Trust in Mental Health Treatment (Part 4): Choose Your Own Adventure

So, I potentially have good news. I’ve gotten to the final round of the interview process for a new job in my same city. It’s what I do now but with a different organization. I’ll update eventually whether I got the job, but talking about it right now feels a bit too much like tempting fate. I’m not a fan of pure CBT, but even I’ll admit I’m engaging in a bit of magical thinking by staying silent. I know, I know. However, PTSD and its sense of foreshortened future mean talking about anything positive that hasn’t happened seems like it will only make me look like a fool when it doesn’t happen.

I have no such qualms, though, about talking about my fears of what will happen if I get the job. C-PTSD is fine with that. The commute will be just far enough that I won’t be able to make it to my therapist during her normal business hours. She was able to do a limited number of phone sessions while I was in the 9th Circle of Hell last summer because she knew that was an active trauma crisis, but she can’t, unfortunately, do regular phone sessions. I’ll also have to go to trauma yoga on Saturdays instead of during the week. That’s…not terrible. But, it will mean a bigger class in front of which to modify my yoga-for-hypermobility. There will probably be social anxiety compared to the three people that regularly go to the class I currently attend, but I guess I can live. How unsettled I feel not being able to attend weekly therapy, though, is one reason why I never fully wanted to develop trust with a therapist in the first place. Not all therapists are the abuse-permitting social workers of the 9th Circle of Hell, but, in the end, they are all running businesses. They’ll only modify so much, so my brain (bully and other parts) says don’t depend on someone for whom helping me lasts only as long as I am convenient. (Alongside the issues I wrote about in the first three parts of this series.)

Forget attachment. I’m still a survivor of enough systemic abuse that I’m shocked I even got to trust with anyone who is part of a system. But, shockingly, I did, and I don’t see myself being the kind of person for whom lightning strikes twice. My therapist attempted to suggest there might be others closer to my potential new workplace whom I could trust, but she shut up quickly upon seeing my look. She then switched to, “Ok, I think you are strong enough that you could do more like once a month. I think you’ve been through enough with irregular support during the Crisis of 2018 that you can manage in 2019.” I’d be willing to take a half day to see her once a month during her hours. I’ll admit to being scared of tapering therapy, but not scared enough to contemplate finding another therapist. The legacy of systemic abuse runs deep, and the system she is in – and the others that both my insurances have covered for outpatient therapy – are really not trauma-informed. She’s the rare exception in a clinic I’d otherwise bitch about. (My psychiatrist, who is not necessarily trauma-informed for most but likes me, has Saturday hours. I could keep seeing him.)

I’d actively choose once a month therapy over trying again with anyone else. But admitting out loud that therapy was an important part of my support system during the Crisis of 2018 was terrifying. What if I’m not really strong enough yet to taper? Last year was pretty damn re-traumatizing.

What if I shouldn’t even be looking for a new job at all because I don’t have the spoons? The commute isn’t just too far to make therapy: it’s also a commute at all. I’m currently a remote worker, and that saves a lot of physical spoons. It doesn’t save mental spoons, though, I’m only a remote worker because I exist within a limbo wherein my boss finds me too useful to purge, but too much of a hassle to talk to.

When I started to panic-think maybe I should just stay with my current company, my therapist very quickly shut me down by reminding me how many of my boss’s communications she has read while I cried. As she has stated, she “can’t ethically diagnose someone” she hasn’t met. But, while she can’t speak clinically, she did suggest that I do some serious research into the various presentations of narcissism and think hard about why my current boss was able to trigger full-scale PTSD episodes when I still saw him in person. 2018 wasn’t the first time I had to testify to ongoing abuse in the 9th Circle of Hell. I testified against the Thesis Defense Rests Stop the same week as my thesis defense (hence the moniker). Yes, each successive trauma adds a straw to the camel’s back. But my boss…also reminds me of someone who abused me personally in a way no one outside the 9th Circle of Hell ever has in my entire life.

The day of my end-of-year-review – which perhaps I will eventually write about – was a perfect example of my the way my boss can start the day in such a towering temper I wonder if I will still have a job at the end it, but then whiplash to being conciliatory to the point he asked if I could use more physical accommodations. What changed in between? A combination of a) something I produced being very well received by clients on a call between the beginning of the day and my review and b) letting him take all the credit for it. With my history, my instinct is to roll over and hand off intellectual credit for anything I do to anyone who scares me because C-PTSD says “stay safe by staying out of sight.” That…works with my boss. It’s probably a big part of why I got concessions and the rest of my office got fired last year.

But, as my therapist notes, he exacts a cost in mental spoons that is likely more damaging to me than the cost of the physical spoons from commuting. It’s not generally a smart idea to work for someone who pings your PTSD to flashback to childhood abuse. Even if I hadn’t experienced childhood abuse, working for someone who can flip moods so drastically and so quickly is not a great idea, period. Nor is working for someone who has flat out stolen the academic work of all those who are under him in a field that typically recognizes subject matter experts as experts. There’s also the pesky fact that I still have the gut instinct that the company itself isn’t financially stable, and I could lose my remote job by 2020 even if I’m able to keep my boss perfectly happy until the day the doors close for good. I’d rather choose my own adventure now, while it still is a choice.

Therapists don’t usually tell you what to do, exactly, but mine seemed worried enough by the prospect that I’d not take a job if I got it because of the fear of losing one piece of my support system that she ended with “we’ll work out what happens with therapy, but I really don’t think you should trust your boss longer when you have another option.”

We’ll see what happens. I don’t know if I will know yet by next week whether I’m their final candidate. Whether or not I do, next week’s post will be a review of the strategies that kept me sane while testifying to abuses in the 9th Circle of Hell in 2018 without consistent access to therapy. Maybe if I write out what helped me then, it will help others unable to access good therapy now, whether because of a therapy break, because they only have access to those horrible therapists in their area that are the reason I’m so afraid of ever starting over with someone new, or because they can’t afford decent care. (The U.S. sucks at mental health, did I ever mention that?) And, maybe it will also help to reassure myself that I can eventually return to working in a real office – with its increased physical demands upon my EDS/dysautonomia – because the mental benefits from reduced anxiety, depression, PTSD and panic are worth it. Maybe it’ll convince me that I can be strong later since I was strong enough before.

Also, if I flat out state that I won’t be writing about what happened with the job next week, then perhaps  I won’t feel internal pressure to “follow up” with the “bad news” my brain thinks it will inevitably receive. I write a lot about failure on this blog, but I’m trying at least this week to tell myself someday I might also write about success.

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Need a recap of anything I’m talking about in any post? Check out the Glossary of Terms.