Last night, I had a very severe episode of depression which evolved into suicidal ideation. It was completely enveloping in an instant and continued for hours. Because we have been continuously working on building internal communication, I had the unpleasant experience of being completely aware of these dark thoughts, with no control over what my body chose to do in response. Feeling self-destruction take hold with no escape route is one of the most terrifying experiences in my recovery.
And it’s not the first time.
Usually, I’ve had a “slow grind” of depression down to suicidal ideation. I begin to recognize inpatient is warranted. I go through the process of putting in an application to Sheppard Pratt, get accepted, wait for my admission. Somehow we survive this arduous process and the work inpatient; they put us back together.
Neither my therapist, K., or I have even been thinking of Sheppard Pratt. Although as a good therapist, she is continuously assessing me for self-harm and suicidal ideation, she’s going to be shocked to hear of this. As much as I am scared, she’ll be shocked (in that professional-shocked kind of way).
Anyway, it’s got me thinking that I need to reconsider my internal meetings to fit the current crisis. In a nutshell our meetings go like this:
- Review our morning routine (get up, get washed/dressed, morning chores)
- Review the day’s agenda (work, any appointments/important events)
- Check-in on any nightmares/difficult feelings
Our evening meetings are similar, except we review our night routine, tomorrow’s agenda, and a quick review of containment strategies for nocturnal parts.
We’ve put a lot of time and thought into this. This is our new “meeting checklist” which is structured, outlining symptom management skills throughout. This way no matter if it is me, or another part who is not used to being forward, can still run through the checklist with whoever is present.
New Meeting Agenda
- Safe Place Imagery – our meeting place was designed (and re-designed) using a skill called safe place imagery. We review the meeting room, which consists of an oblong, white table. Inside the room are numerous items mostly younger parts have added over the years. This allows us to both connect to the meeting space, and introduce any new parts to the space (even if we are not aware of their presence). If a part is unfamiliar with safe place imagery, we like to refer to The Shop exercise as an aid from Coping With Trauma-Related Dissociation.
- Review of our Orientation Card – this is an index card we have taped to the front of our journal. It explains how old the body is, where we live, who lives with us (including pets!), and how the present is different from the past.
- Take a moment to reflect on our intentions for the meeting. This is a good time for parts to write down any pressing things they may (or may not) want to discuss: Any prevalent or repetitive thoughts? Any feelings you are trying to get rid of/avoid? Any negative beliefs you are holding about yourself? Any difficult dreams/anything difficult happened earlier?
- Review of our Crisis Continuum – what is our current number?
- Stay within our window of tolerance – employ symptom management corresponding with the number on our crisis continuum.
- Review of today’s agenda – general outline for the day including any BDA plans and important appointments.
- Before closing, invite to help any numb/avoidant parts, angry parts, and protect any vulnerable parts.
- Recognize successes such as: using a symptom management skill, being respectful during a debate, or a part who was willing to compromise.
- Part who was scribe for the meeting will post the meeting summary on our internal meeting whiteboard for parts who could not be present.
And now I leave you with a very fitting song for the times…