Last month, I drove my husband to the hospital emergency department.
It was a difficult decision. I wrestled with it for several days. It was hard because first of all, I didn't know if the hospital would take our situation seriously (he wasn't actively suicidal). Secondly, I didn't know if the attending physicians and nurses would understand anything about his condition. Thirdly, I didn't know if anyone would pay attention to the exhaustion of our entire family. But I needed to try. He was in crisis and I was heading for one too.
So I decided to take him.
We were fortunate. Our experience was better than many I've read or heard about. The outcome was a referral made for another assessment and another medication prescribed to help with his sleep. I was glad we had gone.
This post isn't about the quality of emergency or crisis care wherever you are reading from. It's about the reality that crisis care is frequently a part of complex PTSD care. We need to be able to talk about it, use it when necessary, and perhaps advocate for improvements within the medical and mental health systems to accommodate this reality.
The reality is the use of emergency or crisis care services is frequently a part of complex PTSD care.
What can lead to a crisis with C-PTSD?
Here are a few of the areas we have experienced that led to crises:
Loss of awareness of surroundings, time, present life.
Helplessness and related hopelessness.
Unexpected contact with triggering individuals.
Inability to self-regulate in a certain situation.
Trauma cycles not adequately recognized or addressed in therapy.
Crisis care does not always mean a visit to the emergency department. Other options for crisis support are:
1. Crisis lines.
Phone support can help de-escalate overwhelm. This option may be of value to partners who need to call for themselves or their children.
2. Crisis text services.
These services are growing in popularity and can provide calming contact.
3. Safe beds.
In Canada, this alternative is presented as an alternative to in-patient care. Unfortunately, limited space in these facilities may make this option difficult to access. In some cases, men and those from the LGBTQ community may have greater difficulty accessing a safe bed as there may be fewer beds allotted to these populations. As well, staff may not have adequate training if the survivor switches between child parts.4. In person visits from a crisis team.
These visits may be offered as part of a call to a local crisis line.
The Role of Partners
Partners can play a helpful role in accessing crisis services. However, that doesn't mean it's easy.
Here are a few issues partners may face:
Sometimes, a survivor may not want to utilize crisis care even though it is warranted. Partners may then need to access these services for themselves and their children. As I write about so often, it's important to take care of you.
Partners may also struggle with the stigma of mental health even when it's the mental health of our partner. The words 'psychiatric unit,' 'seeing a psychiatrist,' or 'taking medications' still carry negative implications. Supportive friends and community like the Facebook group Partners to Survivors with Complex PTSD can buffer these cultural assumptions.
Even once contact is made with the crisis service, there is no guarantee of the outcome and that's scary. Furthermore, although C-PTSD is gaining small awareness and knowledge within psychiatry, the complications of dissociation are not well understood by medical and mental health professionals. It's important for you to know that if your experience with crisis care is negative, it's not your fault. Please know this doesn't mean it won't work the next time.
No one wants to be in a crisis, but if your loved one with C-PTSD reaches that point, crisis care may be the best option. We need to acknowledge it and use it when needed.