Recently, I finished out eight weeks of an IOP (Intensive Outpatient Program) therapy to have space to think through how I wanted to handle some recent trauma, as well as ways to address my gripe with how victims are treated as aggressors. The IOP was helpful in many ways, and sometimes it was just plain overwhelming. I did accomplish my goal of processing through my psychotic break (yay, love that for me), but it was overwhelming to hear other people offer well-intended feedback that missed the point.

Group therapy has many benefits. There’s so much that can be good about it.

And, the biggest issue is, in my context, group therapy creates a space where people who don’t have very good solutions are offering up their “this works” solutions to people who want – maybe need – the better than “just okay” solution. Maybe the people asking for help also don’t know how to phrase their problem very well, and that’s another way how group therapy full of humans helping each other can harm people.

But I got the help I needed by learning that it would be less helpful to hear feedback from people who weren’t at my place in life tell me what they’ve found works. Maybe sometimes part of being in therapy is figuring out that it’s OK to not take advice.

Also, though, an IOP assessor not realizing that a young adult female therapist is actually a very skilled clinician was a gripe that wasn’t the fault of many people. It just threw me in many contexts where staff of the IOP weren’t understanding my concerns. I know that it’s not my responsibility to change an IOP, but it was hard to not pull the clinical counselor card in retort to some comments I got when asking for reasonable changes.

I cannot change that I am an unusual age to be in a multi-family group therapy setting and be the best voice of reason to everyone there for their issues. I wasn’t being seen as anything but super earnest and kind, but it was hard to not see the therapist assuming my role. If group therapy is contingent on one group member being the therapist, then what’s the purpose of the therapist there if the member cannot get clinical hours?

Perhaps it was neither here nor there that it seemed contingent on me.

Perhaps the goal was not to arrive at solutions.

But to me, that seemed then even more appropriate of a therapist to intervene. Because therapists don’t really give us solutions or advice. There could be some skills given along the way and some answers, but they aren’t really there to solve anything.

People in the IOP were very kind and lovely. It was kind of just when they tried to help one another that I realized they were using prior guidance that wasn’t great. As well, I could see how a lot of these people were looking to see that they weren’t in the wrong for being distressed that their needs were steamrolled over. And maybe part of my problem as being a trained therapist was knowing that things don’t always change but also that it’s okay if you want to really be mad at people while also really loving them.

Because it can be frustrating that people really hurt you. And then they still actually want what’s good for you. They just really don’t get that they’ve hurt and harmed you, thinking that you are being overly dramatic and not seeing that people are allowed to say, “You really harmed me when I most needed you,” because we’ve all been there. And when our loved ones or people we think care most about us do it, it’s complicated as hell.

But also, it’s complicated to figure out the people we need in our lives.

IOP was helpful in some sense, but I think I mostly saw how we also throw out of proportion when to call what things harmful, and when. Things were called harmful and it was true, but not really understood to what extent. A lot of my issue with what went on was not intent of comments, then, but ultimate result. And for staff to kind of just let the result be in the “good enough” column, and not say the, “here’s what to do if you get to a crisis point and you need an accomodation to help cope” sector made me kind of spin out of control. Because I often felt the need to provide crisis interventions. I didn’t need to. But I often felt that it was so mean to leave people without an answer no one was giving.

Maybe that wasn’t the point, though.

Maybe the goal was to allow people to address they were in a crisis and have a safe space to sit in the messy, complicated, hard feelings of being in a crisis. I personally still probably don’t like group therapy, then. I don’t say this because I can’t be a group therapist. I have been a group therapist. I get it. You don’t necessarily “solve” or “answer” all the questions people have. It’s not reasonable. Sometimes it doesn’t work.

But as a friend (in some sense) to these fellow clients, it was hard not to.

Perhaps that’s why being in groups of people can be really challenging.

And sometimes the guide dog is blind.

I was there to process my trauma.

Because I was here thinking the issue was that the police thought I was violent.

I was here thinking they were victim blaming me.

I realize now, to me, the term “dissociative PTSD” means something. And it means that a freaked out person is under so much duress that they cannot rationalize anything. To me, it should be understood that police are the least properly trained to interact with people who are in a mental health crisis. And calling the police on someone in one is awful.

I was blind to it because the court threw their foot down that a (supposedly) scared neighbor must be right that I am a danger to the neighborhood.

To me, I saw it as me being bullied.

I saw it as a neighbor trying to harass me out.

Maybe the police were on her side and maybe they weren’t.

But I was so blind to being able to cope because it didn’t make sense that people who didn’t see a situation as a legal matter would make it into one. It seemed so obvious that this was an abuse of power. It seemed out of their jurisdiction. Maybe I was blind.

I have taken more time to respect that I was probably (and logically) very right that it should have been completely dismissed. I have taken more time to respect that courts exist to protect all actions of police, ethical, abusive, or not. I have taken the time to respect that no one who knows me thinks that I did anything wrong, in any sense.

To me, this was my problem with a COT program.

It’s why I wanted an IOP program, really.

The IOP staff were interested in giving me real diagnoses and intervening in actual experiences of mine to assess more about my mental health. The COT staff (at the location I am forced to attend) are often unprofessional and have the pitiful clinical expertise to hear me say, “I was dissociated and I may have hit someone, I don’t know,” and respond with, “Well, you know, you were probably angry and acted in rage.”

The IOP staff may not have been able to do everything I needed.

And still, having the space for three hours a day to cry and journal and think about the value of sharing more of myself than the easy stuff – was worth it. The COT program is a sham to allow courts to claim they help people when they just push along bad policing.

To me, the guide dog being blind is the guide dog misunderstanding what their owner is needing to be guided to. IOP sees teaching and practicing coping skills. COT sees giving and expressing (often lengthy and superfluous) weekly check-ins.

My opinion is not that I am some skilled clinician who needs to fix the world.

My opinion is that I am a skilled clinician and my code of ethics includes a statement about how I am meant to evaluate and assess programs. I am allowed and meant to call programs out for doing more harm than good, or even for misrepresenting themselves.

And sometimes we get people who understand how to meet us where we are at.

And sometimes we don’t.

But when we can, and we get that conversation with someone who looks at us and sees us as more than the mistake that someone chose to put us under, it’s nice. Because my issue has always been not that group therapy is horrible, but that listening to people’s issues for an extended period of time can be completely overwhelming. I want to hear about more than just the worst things that you’ve ever experienced and gone through.

IOP gave me the space to take breaks and practice skills.

COT is about trying to be clinical without much directive.

I don’t think it’s malicious, but I do think it’s the wrong response to over policing. The response to police seeing mental health as criminal is to dismiss the charges in court and allow the person to select treatment that will satisfy their diagnosis and needs.

I would rather experience both and be in a place where doing what I thought would help (IOP) makes it so I can push through what I need to do (COT). At least now the guide dog who was blind is calmer. Now there’s some more calm in seeing that systems that are not great are trying their best even if the ways they are trying aren’t the ways that are good.

And my goal?

Provide research and evidence based practices to fix these systems.

XOXO,

Dorothy B.