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28 April 2017

Still on my own

I still had an appointment scheduled with a social worker in Lawrenceville this afternoon. At my family's urging, I went (note the emphasis, I'm completely ready to just say fuck it).

But wait-- there's more. There's always more.

This morning, I got a call from a psychologist from the intensive outpatient recovery program (IORP). This is apparently who I was referred to from the trauma recovery program (TRP), who I saw last week. IORP is a six-week program that meets four times a week for about half a day each session; it's a group oriented thing. It sounded very much like the Transitions program I did in Madison WI in 2012, exactly five years ago through Resilience and Recovery.

The next group, or sequence, or whatever it's called doesn't start until June-- this I expected, you usually can't jump into a group that's started, you have to wait until the first session comes up again. It really doesn't matter, though, because I said no.

My first reason is the same as the reason I didn't go to walk in at trauma recovery in the first place. The clinic is 55 miles from the house. On a very good day, it's a little over an hour to get there. Considering that I-85 (which I'd take to get there) is effed up, and considering normal Atlanta Traffic, it's a trip that really requires planning on two hours driving (and/or sitting) time each way. So let's do some math here: four trips a week, two hours each way, that's eight hours a week just for travel time. It's 110 miles round trip, assuming Google Maps doesn't need to get creative, so 440 miles driving per week. Depending on the price of gas, and my truck's gas mileage, that's about $55-$60/week for six weeks just to get back and forth, or $360 for the entire six weeks. This math would work fine if I was doing this to get to and from work, where I'd get paid, but it's my money and gas I'm spending. 

My second reason is that this isn't what I fucking asked for.

I've been very clear throughout all of this that I want to do Cognitive Processing Therapy (CPT), but this time around (I've done the entire 12-week program before, but focused on childhood sexual abuse) I want to focus on the Persian Gulf War. I've made my peace with everything that happened when I was a kid-- now it's time to make peace with the Desert. In looking over my notes and blog posts over the years since then, a lot of the problems I've encountered with PTSD haven't really been addressed all that well (certainly not enough). I still use my notes and worksheets from that first time, but this really isn't something I can do alone. Accountability from a mental health care professional really makes a difference.

So I explained all of this to the psychologist who called, and she completely saw my points and agreed. Kthxbye.

Now we can talk about the social worker at the Lawrenceville clinic. I got there about 20 minutes early, traffic somehow being pretty light. Checked in at the kiosk, indicated that I was completely dissatisfied with the time it took to get the appointment, and sat down. There is of course a TV on the wall with the volume turned up loud enough that foam earplugs like the kind you'd wear in a factory can't block out the noise.

My appointment is at 1330. 1330 passes. At 1345 I go to Front Desk, wait there several minutes while person cleans the lid to her coffee cup (priorities, right?), and then explain that it's fifteen minutes past my appointment time. Now, it's Friday afternoon-- there were plenty of spaces in the parking lot, and only a couple of other veterans in the waiting room, which are indicators that this isn't the busiest time for this clinic. After talking to Front Desk, I wait another few minutes before SW shows up.

Three times I've been to the CBOC in Lawrenceville GA for scheduled appointments. Three times I've had to let someone know that I'm fifteen minutes past my appointment time.

SW asks what kinds of problems having. She doesn't have access (?!) to my records on the computer. I explain, list all of the symptoms I've been dealing with. I explain what's happened with trauma recovery. I state as clearly as possible that I want Cognitive Processing Therapy, and then I list each of the people (including her) that I've told that I want Cognitive Processing Therapy.

It turns out that the person from trauma recovery that does cognitive processing therapy at the Lawrenceville clinic happens to physically be in the clinic today. Well, shit. Yes, go talk to that person and tell them what's going on. After that happens a couple of times, I'm being put in the queue for CPT, which may take a month or so to actually get scheduled for. Another month. 

Turns out that whoever this guy-who-does-CPT is, he knows my name and my situation. He must have been in on the meeting last Friday when patients were talked about. So at that meeting, even though I have specifically asked several times, including at my appointment with the staff psychologist at trauma recovery who was also at that same meeting, no one was doing anything to get me into CPT.

I make it very clear that no, I don't want to wait another month or so, I've been waiting for four months now, but fine put my name on the list. It's as close to therapy as I've been through this entire process.

Had I been referred to the this specific person, or at least someone that does cognitive processing therapy, back in February when I first visited primary care I might be two thirds of the way through the therapy right now. Instead I've been passed from one person and place to another, each one acknowledging the problem, each one "doing their job", yet not doing anything to help.

So I'm on my own, still. Me and my demons.


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Let's review, for those of you who are keeping score at home, the number of mental health professionals employed by the VA that I've talked to so far without getting into PTSD therapy.

Social workers: 5
Medical doctors: 1
Psychiatrists: 1
Psychologists: 3

This doesn't count any of the other VA staff that have looked at my case in reviews or meetings, or other appointments.

I haven't called the Veterans Crisis Line, because everyone they'd possibly refer me to, I've already either visited or talked to directly.


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