28 January 2011

Another day, another appointment

The VA Hospital here is a quiet place late on Friday afternoon.  Or at least, as quiet as it ever gets during daylight hours. As I discovered when I called to let the mental health clinic know I'd be a few minutes late, the computer system that holds appointments was down.  (I haven't heard "the system is down" in quite a while, anywhere.  Usually it's "the xyz server is down").  If today was a few years ago, I'd be highly agitated, upset, and overall pissed off.  Today wasn't such a big deal, though-- my new social worker was at the check in desk waiting for me. 

The appointment went well; he'd already reviewed my records, knew what medications I'm on and what therapy I'd already had.   We went over the self assessment I'd filled out when I arrived (get used to filling those out), and discussed PTSD a bit, along with some of the trust issues I have regarding relationships with other people.  We also talked about mindfulness, learning how to deal with things in the present instead of letting your brain do things on automatic.  I've heard about mindfulness before, and even tried working with it a little.  My opinion:  I had to get farther along the path to find a place where being mindful is realistic.  I think that when you're ass deep in a bucket of your life falling apart, you need to work on getting the basics covered (food, clothing, shelter), getting your life settled down a bit (in my case, divorce, bankruptcy, and moving to a different city), and then moving forward from there.  It makes sense for me now, where it didn't make sense earlier (ie, before I got into cognitive based therapy, medication, and then a lot of me working on things on my own).

Standard disclaimer:  I'm not a doctor, social worker, or counselor of any sort.  Everyone's different.  Your mileage may vary.
I haven't read much about mindfulness.  I've heard a little bit about it.  I learned a little more today, and I'm sure that in the near future, I'll have more to say about it.

There's something else I noticed about my appointment today; well, two things.  When we were talking about what kinds of therapy I'd be working on (mindfulness, as well as more cognitive based therapy), my social worker made it a point to mention that these are overall productive forms of therapy.  I heard the same thing about all of the medications I'm on from my psychiatrist.  My social worker (and my psychiatrist, when first discussing medication) also asked me if this therapy sounded like a good idea to me.  

I've heard vets both online and off talk about medications or various kinds of therapy being pushed on them-- that's never happened to me.  Whatever provider I'm seeing has always explained what they have in mind (and why), and given me the option to go ahead (or not).  You can always ask why, or for additional information, or just say "no, I don't feel comfortable with that."  I suppose it seems that you're being steamrolled; when you walk in and tell your story, the folks at the VA are pretty quick to suggest something, be it medication or therapy or both.  As someone once explained, the VA has a lot of experience dealing with vets having problems.  They're getting better at it all the time.  It's not a perfect system (ie, the computer system was down), but you and I are not the first vet they've ever seen.

They know what works.

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