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DBT Session 2: Time Travel and Distress Tolerance

I put off writing this one. TW: talking about triggers and medicine.

I did not have a good week. It took several days for me to feel okay again. The interesting part is that we are learning distress tolerance and self soothing skills, but once I hit a certain level of trauma I can't seem to bring myself back down again. Or at least stay in a lesser trauma mode where I feel safe.


Essentially this week in group I was triggered multiple times in rapid succession.

Context: I have PTSD from medicine, from about a year's worth of medical malpractice, negligence, humiliation, and abuse. I also may have a mood disorder and I'm a survivor of DV in forms of emotional manipulation, coercion, etc. I've been through some shit. But medicine is my biggest trigger and the threat of it causes me a lot of distress.

For my treatment I have to go back to the same hospital that hurt me, and often on the way there I see the private clinic that destroyed me. Immediately I am in a lesser trauma mode. Let's say on a scale of 1-10, this is about 2-3 if I keep to buildings that are less troublesome. If I work at it, it can be 0. It will surge to about 5, but that's usually me being angry that day, or if I am in pain. If I can keep it at 0-1, I try to visit sections of the hospital that upset me, and see how far I can get.

While I was in ERPS (Emotional regulation and interpersonal skills), I got better at going to the hospital, but that's also because the room for ERPS was a non-hospital looking board room and it was in a building where only good things happened to me. I felt very safe. I frequently could make myself hit a 0.


DBT is in a very small room with a very large table and it probably was an examination room at one point. So that brings up my trauma mode, because it looks too much like rooms where I was injured. I'm usually up at about 4-5 while in this new group. I knew I would be, because I need to get comfortable. I have mentioned that I am triggered by the room and by the lighting which is very clinical.

The session begins with one of our group leaders barely able to contain their joy. A family member is in the hospital giving birth. This upsets me, I'm up at about 6, and then I tell myself, it's not about me. This is a happy occasion. Just move past it. I breath, and I bring it back down to 5. I can feel myself slipping into distress, but I quell it because it's okay. It's a good thing.


A group member mentions that they work in the hospital, and I jump back up to 6.5 because I start to think about the person in a similar job who hurt me. I try my hardest not to time travel, and assure myself that this is not the same situation. That it isn't happening. That I am safe, and that I'm not going to be hurt.

Then another group member states that they also work in the hospital, in a section that has really hurt me and that I often don't talk about because it upsets me too much. I'm up at about 8. I'm quietly trying not to loose it, and I start doing my mindfulness and assuring myself they aren't the same. They are just another person.


Yup, you read that right. The person with PTSD from hospitals is in a group therapy with two people who work in hospitals. Basically, it's like surviving an attack by Dracula and the Wolfman and having to be in a support group with another vampire and a werewolf. Yes, totally different people, but I was startled by the news. It was too much to take in and for me to rationalize that they are not the same person. The good part, is that it will hopefully grant me some understanding of people who work in hospitals. And will probably help me heal and it will probably prove my theory that the hospital work environment is essentially toxic for everyone and it needs to change so everyone can thrive.


I'm quietly freaking out and trying to manage it. The leader dims the lights starts the official mindfulness exercise, it is one that is very similar to one a nurse tried to get me to do in recovery when I was in a lot of pain and panicking. And that's it. I hit 9-10. I start to hallucinate. There it is, green and that other colour. The pain. I'm not even in the same room. I try to do another mindfulness activity to help me. Count. Play a song. Anything to tune it out. I try to say the current date, but I start saying one of the trauma dates. I feel like I am drowning. Frantically thinking of anything that will save me from this invisible terror. I can't tell anyone because I am terrified of looking like an over reactor. I hope I can just control myself. I know, ridiculous. But that's what people always tell me. I over react. I do everything in my power to not react, which of course causes other problems. I also find it embarrassing. Even in ERPS I was the only crier. I always held back the tears. SisterBot tells me to just let it out. But I can't, it's not okay in my programming to cry.

All of these triggers occurred in about the span of 7 minutes.


I kept trying to lower my distress. After the activity everyone is talking about how relaxing they found it. And they get to me and I can barely get out without sobbing "No, it wasn't good. It was triggering." They ask me if I am okay and if the lights will help. The lights make it worse, because it becomes a clinical examine room then. I tell them "I'll look at my coping sheet." I start to draw and I quickly draw myself in a hospital bed, and then I draw over it. I didn't want to draw that, but it was automatic. I start to flip through my book and try to focus on a project I am doing. Planning events and making things makes me feel better, because I have a purpose. I have things I need to do.

I don't feel well for the rest of the session. I try to feel better, but I'm so cold and exhausted. I wrap myself up to keep warm. I don't feel safe. I don't mention it, because I don't trust them to help me. (The group member who works in the section that scares me, they went and turned the heat up. Which I thought was very kind, because I couldn't leave my chair if I wanted too) When I've asked for help in hospitals I've been laughed at or treated like I'm trying to get attention or a burden. My ex was the same way. I am aware that the hospital is largely a mirror of our relationship. So I just don't say anything anymore, because I know no one will believe me anyway. I'm being dramatic. I'm hysterical. I'm a liar. That's the trauma talking. It's easier to be hurt, and self care than to be vulnerable to trust someone to help me. I know they will fail me when I need it the most, so I can't take the chance and be hurt more, so I'll suffer then and cure myself.


This is why I've never used a crisis line because I'm so terrified that when I am on the edge that I'll get the person who doesn't care. I won't be able to take the rejection. So I take care of myself.

I try to participate, because connecting with people can bring me back into the present. But it doesn't really work. I don't know these people. I want to see my friends or my therapist. Unfortunately everyone is busy.


Going to work doesn't make me feel better either. I just go into fake me mode. It's a performance, and it's exhausting.

We go on to coping skills and distress tolerance and self soothing. I don't really understand the difference. I self sooth when I am distressed and that helps me tolerate it. Apparently they are different. I guess self sooth is aftercare and distress tolerance is for the moment the distress is happening?


Amusingly, they keep using the hospital as an example of a safe place. That people often don't want to leave because they are taken care of. The other group member and I disagree.

My memory gets a little foggy. I think I asked about what do you do when you hit that 10 and you get down to a 7 and keep hitting 10. I don't think I got an answer. Or they didn't know what to tell me. Or I rambled on about something else. I honestly don't remember. I need to look over my sheets again.


They tell us that people aren't always good at the self care because they feel guilty for taking breaks, for making time for themselves. But you need to make time for yourself. It's okay to take care of you. I know this and I struggle with guilt, but I am significantly better at giving myself little holidays than I once was. I know what works for me. I like to be warm. I like tea. I like certain movies. Exercise helps me. Focusing on a short puzzle helps. Doing my daily duolingo stuff helps. I often feel better when I write these posts, but I couldn't bring myself to do it. Videogames can be okay, but they are often too numbing. Taking joy in simple things, like sunsets or being warm is helpful for me.

You need to know what makes you feel good. But sometimes when it feels so bad, how do you let the good in? I just start to feel disconnected and drift off to places. I try and reel myself in, but it doesn't always last. I'll get out of the hole, but then I'll get back in. Then out, then in.


On my way home, I end up buying some yarn and knitting while watching Being Human UK. It's not great, but at least I'm in the present. At least I am warm.

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