Stack Valediction
Note: Stack Behavioral Health is a name I made up, not the actual name of the IOP I attended. The names of the four staff members at “Stack” have also been changed. Additionally, each “group member” arbitrarily referenced is a real person whom I addressed with their real name when I read this piece out loud on my last day of IOP.
When I first started at Stack Behavioral Health, my goal was to get out of here as quickly as possible. I was in denial that I needed a higher level of care, I was angry at myself for letting my suicidal ideation escalate so much in the fall, and I was resentful of all the people who forced me into treatment I didn’t want. I came in expecting to have a bad experience and wanting to prove to everyone I didn’t need the help.
During one of our individuals a while ago, I told Daphne, my individual therapist, “Unfortunately, I like you a lot more than I was hoping to.” That’s basically how I feel about everything and everyone at Stack although now I would call it fortunate.
I’m not entirely sure when my perspective shifted because it was rather gradual but I do think the week of February 25th was a turning point. In Sociometry that Monday Daphne asked us, what is something we need to say, either to ourselves or someone else. I don’t remember what I said in group but that night I messaged Daphne a revised answer, which was that I needed to admit to myself I might have an eating disorder. I explained how I had been hiding behind the physiological discomfort I got while eating and while that was true to some extent, it wasn’t the full truth. Later that week, I had a joint session with Daphne and Harriet and that was the first time I said out loud that I did need IOP and I was in the right place.
I won’t discredit the time I spent resentful of treatment because I needed to come to terms with still being unwell on my own timeline, but it was after that week that the work truly began.
Honestly, I don’t want to leave Stack yet. The most efficient way to work on the many things I still struggle with would be to remain in a higher level of care, surrounded by people I’ve already built a rapport with. But Stack over the summer just wasn’t in the cards for me. Even though the outcome wasn’t what I wanted, I am proud of the way I stayed true to my feelings when talking to my parents and didn’t take on their emotionality as my responsibility.
I’m not sure what this summer has in store for me and I’m quite fearful of what a life without Stack will look like. The IOP routine has become my normal; it’s almost second nature at this point. I wish I had had the opportunity to step down to three days at Stack and then transition to weekly outpatient without the concurrent transition of going back home but that was out of my control. What I can do, though, is focus on what is still in my control. That means continuing to communicate authentically regardless of the reaction, being extremely intentional about fueling my body, getting out of the house everyday, ensuring I have routine social interaction, and using all the skills I’ve learned over the last five years of various treatment. I do feel confident that I have sufficient tools to manage my distress enough to prevent crisis and if a crisis does arise I know I will be able to communicate my needs to stay safe.
I have gained so much from my time at Stack, it’s difficult to adequately verbalize. I have learned to extend the compassion and empathy I provide others to myself. I have learned how to ask for help when I need it and I’m starting to learn to recognize when I actually don’t need help and can handle something on my own. I have learned to see common humanity even in those I disagree with (and I disagree with a lot of people). I have learned to recognize distress bubbling up and catch myself when my SUDs level is under six rather than always feeling like my crises come out of nowhere. I have learned to separate my own academic expectations from my parents’ and in turn been able to enjoy the education I’m so privileged to have way more. I have learned to emotionally attenuate to many unpleasant emotions including anger, sadness, and fear.
All of this growth would not have been possible without the unwavering support of all the Stack staff and my fellow group members, so I wanted to take a second to express my appreciation to each of you.
To a group member: You are one of the coolest people I’ve ever met. To be pursuing a PhD, to be able to make your own clothes and then style them impeccably, to have such deep knowledge about the things you’re interested in, etc. You’re just SO cool. Thank you for making me feel safe and valued almost immediately. I wish we had had more time to get to know each other but I will remain in touch and I hope to hang out more next school year.
To a group member: You are an odd one and I fucking love you for it. You are authentic, kind, and hilarious, all traits I find myself being pulled to. Thank you for all the compassion you have shown me. Said compassion is often nonverbal, expressed through an empathetic facial expression but that doesn’t mean I didn’t notice and appreciate it every single time. I’m going to miss you but will continue to check your Vimeo periodically to keep track of your artistry. I am so excited for your future.
To a group member: Your drive and passion is unbelievable. I am inspired by your dedication to yourself and your wellbeing every day because of the infectiously positive energy you bring into group. We are quite different people which I have found hard to navigate at times but I am so appreciative of how much personal growth our friendship has yielded. I’m going to miss your bright smile and your openness to constant learning. I will definitely let you know if I’m ever in Hungary.
To a group member: My fellow freshman! We both have a long way to go and I’m grateful we got access to this type of support system relatively early. You are so kind and caring and I hope you start to open yourself up to receiving that back from people in your personal life. You deserve it and it is not weak to be vulnerable about what you’re going through. Maybe you’ll get some more hugs then too!
To two group members: I haven’t spent much group time with you both but I really wish I had. I hope over the next few months, as you start to open up and feel more comfortable here, you’ll reap the benefit even half as much as I have.
To a group member: I admire your strength so much. Life has punched you down countless times and you’re still here, alive and trying to build a life worth living. Your resilience and work ethic will get you so far. I haven’t gotten the chance to get to know you as much as I’d hoped, but maybe we can hang out once I’m back in LA in the fall.
To a group member: I have so much respect for you and the courage you have to be yourself. Whether it’s being forthcoming about your non-binary identity, taking your time before speaking, or randomly meowing, you are unashamedly you. Thank you for encouraging the same confidence in others by always being down for whatever and showing up for people. I know you’re someone I can count on and I appreciate that a lot. I can’t wait to see the impact you make with both your art and environmental engineering career.
To a group member: I really appreciate the healthy skepticism you bring to groups and the world. Challenging the status quo is something I wish more people did, so I have an especially soft corner for you. I wish we had gotten the chance to talk more because I’ve really enjoyed the conversations we have had. Looking forward to hopefully hanging out in the future.
To a group member: When people say ‘you are a mosaic of all you have ever loved,’ they’re right because I’ve started replying “bars” and nothing else when my friends say something that resonates. Thank you for bringing a casual and fun energy to groups. Things can get tense here and having comedic relief is so nice. Can’t wait to go on a run with you once I am cleared to exercise.
To a group member: You are the right mix of serious and unserious that makes me feel comfortable sharing anything with you. I know you aren’t going to bullshit me, I know you’re going to crack a joke if the situation calls for it, and I know you’re going to meet me with empathy when I need that. I really admire the dedication you have to positively impacting the world and supporting South Asian women. It means a lot to me. I’m going to miss you but I will definitely stay in touch and reach out for advice for the rest of college.
To a group member: You have such a heartwarming energy that makes me perk up each time we meet. I see so much bravery in you, even in something as simple as asking for clarification when you don’t understand. That shows both a deep respect for others that you truly want to get what they’re saying and a deep respect for yourself as you acknowledge that you deserve to understand. I’m going to miss your smile and curious questions so much.
To a group member: I am so proud of you. The way you’ve persevered through such painful times is admirable. I can’t wait to continue to see you grow as we stay in touch outside of Nack. Thank you for being one of my best friends and showing me compassion and love. Whether we were silent in each other’s company, dying laughing, hugging tightly, or just yapping, I hold each of our memories together so close to my heart.
To a group member: Your confidence in your ability to achieve the goals you have paired with the hard work to get there is something I’m envious of. It’s inspiring to see your commitment to acting and running and I have so much faith in your future success. See you at the end of your marathon in San Francisco with a punny sign!
To a group member: I remember one group where I said something about how self motivating with compassion feels like way too big of an attitude shift and you bluntly told me “That’s the point.” I appreciate your utter realness every day of program and I’m going to miss getting a healthy dose of truth bombs from you. Also, thanks for always hyping up my outfits.
To a group member: When you chimed in during Process group on just your first or second day here, I immediately knew you were a force to be reckoned with. I haven’t gotten to know you too well yet but I have really appreciated your insights during group. You choose your words carefully but when you do speak up, it’s impactful each time.
To a group member: I am really proud of how you’ve begun to open up and share your feelings more. If it helps at all, most people keep things bottled up, so by expressing your emotions authentically, that’s another way you’d be rebelling against the norm. You seem like such a fun person to go to a concert with so if we can find any music taste overlap I’d love to go to one with you someday.
To Kevin (Founder and CEO): I am so grateful for the vision you brought to life. To struggle with mental health in college without adequate support and then decide you were going to bring that support to other college students is incredible. Additionally, I’m not sure how you do it but to manage a business that offers comprehensive, culturally-competent support to people of different socioeconomic statuses and diverse identities is commendable. Speaking of, I know Medicaid reimbursement rates suck but hopefully you guys can figure out a way to accommodate MediCal patients eventually. I’m super excited to see Nack expand in the future.
To Kate (Senior Primary Therapist): The DBT queen! I was looking at your LinkedIn the other day and I was like ‘damn, she has a million certifications’ but honestly that makes sense given how good you are at what you do. What I’ve appreciated most from you is your humility and commitment to ongoing professional development despite having so much experience. It would be easy to get overconfident and complacent but you continue to remain open to client feedback as well as spend time outside of work reading about how to be a better therapist. You once mentioned that you’re trying to trust your gut feelings more and I truly hope you feel that goal is fulfilled soon. You haven’t worked this hard and had this much success to second guess your instincts.
To Harriet (Chief Clinical Coordinator): My first month of program, I told my mom “This is the best combination of clinicians I’ve ever worked with.” In all of my past group therapy experiences, there’s been one or two providers I loved and the rest felt mediocre or even incompetent. The overwhelmingly positive reflections clients have after Nack is a testament to your leadership prowess. You hire amazing people and then cultivate an environment of growth and collaboration. I hope one day you do become the leading expert in mental health for transitional and college aged youth.
And finally, To Daphne (Primary Therapist): I am so lucky to have had you as my individual therapist. You have consistently shown me non-judgmental compassion even when I was extremely judgmental of you. You have gone above and beyond to support me at my lowest. Instead of jumping straight to hospitalization — like many MH professionals would — when active suicidality has been a concern, you have done the absolute most to ensure my safety while remaining outpatient. I will never be able to express how much gratitude I have for the time you stayed an hour and a half past the end of your work day to support me and my safety. Thank you. Thank you for all the times you have pushed me out of my comfort zone. As difficult as it’s been for me, I needed those nudges to grow. Thank you for helping me heal the part of myself who is ashamed of my sensitivity — I’m now starting to appreciate that sensitivity as a passageway to empathy and introspection. Thank you for helping me improve my communication with my parents, a skill that will continue to be invaluable for me. Most importantly, thank you for helping me give Siona a Siona. If it were up to me, the number of required supervised hours would reduce just for you and you’d already be an LMFT.