker thought I could go into supported housing for autistic people. I, at first, thought so too. Until I saw all the criteria relating to independence, lack of challenging behavior, trainability, etc. That wasn’t going to work out.

To be quite fair, I never fully understood my actual level of functioning until sometime in 2020. I had wanted to prove myself for so long. I had worn so many masks that hid the real, messy truth of who I am. Consequently, I constantly overestimated myself and my abilities. So did the people around me. Until one day, in November of last year, I crashed again. I probably suffered another burnout. That was when my one-on-one support was started.

There still are voices in my head telling me I could, should in fact go back to my life of before my first burnout in 2007. Back to independent living and college. Otherwise, how can I claim recovery?

The thing is, people who experience work-related burnout, usually don’t go back to their exact jobs from before their burnout either, if to the same job at all. Why should I then go back to a life I hated from the get-go? I try to see recovery from burnout not in terms of recovering lost functioning, but in recovering lost pieces of myself.

Starting to Explore the Enneagram

A few days ago, I read on another blogger’s post about the enneagram and suddenly got interested in exploring it. At first, I thought it may be against Christian values, so I shouldn’t be exploring it if I’m serious about being a Christian. Then I checked out some books on it anyway and discovered that several actually look at the enneagram from a traditional Christian perspective.

I first got Helen Palmer’s book The Enneagram, which explained the basics of how the enneagram works. I honestly had no idea at first. I mean, I saw it as just another personality typology just like the MBTI and had little idea that the points are actually connected in several mathematical ways.

I took an enneagram test and it showed I’m a Four with a strong Five wing. I’m still undecided whether that’s correct or I’m really a Five with a strong Four wing. After all, I really do feel deeply (which is consistent with type Four), but I don’t easily verbalize my emotions.

I got a book off Bookshare called The Enneagram Type 4 by Beth McCord. This book is rooted in the Christian faith and the enneagram alike. The first chapter explores faith and the enneagram from a type Four perspective. It starts out by giving an overview of the type.

In the first part, Fours are described as having a deep and rich emotional life. My gut response was: that may be me, but is it truly me or is it what I want to be? Then the explanation goes on to talk about how Fours see themselves as somehow apart from the rest of humanity. They often feel that they’re missing something that everyone else has. Wowah, that’s so me! When I read on, I got a flashback of my father telling my psychiatrist shortly after my admission to the psych hospital, that I just want to be different. Maybe he’s right in some way.

Fours also long for the ideal life and are constantly seeking to change their circumstances and themselves to try to find that “missing piece”. Wow. I read somewhere that most Fours keep the door even in a committed relationship ajar, always keeping the possibility open that their truer love will come by at some point. I don’t do this with my marriage, but I certainly do this with my living situation.

At the end of the chapter, there are some questions for reflection. One of them is about rescuing yourself or bringing about change on your own. How have you attempted to rescue yourself?

Well, for me, I’ve constantly been on the lookout for a better living situation. Even just yesterday, for no apparent reason, I started looking at another care agency’s website to see if I might fit better into one of their homes.

I feel constantly insecure because of my childhood trauma. Then again, maybe I’m also hopelessly looking for an ideal that doesn’t exist.

A thought that has been on my mind for a while now, is what one of my fellow patients at the locked unit told me back in 2007: I need to work on me, not on circumstances. This ran totally counter to my admission’s objective, which was to find a suitable living facility for me. However, now, over thirteen years later, it’s truer than ever. I am in the best possible living situation already and there’s no perfect place. Besides, I always take me to whatever place I go.

The last question for reflection is how realizing you belong to Christ helps you? It is still hard for me to truly surrender to belonging in Christ, so I’m not 100% sure how to respond. However, when I can get myself to understand that I truly am God’s beloved child and belong to Christ, it will radically transform my life. I no longer need to be on the lookout for the perfect life, since I’m made whole through Jesus.

Angry and Dissatisfied

Today, I feel flooded with emotional flashbacks that I’m not 100% sure about what triggered them or even what they are about. To give myself some insight, I picked up the book Journal Writing Prompts for Child Abuse Survivors again. Somehow, the prompts about anger appealed to me.

Growing up, I was always described as “too quick to anger”. There is some truth to this, in that I have and always had an extremely low level of distress tolerance.

My parents would react to this with resentment, but they’d generally solve my problems anyway. This at one point was described as having low expectations of me. When the psychologist who did my latest autism assessment, said that, I was triggered. After all, if my parents had expected me to be able to work stuff out myself, would that have been any better? I understand all about letting babies “cry it out” and I’m not a fan of it. I don’t have a clue whether I was left to “cry it out” a lot. I think so, as I was in the hospital for the first three months of my life and I don’t expect the nurses to have attended to each baby’s every cry. As such, even if my parents did attend to my every cry for attention, I must’ve been allowed to learn some self-regulation through “crying it out”.

My parents weren’t the most patient people in the world. At one point, my father explained to me that a family is like a business, in that it has to be run efficiently. As such, I can understand why my parents rarely let me work stuff out on my own. I also understand why they resented helping me.

Growing up though, my poor distress tolerance skills were seen as mere anger and oppositionality. I’m not sure why people perceived me as always angry. They weren’t just my parents, after all. Maybe I am quick to anger. I don’t know, but to be honest I think distress is different from anger.

When I became an adult and was admitted to the psych hospital, my nursing diagnosis at least off the record was “angry and dissatisfied”. Again, I’m pretty sure the staff confused distress with dissatisfaction. Distress is an inability to cope. Dissatisfaction is an unwillingness to accept the situation. I was perfectly willing to be discharged back into independent living if that was what was deemed necessary, but I didn’t promise I’d cope. This was considered blackmail.

Now that I’m in long-term care, my staff no longer see me as angry or dissatisfied a lot. Even so, I haven’t changed much. I still swear and scream when my computer or iPhone won’t cooperate. Staff do help me now, but they don’t resent it anymore. This has also allowed me to practise asking for help in more productive, proactive ways, which, in turn, helps me become frustrated less easily. I like it that way.

Runaway #SoCS

When I was still in the psychiatric hospital, I’d run off often. At the locked unit, this was dealt with by introducing seclusion and restraining measures. On the other hand, at the unit I resided at later, I was made to be accountable myself. This meant that staff wouldn’t go after me if I ran off. They believed that, if I got lost enough times, I would unlearn to elope. I didn’t.

I am a truly frequent runaway. Always have been. When I still lived with my parents, I would often run away too. Same when living independently. I had frequent police encounters because of this. They would invariably call the crisis service, who would refer them back to my home support team. They all had no idea how to handle my elopement.

Then, when I went into long-term care in 2019, I still ran off a lot of times. I usually didn’t get far, as my staff would come after me. I also did get some restrictive measures, such as a sensor that alerts the staff when I leave my room. The door of my care home is locked at night because of my elopement risk too. (The other clients can’t work the key and most aren’t safe outside of the home alone either.)

Since my one-on-one support got introduced last December, I hardly ever run away. It’s been a true blessing. Sometimes though, I still wonder whether I’m indeed just manipulating, like the people in the psychiatric hospital would say, and need a lesson in accountability.

This post was written for Stream of Consciousness Saturday or #SoCS, for which the prompt this week is “Run”.

Free to Belong in Long-Term Care

Today, one of Mama Kat’s writing prompts is to write a blog post inspired by the word “Free”. This definitely appealed to me, as a survivor of childhood trauma as well as abuse in the psychiatric system that continued until I was 30.

Last Tuesday marked the five-year anniversary of the opening of my current care facility. It also was the day I was here eighteen months. Five years ago, I myself still resided in the psychiatric hospital. Some of the worst abuses of power of my psychiatric hospital stay hadn’t even happened yet.

As a child, I suffered significant trauma both at home and at school. Most of it left only invisible wounds, but these are as deep as any physical wounds could’ve been.

Like I said on Sunday, my parents fought my schools, especially special ed, all the time. As a result, I endured frequent school changes and was at the center of conflicts pretty much my entire childhood. Whenever I had adapted to a school environment, I was removed again. I also didn’t have the opportunity to form lasting friendships. The feeling that I didn’t belong anywhere, was instilled in me from an early age.

When I finally moved to the mainstream high school my parents deemed best for me, I knew within a month that I didn’t belong here either. I managed to finish the grammar school program and graduate in 2005.

Then started my long journey through the adult disability and mental health care systems. My parents wanted me to go to university and live independently right away, but I asserted myself and sought help first.

I eventually lived independently for three months in 2007, but then landed in a mental crisis and was hospitalized. Over the following 9 1/2 years, I endured a lot of ongoing trauma at the hands of the psychiatric system. I eventually got kicked out of there and started living with my husband. That didn’t work out either. That is, our marriage is still strong, but I couldn’t cope living semi-independently.

All this to say, now I’m in long-term care and finally free. I am able to make my own choices now. It’s still a little hard to grasp that I am asked to sign for any restrictions to my freedom that may be needed for my safety. In the psychiatric hospital, seclusion and restraint were just shoved down my throat even though I was an informal admission. Either that or I was basically left to my own resources, since, being diagnosed with borderline personality disorder, I needed to take responsibility. Both of these extremes left me feeling unsafe.

Now, I not only am asked to sign for restrictive measures, but I am allowed to request extra support. This allows me freedom as well as safety. I am free now and yet I belong. If only I felt this way already. That may take a long while still.

Mama’s Losin’ It

PoCoLo

Five Years Ago #Write28Days

Welcome to day four in #Write28Days. Today, I am not going with the word prompt. It is “Make” and maybe I can make the prompt fit into my post somehow (pun intended). Not sure though. Instead, I picked one of Mama Kat’s Writer’s Workshop prompts. It asks us what, if we could give ourself a snapshot five years ago of what our life would be like now, it would look like and how we would’ve felt.

Five years ago, I still resided in the psychiatric hospital with the intention of leaving for my and my husband’s then home by my 30th birthday on June 27, 2016. I still trusted my mental health professionals to a degree and had at least some trust in my ability to live with my husband. The whole saga of my changing diagnosis, or diagnonsense as I called it, hadn’t happened yet.

I just checked my old blog for what I’d written in February of 2016. I admitted, in some posts, that I still struggled with the reality that I hadn’t fulfilled most of my childhood dreams and yet wasn’t a total failure, in that I’d be living with my husband. I didn’t use the word “failure”, but my writing certainly connotes that I should feel like a failure if I need residential care for the rest of my life. Which possiblity I held open to an extent, and which indeed came true.

I mean, I got kicked out of the psych hospital not by the summer of 2016, but by May of 2017. Then lived with my husband for nearly 2 1/2 years, until I was accepted into the care facility.

If I could give myself a snapshot of my life right now, it’d likely be of my room here at the care facility with my one-on-one staff in it. I might give myself an additional snapshot of my and my husband’s house in Lobith to convey that we’re still together.

Honestly, I have no idea how I’d have felt about these snapshots back then. I mean, four years ago is easier. Then I’d certainly have been elated at knowing I’d eventually end up in long-term care despite all the attempts my psych hospital staff took to prevent me getting the care I need. But in early 2016, I may not have seen this need.

Probably, the most likely emotion I’d have felt is mistrust. I mean, how could I possibly ever get the level of care I never even openly admitted I needed? I mean, I never asked for one-on-one, but got it anyway. How is it possible that people truly saw this? I can hardly believe it now, let alone five years ago.

Looking back at my life five years ago, however, makes me so intensely appreciative of the life I have now! I thank the Lord for sending my former support coordinator, the Center for Consultation and Expertise consultant and my current staff into my life, as well as the funding authority people in charge. Without these people, I honestly don’t know where I’d be right now.

Mama’s Losin’ It

Life Challenges I’ve Overcome

Earlier today, I saw Emilia’s post about challenging life lessons. It was based on a prompt from Listify. I have this book too and thought it’s an interesting prompt indeed. It asks us to list the challenges we’ve overcome in life and explain what life lessons we’ve learned from them. Here goes.

1. I spent the first three months of my life in the hospital. I was born prematurely and had to be in the incubator and on a ventilator for several weeks. Then I spent the remaining time I should’ve been in the womb in hospital. Of course, I can’t remember this at all, but it might’ve caused some early attachment issues.

2. I lost my vision. Okay, I was born legally blind, but still relied on my vision quite a bit until I was around twelve. All official documents say that I lost what little vision I did have at the age of eight, because that was when my parents and doctor decided not to pursue further sight-saving treatment. In truth, though right now I consider myself totally blind, I still have light perception in one eye and had it in both eyes until at least age nineteen. At that interesting age of eight, I still had about 20/1000 vision. Yes, I was considered functionally blind. That’s how sighted people look at it. However, when I attended the rehabilitation center for the blind in 2005, I was told by someone who’d gone from fully sighted to totally blind, that losing the last bit of residual vision was harder than losing most of the sight he’d had before.

3. I endured childhood trauma. I wrote some about this before, but I don’t know whether my family reads this blog, so I won’t go into detail right now. It mostly boils down to my parents not having a clue how to raise a multiply-disabled child and as a result being pretty harsh. None of the trauma I endured was severe, but the long-term nature of it still means I have significant complex PTSD symptoms.

4. I was bullied. At the school for the blind as well as the mainstream school I attended, I was regularly bullied by my peers. It didn’t help that my teachers and parents more or less blamed me for the bullying. I was too nerdy, too socially awkward, too dependent, too much and not enough.

5. I endured some medical trauma. Well, I’m not 100% sure of this being genuinely traumatic, but I certainly endured a lot of hospital stays, surgeries, etc. Most times, the doctors and nurses were really caring. A few times, they were ignorant. For example, when I had my wisdoom teeth extracted in 2010, the medical staff almost didn’t put a sheet over my face because “she’s blind anyway”.

6. I experienced long-term psychiatric hospitalization. I’m realizing more and more how much of an impact this has on me. With my not having felt safe with my parents at least some of my life, and me having been more or less in temporary placements most of my adult life, I’ve never felt that I can be safe anywhere. As a result, I’m constantly challenging my current staff, believing they’ll kick me out of here anyway.

7. I survived two medication overdoses. Both happened in 2017 and I wasn’t really suicidal at the time, but I wasn’t coping either. I never actually realized how things could’ve gone until my mother-in-law told me after my second overdose that the medical staff had asked me whether I wanted to be resuscitated should it come to that. I can’t remember the question or what I said. Both of these made me realize that I needed more help than I was getting at the time. At the time, unfortunately, I had a rather unsupportive psychiatric treatment team, who were very much focused on my independence. As a result, it took me a year from my second overdose to be truly honest that I needed long-term care.

In Crisis Yet Again #Blogtober20

Okay, this may not be the most appropriate post for #Blogtober20. After all, the prompt for today is “relax”. It is also World Mental Health Day. Most people would use this to advocate for better mental health services, or to share tips on coping with mental health issues. Tonight, I’m too stressed out to do either. In fact, this is just going to be a raw post on my having been in crisis tonight – and not having fully recovered yet as I write this, in fact.

I was on edge all day. By mid-morning, I started feeling irritable, but it was still manageable. When it was time for lunch, a different staff from the one assigned to my side of the home came to eat with us. We also didn’t get the usual weekend lunch stuff, such as sausages, pancakes or soup. We did get a baguette with cream cheese on it. It was okay. IN fact, I much prefer that to our weekday lunches. I don’t think it’s even the fact that I didn’t get the treat I wanted, that set me off, but the fact that so much was different about the lunch. Thankfully, after being on the verge of a meltdown for a bit, I was able to calm down.

Then in the evening, I spiraled into crisis. I don’t even know why honestly. I was getting very irritable about the staff having the TV on even though the volume was turned to low. Within the next fifteen minutes or so, I landed in a full-blown meltdown that seemed to last forever. I eventually asked the staff to fetch me a PRN lorazepam, but then somehow got it into my mind to climb over the balcony railing. I didn’t, but the mere fact that I was standing on my balcony on bare feet in the rain and disclosed my thoughts, worried the staff.

I was near a staff all the time until I had to go to bed at 10:15PM because the evening staff were leaving. They did remove the knob on my balcony door, so that for now I cannot go on there. I gave them permission for this, for clarity’s sake.

The lorazepam has started to kick in, but I’m still pretty tense. I must say that I am completely in awe of how my staff handle my challenging behavior too. It must be hard having a mentally disturbed person on an intellectual disability unit. In psychiatric care, they’d probably have sent me for a time-out off the ward. After all, psychiatric professionals commonly see me as a borderline case. I’m not sure my current place is the most suitable for me, but the staff definitely are.

#Blogtober20

If I Could Turn Back Time… #Blogtober20

Today’s prompt for #Blogtober20 is “If I Could Turn Back Time”. I think we all would do some things in our past differently if we could. I certainly would.

I mean, when I was in the psych hospital from 2007-2017, I regretted almost every step I took or didn’t take. My last psychologist was right in a way that so many places to live had passed that I’d turned down. I had turned down a shelted living place for the mentally ill, a workhome for autistics, a training home for autistics, etc. They were not suitable places for me and I completely understand I decided not to take the step. However, I particularly completely regret the step I did take to move to that last psych ward in 2013. Most of the places I’d turned down, seemed more suitable in hindsight than that last unit.

Still, now that I’m in a suitable place, I can see why the things happened the way they did and I made the choices I made. None of the places offered to me back in those early years in the psych hospital were as suitable as my current care facility is.

For the most part, this boils down to them being psychiatric living and/or treatment facilities rather than those serving people with developmental disability. You see, here in the Netherlands, autism is seen as a psychiatric condition if you have an IQ above 85. And in case it isn’t clear, the care approaches of psychiatry and developmental disability differ significantly. In particular, all psychiatric facilities are aimed at people developing their independence, or as they call it “rehabilitation”. I find this particularly unsuitable an approach to me.

Looking back, I maybe should have accepted the very first placement offered to me: a treatment unit and independence training home for autistics. Maybe the staff would’ve recognized my needs there. Or maybe not. Maybe I should’ve gone to the workhome. At the workhome for autistics, the staff did understand I needed more support than they could offer. They tried to help me and my staff find another place for me but came up with a facility for people with intellectual disability. The staff at the psych unit at the time were very understanding of my needs, but they still felt an intellectual disability place wouldn’t be suitable. You all know that I beg to differ.

To make a long story short, I’ve had quite a few regrets, but in the end, my life is good the way it is now. And that’s what counts!

#Blogtober20