My case has been referred to the expedited review unit at Kaiser. I was given the option of giving an oral report to help bolster my case. As it turned out, I had about a half an hour or forty five minutes to write something. This is what I came up with. I presented this report to the Kaiser review board about five minutes ago. I was told by the case manager that she would try to get back to me by tomorrow afternoon. We’ll see…
PTSD and Trauma Treatment: Specific Therapeutic Needs
PTSD and trauma treatment is very different from typical therapy. Whereas many mental health patients benefit greatly from learning how to calm themselves down, retrain their negative thought patterns, and other such coping mechanisms, trauma needs a different approach. PTSD and trauma must be processed by delving into the incidents which induced the PTSD response. The PTSD patient spends a lot of emotional energy avoiding anything that reminds them of their trauma. Typical coping skills therapy replicates this pattern and harms the PTSD patient by not allowing them to heal. A trauma therapist must be well versed or experienced in treating trauma patients. Otherwise, the therapist runs the real risk of triggering painful responses in the patient or missing significant clues that could be the keys to healing.
A residential treatment program is necessary for the PTSD patient who is experiencing acute symptoms of flashbacks, nightmares, and extreme avoidance of triggers. A proper PTSD and trauma treatment program has a carefully selected group of patients and therapists to achieve a therapeutic milieu. The peer support group is crucial to healing and learning how to interact with people healthfully. The support group must be comprised of people who share at least the main component of trauma. Otherwise, the PTSD patient can end up feeling more alone and isolated. The healing process is hindered when the PTSD patient feels like no one else understands.
The residential treatment program provides intense therapy to jumpstart the healing process as well as a very supportive environment for the patient. The tightly monitored and controlled environment helps the patient to feel safe. When the patient feels safe and secure enough to address the vulnerable painful memories of their trauma, healing can truly begin. Going home after therapy requires the patient to close down, compartmentalize their emotions, or put on a mask. This necessary and often subconscious coping mechanism makes therapy take much longer or entirely ineffective. That is how it was in my case. I have been in outpatient therapy and support groups for many years. But as a mother and wife, I could never focus on myself long enough to allow my exceedingly painful memories to surface long enough to process them.
The reasons I chose the two facilities that I have are as follows. #1. Proximity: It is important to stay close to my family for my kids and my husband. When the time comes for family therapy to be incorporated into my therapy, it will be easier for my family to come to the therapy sessions. #2. These two facilities have reputations for being trauma specialists. Their programs include intensive trauma therapies in individual and group sessions. They have evidence based therapies that have been proven to be very effective in treating PTSD and trauma. Even the group activities are geared towards healing and are supervised by people who have experience in treating trauma. #3. Continuity of care: Outpatient programs are best when the patient can go to similar or the same area to get continuing therapy. Bridges 2 Recovery often refers their patients to PCH after the residential treatment is finished. PCH has inpatient and then outpatient treatment for continuity of care.
There is a third facility that is in Arizona. It is the renowned place for Trauma based therapies. It is called the Meadows. The reason I didn’t put it in my list if because it is so far away from my home. But if the two other treatment facilities do not meet Kaiser’s requirements, maybe the Meadows would be an option.
My insurance company, Kaiser Permanente, has denied their own psychiatrist’s referral to an outside facility for PTSD trauma treatment. By the many employees who work within the system, they agree that Kaiser doesn’t have this kind of treatment available in their system. Nonetheless, Kaiser has proved that they are a for profit company and will not provide the care that I need to heal.
I know that I should have expected this. But my doctor and his wonderfully sweet nurse thought it was possible to get me the treatment I needed. I was duped into believing that Kaiser might actually pony up for part of the program payment. I am crushed. I try to tell myself that it was going to happen. I should have been emotionally prepared. But I am not.
I filed a grievance yesterday with member services. I was told that I will get an answer in 30 days. Until then, sucks to be me.
Found a wonderfully hilarious website that actually makes a whole lot of sense. I have been told by my doctors that the nerve problems in my cervical spine (neck) are greatly worsened by wearing or carrying a bag around my shoulders, neck, in my arms. Don’t carry, they tell me. Okay. But women’s skirts don’t really come with working pockets. Rarely so. Can’t wear pants bc that’s assur in my community. “Assur” means not allowed in Hebrew. Thus, no cargo pants for me. What’s a person to do? I have my wallet, keys, phone, blood sugar tester, insulin pump… Need I go on? Those are just the basics. Even on Shabbos, I must still carry my diabetes supplies. I need pockets! The doctor retorts, “Just wear a kilt!”. Aha, I think we’re on to something.
I really do try to work within the system. I want to be who i am, take care of my medical needs, and still follow what the community dictates. I allow myself to be creative but follow the accepted practices of the people I am with. So, I look for cargo skirts, again and again, with increasing futility. This is going no where. The only skirts are really tight and really short. I won’t wear a mini skirt. That goes against my basic sensibilities. Time to change tactics.
Today, I decided to explore the kilt side of the world. They are skirts with deep pockets, right? I found a few websites that had some very interesting pieces of clothing that looked perfect. Utilikilt was one such site. How perfect for me! The boy in me can be happy and I will still be wearing a skirt, right?
Then I came across this website. The purpose is so funny, yet so true on many levels. I was highly amused. You may find the link here. I’d love to hear what you think.
When I was in the psych ward of the hospital, I drew this. The patients were only allowed golf pencils. At the time, all the pencils were dull. I dug my nails into the wood to release the lead tip and then sharpened the tip by shading sideways on a scrap piece of paper like my menu. I’m not trained in drawing but the medium is therapeutic nonetheless.
This picture is crude because of the lack of materials. Yet, the message is loud and clear for me. I wasn’t allowed to listen to music (read KoRn) in the psych hospital. Still, they held me while I was contemplating how to live again.
This is Bunny. Bunny is the house bunny for Miriam. Bunny runs the house. I love her. It seems that she has a mutual affection towards me. When I stop petting her, Bunny growls and tries to get her head back under my hand. She wants to be loved and petted. Bunny has no problems asking for what she wants. Thankfully, Bunny is irresistibly soft and smushy. I am more than happy to pet Bunny. She is pet therapy for me.
I originally began telling a select few about the sexual abuse when I was fourteen. When i was eighteen, I told my youth group at the end of our year living on a kibbutz in Northern Israel. That following summer, I led a group in my summer camp teaching kids how to protect themselves from sexual abuse. Some weeks, it was the most attended seminar. The campers seemed very grateful for the group. My peers and the older counselors pretended that I didn’t exist.
When I got to college at nineteen, I was done being silent. I went to a survivors group the first weekend I was there. By my fourth year, I had been quoted in the city newspaper, had my own double page spread article about my life, published prose in the college survivors semesterly booklet, and compiled an anthology of writings by female survivors of female perpetrators for my thesis. I was “out”.
When I decided to become part of the orthodox community in every way, my whole history went underground. My husband knew everything. The rabbi who married us knew bc of the issues that could arise in an orthodox marriage when one of the partners is a survivor. My own rabbi knew bc he brought me back into the fold. He met me before I was even thinking about being a girl again. He knew all of it. Other than those three people, No one else knew.
In my early married life, I found it absolutely necessary to tell a few select people. I felt so invisible. Breaking the silence helped, some. Every couple of years, I told someone new.
I started branching out again back in 2008. Amongst my web searches, I found Angela Shelton and her book about the documentary she made. I bought the movie and made cautious comments on her blog. I was careful to stay under the radar. Angela took part in an informal comedy night hosted by John Fugelsang. I went, hiding in the back, talking to as little people as possible. But then a comedian named Will C. came up to do a bit. For some reason, he told us, the audience, that he had been molested as a young child. He grew up, became a marine, fought for our country, and was trying to break into the comedy scene in LA. I made sure to speak to him at the end of the night. We’ve been close buds ever since. Neither of us had anyone else to talk to about our horrors. When we spoke, it was powerful.
Around this time, I met my friend Miriam. We had been friendly but never said more than a couple of words to each other. Three years ago, she posted a link to a book about domestic violence and commented that the story was just like hers. I emailed her immediately and the strongest of friendships ensued. We helped each other. She held me. For a while, that was good enough.
Then I found the song “Daddy” by KoRn. It changed my life. The anger and raw pain unearthed what I had never been able to access before. I sent the song link to Will C. He told me that he started crying. I think we spoke for hours that night. I was becoming ready to seek out my fellow survivors. I needed to connect. I joined the KoRn blog and came out there. In June, I joined a survivors forum. I was branching out. I needed so much more.
About six weeks ago, my coping skills began crumbling around me. The “what happened” is a story for another time. I checked into a psych hospital for hopelessness, unremitting PTSD symptoms, and suicidal ideation. The time had come for me to get into a residential treatment facility that could give me therapy for the longstanding abuse wounds that had never healed. I was away from my family. I needed help to pay for the costly treatment. My family needed outside support. I didn’t want to keep my abuse a secret anymore. It was stifling. Killing me? Don’t know. I gave my husband and Miriam permission to tell people what was really happening. I felt so much relief at not having to hide what ailed me.
I am coming out, again. Most of the people around me didn’t know. It’s not like college. Not every one is supportive. People don’t want to share my story. I am finding myself at this new? place and it’s very different this time. The last times, I was embraced, by everyone around. That was college. An open world. People treated me with dignity and respect. This time, the coming out was through the internet. Facebook. Miriam set up a Donation site for me to help raise funds for the treatment I desperately needed. Miriam asked my friends to simply “like” or share the site. People were asked to publicize my story. A surprising few of my frum friends did.
Many requests were made. A bunch of people were very supportive. My local community made meals, donated money, helped out with the childcare. Help was there, in spades. But not many people were willing to share.
I was upset. I felt that people were ashamed of me. Then I considered the possibility that they wouldn’t share my story if I didn’t come out publicly myself. So, I did.
A few more people started coming over to the “dark side”. More people liked my post and more than a few shared it on their pages. Some people called and emailed me directly. I was touched by their caring gestures. I tried to focus on that.
For some reason, I am still bothered by the numbers of people who wouldn’t publicize my story. I don’t take it personally now. I think that the issue is more global. I feel that secrecy and shame is at play. Childhood sexual abuse is a nasty and painful subject. No one wants to talk about it. Rarely do I hear a person discuss it. I’ve never heard anyone come out and say they were abused in the last fourteen years that I have been in the frum community. Even amongst non Jews, the subject is almost never broached. If it is, survivors stay silent. I am guilty of this as well.
I guess, I thought, that if I had the courage to come out by saying that I had been sexually abused as a child, the doors would flood open. Sigh. Not true. No flood gates, that i am aware of. That means there’s lots more work to be done. The secrecy must end, for all of us.