My experiences with Group therapy

I often struggle to pick a topic to write on, not because of lack of ideas, but usually because I have so many ideas of what I’d like to write on.  Some deep, some not so deep.  One of the joys (?) of having bipolar is having a mind that is constantly swirling with ideas.  Not just when manic, not just when depressed, but every day.  I think mood only impacts on what themes those ideas have – when depressed, my swirling ideas tend to be negative ruminations, when hypomanic/manic, my swirling ideas tend to be all these grand plans of things I’d like to do, but when “normal” (if there is such a thing as “normal”), my swirling ideas can be anything and everything.

There are so many topics I want to write on – I would love to share my story about domestic violence, about what it’s like to be married to someone with severe borderline personality disorder (as my first husband has), about me more, my past experiences, my future dreams, but I decided tonight to take the easy way out and settle for a mundane topic.  Well it’s not too mundane, but it’s a emotionally neutral topic, just based on my dad.

Monday is my anxiety group therapy day.  I’ve shared a little about my stay in hospital earlier this year.  I was in hospital for 18 days in May/June.  When I got out, even though I was feeling great (actually rather hypomanic) I decided I wanted to do some group therapy to try and prevent a relapse of my depression.  The hospital I was in runs group therapy programs. Since there was no depression group running for the rest of the year (sadly I had just missed the start of one at the time), it was suggested I try the anxiety group as apparently the course was nearly identical.

So for the last two months, I have been doing this group.  In all honesty, I have been a pretty lousy attender – I have only made it to just over half the sessions, but considering I’m back at work and can be rostered on any day and with me and the kids being sick a lot over the last two months, I think half attendance is pretty good.

Ironically, since starting this group (or probably just before I started) it was my anxiety that needed help far more than depression.  I’m still not sure group therapy is my thing.  It seems that a lot of people in these groups get better, but for me, the only improvement I’ve had was a sudden one when the higher dose of my medication kicked in and I stopped my second medication (with was making me physically agitated which in turn was making me more anxious).

I don’t know what it is, but groups like the one I’m going to just doesn’t do much for me.  We spend the mornings learning about anxiety and cognitive behavioural techniques and healthy living, and then the afternoon walking and doing “relaxation”.  The mornings I find boring because it’s stuff I could teach and with my background in psychology and nursing, I know the topics far more in depth than what is being taught.  I do like the walks but I find the “relaxation” to be incredibly irritating and have no idea how others find it relaxing – but they do. It seems I’m in the minority with that one.

Proper group therapy is pretty new to me despite floating around the mental health system for over 12 years since the first time I went to a hospital.  The first hospital I went to had no inpatient groups at all beyond a once a week feedback session with a consumer advocate who I was too scared to  talk to about the abuse at that hospital the only time I was there on the day it was run because I was too scared of retaliation.  The closest thing to “group therapy” they had was an activities room with colouring in stuff and a ping pong table, which was rarely open.

At the second hospital I was in, just the one time, they had a lot of groups, but they focussed more on social activities (Eg BBQs, make up classes etc) and life skills (eg teaching basic cooking, basic budgeting etc) and while the social activities made an ok distraction, they didn’t “help” and the life skills classes were kind of insulting.

At the third hospital I was in, I don’t think they had any groups but I honestly don’t remember as it was probably at my most unwell I was there and I think I was only in the main ward twice.

I was supposed to do an outpatient group therapy through a public hospital, but they cancelled on me a few days before it was due to start.  They gave some pathetic reason which I don’t remember – all I remember was it wasn’t genuine.  They had referred me for the group believing I wouldn’t go to it so they could use it to abuse me with “oh you’re not trying to get better” and while I don’t think that particular group would have been of any use (in fact, after researching it, I think it would have made me worse), I am always willing to try anything to get better.  I was disgusted when I found out they’d only offered it to me because they believed I wouldn’t attend, and then pulled the offer just days before I was due to start.

That’s my experience with the public mental health system in Brisbane with group therapy.

My experience with the private system has been as a professional not a consumer – or more precisely as a student.  I did my student mental health placement in a private hospital in 2007 and since we couldn’t do very much as students, we attended all the groups to get an idea of what they were like.  The two I remember were an AA (alcoholics anonymous) meeting which I found fascinating – I’ve never had an alcohol or substance problem, in fact I rarely drink and hate drugs, but it was good to get an understanding of people who do have an alcohol or drug problem,  and the other group I remember was actually an anxiety group.  I remember it quite well because they let us students join in.  We did several anxiety tests as well as activities which I found quite useful – the only downside is I was scoring as more anxious and depressed than most of the patients which was a worry at the time.

The same hospital also ran day therapy groups for outpatients.  I very much liked how that hospital did their groups.  I found the groups that focused on exploring the person’s mind were more useful than simple educational groups or relaxation groups.

I was also part of a community anxiety group, but sadly and ironically, about a month after I joined, it shut down because everyone was genuinely to anxious to attend in person.

Last year when I worked in the public system where I live now, I had nothing to do with the groups as they are run by the psychologists so I have no idea what the groups did.  But I do know some people said they were really beneficial.  I was just impressed by a public hospital that a fully functioning, therapeutic group program.

And in the private hospital I was in this year, the inpatient program was much like the outpatient group – focused on education about different mental illnesses and therapies.  As well as daily relaxation and walks. With a few social things like cooking/craft thrown in as well as visits from a therapy dog.  The most useful I thing found was a visit from an outside organisation that went through the various non government organisation supports that were available. To be honest I think I would have benefited more from groups that more therapeutic and less educational but that’s just me.

And now, I’m on the waiting list for several groups.  I’m on waiting lists for several DBT groups as Dr A thinks DBT will help with my PTSD.  I’m not so sure.  The majority of people in DBT groups have BPD and I find most people with BPD to be a trigger for my PTSD due to my exhusband’s abuse of me.  Plus the research shows that people with PTSD actually tend to get worse in groups with BPD sufferers, mainly because of the hyperarousal of PTSD not going well with the hyperemotionality of most people with BPD doing the groups.  But I said I’d give it a try.

The real problem being now is the group I was thinking of is $5000 (about $3500 after rebates) which we just can’t afford.  The group I really wanted to do, a DBT group for people with anxiety and depression that specifically screened out BPD sufferers, I only found out about a week after it had started.  They said they’ll contact me if the group runs again, but it was only a research trial and highly unlikely they will.  Then there is another I’ve had my name on the wait list for quite some time that said they were no longer running the group, but I found out a few days ago that they started the group again and had places and didn’t bother contacting the people on their old waiting list and it started a few days earlier so I missed out again.  Then there is one last group run by the public system that I was told I would be on the waiting list for, but then my case manager told me when I saw him last that there isn’t actually even a waiting list yet because they are still sorting out whether or not the group is even going ahead.  No one had even handed over to him that I was interested in the group.

So in the meantime I’m down on the wait list for a public system anxiety group and hopefully it will help more than the private one I’ve been doing.

I just remembered one thing I forgot – I have kind of being doing group therapy for the last 4 months.  I forgot that I attend a group for mums with PND that is basically a therapy group.  I have actually found it immensely helpful.  Not so much the education session for half an hour at the end, but the talk session at the beginning where we share with each other and the psychologist gives us input on what we share.

Sorry if this post sounds rushed tonight – it is.  I have little Rose curled up in my lap asleep and it’s very hard to type with a sleeping baby in one’s lap. I’ve left out half the things I wanted to share on this topic, I’m sure, but I guess I can always add more at a later date.

How have your experiences with group therapy been?