Inpatient

Today was a fairly typical day in my life. I spent some time on a couple of the underwhelming and frankly pathetic part-time gig/“job”-type things I have cobbled together.

I met with my therapist. (We meet 3x/week.)

I could not quite get myself to do things to improve my financial situation, my sense of self/value, or my mental well being.

I texted with my brother and spoke on the phone with my mom, in both cases repeating conversations we have had before. I don’t want them to worry about me, but I say enough to let them know all is not well without trying to elicit either sympathy or inordinate concern.

In short, my life is far too much like it was before I went to treatment. After all the time and money spent, this reality is horrifying.

But let’s review how I got to where I am today.

Though I first consulted a therapist briefly at 21 and again at 25, there was no sense that I had mental health problems until the breakup of my first marriage at 26. More about that another day. But for the first third of my life, I was recognized by everyone as a smart, good, and promising young man who was well-mannered, empathetic, and possessing good social skills.

Looking back, much was amiss, largely in the areas of sexuality, secrecy, and what would later be described to me as “emotional misattunements in early childhood.”

The breakup of my (first) marriage was shocking, dramatic, and traumatic, chiefly for my wife who has largely been lost and absent in my and my family’s processing of all my destruction. I withdrew from my vocation and social world in shame, and for a time did not wish to be perceived.

But even after addressing my divorce (largely through the lens of sex addiction) in therapy, I set back out into life again with a job, a beautiful new girlfriend who was the polar opposite of my ex-wife, and a desperate need for redemption which I disguised as the normal ambitions of an achiever-attainer meritocrat who had been sidelined for a season but was back.

Almost immediately, however, it became clear that none of my issues had been resolved or even worked through. I still kept secrets, broke promises, and acted out sexually in deceptive, and harmful ways. That I had moved with my girlfriend to begin a PhD program in a new city only served to paper over the issues would ultimately destroy my life again and cause even more widespread harm and devastation.

The relationship continued in spite of me continually getting caught in lies. My sexual behavior was once again out of control.

I started therapy again and, for the first time, antidepressants. I tried Celexa, Prozac, Strattera, Wellbutrin, and Effexor. Some for a long time, others for shorter periods. Nothing worked. I could not notice any effect from any of the drugs.

Instead of breaking up, we soldiered on even though she rightly stopped trusting or respecting me. We got married. Started a family. Forged ahead with our careers, in fits and starts. But eventually it all blew up again. I timed out of the PhD program, leaving with a consolation-prize Master of Arts degree after 8.5 years. While I found some work as an adjunct instructor and freelance writer, I failed to deliver on my promise both before and after getting kicked out of grad school to get a full-time job. We barely survived financially, after my wife resigned her job while pregnant with our third child. As she stayed home with the kids, I struggled more and more to cover our expenses.

At one point, I managed to get a few consulting contracts. But the work was never steady or gainful enough. I continually convinced myself that I was on the verge of succeeding, but I was not. My life was a slow-motion train wreck, this time with three innocent children.

As before, the marriage ended because I got caught. Maybe it was inevitable, maybe I hastened it because I subconsciously wanted to get caught. In any case, my behavior and the secrecy surrounding it were substituting for things I felt or wished to say but did not or could not. The path I was on — that we were on — was unsustainable. But again it ended in dramatic and devastating fashion.

I did not move out for three months, largely because I could not afford to and my wife needed the child-care help. It felt a lot like the last 3-5 years had felt. While we still cared for each other based on shared history, the relationship had ended long years before. Perhaps we were both relieved. Even now, it’s hard to say.

Eventually I moved into a room in a shared apartment. The children never stayed there with me. I just visited them at our family home every few days. My work had dried up. I soothed my shattered sense of self with a few new sexual adventures finally free of the burdens of a monogamous relationship and the secrecy and shame that had always accompanied my selfish and destructive liaisons. But I was nearing the end of being able to function and survive financially. My physical health was the worst it has ever been.

This was when my parents got connected with a treatment consultant. Earlier that year, following an uncharacteristic moment in which I unloaded to my mom via text message about the depths of my unhappiness, my parents had become very concerned. They could already see, of course, that I was miserable, my marriage was terribly unhappy, and my financial independence was hanging by a thread.

They urged me to investigate psychiatric treatment options in my city, which I did out of perfunctory obedience with no real intention of following through. The psych unit of a very nearby teaching hospital was only for psychotic patients and recent suicide attempts. An older psychiatric hospital had inpatient and outpatient programs, but both seemed like overkill. I did an IOP offered through my insurance company. But nothing was helping.

The treatment consultant named a few of the more prominent sex addiction facilities. But he also suggested a hospital in another part of the country that offered a two week outpatient “therapeutic assessment,” in which a team of highly regarded clinicians observed me in individual and group therapy and formulated a rigorous psychological and psychiatric evaluation.

At the time I consented to this two-week process, I was nominally looking for consulting gigs and jobs while driving for a ride-share service. Everything about my life, looking back, was pointing toward definitive failure, if not rock-bottom.

My life needed a pause button. My parents needed to believe I was sick, not bad. I needed a wake-up call. My wife was now a jobless single mom. I had no money. I do not know what would have happened if my parents had not intervened and generously offered to support my treatment.

But I was on the verge of entering a world I never knew existed: the world of elite mental-health treatment, the world of diagnoses and disorders, the world of the inpatient.