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I like to tell people I have frequent flyer miles at the psych ward...

Trigger warnings: inpatient stays, trauma, self-harm, suicidal ideation, sexual assault, substance abuse, depression.

Story by Sam #2 from the Harmonic System reproduced by DID we write with (non-exclusive) permission.

I like to tell people I have frequent flyer miles at the psych ward. My first trip was back-to-back -- well, maybe it wasn't really "my" trip, but we'll come back to that. I was inpatient at a facility in my hometown, then had a brief layover in a partial hospitalization program before a second inpatient stay in a nearby city.

That wasn't part of the plan, the second stay. In fact, not much of it went according to plan. I knew what I was getting into, admitting to hurting myself, admitting to wanting to die. I knew I'd go somewhere. But I didn't go to the hospital I'd heard about from a friend, the one with the swimming pool -- no, I went to a different one, though it was probably just about as good, or as bad.

Honestly, I didn't think it was that bad. It was just like being around my mother, always being watched, always being corrected. In fact, the staff at the hospital were in many ways more permissive than my mother and more interested in me expressing what I actually thought and felt. That was kind of new, I guess.

Let me back up. I was 16. I think? It can be hard to remember how old the body was at different times. We had just decided to develop worse coping mechanisms that year at school, and then lost control. Okay, okay, that doesn't sound very logical, let me explain: we had self-destructive coping mechanisms before, but they just weren't very effective; however, they were significantly less dangerous. But after hanging out with the other kids struggling with depression and suicidal ideations, we picked up some new tricks; our self-injury graduated to cutting, and our fight with self-denial graduated to an eating disorder. Under it all, the same self-hatred.

But back to being inpatient. Okay, so, yeah. The first time. I didn't fight the rules, the medicines (other than to ask to be switched when the first antidepressant caused digestive problems), or how much my life was suddenly taken away from me. I didn't need to. I didn't want to be there to fight. I did get frustrated, sometimes. My autonomy wasn't respected. Any sense of privacy I did want wasn't respected, and there were a few times where I really did want to have some privacy and autonomy, because when I was back at home I had limitations on my privacy and autonomy already, limits which were the product of a weird emotional enmeshment with my mother, and if I was more self-aware then, I might have realized I needed to work through some of that.

I didn't get a choice in anything there. But, luckily, I had become muted and empty inside, not caring if I had a choice. If I was going to die anyway, what did it matter? But, honestly, that first stay was pretty good. When I say I didn't get a choice, I mean that I was expected to take meds, eat food, participate in groups, see my doctor, and sleep at the designated times. I did get to choose ways of expressing myself that weren't tightly controlled by shame, though I didn't get very far exploring that, because by that point most of the shame I experienced was coming from within.

The second stay, right after that, wasn't as good. I had been discharged from the first place into some sort of outpatient program. But, let me back up. One of the contributing factors towards my spiral downwards that led to the first stay was a break-up, after a betrayal, followed by social conflicts with my peers, and the normal stress of fighting for boundaries and a sense of self with your parents (with a father who would catastrophize for an hour every time you did something wrong, and a mother who tried to manipulate your behavior and emotions in subtle ways almost constantly). So that break-up, the girl that I'd broken up with, she went inpatient in that facility when we were on the second day of outpatient. The brief bit of stability we had seemed to be suddenly fragile, not something we could hold onto.

Stability? Maybe that was an overstatement. Mostly we just followed all the rules and did all the things so that we could get out. Fuck, we even cut while we were in there. Careless fucking clothes inspectors let a safety pin slip through in clothes our parents brought. The mother unknowingly brought a sharp in, haha, and we secretly cut in the bathroom in our little room. Nobody fucking knew. We got away with it. That's stable?

Sorry for the interruption, that was someone angrier. I don't know who. They won't give a name. Let's call them... Angry Bob. So when that glimmer of maybe-stability was snuffed out, we decided we needed to go back in. Were we trying to follow the girl back into those depressing rooms? Or did the outside world, with its possibilities of unpredictable interactions with strangers and heartbreakers and a thousand expectations all the time, become too much again? At any rate, there were no beds now, so we had to go elsewhere. A facility was found, and our parents wanted to take us, but we begged to go in the ambulance.

We didn't want to be around them. We didn't trust them. They made us angry. They looked forlorn and acted sorry and confused and made all of our agony about them, made it all about what they were supposed to do. Fuck what you're supposed to do, I don't care, I am trying to figure out whether I want to really die or not?

Yeah, you guessed it, another little interruption there. We eventually relented, maybe, I don't remember. But we ended up in facility that was much scarier. It wasn't just depressed and anxious kids from our age, it was a variety of kids from a wide age range, some of whom were there because they didn't have anyone to take care of them, some of whom were there because they were facing serious legal trouble and had threatened suicide or self-harm. I'm not trying to imply that their threats were empty; I'm just saying that from the perspective of a kid who hadn't ever been in legal trouble, being around other kids who were made things seem suddenly more terrifying.

There was one counselor who listened to us there, as compared with several counselors at the first place. The doctor at the new place didn't really seem to care. There weren't really activities or group therapy; you mostly just spent your time sitting there waiting for the next meal, except for the visit to the gym a few nights a week. The ward staff raised their voices for no reason a lot, asked very weird and probing questions about our sex life, made a lot of awkward assumptions about us that I don't care to remember, and just generally were kind of mean. Since nobody was helping us much with our problems there, the one nice counselor suggested we start writing. We wrote a lot, in all caps, so much that we started modifying how we wrote letters to save pencil strokes so our hand would cramp less. The only other thing to do besides write was read; our dad brought us the Lord of the Rings trilogy and we read through most of it during our stay.

Most of the writings were just fears and anger, fears and anger we were always told we shouldn't express because it was impolite, or improper, or inappropriate, or awkward and made other people uncomfortable, or was embarrassing, to her. To the mother.

Hey, sorry, we're getting blurry. Kind of trading off who's writing.

We eventually left that place, grateful to be home. Grateful at least to be around our dad, who seemed to be a little more gentle and less accusatory about things. He's never been a mean person, but he can take things a little far and make you feel pretty bad about stuff; that got better then, at least for a while.

We were back inside four years later. Instead of an interruption to our second years of high school like before, now it was an interruption to our second year of college. The year we decided, someone decided, that it would be better to destroy ourself and stop trying to feel things or fix things. We had decided we were going to do lots and lots of drugs that year, to get back at a girl who didn't understand us, a girl who manipulated us by threatening to kill herself if we left her, a girl who violated our consent the first time we had penetrative sex, a girl who would go out of her way to humiliate us in front of friends, a girl who pulled us away from our own social circle and support system. Mostly we were mad that she left us, but we were mad about a lot of other things, too, so that's why we did it, why we started destroying ourself. Because fuck what other people think or want or care or say. It doesn't matter. Fuck them. We were going to fry our brain until we stopped being so sensitive, until the world stopped being so fucking confusing, until people stopped making so little sense to us.

Oh, let me back up. We're autistic. We've had some weird sensory problems, a lot of social problems, and a lot of emotional regulation issues, all our life. Our first psych assessments were when we started school, our first regular therapist was probably when we were in 2nd or 3rd grade? It's hard to remember, time is fucked.

But we went into denial. Who wants to believe that they are different? We didn't need the reminder of how alien we felt. So whoever was around at the time became adamant that we'd outgrown autism. They didn't understand that we'd merely learn to mask on the outside and hide our suffering on the inside. Heck, people actually thought we were cool in high school! At least for a little while.

Okay, back to inpatient stay number three (which was in the adult wing of the same building as stay number one). We got there after shit collapsed sophomore year of college. I don't even know how we ended up there, exactly. But we'd had to get stitches for a cut we made a few months before, and there were other incidents. We ended up in their dual diagnosis problem for mental illness with substance abuse. Funny, though, our parents hadn't picked up on the substance abuse, not until one time our mom called when we were high and thought we were having a bad reaction to a psych med, so she called an ambulance; we had to explain our behavior then. But I don't know exactly when that happened. I think the concerns about psych med side effects may have been from getting put on new ones for bipolar II when we were hospitalized?

Oh. So I guess we can talk about diagnoses. Childhood, attention-deficit disorder, but my mom didn't like that and found another doctor who said high-functioning autism. We have both ADHD and autism. And high-functioning is a misnomer: we have some talents in some areas, good masking in other areas, and then deficits in yet other areas; basically, we can mostly hide our autism if we have to, at least in some settings. Our first hospitalization netted us a major depression diagnosis. Our third hospitalization four years later netted us bipolar disorder and polysubstance abuse. Later on, we also picked up ED-NOS for our inconsistent assortment of binging, restricting, and purging. Later in our 20s we landed an anxiety diagnosis, following that third hospitalization.

I don't remember a whole lot about that third hospitalization. And many things after are a blur, thanks to substance abuse and some degree of trauma during our mid-to-late 20s.

Eight years later, we went into a rehab facility, but didn't stay sober. A few months later, we went into an inpatient psych ward again. Same place as the first and third inpatient psych visits! Now do you see what I mean about frequent flyer mileage? I don't remember a lot then, other than people thought we were gay because we were wanting to transition.

Oh, yeah, the body transitioned to female, but not until some years after that. A different person would maybe tell that story, a different time. But we didn't transition then. We'd tried to start a few years prior, but couldn't obtain the resources or support and stopped. So this period of our life was a mix of different genders in different places, which would continue for some time. Records from this period are always interesting to look at, because some people were kind enough to use she/her when we asked them to, while others insisted they could not use our pronouns for whatever reason. (Our collective pronouns now, by the way, are they/them. But hardly anyone seemed to be ready to admit to being part of a system then, though we had looked up dissociative disorders a few times and recognized that we had plenty of symptoms.)

From that inpatient stay, we went to another rehab. This second rehab was a couple hours away, farther than the first rehab which was only about forty minutes from home, or at least what we called home then. But I'm not telling our recovery story today -- that's a story for another time, and which maybe another person (or several) need to tell. Suffice to say, we spent some time in a halfway house and did better after the second rehab, but it didn't last. Even having had acute pancreatitis multiple times (bad enough to be in the medical hospital for it twice) due to excessive alcohol intake hadn't stopped us; the trick there was to chase it with enough pain pills, right?

Okay, so, about two and a half years later, we'd followed a pretty treacherous relationship a thousand miles away, after our family had moved over a thousand miles in a different direction. We went on a drinking binge and were about ready to give up, being somewhere unfamiliar, with only a toxic relationship there and no friends, and our family being somewhere far away. At this point it didn't matter if we lived or died. An ambulance was called when the people we were staying with thought we'd passed out; we hadn't, but faked it to get away from that relationship. We detoxed and landed in a psych ward, where we stayed for a while awaiting rehab.

Oh, by the way, our average inpatient stay seems to be about ten days. Sometimes it's been slightly shorter. This time I think it was more like two and a half weeks, waiting for a bed in a rehab. What I remember about this facility was that it was like one giant hallway, with a bunch of rooms off to the side. We were housed with a male again, because we weren't yet on hormones and our records still had a male name and male gender marker. Staying in a care facility in the room of the wrong gender is an unfortunate experience; we were fortunate that staff usually looked out for us, intervening enough to prevent anyone too dangerous from becoming our roommate. But it wasn't comfortable, ever; in fact, it was sometimes incredibly humiliating (many rehabs have gender-specific group therapy, and we have heard our fair share of misogynistic commentary from guys in those settings).

There weren't a whole lot of group therapy sessions at this facility. We spent a lot of time doing sudoku, crosswords, coloring, mandala / finger labyrinth designs you trace as a form of meditation, and socializing. I don't think we had a whole lot of books available to us. Gosh, we colored so much. I think some of the littles inside were near front sometimes, but it's so hard to piece together exactly what was happening.

We spend so much of our time in different blended states, or with different selves passive influence front. When we let our guard down, there are noticeable changes to front. And our memory gaps are so bad that our wife thought we were going to forget our own wedding. We got a DID diagnosis from all of that, though that was a long process of self-discovery and self-evaluation followed by a lot of phone calls and emails to try to find a DID specialist who actually took our insurance, was taking new clients, and was familiar with autism and trans issues. The therapist we found that way confirmed the DID diagnosis we suspected, well, some of us suspected; others in here are still denying it, and still believing that we're one person, months after the diagnosis was confirmed.

But anyway. We have a lot of shared access to most life history, luckily, but a lot of it feels far away and vaguely emotionless. So I don't know who actually owns those memories. Maybe we'll get it sorted out one day; right now, a lot of us have been reluctant to choose names or even be known by the regular fronters. But again, that's another story we'll tell another time. Oh, and, the person who's writing now isn't exactly the same person who

started, but isn't an entirely different person... it's hard to explain.

We finally left that inpatient facility for another rehab, and went into some group housing for a while before ending up staying with an acquaintance from a 12-step recovery group. It didn't end well; she had some misconceptions about trans people, plus she made some accusations towards us that damaged our support system in the local recovery scene, claiming we were getting high in her house.

But, fast forward a number of years, and things are much improved. We're married and have stable housing. We are in regular contact with our father again, and talk to our mother sometimes, though not everyone inside is happy about that. We keep supportive people around instead of letting abusive and manipulative ones control us. We have stable income and a decent job, albeit a high-stress one.

But we still wonder sometimes, a lot, in fact, about whether we need to go back there, to go back inside again. Would it be less awkward now that we have our gender marker changed? Or would it be even more awkward because we haven't had bottom surgery? Hard to say who they'd stick us with for a roommate. We struggle with suicidal feelings a lot. There are self destructive headmates who are tempted to launch back into heavy substance abuse. There are some headmates who will grab enough control to make some scratches on the skin before someone else is able to intervene. I don't know if we're going to be able to stay on the outside for the rest of our life. I suspect we won't.

It feels like we are a ticking time bomb, waiting for our next hospitalization. Maybe that's just a feeling... but is it a feeling which will ever go away?


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