Intake

Welcome to Outpatient.

I sat in the uncomfortable plastic chair, scuffing my boots against the carpet. I snuck peeks of the other people in my group while being careful to avoid eye contact. Sad girls and women of varying ages. Rich young girls fresh from private school and worn old women with blank eyes and monotone voices. A few were on their phones. Some flipped through binders, scribbling notes to themselves. One or two were openly weeping.

I sank further into the safety of my worn hoodie and folded my arms over my chest. Slumping down until my legs were almost straight in front of me, I resisted the intense urge to get up and walk out of that grey room as quickly as I could.

We were about to start our check-ins. This was the part where we all went around and talked about how we were feeling and why. We used emotion wheels to pinpoint the feelings we couldn’t articulate. We were supposed to be open, to be vulnerable here.

I could feel my jaw tightening at the thought. I didn’t want to take a turn checking in. I didn’t want to talk to these people. I didn’t want to be like these people. I was different; sure I was traumatized and unstable, but I was in control of the situation. I was tough. I didn’t need to learn skills. I was fine. Fuck these people.

I was upset for multiple reasons. I didn’t want to be in Intensive Outpatient Therapy. That was first and foremost. I resented the implication that I was that sick. It felt like a failure, like I’d somehow gotten worse despite my best efforts. I was annoyed about the gender-specific nature of a Women’s Program (they had one for men as well), although I completely understood their reasoning. I didn’t want to talk to doctors about my medication. I certainly didn’t want to discuss the tangled mess of my emotions and trauma.

Fundamentally, I wanted to not need therapy. I wanted to be functional without having to spend all this extra time and energy on being functional. I wanted it to be natural and easy, the way it seemed to be for other people. I was angry at the universe, at my family, at biology, and at myself. It was bullshit. It was unfair.

Unfortunately, that’s how it goes sometimes. I could rage and scream and sulk and self-destruct, but the facts remained the same. So there I was, in an eight-week outpatient program for people in crisis. Three hours a day, three days a week, of learning how to Deal With My Trauma and Emotional Regulation and Learning Effective Communication.

I want to make it clear that I hate all that phony positive bullshit. Go live laugh love in a fucking black hole. I despise false optimism, when people are focused on the optics of kindness instead of the act itself. Be an asshole, but don’t pretend to be otherwise. All this Radical Acceptance and Affirmations and Mindfulness sounded like more of that. I wasn’t interested. It seemed like an elaborate lie, denying the world we lived in for some wonderful delusion. I considered myself too pragmatic and realistic to get sucked into any of that nonsense.

But here’s the thing. My old methods weren’t working. I was doing the same things, but the situation kept getting worse. I was sliding down a deep pit, and clawing at the sides was only resulting in bloody fingernails and a throat ripped raw from screaming. Being negative and shitty about everything was my default, and while it has its advantages, it was feeding into my mental illness and destroying my life.

I made a deal with myself, that first day of group. I watched these strangers share themselves, be authentic and vulnerable and honest, and I decided to give it a real shot. I was going to try my hardest to work the program. I wasn’t going to half-ass it or go about it with an attitude. I wasn’t even going to be sarcastic. I would give it my all. That way, when it failed, it wouldn’t be my fault.

But I would do it on my own terms. None of that false positivity, none of that ‘taking a walk outside will cure your mental illness’ horseshit. Sometimes things are terrible and the world ends right before your eyes, and then you still have to get out of bed and go to your shitty job the next day. Sometimes things suck. Some people are fucking monsters.

These are facts. Luckily, they’re not the only facts. You can survive horrible things happening to you and still live a full life. This world is ugly and beautiful and devastating and breathtaking all at once. It’s important to remember that. You can be mindful and appreciative of the good things while acknowledging the bad. To badly paraphrase Dickens, things can be wonderful and terrible simultaneously.

And it worked. That’s the infuriating bit. Mentally and emotionally, I’m in a better place than I was before program. I can handle my shit with more grace. I’m no longer teetering on the edge of the void and dangling one foot into the darkness.

Sometimes I still go back to the ledge. It’s familiar. I spent most of my life there, looking into the abyss. Dancing along the edge, sometimes hoping I’d slip and disappear. I’ve been to the ledge over and over because I know it in my bones. I know the ledge, the abyss, the void, I know them better than I know my own face in the mirror. In some ways, the pain and loneliness and hurt were a comfort. I felt like it was all that I deserved.

Now I get up in the morning without a major existential crisis. I take my medication. I do my mental exercises and mindfulness practice. It’s daily work. A lot of the time, it sucks. I’m still annoyed that it works as well as it does. It feels corny and pat, almost too easy - frame things differently and you’ll feel better. Force yourself to fake smile for a few minutes to lift your mood.

But the science backs it up. Rewiring the brain is possible for some. I’m one of the lucky ones. It’s not foolproof, of course. I know I’ll go back to the ledge. It’s part of my disease. But I don’t have to fling myself over the edge. I can admire the vast, endless, empty view, and go back to my life.

On the first day of group, I knew none of this. I only knew that I was going to try my fucking hardest to get better. And if I failed, nobody could say that I hadn’t tried my very best.

I didn’t know any of this then. Instead I sat in that hard plastic chair, arms folded across my chest, and waited for my turn to speak.