The Advocacy Letter

Dear Sir or Madam

Re: Advocacy in Accessing Mental Health Services

I am writing to enquire as to my rights and to what extent you can assist me in accessing the services to which I am entitled.  I am diagnosed with borderline personality disorder with psychotic features with a possible co-morbidity of bipolar disorder, type II.  I take anti-depressant and anti-psychotic medication, and although I only received the diagnoses in June 2009, I have been utilising mental health services both on the NHS and  in the private sector since 1998 (having originally been diagnosed with clinical depression and social anxiety).  The care that the NHS has provided has always been wholly inadequate; until recently, any therapy I have been offered has either not come to fruition, has ended abruptly or, in one incident, has seen me being regarded with outright hostility.

Since 29 February 2009 I have been seeing a clinical psychologist on a weekly basis for psychotherapy broadly of a psychodynamic nature (though the  approach is integrative).  As of today’s date, we have had 35 sessions in total. It has taken me some time to fully open up to and to trust this psychotherapist, but now that I have, I feel that progress is being made, albeit slowly.  I believe that further progress can be made through this relationship.

Unfortunately, my psychologist has informed me that he can only continue to offer me therapy for 24 further weeks (starting from the next session).  This would, of course, equal 59 total weeks of therapy (including three assessment sessions at the start, and four sessions to end the therapy).

As you will be aware, all published research on borderline personality disorder strongly recommends long-term therapy for the condition. Indeed, NHS and NICE guidelines on this illness and on personality disorders in general completely contradict the view that one year’s worth of psychotherapy is remotely adequate treatment.  I believe that the New Horizons consultation recently undertaken by the health service would not support this situation either.  I strongly believe that not only is long-term treatment advisable, it is in fact necessary to deal effectively with my condition and therefore I feel that it is my entitlement.

Whilst I appreciate that resources are limited, I am frankly disgusted by the postcode lottery that seems to be in operation.  For example, I am aware that there is a specific self-harm team within the <other NI area> Trust – whilst self-harm is not, of course, by any means the only symptom of BPD, I am sure that this team would work frequently with individuals with this diagnosis and would thus understand it well.  Furthermore, I am familiar with several other individuals that have this (and other) disorders – in most cases less severe than mine – that have received guarantees of treatment lasting at least two years (in some cases) and three years (in one).  I have yet to encounter a single other individual who has received only a year’s guaranteed treatment.  My psychologist himself admits that ideally BPD should be treated twice a week for a minimum of 18 months.

I believe that if therapy comes to an end as proposed that I will in fact undergo a significant regression, and probably end up utilising yet more NHS resources.  I am unable to work, and am in the regrettable position of being dependant on state benefits – a situation that I abhor.  Any saving of government resources in cutting short my treatment is, therefore, a false economy.  I also feel that the worry of treatment coming to a close will overshadow my relationship with my therapist thus preventing us from tackling more substantive issues together in the relatively short period we have remaining.

Additionally, I understand from the various guidelines from the health service that multi-disciplinary approaches are considered desirable and indeed necessary for personality disorders.  To that end, I am surprised that I have never been offered access to the CMHT’s social workers, CPNs or occupational therapists, despite presenting symptoms perhaps best dealt with by such individuals in conjunction with my psychologist.  Although I have had one experience of the Crisis Response Team (which, I might add, was an utterly appalling meeting), I have never been advised on how to contact them again in an emergency, of which I have had several in the past year.

I am not prepared for the NHS to once again treat me as a second class service user and am prepared to contact MLAs, MPs, the relevant Minister and Permanent Secretary, and indeed the media in order to obtain the treatment to which I am entitled.  I would therefore be strongly grateful for your advice and assistance on (a) ensuring that I obtain a guarantee of continued psychotherapy, in line with NHS guidelines on the longevity of same; (b) ensuring that said psychotherapy can preferably continue with the therapist I presently see, as of course issues of trust and abandonment are a big part of this illness; and (c) ensuring that I can have access to the full range of services from the CMHT and the Crisis Team in an emergency.

As you know, borderline personality disorder, especially when psychosis is involved, is a severe mental illness and in this case has not been taken seriously.  I feel that this matter is urgent and desperate, and to that end would be very grateful for your help and advice.  Should you require further details, or if you would simply prefer to correspond via another medium, please do not hesitate to contact me via email on <my email address>.  I look forward to hearing from you.

Thank you in advance.

Yours etc.

Copy to: Chief Executive of my Trust

The Fantasy World

Tonight, as I was editing the ‘About‘ page briefly, I was reminded that I had mentioned my pathetic little fantasy world there, but that I’d never discussed it in detail elsewhere on the blog.

Well – I’m not about to.  I don’t think I’ll reveal the specifics of it to anyone, ever.  But I will say a few words.

I suppose the best way to put the fantasy world is that it is just like a grandiose delusion (or such is my supposition) – except that I don’t believe it is real.  There’s a fine line here between creativity and madness; if I had written down all this stuff and sent it to a publisher, it probably would have made quite a successful (if far-fetched) novel (or set of novels).  Alas, any such attempt now would make people aware of the specifics of the fantasy world, and I couldn’t cope with the shame of that.  Plus I wouldn’t have the motivation to write a fucking novel anyway.

The only people that I’ve spoken to about the fantasy world are A and C.  C didn’t seem especially concerned about its presence, though I was interested to note recently that, after the development of ‘They’, he asked if ‘They’ were connected to the fantasy world in any way.  It had always been my concern that my use of the fantasy world as escapism would actually develop into an actual escapism – a complete break from reality.  And cevidently that was on C’s mind at this later juncture too.  So far it hasn’t happened, but it is still a worry.  Having said that, frankly sometimes I wish I would just lose all contact with reality and stop teetering on the brink of it…but that’s a whole another post.

Anyway, both A and C, and in fact all of the most significant personnel in my actual life, figure to some degree or another in this fantasy life.  However, they are supplemented by an entire cast of fictional people, some reflective to some extent of real people, others purely borne entirely out of my imagination.  The fictional people are crafted down to their wrinkles, down to whether or not they like brussel sprouts.

The universe itself is similarly crafted.  My living and working environments are also detailed to the nth degree, and on a major scale.  The streets I walk, the strangers I meet, the pubs and cinemas I go to, the books on my shelves.  Everything is covered.  It really is like an entire other life, and I can slip into it at will.

I am completely unsure as to what this means psychologically, but let’s not overcomplicate matters, and take it broadly at face value.  In the fantasy, I have a wonderful job and am very much the confident(-seeming) person that I was as a child.  I am surrounded by people who, despite my idiosyncrasies, like and respect me.  I have a stable and loving private life.  I have money, though not riches and my own home, though not a mansion.  Basically, I have the perfect young professional’s life.

From that, it would be easy to say, “well, it’s merely reflective of a longing, perhaps of regret over missed opportunities.”  And maybe it is.  Except, it’s not that simple.  In the fantasy world, I am still mental.  Does this go back to all the wank I wrote a few months ago about not flicking the metaphorical switch to sanity if given the chance?  Maybe.

Maybe also it’s reflective of my feelings on the stigma of mental illness.  I want to have achieved all of these things despite being mental, thus proving that mental illness is not a barrier to success.  But I have to ask myself, if this is indeed the case, is it because of altruism, or is it another narcissistic desire for me to achieve something?  Probably the latter to be honest.  What a self-centred bitch.

When I told C about it – probably back in April or early May – I broke down and cried for ages because of the shame and self-disgust I felt about not being content with my real life.  It was the first time I’d wept like that, and as regular readers will know, it is not something that I have done with frequency since.  I derided myself to C as “completely fucked up.”

And I am.  I really am.

Protected: Why Does He Hate Me? C: Week 34

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Countdown to Abandonment – C: Week 33

Those that follow the Twitter stream that I have allied with this blog will know that I did not intend to write a blog today (LATER: yesterday). I was feeling a bit low after CVM called me this morning to report that her father had sadly died early this morning (LATER: well – technically now yesterday morning). However, sitting here brooding won’t do either her nor me any good, so I decided to go ahead and write it anyway.

CVM is very much in my thoughts and I wish I could do something to ease the pain of her and her family. I am publicly sending my sincere condolences here. <3 xxx

—

I know that I have an annoying tendency to open these posts on C with, "today was weird," or some such. Well, Thursday really was strange. It was totally bizarre. C was evidently puzzled by certain directions it took, and when I told him at the end that it had been “weird,” he actually responded by saying that it had, indeed, been “different” (for what it’s worth I feel reassured rather than invalidated by this).

I’m not sure if the written word can adequately convey the oddness of the session, because although it can look disjointed, it would take a better writer than I to convey the sudden and sharp shifts in mood, the nuances of the spoken tones, the randomness and subtlety of the non-verbal communication that took place. Nevertheless, as ever, I shall try.

It was very much a meeting of three parts. During the first – I dunno? – maybe 10 or 15 minutes I sat there petulantly, stubbornly avoiding his gaze and giving one word answers (at best) to any questions he posed. For once he had the decency to open proceedings, and not piss about waiting for me to do so. He said he was aware that part of me was attached to “here” (this annoyed me, though I did not say anything to him – I am not attached to his fucking office for Christ’s sake, I am attached to him!) and that I was concerned about the cessation of therapy. Wow, insightful. I’m absolutely profoundly impressed, Dr fucking Freud-Einstein-Mary Poppins.

I’m ranting about him now for stating the obvious, but I also got really pissed off when he strode into the territory of conjecture. He said he was also aware that I was unhappy that I only had 50 minutes of his time each week and that I was annoyed that I couldn’t just turn up or phone him or whatever outside that time.

This sent me into a rage. At no point have I ever said such a thing. Struggling to control my anger, I snarled that his comment was unfair, and that he was putting words in my mouth. I asked him to exemplify exactly when I had made these assertions to him.

He admitted that I hadn’t, and moved on, but I think I now realise where he got this from. Some months ago – I can’t find the relevant post offhand, sorry – I had asked him who I was meant to contact in an urgent situation (because if my life depends on it I still want to avoid the fucking Crisis Team). Could I have a CPN, a social worker – anyone at the two CMHTs based at C’s hospital? I don’t remember his answer but it was some nonsense about ringing Lifeline or the Samaritans. Yeah, thanks C. So he had obviously read this request – a reasonable one, in my view, given that CMHTs are meant to be multi-disciplinary and he is only one tiny part of them – as a demand for his attention outside of our sessions. This was profoundly irritating. If he had failed to understand my question, then he should have asked for fucking clarification.

Anyway. To follow on from the uncertainty of the last couple of weeks, he brought up the matter of how long he can continue to act as my psychotherapist. Apparently, he can offer 10 week blocks, with four weeks at the end to deal with the closing of the relationship. Fair enough? Well, no, not really; he can only offer me two of these blocks – ie. 24 further weeks (beginning on Thursday 10 December) in total. Now, that will amount to something like 57 total sessions (including the three assessment sessions at the beginning and the four ‘leaving’ sessions at the end) which ostensibly sounds fair enough. Unfortunately for me, BPD is well known to take a very minimum of a year to treat properly, and usually three or four.

I didn’t tell him this as, in the past, every time I’ve made reference to my diagnoses he’s come off with (or at least inferred) some crap about fixating on labels. Heard it all before, C. So instead I asked what I was supposed to do if things weren’t adequately improved by that point.

He said, “I would expect you to have made progress by then – I feel you have made progress.”

Great – I’m so glad one of us does. Most reassuring. I pressed on. “But what if I haven’t?”

He said something suggesting that I shouldn’t be expecting cures from psychotherapy, at which point I interrupted him by telling him I didn’t even believe in cures and, in fact, didn’t especially want them. My question, I insisted, was in the context of alleviating the worst of the psychological pain and providing me with coping mechanisms and greater understanding that I could take onward in life. What if that had not been achieved within his stated timeframe?

I honestly don’t recall his answer, but there was a strong inference in whatever it was that if we were unable to progress by then that there was effectively nothing he could do for me (an assertion with which I do not agree, but what do I know – I’m just the stupid mental that sits opposite him).

No arguing with that, then. That’ll be it. The end. Finito. Fuck you, SI. In response, I just sat there looking at the ground for a while. It’s difficult to articulate how I was feeling. It was a veritable cocktail of fear, dread, hurt, anger, bitterness and depression. I fought, ironically using the breathing exercises that C had so fervently espoused, against tears and rants. I fought them because I didn’t want to give him the satisfaction of knowing that this abject rejection completely fucking cut me to the core. But he knew. Of course he did.

After a minute or two, he proceeded with that usual question of ultimate annoyance, “how do you feel about that?”

One thing I’ll say in his defence was that at least he was completely straight for once. Often he dodges and dives from material that he doesn’t really want to bring up with me for fear of setting me off (or such is my supposition for why he avoids it), but on this occasion he was upfront and honest, and through my anger and hurt, I felt appreciation for that. I told him so.

He told me to think about this over the next week (“but not so much that you end up ruminating on it” – as if that wouldn’t happen!) and bring all of my thoughts and feelings on the matter to him in the next session. He said, “you’ll probably feel anger, frustration…”

Once again, I got really mad at him for putting words in my mouth, so he desisted from that angle of probing. Whilst it will indubitably be the case that I am angry – I already fucking am – and whilst it was indubitably the case that, in an ideal world, I could phone and/or meet him outside of scheduled sessions, how dare he presume any of that. If he wants to know my thinking on these matters he should fucking well ask me – it’s not like he’s never asked before. He shouldn’t just assume that his suspicions are gospel, regardless of the probability of their accuracy.

During the silence that ensued, I fought a mental battle with myself. One side was crying out, “but that’s another six months! You should be grateful!”

The other responded, “the NHS has failed you yet again, SI. They are ignoring all research on your diagnoses.”

For once, the negative side was, I am convinced, the more rational. BPD takes a long time to properly treat. It is as simple as that.

Finally I said to him, “why do you do this job?”

I knew he would respond with a question, and indeed he didn’t disappoint.

“Can you tell me why it is it important for you to know that?”

“I’m curious.”

Once more, I knew he would fail to answer, and instead question me again. Once more, I was correct.

“But what is it that gives rise to that curiosity?”

I laughed cynically in his face. “Just answer the fucking question,” I demanded. “Please.”

He looked away and appeared thoughtful for a minute. Eventually he said, “because I think it is of value.”

I nodded non-committally and waited for the backlash.

Well, apparently my questioning his decision to practice clinical psychology ties in with my intense rage towards him / the health service (because that couldn’t possibly be fucking justified could it? Oh wait, it could!) and my assertions last week that he was a ‘headfucking sadist’.

I winced. “Yes, sorry about that,” I muttered awkwardly.

“No, no,” he insisted. “You should bring that anger with you.”

I ignored him and said that it must be something of a nightmare to spend an hour with me every week.

He sort of laughed and said that I have to spend all the time with myself. (This could be read as an invalidating statement, which it shouldn’t be – there was more to it than this, but I don’t recall the specifics. Whatever the case, the point was actually made more sympathetically than I’ve made it sound).

“Yes, that is a disability,” I mused. “But honestly – I’ve been such an angry child here recently, it must be shit for you.”

I saw his eyebrow quiver slightly at my use of the term ‘angry child’. Excellent. It had been intended to pique his interest.

“I’ve been reading about schema models recently,” I proclaimed, triumphantly.

This is where part two of the discussion began. Let’s call it Intellectualise my Mentalism.

The other week, when I was convinced my therapy with C was coming to a dramatic and premature halt in January, I rushed to the Yellow Pages looking for suitable therapists. I was looking primarily for practitioners of psychodynamic therapy, as I have been receiving from C, because it’s the only type that I have found remotely effective to date. However, I was open to exploring both schema and gestalt therapy, having read quite a bit on both, and found practitioners of both in the vicinity. As two major studies have demonstrated its effectiveness for all symptoms of BPD (unlike stupid DBT), I have more faith in schema therapy, even though it does involve some wanky (if apparently advanced) CBT, for which (as you know) I have no time, so – convinced I was in imminent danger of abandonment from C – I Googled “Schema therapy borderline personality disorder” and came up with this book. On a whim, I bought it.

The book contends that people with BPD have five main strands to their character:

• The healthy adult (the authors admit this seems an unlikely component, but make the reasonably fair point that many with BPD are not always going mental. Not that they put it quite like that, of course).
• Detached protector – this mode sees the patient protecting the harmed brats that form part of her consciousness.
• Punitive parent – “everything is my fault” mode. Must punish myself. I am usually pretty good at this, especially in session.
• Angry or impulsive child – furious, mainly as a defence mechanism. It is convinced it will be fucked over. It is also angry that its needs / rights are not met. (I am a walking stereotype).
• Abandoned or abused child – alone, no one cares about it, whinges, cries, blah de blah.

I told C that today I was the protector. I was avoiding his questions, getting irritated when he probed me – classic protector traits, according to the book.

We had a discussion around the whole concept of schemas, schema therapy and its development, which to my amazement resulted in him bringing up the term ‘borderline personality disorder’ in a completely unsolicited way. He went on to explain the schemas seen in BPD in more detail, to the absolute delight of my ears and my mind.

Feeling that we were on something of a discursive roll, I presented him with a print-out of this post from Kathy Broady’s blog. I had analysed the piece bit by bit in terms of its applicability to me.

I pointed out that it was written by a DID therapist, however, and that therefore it might not all apply directly to me.

He sort of shook his head and said, “there’s a debate in psychiatry and psychology as to whether or not DID and BPD exist on a continuum. At the very least, there’s often an overlap of symptoms. So therefore I’m sure some of this stuff can apply.”

(For the record I think I’d identified about 18 of the 20 signs Kathy listed as being applicable to me to one extent or another. Fuck! Is there more I don’t know about?!).

Satisfied with this response, I gestured for C to go ahead and read the list. Not wanting to sit there like a numpty whilst he read it, I stood up and looked out the window.

I could see out of the corner of my eye that he was looking at me, puzzled. I turned to him.

“What, am I not allowed to stand up now?”

“Well, yeaa-ahhh, you are,” he began, doubtfully, “but I’m just wondering why you’re standing up.”

“You’re reading that, so I’m going to look out the window,” I replied.

“I think you’re trying to distance yourself from the material in this article,” he told me. “It would be better if you sat down and faced it.”

So, the mere gesture of looking out the window is reflective of an entrenched tendency to avoid confronting one’s problems, is it? Well, fuck me, I’ve heard it all now. I was going to argue, but decided against it, not really seeing any point. I made an arm gesture of “you win” and sat down, internally laughing at how absurd I felt his deep reading of my meaningless action had been.

C read the list – to my annoyance, he read a lot of it out loud – then paused on one particular point. I don’t remember which one it was, but I’d provided an ‘analysis’ at the end along the lines of, “I do this, I do that, blah de blah.”

“Blah de blah?” he queried. “What does that mean?”

“I don’t know,” I said. “It’s just flippancy.”

“Yeah,” he agreed, “but where does that flippancy come from?”

“It’s stylistic,” I argued (I’m sure most readers of this blog will agree that I have a penchant for flippant remarks). “It’s just my writing style. You haven’t read any of my writing…”

“But…” he went on.

Enter stage three of the session – the mad, maniacal bit.

“Right,” I said authoritatively. “You don’t believe me that that’s how I write? Well, let me show you.”

From my bag I pulled out a print out of this post, my (latest) rant on the NHS. I began randomly reading some of the more colourful parts of the rants, in a deliberately exaggerated and dramatic voice. When I finally drew breath at the part where I talked about reading Grey’s Anatomy at the age of five, the completely befuzzled C interrupted me, exclaiming, “what’s happening here today?!”

He looked completely bemused, and on reflection I can’t say I blame him. It was a bit of a random tangent.

I defended myself on the grounds that I wanted to demonstrate to him that the flippant comments he’d seen on the trauma list were sod all in comparison to the flippant comments made by me elsewhere.

“But,” he said, metaphorically stroking his chin, “we’ve been all over the place today [I'm not sure that he phrased it quite like that]. For the first while I thought you were quite upset, quite agitated…now I’m not sure what you are…angry? And in the middle we perhaps intellectualised matters a little.”

“Oh fuck, I’m sorry!” I cried. “I led you into that.”

“These meetings are a co-construction,” he insisted. “I’m just as culpable for any straying off course as you are – we just have to be careful not to head into intellectual territory too much.”

He pondered for a minute and, referencing point 10 on Kathy’s list of trauma signs, said, “your rush to apologise just now ties in with that.” He noted that I had commented on the list that my self-blame wasn’t excessive because that for which I blame myself is, in fact, my fault.

“You do realise, objectively, that it is excessive, don’t you?” C asked.

“No no no, it’s my fault. It’s my fault,” I contended. “Just now I seduced you into that discussion on academic psychology. It was my fault, I’m sorry.”

Readers, why – WHY?! – did I have to use the word ’seduce’? Why? A dozen other words would have sufficed. It just rolled off my tongue, as hyperbolic metaphors often seem to do.

He raised his eyebrow and narrowed his eye slightly. “Seduced?” he enquired.

Fuck. FUCK. FUCK FUCK FUCK! Now he thinks I want to fucking fuck him. Fuck fuck fuck.

I felt my cheeks turn red in utter mortification and in my rush to defend my use of the term, on the grounds that it was figurative, probably made an utter tit of myself – thus reinforcing any belief he might have that my transference is of an erotic nature.

Fucky fuck, shit and damn. I did try my best to explain what I’d meant, but I was flustered, and in any case it probably looked like a case of the lady doth protest too much. So eventually I gave up, looked down and gestured for him to continue to read the trauma list.

Thankfully for once he had the grace to do as he was told and not press me. He read on in silence this time, and when he’d finished I asked him if he thought the points included were applicable to me.

He said that he thought they were, and indeed that a lot of it had already come out in therapy and that we were beginning to address those issues.

He handed me the list back, and I read over it. For some reason I then went into a dysphoric but energetic rant against myself, telling C that I was “nothing but histrionic” for thinking any of the list was applicable to me, and indeed for bringing it to him.

He listened to and watched me in a kind of bewildered way. Perhaps he’s not that familiar with mixed states.

“Well, this has been weird,” I declared.

He cleared his throat, as if for dramatic effect. “It’s certainly been…” – he searched for the word – “…different,” he acknowledged finally, with a slight wryness I thought, which I found bizarrely reassuring.

“I was nervous about telling you about the schema book,” I admitted to him, rather randomly. “I’ve always got the feeling from you that you think to so much as mention a diagnosis is to fixate on a label.”

“Not necessarily,” he began. “It’s very important not to fixate on it, indeed. You mustn’t allow yourself to be ‘built’ around a diagnosis. But it can have benefits, yes.”

“I’ve found it helpful,” I said. “For one thing it’s enabled me to connect with a range of people who have been a great support network.”

“Good,” he declared. “No, I have no problem with diagnoses. It’s just important that you know that it’s not ‘borderline personality disorder’ that comes into this room, it’s [my name].”

I nodded. I think I do keep a sense of perspective on the diagnoses; if someone asks me about myself, unless it has been directly in the context of mental illness, I’ll usually tell them I’m a rock bird with a love for reading, writing, pubs, sci-fi and Newcastle United. The illnesses are part of me, and I am not ashamed of having them, but they’re certainly not the whole story.

As I was about to leave, C asked me to think over the prospect of there being a maximum of 24 weeks of the process left in order for us to discuss it at the next session. He all but begged me to “bring the anger with [me].” I protested that I couldn’t do so with absolute impunity, as I couldn’t face being heard screaming at him by those in the offices adjoining his.

He looked extremely taken aback at this, which I still don’t fully understand. I have social anxiety for Christ’s sake, does he honestly expect that I can allow anyone but him to be party to my rants? In any case, his secretary phoned today. Having convinced myself at the weekend that he was dead (whilst simultaneously reckoning that he wasn’t dead, but nevertheless believing that he was), I was horrified about what she had to say. Mercifully, so far C is not dead and will see me on Thursday at the normal time – just not in the normal place, due to building work. He is temporarily moving back to VCB’s stomping ground.

In a way, it’s worse to lose it with him there than in his own office. The office in which I suspect I will meet him is next door to the one VCB shares with other psychiatrists. These cunts all have it in their power to section me should I really lose it, which is hopefully unlikely but frankly not impossible, especially with ‘They’ still hovering about from time to time (though wouldn’t you know it, the anti-psychotic has seemingly killed Tom. Just my luck to lose the ‘good’ psychosis and retain the ‘bad’). On the other hand, an advantage of this location is that the building is attached to the day bin and adjacent to the actual bin, so hopefully they’ll be used to having crazies losing it on them fairly often.

As for now, I don’t know what I think. The argument is still ongoing in my head – More NHS Fuckovery, I’m Calling an Advocacy Service vs. Well, It’s Another Potential Six Months, Be Grateful. The truth is I feel both at the same time. A little bit positive, but more than a little bit lost.

Christmas Mourning

I alluded briefly to the fact that I find Christmas a profoundly difficult time of year the other week.  I have hated the day and all its build-up since, I would guess, my early teens.

I still do, and I rationalise it on the grounds that it is a commercialised load of crap borne purely out of capitalist greed and people’s insatiable desire to get completely wasted with apparent impunity.  But as with seemingly everything in my existence, nothing is quite as simple as pure rationality.

I wouldn’t have seen a deeper side to my dislike of the festive season but for some weird behaviour that’s developed over the last couple of years, that I would say correlates roughly with the development of borderline tendencies in my psyche and behaviour.  I have found myself uncharacteristically emotional over ‘cute’ images or statues of Santas or snowmen, feeling sorry for them (?!) to the point of tears.  The odd sentimental Christmas song will do it too.  Anything, I suppose, that is a non-tacky or potentially ’sweet’ way of communicating how supposedly special the occasion is meant to be can bring this ridiculous behaviour.

Last night I ended up in tears because I ‘felt sorry’ for Christmas because I had ‘rejected’ it for so many years*.  It was triggered by a cinnamon candle which smelt ‘Christmassy’.  What a complete and utter moron of complete imbecility I am.  Who does this?!

A discussion with A ensued when he enquired as to why I was upset about rejecting Christmas given that I hate Christmas.  I have developed two armchair psychological theories for both the hatred and the development of this over-emotional nonsense.

1. The most obvious theory is that I associate the entire season with the McFs and, specifically, the fact that I have to see PaedoMcF (as he shall, I think, henceforth be known on this blog).  I spent, as I recall, every Christmas with them until I was about 21, and once I’d reached adolescence, gone through the rape, grown increasingly contemptuous of my family, I began to dread and dislike the season more and more.  It’s not just about Paedo; MMcF is overbearing too, as is the entire group dynamic that permeates the culture in which they live.  One way or another, they are at least partly responsible for my dislike of December.
2. There is a deeper thread to this; it’s clearly about abandonment by both my father and then my subsequent surrogate father-figures.  Part of the sadness is pathetically (in the original sense) childlike – it’s like a little girl weeping because she knows she’ll yet again be rejected.  Thus, she has to reject all circumstances surrounding that rejection first.  Except that it’s not that simple, because it eventually comes back to haunt her.  Eugh.  Fuck you, V.

Yes.  Christmas is, in part at least, supposed to be about families – about parental love and a parent’s desire to see their child happy, the pleasure and joy the parent takes from seeing the child’s delight in receiving that for which she has so fervently longed all year.  I only ever had 50% of that.  My poor mother, dear love her, tried her best to make up the deficit, and I suppose on the face of things that seemed to be enough…but it wasn’t really, was it?

In the absence of my actual father, I built my grandfather into the supreme male figure in my life.  However, his senility began in my earlier teenage years, and he finally succumbed and died when I was 15.  None of that is his fault, of course (I mean, of course!!!), but it could still be considered abandonment by the deepest, undeveloped corners of my psyche, those dark recesses that have still failed to develop healthy object relations.

If I’m completed honest, I probably had allowed Paedo to be a semi-father figure too, but sadly he chose to violate the sanctity of that relationship.

When I was about eight, my mother met and fell in love with B.  Although B and I didn’t always get along perfectly (how dare he ingratiate himself into my life in the place of my father?), I got used to him being there and was stunned when he died very suddenly and unexpectedly just before my 11th birthday (which is not that terribly long before the accursed Christmas).

So yeah.  Christmas must remind me of childhood abandonment.  No waking up at 5am on Christmas morning and dragging Daddy out of bed to see the joy on his daughter’s face.  Only ever futile hope that maybe one day he might care enough to at least call me to say, “happy Christmas darling,” only ever futile hope that maybe one day he might care enough to even send a cheap card.  And now he is gone permanently, as to all intents and purposes are those that ‘replaced’ him, and that hope is lost and gone forever.

Anyway, I relayed this information to A last night, and then just sat and cried for a while.  My overwhelming feeling was of grief.  Grief.  This, and all these apparent projections, kind of affirm my belief from the other week that I am in mourning for the little girl that was in many ways denied her childhood.

A thinks the fact that I am feeling this and indeed even recognising it is progress, and I suppose in an objective sort of way it is, but the pain is raw and lately I feel horribly vulnerable and weepy all the time.  I am not looking forward to the next few weeks.

—

For the record, I still hold to the logical arguments against Christmas – the drunken revelry, the crowds and the commercialisation of a festival that, by rights, is applicable only to Christians (regardless of the fact that 25 December was originally a Pagan festival) does annoy me.  But I don’t think that is, in itself, enough to explain a feeling much stronger than ‘bah, humbug’.

—

* Although the smell of the candle was the main trigger, I was in something of a fragile mental state yesterday anyway; I’d had a minor car accident (my own stupid fault), I’d had a minor operation with LGP (a lump removal) and, most of all, I’d learnt something horrific from A.  On the night of the Sunday 22 November, a point at which I’d thought the psychoses had died down a little and that my moods had regulated somewhat thanks to the Olanzapine, apparently ‘They’ answered the phone when I tried to call the local Chinese take-away.  When A protested that ‘They’ weren’t there, apparently I went off my head at him, screaming and behaving like a wild woman.  I have absolutely no recollection of this whatsoever, though it must have been the night I made the ‘Bitch’ cut, because I discovered that on the Monday.  I was horrified because (a) it’s just plain nasty to A, (b) ‘They’ had always previously been in my head, not outside it – this is a bad ‘progression’ and (c) the amnesiac properties of this incident are frankly terrifying; who knows what could have happened that I wouldn’t later recall?

Admittedly, we had been drinking that night, but I remember very disctinctly phoning the Chinese the first time, then I recall nothing until later, when I was trying to get A to come to bed rather than sleep on the sofa.  Again, my recollection of this is distinct, so I don’t think the amnesia is alcohol-induced; it sounds like a dissociative episode to me.

On the plus side, when I saw Lovely GP yesterday I said that although I thought the Olanzapine had been,overall, a good thing, that the return to 75mg of Venlafaxine had hit me hard.  LGP told me to go ahead and start taking 150mg again.  He said that if VCB objects I am “to send her to [him] and [he] will take care of her.”  Love LGP.

Wanking Yourself Sane (or at Least Calmer)

First Signs are a UK-based charitable organisation devoted to the prevention, or at least the minimisation of, self-harm.  Whilst as regular readers of this blog will know, I don’t really see the big issue with (controlled) self-harm, I can and do admire the work that FS are undertaking.  If nothing else, at least they’re raising awareness on the issue – why people self-harm, that most people who do it aren’t dangerous to normals and so on.

However, as you can see from the title this isn’t a post espousing the worthwhile cause of this user-led charity.  I am writing in response to this supposed distraction technique.  Yes, folks, they are arguing that bringing yourself off is a viable alternative to cutting or burning yourself.  Riiiiight.

I read a lot of articles on psychiatry and psychology, much to the detriment of my Twitter followers (not so much on the account allied to this blog), but I rarely feel the need to respond to them.  However, I just find this article so ridiculous that in this case I felt compelled to do so.

The first thing that struck me about the piece was that FS had devoted the entire thing to masturbation.  I mean, even if you do accept that wanking is a credible alternative to self-harm, it’s not the only distraction technique that exists out there.  When C and I first discussed the stupid DBT bullshit way back in week 12 of our therapy, some of the stuff in the material he gave me was devoted to distracting oneself – and, as it happens, masturbation was mentioned (to which I responded with an ‘LOL’ which I know is really rather puerile)…but the difference was, it was only mentioned in passing, as one technique amongst dozens available.  No 1,300 word article on this topic per se was deemed to be required.

Personally, I think distraction techniques are all bollocks, but that’s not really the point.  The point is, to what extent is masturbation really a viable alternative to self-injury?

FS pose this question:

When you’re urging to hurt yourself, aren’t you looking for a release, and some relief from the emotional distress you’re having trouble coping with?

This basically forms the central tenet of their entire argument as far as I can see.  In fact, looking again at the article, it seems to be their only tenet.  What a convincing argument they must have if they only have one major thread to their point.

That said, OK – successfully orgasming undoubtedly does relieve tension, and no doubt endorphins are released upon climax just as they are in cutting.  But for goodness sake, how obvious is it that it is an entirely different type of release?!

I wrote about the satisfaction, if that’s the correct term, that I get from self-harm in this post a few weeks ago.  I suppose my main point was that bloodletting is beautiful because one feels, temporarily, that they are watching their own evil flow away along with their blood.

Which, to be objective, is the only point I really made – but it feeds into the idea that many people will injure themselves as some sort of ritualistic punishment for their perceived inherent evil, or for the self-disgust they feel.  I know I have been known to cut for this reason.

Why, then, would I allow myself the satisfaction of a pleasurable activity?  If I am a bad person, I need some obvious form of punishment, not a reward, whether that’s sexual or otherwise.  Now, satisfaction is undoubtedly garnered from the ‘punishment’ of cutting – but it’s not a premeditated satisfaction (masturbation is in my view, even if a sexual urge comes on one quickly, because it usually has a clear objective that one is trying to meet).  And in any case, the satisfaction is, primarily, mental, not physical (which is all masturbation, unless conducted mutually with a partner, can ever be).  You are satisfied because you have done what needed to be done to this bad individual; you have hurt them.

Of course, that’s only one aspect of self-harm.  One other major function of it is to reorientate oneself when going doolally or, as FS admit, to release some psychic pain in the same circumstances.

Now let me get this straight.  When I am going off my head in a mixed state or panic attack, am I seriously going to sit down and analyse distraction techniques (this is why I think they are all complete arse, as discussed here, for example, or there’s always this epic rant specifically about methods of distraction)?!  In particular, am I going to think, “Christ, life is so fucking terrible right now…an orgasm would make it better”?  Well, maybe it would actually, in an ephemeral sort of way, but would that really be forefront in my mind?  The idea, as any one who’s experienced such a state will appreciate, is ludicrous.

All one can think about when going mental is the mentalism.  The ‘decision’ to harm, if it can be termed that as it is not always conscious, is almost innate.  OK, so sexuality is innate too, but there the comparisons end.  Perhaps the reason for the visceral nature of self-harm in these circumstances is simply that its effects are instantaneous (my mantra to C: “it’s quick and it works”).  Even if we (erroneously) were to agree that an orgasm can have exactly the same physiological effects as self-harm, time (for most women but I reckon to some extent blokes too) is required.  One does not feel like they have time when one is going mental.

Another issue that escapes them, and my aforementioned post on blood being beautiful ties in with this, is that cutting isn’t always about pain or distraction; sometimes it’s about blood.  Personally speaking, I love watching the blood.  Occasionally I cut only to watch the blood and how it flows.  Again, if we make the false assumption that orgasm release = cutting release, where is anything tactile or tangible from that?  FS do state that “…masturbation doesn’t cause any physical problems..,” and in doing so of course acknowledge that cutting can and does of course have physical consequences – but, as I said, they miss the point that that can be exactly why it is done in the first place.

Above all, what antagonises me most about this article is how it trivialises the issue of self-injury.  Now, I don’t think it’s a big deal if done under controlled circumstances, but neither do I think it can simply be equated as having similar physical and mental properties as something that most people have done in their lives and that is seen, rightly or wrongly, as something to be sniggered about at the back of a classroom.

FS state several times in the article that they fully recognise that self-harm is a serious issue, and to be fair they wouldn’t exist in the first place if they didn’t think so.  Nevertheless, singling out masturbation as a distraction technique in this fashion strikes me as counting it as some sort of panacea in a path to recovery from self-harm.  That probably wasn’t their aim, and what they have written was clearly with the best of intentions, but it has sadly worked out as over-simplified and utterly ineffective.

It may seem like I’m saying, “fuck distraction techniques, self-harm for the win!” in this and other posts – I am not.  This may be what I think for myself, but I would not advocate such for anyone else.  One thing FS got right in this article was to remember that everyone is different, and so other cutters / burners / whateverers may find a range of distractions, including this one, effective.  To that end may I reiterate that I admire the work that First Signs do; I applaud their very existence.

But wanking is never going to be a viable alternative to the scalpel for me.  Sorry folks.

“I Hate You, Don’t Leave Me” – Therapy Sucks – C: Week 32

The best-selling text written on borderline to date is a book called I Hate You, Don’t Leave Me, by Jerold Kreisman. I am struck by how much that title applies to this weeks session with C, which was fraught. Fraught fraught fraught. In a way, given parts of the post regarding last week’s session and my slightly more generalised anti-NHS rant of Wednesday, this should not be a surprise. On the other, given how passive – nay, submissive – I am known to be towards C, the fact that I was able to let it be fraught was surprising.

Not unlike last week, my memories are rather skewed. My most clear recollections involve me shouting at and insulting him and then threatening to walk out, then later breaking down and crying for what seemed like ages, in a defeated, resigned sort of fashion. Am I defeated and resigned? I’ll see if I can make some sort of sense of it all, but don’t expect miracles.

OK, so I went into his office and sat there like a knob, as seems to be fairly typical these days, as I refuse to start the conversation (no doubt an avoidance tactic). I had vowed to A that I would bring up the material in the aforementioned NHS rant, but as I sat there under C’s silent and enquiring gaze, I felt that I was going to chicken out completely. Eventually the silence led to the usual miserable whinge from me about wasting his time.

I saw my opportunity here – an opportunity to somewhat surreptitiously bring up my concerns, under the pretence that I was concerned about wasting C’s time. So when he yet again asked me why I felt the silences were so bad (apparently they can be very revealing and useful – since when did this become psycho-fucking-analysis?), I responded with something like, “well, we have a limited amount of time to talk about a number of things about which I need to talk. 50 minutes today, something like five more weeks overall.”

I don’t remember his verbal reaction (if any), but I think I noticed a split-second narrowing of his eyes at this, denoting confusion at the statement.

I have no idea what happened next. He must have probed me on my assertion that we only had five weeks of therapy remaining, though I distinctly don’t recall him doing so until later. In any event, I started babbling on about how I’d spent the preceeding few days looking online and in Yellow Pages for an alternative psychologist of a similar therapeutic bent to assist me on a private basis, but that I was having no success so could he please recommend someone, because if he wasn’t going to treat me until I was well enough to face the world without a therapist, then someone else would have to do so.

Again, the sense of confusion emanating from him was palpable, and I think he actually questioned why I’d felt this exercise was necessary.

I can only imagine that this was the point where I demanded specific answers from him on whether or not we were going to discontinue our relationship in January. Most (though not all) of the rest of the session centred around this, but I can’t be bothered to break it down into a specific chronology, and am not sure that I could even if I wanted to.

The very much paraphrased essence of this bit of the meeting was:

• C – I never said it would discontinue in January.
• SI – fuck you, you did.
• C – I said we would review it.
• SI – Same thing.
• Repeat 700,000 fucking times
• C – but you know it’s finite.
• SI – but it would be irresponsible of you to make it finite now. MEGA RANT ABOUT THE NHS – Starting with point 1 from last post (if they’d done something with me when I first showed outward signs of being mental, then we’d probably not even be here), moving on to point 2 (it’s either the bin or C – latter is surely cheaper, but the NHS is such a stupid fucking bureaucratic mess that they won’t consider that).
• C – you may well be right but unfortunately that’s the way it is.
• SI – how do you expect to adequately reverse two decades of mental illness in less than a year?
• C – answer not recalled but probably some politican-esque answer of avoidance.

Blah blah blah. He kept refusing to tell me directly whether his reference to reviewing things in January was a suggestion that we would end things then. He did, however, have the audacity to ask me what I wanted him to say. Hmm, that wouldn’t be obvious or anything, would it?

I said, slowly and menacingly, through (very evident) gritted teeth, that what I wanted him to do was to give me a straight fucking answer.

I don’t remember what he said, but it wasn’t a straight fucking answer – so I lost it. I absolutely, completely fucking lost it. I felt the anger well up in my stomach, like some sort of raging inferno, and felt it rise through my internal organs, eventually finding its way to my vocal chords.

I screamed at him, “I’ve fucking had enough of this. I’m leaving right now!”

And, indeed, I got my things together and went to stand up, but he started blathering on again – so, curious though still furious (I’m a poet, didn’t know it), I relented and sat back down. I think he was asking me where this anger was coming from or some such other non-sensical wank given that it was profoundly fucking obvious where it was coming from. (Or maybe not. Maybe I am angry at my father for abandoning me and C, in his role as a temporary surrogate father, is now bearing the brunt of that anger thanks to the perceived threat of abandonment. Oh yes. It must all be to do with one’s subconscious, mustn’t it? Nothing to do with the fact this uncertainty is fucking with an already fragile mindset. Fuck off, psychology).

I threatened to walk out again, telling him that if we were going to end things that we might as well just do it now rather than waste more of our time, but he kept managing to entice me not to leave.

I then spat at him (in something of a stylistic homage to part of this post) that he was “nothing but a fucking sadist” because he and the profession to which he belongs do nothing but make people relive trauma and misery and that it takes “a special kind of twisted individual” to think that that’s an enjoyable career path. I asked, rhetorically, if he’d use the old cliché of ‘I want to help people’, sneering about that being used as some sort of defence of his decision to practice clinical psychology.

I continued with my contempt-filled bile, telling him that he didn’t want to help people, that instead he wanted to “headfuck” them (I was gratified to see how agog he was at this. “Headfuck?!” he repeated, apparently aghast and astonished. Hahaha). “You’ve had your fun with me,” I asserted, vindictively, “so now you want someone else to headfuck.

He harped on the ‘headfuck’ comment for a bit, asking me to explain it, but I don’t remember exactly what he said and neither do I remember my response. So let’s (regrettably, cos that was fun) move on; at one point he asked what it would be like to end therapy. I said that I would have no real outlet to help me cope with the enormity of what I feel and of what I want to talk about. I said that I was emotionally (yes!) fragile in the extreme and that being left alone with the totality of my mentalism might well send me over the edge.

And how would it feel to continue, then, he pressed. Well, we have reached a point in our relationship where I feel that I can trust him enough to fully explore all that needs to be explored (not that that will be easy, but at least I think I can do it now). Our relationship is, I feel, the only adequate vehicle that I have – and have had – for a recovery of sorts. Only with his support and guidance can I face these things and, hopefully, move on from them. Or something – I don’t remember the exact nature of what I said. It was something like that.

Was it at this point that I uttered those tiny but synchronously hugely vile, belittling words? I don’t know, but this post is so disjointed anyway that it hardly matters. I said, “you can’t have escaped the fact that I’m very attached to you.”

He didn’t specifically respond to that as I recall, but at some point or other he did say that terminating therapy was going to be “a problem” whenever it happened, irrespective of whether we continued now or not and whether we’d worked through things properly. He didn’t say it, but the clear implication was that that would be due to my attachment to him. He’s right; I can’t deny it, it will be fucking horrible. The only thing I can say is that I would hope to be in a better mental place to deal with such a difficult prospect further into the relationship; right now, I am convinced that it would merely result in a hospitalisation – or even a possible run to catch the bus.

The long and the short of it is this: (a) we will review progress this Thursday rather than in January, as he recognises the enormous pressure that Christmas places on me, which will be compounded by his fortnight’s worth of absence at said point; (b) again, he stressed, there would be at least four sessions in the run-up to a termination of treatment devoted entirely to how to deal with that cessation (and it would probably more like six sessions); and (c) he is happy to continue ‘working’ with me as long as there is actual work being done – he won’t just do it for the sake of avoiding ending it.

On (c), I accepted the reasonableness of this position, but told him that if there were occasions where I found it very hard to talk to him about a particular issue, I did not want him to be of the view that that was me simply trying to manipulatively (not that that’s a word) extend therapy. I wanted him to be aware that some issues are just difficult to face, and it will take yet more time to address them.

He seemed surprised that I thought he would think that I would try to draw out the process, but assured me that he wouldn’t and didn’t subscribe to such thinking.

It was probably here that I started crying. I babbled incoherently through my sobs and he couldn’t understand me, and kept trying, in this annoyingly understanding and compassionate tone, to get me to repeat myself. Eventually I managed to articulate that, although I desperately want to continue with psychotherapy, the idea simultaneously petrifies me as I really don’t want to think or talk about so many things that I probably need to think or talk about (deja vu, anyone?).

I sat and cried for a few minutes, then started (literally) beating myself about the head as punishment for crying. He told me to stop it and said that I should allow myself be upset and indeed that he would actively encourage my tears if I was feeling an emotion that may precipitate them. For once I did as I was told, sitting silently in tears for a few minutes. As I said at the start of the post, for some reason I just felt terribly defeated – even though I shouldn’t because it seemed like I had got what I wanted – ie, C was saying that we could continue the psychotherapeutic process. Perhaps I felt defeated because continuing is agreed with the qualification that we are actually still doing something constructive – my visceral desire, of course, is to have him in my life permanently in some way. But this is armchair psychological conjecture; I have no idea why I felt this weird resignation. Perhaps it is simply that I was exhausted by riding on the rollercoaster that this session had been.

At what I think was my instigation, there was a discussion around the fact that it’s basically taken me six months and more to even begin to open up to him properly. I have discussed many things in sort of superficial ways, but I’ve not gone into much detail about specifics relating to my past at least and certainly, I have very rarely – if ever – behaved in a fashion like I did in this or the preceeding meeting whilst in session. I, of course, lambasted myself left, right and centre for being a time-waster.

C disagreed, opining that it was perfectly reasonable for me to have taken all this time to ‘test’ him, to make sure that he was worthy of my trust. Apparently he does not believe this to be time-wasting at all.

Whilst that is ostensibly reassuring, of course I find this a rather curious declaration on his part. If it was reasonable for me to have taken so much time to get to know him (well, kind of) before opening the floodgates, then how can it be unreasonable for me to expect long-ish-term therapy from this point to examine relevant issues from my past, or of transference, or of my life right now? The notion of continuing on some sort of rolling contract, rather than setting an initial timeframe of, say, six further months, seems incompatible to me with the idea that it was a positive thing to have used up the first six months essentially getting to know each other.

Anyway, I dried my eyes and apologised for shouting at him and for “being nasty”. Ever the psychologist, C replied by stating that if that was something I was harbouring, that it was good to demonstrate it to him, and that he would encourage me to do the same in future. He’s right of course, but it seems so terribly cruel for me to sit and shout “sadist! Headfucker!” or some such across the room, when the reality is that I don’t actually believe that and that I probably just wanted to hurt him (which I have no doubt he realises).

One thing I remember clearly about this session was that he seemed reluctant to let me leave. Normally, on the 49th minute mark, he pipes right up with the “we’re going to have to leave it there” line, and uses the remaining seconds for very brief housekeeping or, simply, goodbyes. On Thursday, I kept grabbing my stuff to leave, but he kept interrupting. It was odd and, looking back now, seems a little unsettling; he must have been seriously troubled by my mental state at the time.

Indeed, he said that he was concerned about how much I ruminate on therapy and that, that day in particular, he wanted me to find something else to occupy my mind, noting how difficult I had found the session.

I told him I would go home and kill people on Grand Theft Auto: Liberty City Stories.

He laughed (I don’t know why because I was absolutely serious) but continued by asking me what I enjoyed.

“All my interests are solitary pursuits,” I advised. “Aside from GTA and other video games, I don’t do much and don’t enjoy much. I do enjoy writing the blog, but one needs a specific mindset to write about difficult things and I am really not in it right now.”

(As an aside apparently C now thinks this blog is a good thing, despite the cuntified whinging that I reported here. Well, not that he thought it was a bad thing then per se – he just thought I was too fucking braindead to be careful in what I wrote here. Anyway, he now believes, correctly, that I seem to find the composition of posts cathartic and that I have found immeasurable support through the people that read what I write. If you don’t already know, folks, this is absolutely true. Thank you).

In the end we agreed that I would make an effort to rejoin the gym – as they all bloody do, C thinks exercise is imperative in promoting mental health. What’s more, though, he seems to be of the view that the physical effort required in exercise alleviates anger, stresses, blah blah. Personally, I find the gym insurmountably boring, but I’m unlikely to try and do myself in there I suppose, what with the other fuckers about. I haven’t rejoined it yet, but I will tomorrow. As for that day, despite my expectations that I would go back to A’s and my promise to C to actively take my mind off the session, in the end I went to my mother’s house and straight to bed. Rather than reveal why, I let her think I was ill.

So, how do I feel now, several days later? To be honest I don’t know. Although C said he was happy to continue working with me as long as we were not just avoiding the end of therapy for its own sake, the lack of a more definite answer and indeed timeframe still annoys me, and I am nervous about this week’s session as of course we are to review progress to that point. I do think significant advances have been made, as it happens, and I assume that C must too otherwise he wouldn’t have felt it was reasonable for me to take six months to get to this juncture. But nevertheless – I am dubious about what he’ll arrange next. Another 10 or 12 weeks – or something more meaningful?

I am sorry that this entry is so confused and disjointed, but that’s an accurate representation of my mental state during this session and, to a lesser extent, of the entire session itself.

I Ain’t Happy with the NHS…Again

This uncertainty with C is doing my head in. I spent this afternoon looking online and through Yellow Pages for private clinical psychologists in my area and found the sum total of two such half-decent practitioners, one of whom I’ve already seen (!). I then tried to work out if I could even afford weekly private therapy whilst unemployed – it can be done, in the most literal of senses, but it’ll take about half my monthly earnings to finance it.

Maybe I am overreacting and maybe C has no intention of ending this herapy in January, unless there is some miracle (and if there is some miracle then it is obviously fine to finish in January – but of course there will not be). But the mixed messages from him are sublimely frustrating – “don’t worry, we will never just suddenly end things” and “we will get there” versus “you know this is a finite process on the NHS,” yadda yadda yadda.

Partly the annoyance is with him and partly it is with this stupid bloody system. Sometimes I think we’d be better off with private healthcare after all.

On the one hand, C is the person that makes the immediate decisions on how long he sees his clients (as far as I can tell, anyway), so he could just say to me, “let’s keep on meeting for the next six months,” or whatever. He refuses to lay down any long term plans, ostensibly as he feels it is important to work to short-term-ish goals. I disagree, but at least he has a rationale, and in any event I am no psychologist. However, if therapy is coming to an end in about five weeks then what is the rationale for that when I am clearly still a nutjob?

On the other hand, C is constrained by all the financial bullshit of the NHS, not to mention the ludicrousness of the service’s inherent bureaucracy. No doubt he has targets and timeframes, must palm off the stupid mental within a few months cos the trust can’t (won’t) pay for the stupid mental any further than that and if he hasn’t cured the stupid mental in that time then he is an evident failure, don’t you know. Targets, man, targets!

The problem with this is that it will end up costing the health service much more in the long-run, and perhaps in more ways than one.

Let me break it down.

1. I am 26. I have been utilising mental health services on the NHS since I was 13. Had I seen a proper therapist for a proper length of time then, how much money could they potentially have saved themselves? Instead, as this post attests, six different public sector salaries were funded, some of the resources of which were devoted to me. Epic fail. (Of course my own money was spent on three other therapists because of the NHS inadequacies. Epic fail again). The point is, one way or another, I will end up back at the GP’s or psychiatrist’s office begging for help yet again, and we’ll be back to square one. Why not just agree a sensible timeframe with someone I know and trust – and clear things up to whatever extent that is achievable – now?!
2. I am so mentally and – yes – emotionally fragile as things stand that if therapy ends in the near future I am convinced I will end up in the bin. One hour of C’s time per week versus 24 hour care by several RMNs, psychiatrists and auxiliaries. Which one sounds cheaper to you?
3. A third possibility, and this may be seen as a threat which it is not intended to be, is that I finally can’t cope and do myself in. When my mother and A instigate litigation against the NHS, as they inevitably would were this possibility realised, even if the NHS won hands down, they would be forking out a fortune to fund their fuckhead solicitors. I used to work for litigation solicitors specialising in the public sector. I know what they charge; even for minor cases that are easily contested and won, it is a bloody fortune. That’s not even including barristers’ fees if it came to court, or out-of-court settlements.

Other points to consider are the following:

1. Dr C is constantly reminding me that psychotherapy is the “mainstay” of my treatment (rather than medicine), yet it seems to be her intention to see me long-term, albeit hopefully only for monitoring purposes once a suitable cocktail of drugs is found. How can therapy be the mainstay of my treatment if I am only seeing her, who only deals with the medicinal and organic sides of things?
2. I know I’ve ranted about this before, but it so utterly and completely fills me with disgust and contempt that I have worked in both full- and part-time capacities since I was 14, and given 11% of my salary to the health service since I was 16. I had two major breakdowns, including this one, during that time – but it still amounts to, I think, eight years of work. When you think about it, is it really that different from US health insurance? Maybe the percentage figure is lower, but then my employers had to pay a percentage of my salary for my insurance also. So why would I get medium- long-term therapy in America, but I can’t here?
3. I am familiar with people in other NHS trusts that have been guaranteed therapy of at least a year and a half on the health service. Now, one person I can think of has a lot more issues than I do, and so that’s fair enough – however, that individual is one of five people I can think of off the top of my head. I would hasten an educated guess that I have much more psychological baggage than each of those other four, but if not, certainly two or three of them anyway. Why, then, is it OK to fuck me about? (Incidentally, I noticed none of them had any trouble seeing psychiatrists either, so maybe my trust is just shit. Now it sounds like I’m playing a teenage game of “but they’re allowed it, so why am I not” – but I hope I’m not. I’m just genuinely mystified as to why my case is different).
4. As stated yesterday, I have been mental for many years. I received my first diagnosis (clinical depression) 13 years ago or so, but as I have discussed here at other junctures, I was mental well before that. Normal children don’t try to amputate their limbs. Normal children don’t hallucinate. Normal children aren’t obsessively paranoid. Normal children don’t deliberately coop themselves up in the house, listen to Bach, read Grey’s Anatomy and seek out the company of the elderly for intellectual discourse. They go outside and play with their friends. So when I said ‘13 years’ yesterday, I probably really meant 23, to be honest. Point being, how can two decades of madness be alleviated in less than a year? It’s fucking preposterous.
5. If I had a physical ailment, the NHS would treat me until it was cured, or, were it chronic, then indefinitely. I am not asking for indefinite treatment for my psychological difficulties, make no mistake. But the striking inequalities between the health service for physical health and the health service for mental health disgust me.

In any case, I cannot see why C has to keep reminding me that the psychotherapeutic process is finite. Of course it is fucking finite, I am not stupid – and I certainly don’t want to be in need of it indefinitely as I want to be able to manage my conditions by myself. However, for the NHS’ sake as well as my own, surely that finity (if that’s a word) ought to be directly correlated with the progress of the patient? Surely it is the height of irresponsibility to discharge someone that is clearly still fucked up and only going to, at best, waste more resources?

Fuck it all to hell. I feel like emigrating.

Be Angry With The Filthy Whore – C: Week 31

Thursday was fucking traumatic, a state of affairs of which you are probably aware given my citation of the disturbing imagery of Metallica’s Until It Sleeps that evening. You’ll have seen on that post that my iPod was reading my mind again in playing it – and other songs on similarly dark themes – but what is most interesting about this is that this strange form of electronic ESP took place as I was driving home from an utterly pointless dissociative trip to a coastal town about 20 miles from home.

My first proper awareness of going to said town was when I realised I was in the centre of it. I do have a very vague recollection of noticing my normal turn off and thinking that the traffic was heavy, but at no time did I think, “why the fuck are you not in that heavy traffic?” I don’t remember deciding to drive on, and I don’t remember the journey. Another small-scale fugue-like episode. Sweet.

I had been quite good on the self-harm front of late, but the good spell has been broken. ‘Bitch’ and ‘grief’ are the latest, though I don’t remember doing the former (it must have bled like fuck though as I had seemingly used a towel to stem the bloodflow). Grief. Am I grieving for myself, or for what I should have been? If so, is that good? Presumably one is meant to say, “well, the self-harm bit isn’t good,” but you know me folks – not really one to listen to that sort of argument. A is raging with C; in A’s eyes, it is C’s fault that I have taken to cutting myself again. But it isn’t. It really isn’t. All C has done is facilitate triggering discussions, and been someone to whom I am hopelessly attached, which is hardly his fault. We can’t avoid matters of this importance simply because there is a risk it may act as a trigger; the entire psychotherapeutic process would then be pointless, and I’d be left as mental as I ever was.

I’m unsure as to what exactly this entry will amount to, as I remember surprisingly little of the session – perhaps unsurprisingly. But let’s start at the very beginning and see what happens.

C pointed out that he’d been looking through his diary and saw that our current contract was due to end shortly (he thought there were two sessions remaining after Thursday; I thought one, but as it turns out it will not matter). This was something of which I was horribly well aware. Having only begun to open up to C properly in the last few weeks, I was convinced that he’d see me as a manipulative bitch – it looked, to my cynical mind, like I was trying to wrangle more time out of him by leaving the avalanche of confessions until this point. Given that my primary diagnosis is borderline personality disorder, it reasonably follows (in my eyes) that he could believe me to be manipulative, as the psychiatric establishment still seems to think that about those who have BPD more than any other psychiatric problem.

Of course, he didn’t like either the idea that he would find me manipulative, nor in particular that he would think this because I have BPD – that fixates on labels, don’t you know. Actually, it doesn’t, because it’s what I think he should think anyway – the fact that BPD is the only psychiatric diagnosis to still be treated with open contempt by mental health professionals just reinforces that point – though to be fair, I have not experienced that disdain personally, thank God.

I honestly don’t think I was being manipulative – not consciously, anyhow – but it did look like it, and that had been my worry all week. Of course, C refused to concede that this was the case in his eyes. Did he point blank deny it? I think he may well have done, but I don’t remember clearly enough to say for certain. What he was willing to admit to was that I may, consciously or otherwise, fear the end of the relationship, and act accordingly to preserve it. Which is apparently not manipulative. Hmm.

The issue of the end of therapy raised its ugly head a couple of times during the meeting. What he said at this juncture was that we should “…continue seeing each other until Christmas, at which point [he'll] be off for a fortnight, and then we’ll review the situation in January.”

Review the situation in January. You can take a wild guess as to what I think about that. He is going to throw me out with the dirty water in cunting January. Just over a month away, after the most stressful time of the year for me (ah yes, I’m sure you’ll be treated to a delicious rant about fucking Christmas in the near future, dearest readers). A tells me that this is not what C meant; apparently, he literally meant that we shall review the situation, and if further therapy is required (as if it won’t be), then that is what the case shall be. Well, Ms Rationality of course says, “yeah, right” to that. He is going to abandon me.

I honesty don’t remember how I reacted in session to the comment about ‘reviewing things in January’. I think I simply agreed and didn’t voice the aforementioned rejection worries, but I wouldn’t swear to it. As I said, it did indeed come up again, but I don’t remember under what circumstances. I can and do appreciate that the relationship can’t be permanent – in the most rational of ways, I don’t want it to be. I want to live an independent life, free of a need for a surrogate daddy. But can C realistically expect to change 13+ years of misery and being fucked about by the NHS in seven-ish months, particularly when I have such a strong neurotic attachment to him? Trying to be objective about it, I cannot honestly fathom that as reasonable, except in especially productive scenarios (which are about as applicable to me as…um…er…something that is very un-applicable to me). This is a personality disorder. It is ingrained into every metaphorical fibre of my self, the conscious, the unconscious, whatever – and it is causing me to self-destruct. Can something of such enormity and longevity honestly be treated adequately in just over half a year?

In any case, eventually the discussion – predictably enough – returned to the eminently delightful subject matter of the preceeding week. Eugh. It was me that raised it, though not exactly through choice; we were talking about something else (no idea what now) which triggered some sort of memory – it’s a shame I’ve forgotten what that subject was, as it would be useful to know these triggers, especially in cases where there is no obvious correlation, as I think the case was in this instance.

I became rather agitated and told C that I wasn’t “going there”. I hid.

Despite my telling him to leave it, he continued to probe me – but gently and quite subtly, to be fair. I eventually admitted that I was thinking about the Pandora’s Box.

My memory is even more fragmented from here on in, though some things do stick out in my mind very clearly. I was very, very careful not to verbally articulate much at all; at one point I desperately begged, “look, don’t you see where I’m going with this?” But it appears that he believes that I need to say the words. I still have not used the word ‘rape’, and strictly speaking he could still be under the impression that it was something other than rape – but he’s not that stupid.

He must have asked what was so troubling about verbalising this material, because I remember then telling him that I am fairly tolerant of articulating the gruesome information on this blog.

“Which is odd,” I mused, “given that it is all the more real when it is written down, even more so than if I verbally discuss it. It’s there, on the blog, in black and white.” (See here, for example).

I went on to postulate the idea that perhaps it is easier to deal with in writing because I can rationalise everything; life events become something that is seen in the third person, by a narrator, an observer with at least a modicum of theoretical knowledge of that about which she writes. If I have to talk about it, I have to feel it. I am there, in the midst of it, with the rawness, the vileness, the trauma of it all.

He agreed. He didn’t say so, but a sense that he wants me to feel that repressed pain was very palpable. Maybe that is why he was such a cock when I put this, and other shit, in writing for him – in fact, I’m certain it is. What kind of profession capitalises on other people’s grief? If I asked him why he became a clinical psychologist, I’m sure he’d respond along the lines of that old cliché, “I want to help people.” What, by making them relive their darkest memories, by making them suffer through them all again? Does that not take a special kind of sadism?

I am, of course, being a little facetious; I don’t believe C to be a sadist in the least, and I do believe he is in his job for the right reasons. But the human mind, and the sciences that arise therefrom, are odd things indeed. It strikes me as strange that it is an apparent psychological necessity to directly face that which you most revile in your past, before you can heal from the wounds it inflicted.

But this is not a post about the curious concept of psychology as an academic discipline, nor is it a post about the mindsets of those practising this form of figurative alchemy; it is a post about a session I had with my therapist. So…was it at this point that I lost it? I’m not sure, but anyway, in my next clear memory, all I could see in my head was the INCIDENT, or more specifically, the moments during which I was pushed to the floor of the outhouse in which it took place and served up as tasty piece of young meat for the delectation of my uncle. I recall very strongly that (in C’s office, not in my mind) I had my head in my lap and was pelting my skull with both fists with as much strength as I could muster. I have never done anything of this ilk in C’s company before.

And so he too did something that he has never done before; he raised his voice to me. He didn’t shout, but he did raise his voice just enough to try and penetrate through the mentalism that had tenaciously gripped my mind.

“SI!” he called. Well, he didn’t of course – perhaps it will surprise some of you to learn that I have a name, a normal, very ordinary name, and he used that instead – but you know what I mean. One thing I’ll not forget about this session was that he actually used my name three times, and at one point I used his too – these things are unheard of in the whole time we’ve known each other. Does it mean something? Why do I attach such importance to something so apparently normal and trivial? Is it because using names is personal, and that I want to see him as a person, not a canvas? Who knows. I certainly don’t, but I do know that that memory sticks with me.

I think he must have somehow brought me back from this mental place, but I don’t remember the specifics. The next part of the conversation that I recall was when he asked me how I felt about myself and that I told him that I felt like a “dirty, fetid little slut.” I then rationalised things for a bit, proclaiming that I am in actuality not a slut. Unfortunately, I still felt (feel) like one.

Then I lost it again. “I’m a filthy whore,” I spat, hiding from him again with my hands.

I think he actually went as far as to tell me that I am not a whore, but that could be a phantom memory. I mean, how the fuck would he know? I could have sold sex in 28 European capitals for all he knows. One thing he definitely did do was try and help me regain my composure. I sat up and pretended to be fine, sticking out my hand to measure how much it was shaking. I have used an incident when I was about 15 as a yardstick to measure anxiety; the day after I found out about an incredibly twisted lie from my first real boyfriend (a long story that I will have to detail some day), I went into school and, in English, happened to notice how much my hand was shaking. That denotes severe anxiety and/or anger. If the shaking is less than that, things could be worse.

I told C about this. However, a brief reference to the lying cunt of an ex must have touched on the self-disgust I was already feeling over my own lying to C about the INCIDENT (when we first met I told him it was ‘mere’ touching, but that was only part of it, obviously. More on this shortly). I told him this – still without using that word – and went into a major self-invective of utter disgust and abhorrence. It was filled with ranting about how much of a shameful, lying, grotesque, hateful slag I am, lying to the one person that might be able to bring me back a little hope in this sorry mental battle, and about how guilty and sorry I am, blah blah de blah.

When I took a second to draw breath, he jumped in to try and (a) reassure me that I had nothing to feel guilty about and (b) establish exactly what it was that I felt I’d lied about.

I answered (b) first, at least to the best of my recollection. He’d specifically asked in our initial assessment sessions what form the sexual abuse took. As is my wont, I had avoided articulating myself properly, and instead managed to answer the question merely by his probing. I think, though I am not certain, that he asked if I was raped, and that I said ‘no’. I am sure that when he asked if it was inappropriate touching that I said ‘yes’, and that I led him to believe that that was all. In my defence – and I told him this in the session to which this post refers – I have dissociated a lot of the INCIDENT. I remember ghastly, loathsome pieces of it in fleeting glimpses, like looking at still pictures in an album or, sometimes, short video clips. I remember the sensations of pain and terror in these moments too. I am grateful that the memories are so brief, but also resentful of it too, as it feels like it removes my power to understand the INCIDENT and my reactions to it. Furthermore, obviously part of me does remember it, and that part is mentally fucked – perhaps it would be easier to address were it all consciously there at the front of my mind.

Anyhow, I then proceeded to respond C’s (a) point. “I lied to you,” I said simply. “Aren’t you angry with me?”

“No, of course I’m not angry with you.”

“Why not? You should be.”

He sort of laughed (he mustn’t have realised I was serious), but seeing the look on my face, he desisted from doing so abruptly.

“SI,” he said again, firmly, looking straight at me. “Do you seriously think that I should be angry with you?” His tone was a more compassionate version of ‘incredulous’.

“Yes,” I began, “fucking dirty, lying, grotesque little bitch, fucking…”

“One,” he interrupted, rather dramatically, leaning forward and counting on his fingers as he did. “We had only just met and you can’t honestly have expected yourself to deeply discuss such sensitive matters with someone you didn’t know. Two, you didn’t lie, you omitted some information…”

“But then that’s a lie of omission…” I began.

“Three!” he went on, raising his eyebrow in a surprisingly authoritative fashion, signaling that I was to let him finish, “three, this is hard for you to talk about, so it is not surprising you withheld it. What is there to be angry with?! I am not angry with you, and neither should I be.”

Well, that was me told, then. I was quite taken aback by the forcefulness of his tone. Actually, ‘forcefulness’ is a horrid word to use as it has negative connotations – let’s say ‘emphatic’ instead. He was incredibly emphatic. I gaped at him in a sort of stupefied disorientation for a minute or two.

He sat back in his chair, recovered his blank canvas and either asked me how I felt, or signalled for me to speak.

“Um…” I muddled. “That’s reassuring. I do feel reassured. But it also confuses me; you have a completely different attitude to it from me.”

He seemed to understand that in fairness, which not an awful lot of people would. He was able to see the black-and-white chain of logic that I was following in believing that he ought to be angry, but luckily for C things in his world do not seem to be as black and white as they are in mine.

I don’t remember how things ended. I know that I was battered and bruised psychologically (and physically to boot what with punching my head). At no point had I been tearful, but one does not need to weep to mentally suffer. I went and sat in the car and phoned A for catharsis and reorientation purposes. Although the trauma of reliving the INCIDENT had been the most awful aspect of the session, the fact that I fixatedly whined to A that C ‘wants to abandon me’ before I even touched on the rest of things is very telling.

In later discussions A urged me to tell C about this abject fear. What’s the point? C already knows I’m terrified of him abandoning me. Perhaps the real question is ‘is my attachment to him healthy?’ There have been mixed views on this from the readership of this blog. cbtish, for example, thinks it puts me in an intolerable position (cbtish is a therapist). Vanessa from eTransference, a clinical psychologist in training who has a particular interest in the phenomenon of transference, thinks it ought to be encouraged in many ways. Others undergoing therapy – bourach and thesamesky (who’s also a counsellor) for example – have their own struggles with the therapeutic dyad (bourach in particular will understand why I thought C should be angry with me, given this post of her’s).

I don’t know what the answer is; just that the attachment is very real. Just that I feel guilty for withholding information and for lying (though he wants me to stop that – and I’ve just remembered that the session ended with him asking me, again, to try and not post-mortem things in therapy. Oops. He was also worried, after what happened with VCB’s SHO in September, that his actions or words could have a…er…detrimental effect on me. Double oops. All I can say is that I think our current dialogue is progress, regardless of any self-harm that follows). And at least I am far from alone in withholding, and even lying.

But it’s still all a bit of a quagmire, yes?

Until It Sleeps

The iPod has been acting as a mindreader again.

I’m not in the habit of doing this as this blog is mine; my life, in my words. However, sometimes others just say it (whatever ‘it’ is) better than me, and this is very much one such occasion.

So, ladies and gents, I give you the nature of my present sorry existence – as presented by Metallica.

Until It Sleeps

Where do I take this pain of mine
I run but it stays right by my side

So tear me open and pour me out
There’s things inside that scream and shout
And the pain still hates me
So hold me until it sleeps

Just like the curse, just like the stray
You feed it once and now it stays
Now it stays

So tear me open but beware
There’s things inside without a care
And the dirt still stains me
So wash me until I’m clean

It grips you so hold me
It stains you so hold me
It hates you so hold me
It holds you so hold me
Until it sleeps

So tell me why you’ve chosen me
Don’t want your grip, don’t want your greed
Don’t want it

I’ll tear me open make you gone
No more can you hurt anyone
And the fear still shakes me
So hold me, until it sleeps

It grips you so hold me
It stains you so hold me
It hates you so hold me
It holds you, holds you, holds you
Until it sleeps

I don’t want it, I don’t want it…

So tear me open but beware
There’s things inside without a care
And the dirt still stains me
So wash me ’till I’m clean

I’ll tear me open make you gone
No longer will you hurt anyone
And the hate still shames me
So hold me
Until it sleeps

(c) James Hetfield and Lars Ulrich, Metallica (from the Load album, 1996).

I will write properly tomorrow, but in the meantime you can listen to and watch the video for the above here.

Mad versus Bad, Stockholm Syndrome and Defending HIM

The phenomenon of Stockholm Syndrome has been bandied about a lot in the media recently, in the wake of the Jaycee Lee Dugard abduction and, to a lesser extent, in discussion of the Fritzl case (though I am not sure to what extent Elisabeth Fritzl was affected by it).  There is a particularly good article, by trauma therapist Kathy Broady, on the condition here.

For those of you not familiar with the issue but who don’t have time to follow the links, Ms Broady puts Stockholm Syndrome thus:

It is when victims form positive, caring attachments with their violent perpetrators.  The more victims have to depend on their perpetrators for their very survival, the more likely the victim will form an attachment to their perpetrator…

[Victims] knew that their life and basic survival needs were completely dependent upon keeping the perpetrator happy.  They learned to base their own survival on effectively meeting the needs of the perpetrator, and the perpetrator had the power to decide if they would live or die.  To survive, they became loyal to the perpetrator.

Perpetrators purposefully create this kind of dependence in their victims.

As far as I am aware, and it fairly logically follows given the above set of circumstances, Stockholm Syndrome is most frequently seen in cases of long-term abuse (and is thus not particularly applicable to me).

During a recent documentary on the Dugard case, my mother sat aghast as the narrator described how Kaycee and her two daughters wept as their abuser (and father of the two younger girls) was arrested.  She admitted that, had they randomly told their story without proof, that she would have thought them to be either unforgivable liars or seriously afflicted by folie a trois.  How, she argued, could you care so deeply about a person who had so horribly and systematically abused you?

I spoke to her at length about Stockholm Syndrome, but to little avail.  She understood the concept in theory, I think, but was nevertheless unable to grasp how it could actually be.  The whole idea is so alien to her that she cannot conceive of it being a very real condition, borne – initially at least – out of necessity.

A similar, though distinct, query arose with her when the Fritzl story broke last year.  “But how is it possible for her father to have done this to his daughter?” she despaired.  As with the Dugard case, had the story not been there in black and white, I don’t think she would have believed it.

“He must be mad,” she concluded.

Quite possibly.  Indeed, quite probably.  But at what juncture do we allow abdication from Fritzl’s personal responsibility (not to mention his duty of care to his daughter, morally if not legally at her age), due to the fact he clearly had a twisted and sick brain?  When does bad become mad, and/or vice versa?

Anyway, the point of this post is not to write a psychocriminological masterpiece on Stockholm Syndrome.  I’m only here to say that, although I do not believe for one second that I have it or anything approaching it, I do understand it.

I suspect some of my readers – those few in my real life, in particular – will dislike the latter part of the title of this entry.  “Defending HIM” – ‘Him’ being MMcF’s husband, perhaps unsurprisingly.  I am going to defend him…but, and it is a very BIG ‘but’, that does not mean that I am defending his erstwhile actions towards me.

I mentioned in the last post that I’d explain why I had become less concerned for MW’s welfare so let me clarify that point.  I have been exposed to Paedo in large doses twice recently and have found myself to feel nothing other than overwhelming pity for the man.

In some ways, I have done for many years, but he was so much a shadow of his former self of late that the sense of sorriness felt all the more palpable.  I think I have alluded to the fact before that he is mental too, suffering from some unspecified psychotic disorder.  He, like me, takes Olanzapine to counteract it, and it has been effective in its indicated usage.  But he is now incredibly depressed regardless.

So what, SI?  (a) Doesn’t he deserve to be and (b) depression is treatable, so why are you decreasingly concerned for MW?

(a) Well, yes, maybe he deserves to be.  But the man has had no life.  His life, for as far back as I can remember, has been nothing more than a pathetic existence.  He was forced to marry MMcF when they were both very young, as she was up the stick (a reviled state of affairs in the ’50s), and he has been under her tenacious grip ever since.

As I have stated on the page about the people in my life, at face value MMcF is a lovely woman.  The reality, however, is that she is domineering, manipulative, cruel and overwhelmingly demanding.  I consider it no coincidence that the two of her children that still live with her – S and K – both have no lives.  In their 40s now, they will never leave that house.  I also consider it no coincidence that S had very severe social phobia and still has depression (she claims she has bipolar disorder, but none of us have ever witnessed anything approaching even hypomania, and she only takes Venlafaxine, no mood stabilisers.  But what do I know) and indeed that Paedo is severely delusional.  The two other sons eventually escaped, but are nevertheless intrinsically linked to every brick of the house’s build, as are their children.  S’s daughter seemingly escaped but her, her husband and little MW might as well move in because they are always there.

The hold is enforced by MMcF.  Frankly I am scared of her.

Now, re: Paedo.  Well, given his entrapment, I actually can understand a willingness on his part to stray.  Could he separate from her, divorce her?  He could – or could have, more accurately – but even if he had, she would have manipulated him back.  I guarantee it.

So, yes, I feel sorry for him, and long since have.  MMcF does nothing but criticise him, and yet he serves her and complies with her selfish desires without complaint, and endlessly worries about her health and welfare (neither of which are great).

It does not, however, condone child molestation, because quite clearly nothing does.  No matter how shite his life may be, may long since have been, I did not deserve to be raped by him (nor, of course, by anyone else).

All I am saying is that the person is distinct from the act, no matter how heinous or twisted that act is, so I have the ability to feel pity for this man, who did this most horrid of things to me.  I don’t like him, and I most certainly do not love him, but I feel regret that he’s had such a waste of a life, and if I can feel that, then I can completely understand how in more serious cases of abuse that that could progress to compliance, submission, friendship and even love.

(b) Yes, depression is treatable, and Paedo may well be able to be treated for same.  Still, it is very chronic, and with the aforementioned shitty life, will be all the more difficult to shift.  We have a saying in Ireland: if a person is perceived to be on their last legs or just otherwise haggard and decrepit, it is often said that they are “done”.  Well, Paedo is thoroughly and utterly done.  Quite honestly, death would be a mercy to the man.

So on the balance of probability now, I am fairly sure that he simply isn’t either physically or mentally capable of posing a threat to MW, MW’s impending sibling, or any other member of that (or any other) generation.  He is beyond it.

Of course, I am not, and cannot be, 100% certain of this – who is ever 100% of anything?  As such, I will remain vigilant and will tune my awareness to any changes in MW’s behaviour as finely as possible.  If I think for a second that the child is under threat, I will act.  I will break Paedo’s neck myself if needs be.  However, I do genuinely not perceive this as likely at the present time.

To address my mother’s points vis a vis the sad Dugard and Fritzl cases.

If you, mother, find it so hard to accept Kaycee and her children’s attachment to their abuser, consider proportionally the defence your daughter has just given of hers.  Does it seem so alien now?

Furthermore, as stated Stockholm Syndrome develops of necessity – in the case of most long-term trauma victims, because they cannot escape the situation, so it is better to ‘embrace’ (for want of a better word) what the abuser wants, in order to make life somewhat more tolerable.  In my case, evidently a less serious one, I would also say that some of my reaction to Paedo has developed of necessity.

I have basically accepted him, and I have kept the story to myself, to save an entire extended family.  Others could have been abused, I know, and I will never stop wondering if I could have prevented that – but I would have had to go to the police, alone, as a traumatised child, and with a total lack of evidence, what would have happened anyway?  So, with the best will in the world, I could hardly have prevented harm to that generation, and so I did all I could in the circumstances – I tried to keep the family my mother loves together.  And now I am looking out for the next generation’s welfare, which is the best I can do now.  I cannot ruin a family over an incident 16 years ago for which I have no evidence.

So no, abused individuals do not automatically hate and reject their abusers, for a multitude of reasons.

Finally, why is it really so impossible to believe that close relatives can and do abuse those close to them?  Many readers will be aware that most acts of sexual violence are perpetrated by someone known to the victim.*  Well, I can’t say the rape and the overt sexual behaviour were particularly systematic in my case but still – he was my uncle, I was his niece, so there you go.

* Child Sexual Abuse Fact Sheet, National Child Traumatic Stress Network – http://www.nctsnet.org/nctsn_assets/pdfs/caring/ChildSexualAbuseFactSheet.pdf

The Questions I Never Wanted to Face – C: Week 30

I’ve been avoiding writing this entry, in part due to a continuing malaise with being arsed to do anything, never mind soul-searching and expunging myself across the internet. But it’s not just been that. There’s nothing that I am going to say that is unknown amongst the circles that read this blog, but talking about this shite in therapy and then making it a concrete black-and-white reality in a journal make it real, and it is not allowed to be real, not by me at any rate. So I have been avoiding it. You should note that I am deliberately going to refrain from putting some details here, due to their personal nature, but I am sure you can forgive me.

Thursday’s session with C was one of the most frank and revelatory that I’ve experienced to date. It was a strange meeting, because initially I thought it was going to be one of those useless, ‘let’s both stare at the floor’ encounters, but if anything it ended up becoming one of the more useful (if difficult) sessions I’ve had in psychotherapy, because we finally began to face some of the stuff I’ve been so strategically avoiding in the last six months (and, frankly, for much of my life).

I was greeted with that usual opening gambit of, “so where would you like to start?” I know why he does this (“the dyad is a co-construction but you have to help inform it by raising issues of concern” or some such, no doubt) but seriously, is it really so much to ask for him to just ask me a question about something he thinks is worth discussing? Although I wasn’t in the same agitated mood that I was last week, I sort of shrugged off the question and we looked at each other.

Two points of interest arise for me here. One – why do I have such trouble just telling him where I would like to begin? Let me try to articulate how I feel in the moments immediately subsequent to his opening question. I suppose the closest I can really get to it is to say that it just feels inappropriate. Is this a boundaries thing? Is it something to do with a possible perception on my part that he is an authority figure? It just feels like I’d be breaking a rule, that it is something of inherent embarrassment to me, like I’d be showing myself up like a child humiliated by her teacher or parent.

Two, regular readers will know that C has directly confronted me – if I may use artistic licence with the term ‘confront’, for want of a better one – about the fact that I hide from him. I mean that I literally hide, not (just) metaphorically: I have fairly long hair, and I either wear it loose in his office and hide behind it, or I take it down from a ponytail in his office, and hide behind it. I also put my hands over my face to avoid him. How, then, is it that I can stare him out at other times (note that above I stated that we stared at each other for a bit)? In fact, I do the stare with such intensity at times that I think I unsettle him – whether or not that’s correct, at the very least I usually win ’stare-outs’ with him. I stare and stare and stare, confrontationally, challengingly, defiantly even, all in a strange dance of intellectual seduction, no doubt designed to avoid actual exploratory psychotherapeutic work, which is no doubt exactly what this o’er weighty prose is also designed to do, so I shall forthwith desist from it. To try and answer the question, though, my suspicion is that the ‘hiding’ occurs when I am vulnerable or open with C, and the staring when I feel confident or (probably erroneously) believe myself to have the upper hand in the dyad. I am a walking Freudian stereotype.

The beginning of the discussion – and in fact the first 30 or so minutes – were really pretty innocuous. One thing that completed cracked me up was that he made enquiries as to the nature of my finger injury. Initially I was slightly taken aback by this – why the fuck would he show friendly concern over a cut finger? That is at most a medical problem, surely? However, I explained the circumstances in deliberately pedantic detail.

He nodded and smiled slightly in that irritating ‘oh-right-that’s-nice way’ that he does when I have said something that he deems irrelevant (which was most frustrating in this case, as he instigated the discussion), seeming apparently satisfied with my response. I wasn’t going to let him off with it though (more avoidance?) and said, “you thought I did it deliberately, didn’t you?”

He hesitated; I think he was reluctant to answer that, but for once he did give me a straight response, stating that, “that had been [his] thinking.”

For some reason I found this preposterously hilarious, and laughed and laughed. Although he tried to humour me, C was clearly puzzled by this amused lunacy, and retrospectively speaking, so am I. OK, so trying to severe my finger hasn’t exactly been my self-harm MO to date, but then this is the girl that recently bought, for the purposes of cutting herself, a surgical scalpel from eBay, and as a young child tried to amputate her foot. His supposition was not that terribly unreasonable when you think about it.

By whatever means of progression, we ended up engaging in a fairly length discussion about ‘They’ and the VCB’s prescription for an anti-psychotic to combat ‘They’. C, correctly, kept calling ‘They’ ‘them’ when ‘They’ were the objects of his sentences. He then went about correcting himself and apologising to me, apparently believing his ‘incorrect’ term was some sort of invalidation of me (because throwing a whole ream of hard work back in my face isn’t, but whatever), but I honestly couldn’t care less. It doesn’t matter what C calls ‘They’ – it’s not exactly going to rid me of their malice, is it? And his ‘mistake’ isn’t a mistake – he’s correct. Allow me to honour Dr Freud again; does my refusal to name ‘They’ in correct grammatical terms hark back to childhood trauma, when such niceties of the English language were only beginning to be understood? No, it probably doesn’t, so let’s move on.

The discussion of ‘They’ led on to further perusal of my recent psychoses (as detailed in the ‘They’ post and in this tweet); namely, the knocking, whimpering and music. I told C how I sinister I found them all, in particular the heinous music, but that in some odd, vaguely altruistic way, the whimpering was the worst. My desire has been to help the whimpering creature, to rid it of its obvious pain, but of course I cannot do that as, oddly enough, it isn’t fucking there because it doesn’t fucking exist. On the other hand, I explained, even if I could find the source of the whimpering, my pathological fear is that it is a trap laid by ‘They’ to somehow torture my mind further…or indeed worse (if you can euphemistically call taking me out ‘worse’, and I am not convinced that you can).

Anyhow, so far so tame. Well, not so for a normal, but yeah – let’s stick with ‘tame’ anyway. Unfortunately I walked into a trap at this juncture. Well, that’s unfair; C didn’t mean to dig into something right at this point (or at least I don’t think he did), and even if it had been a probing question, it would not be fair to consider that entrapment. He merely asked how I experience these sounds.

I won’t go into my answer nor the next 10 minutes of conversation, as this is the personal information to which I alluded in the opening paragraph. This remains private, between C and me, and no one else; all I’m willing to say is that it relates to me protecting myself. I’ll make only two other points about it. Firstly, this particular subject could have been horribly uncomfortable and awkward – and with the wrong person, it indubitably would have been. But I felt at ease with C, relatively speaking, and thought he dealt with it with tact and sensitivity. Secondly, this part of the session ultimately led to one of the topics I have been dreading to face in detail.

“You’re opening a Pandora’s Box here,” I cautioned at this point.

“Do you want to tell me what’s in the box?” C responded on cue.

I very deliberately turned round to look at the clock, noting only 10 minutes remained of the session.

“What a shame we don’t have time for that,” I smiled, probably patronisingly.

He took another route. “Can you even tell me the name of the box then, or give some details as to its contents?”

I took a deep breath. “You are aware of what happened with my uncle.”

He nodded, and what followed was some slightly circular discussion about my continuing worries about MW and his soon-to-be sibling (my cousins twice removed, or third cousins if you prefer the more common, yet inaccurate, assessment), and how that’s diminished a little of late*. Another point was regarding MMcF’s husband’s exact relationship with me – ie. that he is my uncle by marriage. There was subtle reference as to what extent the incident (lovely word) has consciously impacted upon my life in the last 16-ish years.

Finally he said it. I don’t remember his exact words, but it was something like, “you haven’t told me it all, have you?”

That sounds like he phrased it in a sort of blaming fashion, but honestly, he didn’t. I just remember that it wasn’t something like, “there’s more to this”, because I’d have said ‘yes’ to that, whereas the correct answer to the question above was ‘no’.

I didn’t feel like a child, or at least I don’t think I did. I did, however, bow my head, look up at C from this submissive position and shake my head slowly, sadly and in a horribly resigned sort of manner – just like a child does when faced with a similarly awkward position. Submit submit submit. You lied to him, you little bitch, you lied.

I would reiterate that this is my thinking and that I got no sense of blame or recrimination whatsoever from him. Still, I hate the fact that I actually outright lied to C about this matter in our early discussions. I hate it. I hate it almost as much as confronting this bollocks itself.

We didn’t talk about the whole shame issue I mentioned in the sex abuse post, simply as there wasn’t time. We did spend the few minutes that were left exploring who else was privy to the information – A is one of only two ‘real life’ person to whom I’ve actually spoken the word ‘rape’ in this context, though a few others will have now found out thanks to reading the material I’ve written on the blog.

The other person who heard me use the word was my mother. Her reaction to the whole thing is a subject for several sessions with C as, to be honest, her way of handling it wasn’t exactly in my best interests. I gave C the brief version, which is what follows, though of course it will be revisited I’m sure. When I first confessed to my mother that anything happened, she said that I had misinterpreted McMF’s husband’s actions, as “he loves children” and would touch them in innocent, companionable sorts of ways – that must have been what happened, SI, you silly girl! Mum still holds to that position, on the very rare occasion that there is some sort of reference to the INCIDENT. When I told her, on a separate occasion, the full extent of the INCIDENT, she – knowing I am not a fan of the McF dynasty – said I made it up to avoid going to their house. Cheers mother.

Of course it was not just the INCIDENT that permeated this period in my ‘relationship’ with McMF’s husband, though that was always the worst bit – well, obviously, I suppose. The fact that I mainly have flashback-like recollections of the worst part – ie. my wriggling under him as he pushed me down and did what he wanted – is presumably suggestive of dissociation from there onwards, for which I am both grateful and resentful. There was more to it than just than one day too, and God forgive me, I played up to it. I did. I played up to it. I would wear short skirts in front of him and make suggestive comments to him – not because I wanted him to touch me ever again, but because I wanted him to suffer (the rationale being, “oh, you want me, do you fuckhead? Well, you can’t have me!”). When he did later touch me again (once in a room full of other children – thanks for that memory, mind), I would seize up and eliminate myself from the situation with as much speed as possible. It makes my skin crawl to think of this.

Yes, it makes my skin crawl, and my reaction to it makes my skin crawl. I know I was a child, and I know flirtatious and sexualised behaviour is a common response to child sex abuse, but I feel like a grotesque little slut nevertheless.

Readers, I cannot do this. I cannot face the enormity of not just this hideous link to the past, but also that of the first boyfriend saga, and that of the desolation of grammar school, amongst others. How can I face this all with C? How? I can’t even face it with me! I am not strong enough. I am weak. The word flows through my blood and inhabits every cell and fibre of my being. Weak, so, so horribly, pathetically weak.

OK, I have totally digressed. This post was about a session with C, and I have turned it into a mini discussion on child sex abuse and my failure as a human being. Sorry. To return to the point, C and I had to finish the session after the talk about my Mum not believing what I had told her about her brother-in-law. A Pandora’s Box indeed. I should have kept my mouth shut – the next few weeks are, I suspect, going to be tough.

And yet I should not have kept my mouth shut because it needs to be confronted, and in this way I am heartened too. Even though I don’t think I can do it, it is a real development. It’s only taken six months, but what’s half a year between therapist and client!

The session ended with C advising me that both offices on either side of him are being renovated shortly and that as “we can’t do work of this nature with such noise”, we’ll have to have an office change. It will be the second, which is a completely cuntified state of affairs – but there is an upside to it. The building work, which is starting in two or three weeks or so, is due to last for 12 weeks. Our current therapy contract is due to end on 26 November which would mean only two more sessions, which from my point of view simply cannot happen or I’ll be straight into the bin (or the ground – who’s discriminating). But C said something like, “so we’ll have to move out during that time…”, which is an excellent statement, as it strongly infers a continuation of treatment for the foreseeable future. Certainly, he once told me before that there would be a minimum of a four-week preparation period prior to any cessation of therapy, and very clearly that has not come to pass, but whatever way he phrased his words it sounded like he still expects to see me back in the current office when the work is over, so that’s a decent extension to the current timeframe.

What I expected to be a reasonably short post has turned into my usual 2,800 word bullshit. I see, reading back, a lot of pontificating about words and language. More avoidance?! Anyway, I’m going to bed. Goodnight, dearest readers.

* I’ll blog on this in a future post. Suffice to say, I saw MMcF’s husband the other week and he really is a pathetic shadow of his former self which, for the benefit of his great-grandchildren at least, is a most beneficial state of affairs.

Remonstrations with C – Week 29

I was absolutely dreading seeing C last week, after the disaster of the previous week.  Although the rawness of my hurt and anger had abated somewhat, I still felt fucked over and undermined, and obviously had no idea what he was thinking.  In fact, I’d arrived at a position of relative indifference towards him, something I’ve never really felt during the whole time we’ve known each other.

My initial thinking was that, from a psychodynamic perspective, this was a very bad thing.  You can’t just switch transference off, not well before the relationship has fulfilled its duties anyway (which as you can tell, ours as yet has not). I mean, one is surely supposed to feel strongly – or at least not ambivalently – about the therapist in the course of this type of psychotherapy.  But perhaps it wasn’t such a bad thing after all.

As I walked behind him from the waiting room to his office, I couldn’t help but observe how much his bald spot has grown since I first met him back in February.  He has lovely fluffy hair, like a man about 40 years his senior (old people always have lovely fluffy hair, don’t they?).  But now it is falling out.  By odd coincidence, I noticed my first grew hair on the evening of the disaster session that this meeting followed.  I must not allow myself to be deluded into thinking that I am encouraging or in some way perpetuating C’s hair loss.  That would be fucking stupid.

I sat down, and immediately cast my eyes downwards, so as to avoid his gaze when he sat down.  I don’t recall what he said at first – maybe he offered some salutation or asked where I wished to begin, but in any case he paused for a few minutes (during which I sat in a fiddly silence) and then told me that I “seem[ed] very agitated.”

Well, look at Dr fucking Insight. Your powers of perception astound me, C!  Well, actually, they do at times – but I think on this occasion the observations could have been made by a dead giraffe with its neck twisted in a strait jacket.

I elected to ignore him beyond a mere shrug.  ‘They’ were laughing spitefully at the back of my head and getting on my tits, though I don’t think they influenced my behaviour around C particularly. He hadn’t mentioned the previous week, and I hadn’t the balls to bring it up unsolicited, so what did I have to say to him?

Eventually, of course, he broke the silent deadlock with that perennially irritating question, “what’s going through your head as we sit here?”

As I recall, I told him that very little was going through my head.  Apart from the grammatically- and personality-challenged ‘They’, not much really was happening in my head.  It felt as if I existed in a thought vacuum.  I didn’t feel good by an stretch of the imagination, but I didn’t exactly have anything tangible to exemplify that at that particular point.

This impasse continued for a few minutes, as ‘They’ assessed C.  Perhaps unsurprisingly, their conclusion was not especially positive.

Eventually, after having ‘They’ berate C for a few minutes I took a deep breath and told him that I was seriously considering voluntary admission due to the danger posed by ‘They’.  I went ahead and explained about ‘They’ in detail.

“I don’t want to go, C, I don’t want to go,” I told him, anxiously.  “But I’m concerned that I’m in dangerous position and that I ergo have no choice.”  It’s funny; it’s the the first time I recall using his name when addressing him directly.  Not that it matters really – but it seems more personal or something.

He talked for a while about the procedure one has to follow to seek admission to an NHS psychiatric ward.  Unfortunately, it doesn’t seem that it is as simple as it used to be.  You have to meet your GP or psychiatrist, but rather than them referring you directly, they then send you to one of those fuckwit Crisis Teams who decide how mental you are.  Based on my experience, you’d need admitted after meeting them, not that they’d realise that, because apparently a cup of tea and some meditating will cure all mental illnesses and emotional difficulties.  Yep.  That’s why people in my position are considerably more likely to end up topping themselves than the general population, you pathetic cunts.

Anyhow, I was actually reasonably impressed with C’s non-judgmental take on on both ‘They’ and my hospitalisation proposal.  It is often his wont to tell me that I can be in control of stuff like this, which to my mind is (mostly) horseshit.  Although we later discussed the possibility of exploring non-medical ways of dealing with ‘They’, certainly at this juncture, his tone was accepting, as was the content of what he said.  That was encouraging.

After the discussion around hospitalisation, I admitted to him that ‘They’ didn’t like him.

This enraged ‘They’.  “That is not what we said,” ‘They ‘ shrieked at me.  “We said he was a cunt.  Tell him.  Tell him…TELL HIM!”

For the first time, in utter frustration, I actually spoke aloud to them – or rather, I shouted at them.

“Alright, for fuck’s sake, I know!” I yelled.  I had actually been in the middle of a sentence directed at C at the time, and he must surely have been taken aback by this random outburst – but he managed not to bat an eyelid.

I don’t remember how the discussion of my anger at the previous week’s annoyances arose, but eventually arise it did.  I do remember that he said that I hadn’t commented on that, and my responding that he hadn’t asked.

Rather than express my raw hurt, I simply said, “let’s put it this way; I wasn’t in the best of moods last Thursday.”

His response surprised me slightly, though I think I hid it well.  He said, self-referentially, “what a bastard, right?”

“Um…well.  Am I allowed to say ‘yes’ to that?”

“You’re allowed to say whatever you like.”

“Then yes, exactly.”

He nodded, apparently unoffended (not that he should be given his job), then we discussed the issue in a fairly forthright and adult manner.  There’s little point in going over it, as most of my annoyances were discussed in the letter – though I didn’t give it to him as I said I would in the comments of that post.  I did tell him about it, though, and admitted to having a printed copy in my bag.

C actively encouraged me to read it to him, but I refused.  I don’t know why; I’m annoyed with myself for chickening out, but it just didn’t feel ‘right’ at the time.  I told him I would think about it, and indeed I have the letter ready to take again tomorrow.

I had made the point that I had taken an awful lot of time to prepare the stuff I’d taken to him the week before, and told him that I’d found it horribly invalidating when that work was “thrown back in my face because [he] couldn’t be arsed to read it.”

He didn’t bother to defend himself in anyway.  Instead, he went to what seemed to me to be great pains to tell me that he really did understand my upset.

“And maybe you felt rejected?” he later queried.

Rather than duck out of this, as I would normally have done, I went ahead and confirmed his suspicion.

I wasn’t overly emotional throughout this discussion (though had been a bit during the discussion of ‘They’), but I had been out the day before wearing eye make-up (and hadn’t been arsed to wash it off – I know, I know, how disgusting), and my reluctance to express myself in this fashion in front of C had more to do with the possibility of having big black mascara-streaks down my face rather than my usual ‘must-fight-against-it-it-is-evil-and-weak’ stance.  For the first time I began to get a sense that I could and should talk openly to C about things I’d deliberately avoided, and that I could maybe start to demonstrate exactly how I might feel – and if that includes crying, or ranting or kicking things, then so be it.

There was nothing clear in the discussion that led to this, but for whatever reason, I felt the dynamic had subtly changed for the better – not that it’s generally been a bad one, of course, but perhaps it took an argument for me to fully trust him not to abandon me; ie. that if he was still there, still very much part of my life – and if anything more supportive – after a major disagreement, that just maybe he could be trusted with a range of unpleasantries.  Not that I ever consciously doubted that, but I don’t know – the subconscious is a funny thing I suppose, and I’ve always been firmly of the view that one should trust no one until they have definitively proven themselves trustworthy.  And even then, the trust should be cautiously administered.

Whatever subtleties took place last week, I hope they can sustain the future of the therapy.  Far from wanting to seek an alternative therapist, as I did the day I wrote the letter, I am quietly encouraged by things with C as they stand.

But it could all change tomorrow…

The Malice of the Voices of ‘They’

Owing to the pain of this -

- I’ve been somewhat in absentia from the blogosphere recently.  Was this gash – which is actually worse than the above suggests, being as it was nearly a removed-tip-of-finger – deliberate?  Was it fuck!  I even commented on the annoying irony of this on Twitter.  On Saturday the lid to a toothpaste tube had become lodged in the sink plughole, and the only way to get it out, aside from amateur plumbing, was to edge it out at the side with a knife.  A certain angle, a lot of force, and it wasn’t just the offending lid that ended up deeply cut to pieces.

I was urged to go to A&E to get this stitched, and I should have; it’s deep, and it’s very, very open.  But I didn’t.  Inertia?  Yes.  Social phobia?  Yes.  But the fact that an XBox 360 Elite has arrived in the house didn’t help either, not that I could use this finger to use the controls.  Neither could I drive initially, nor type, so forgive my lack of posting.

I admit to some malaise re: blogging though – I can’t blame everything on my half-axed physical extremity, given as the blog has gone unwritten for just under a fortnight.  A post that I’d originally started on Wednesday afternoon was to be called ‘The Rollercoaster’, such was my mental state between the last post and then.  Most of it is faff and I could never be arsed finishing it, so I thought I’d condense (ha!) the salient points of it into this new post.

Of course, I am aware that I haven’t written about my last session with C; I shall try and rectify this tomorrow.  In short summary, we are, for now, friends again.  We discussed the previous week’s annoyances, and although I didn’t give him the letter as intended, I did tell him about it.  He actually wanted me to read it to him, but I’ll detail that later.  I was honest with him for a change, but because I’d been too lazy to wash my face from the previous day, when I had worn mascara, I refused as ever to cry in front of him.  I think I might have done, though, had I not been horrified by the thought of having black streaks down my face, so I suppose that’s progress.  A silly reason?  Well, if I was a therapist, I’d laugh at an individual in such a position, so I can’t expect C not to.  On the other hand, I’m probably just a sick fuck.

Anyway.

The main thing of interest since my last post is the development of ‘They’.

‘They’

Poor A has been doing a lot of home-based overtime recently, and the morning of Saturday 31st October saw no exception to this.  That morning, he was in the study working, whilst I was lying in bed trying to fight off the usual Saturday migraine (this used to happen when I was at work each week, but when I became a dolescum, it mostly disappeared.  In the six to eight weeks prior to this date, however, the weekly migraine has returned.  Reassuringly, A asked me to ask Lovely GP if this combined with recent hallucinatory behaviour could be symptomatic of a brain tumour.  Yippee).

For contextual reference, overnight on 26/27th October, I had been plagued by horribly frightening auditory hallucinations all night (see this tweet), indicating to me that the hallucinations had moved beyond ‘just’ Tom and the shapes.  The music was the most terrifying, for reasons I cannot really articulate.  It was only about four or five notes on what sounded like a xylophone, but it carried the same unspoken message of hostility that the shapes do.  Not that the knocking and the whimpering didn’t.

So, anyway, here I was trying to soothe this migraine by lying in the darkened bedroom, when someone who wasn’t A nor Tom told me to get up and brush my teeth.  For some reason, I acquiesced and did as I was told.

Upon completion of this, the ’someone’ became a ‘they’ – instantaneously, yet simultaneously gradually.  I know that makes no sense.  The best way to put it, I suppose, is that it was like an operatic or orchestral crescendo.  The nebulous ‘they’ then instructed me to go to the top of the stairs.  Tom turned up and told them to leave me alone, but they laughed at them.  I (internally) enquired as to what I should do.  Tom said to go back to bed.  ‘They’ repeated their aforementioned direction.

‘They’ and Tom kept bickering about what I should do but, much as I don’t mind Tom, the collective voice of ‘They’ was so much stronger, and carried a weight I can’t explain.  It was a compulsion.  I went to the stairs.

I have fallen, and thrown myself, down the stairs at my mother’s house many a time, but the stairs there are relatively ’safe’; they aren’t especially steep, are thickly carpeted and, until recently, had a…shall we say…deceleration zone.  This is not the case at A’s; the carpet is thin, the stairs are incredibly steep and there is maybe a foot of hallway at the bottom before you go crashing into the front door.  That’s if you don’t hit the radiator on the right.  In short, falling down A’s stairs could seriously injure me.  I doubt it would actually kill me, but it could definitely injure me.

Here I was at the top of these steep stairs.  It was almost as if they had morphed into a sheer cliff face – I mean, I didn’t see such a thing, but…I don’t know, it’s hard to describe; it just felt like that.  At this point ‘They’ started telling me that I was to throw myself down the stairs.  Tom tried to intervene, as did the voice of Me.  But ‘They’ were too strong.

When I didn’t immediately throw myself down, they became enraged and started chanting/screaming: “YOU MUST DIE!  YOU MUST DIE!  YOU MUST DIE!” followed shortly by, “THROW YOURSELF, THROW YOURSELF HARD!”.  Simultaneously, parts of ‘They’ were laughing in the manner that the dark monster’s under a child’s bed are supposed to.  Sinister.

I remember little of what was going on outside this mental cacophony, but I do recall that it was a physical effort to not throw myself down the stairs.  I have a very vivid memory of watching my bare toes teetering precariously on the edge of the step, trying – amidst this madness – to will them not to go over.

It’s funny really.  Given the almost perpetual suicidal ideation in which I engage, why not just go with the flow of ‘They’?  But I wanted to fight them.

Still ‘They’ went on, “die die die, throw yourself, throw yourself hard,” in their ritualistic chant.  Still Tom and Me tried, with considerable futility, to dissuade them that this was a desirable course of action.  But ‘They’ either just spat bile at or ignored us.  They called me (both me-me and the Voice of Me) a range of names such as “slut,” “cunt,” “bitch,” etc, but they just audibly sneered, if that’s possible, at Tom.

Somehow I sat down.  By this point, I presume in order to distract me, the amorphous ‘They’, were knocking at the side of my head, exacerbating the headache (as if their bloody noise hadn’t done enough of that).  I put my hands over my ears and started rocking back and forth, but of course that didn’t stop them.  That was a pointless gesture – they’re in my head so, how can covering my fucking ears shut them up?  But it was instinctive, I suppose.

Despite Tom’s best efforts to diffuse the situation, it wasn’t getting any better.  ‘Me’ wondered if taking my gaze away from the stairs would do anything to help things, so I lay my head down on the next step and hid under my arms.  They didn’t stop, but part of me ceased to be entirely sure of where I was, so the sheer compulsion to obey ‘They’ abated – but only slightly.

It was shortly after this that A emerged from the study and asked if I was OK.  He had been talking to himself whilst in the study and his voice had kind of morphed with that of ‘They’, so I didn’t even know if he was real.  Nevertheless, aside from Me and Tom, he was the only voice there with which I was familiar, so I told him what was happening.

A helped me down each individual step.  ‘They’ mocked him, sneered at him and wanted me to hurt him, but somehow, I managed to resist them.  When A finally managed to get me into the relative safety of the living room, he called ‘They’ “pathetic non-existent cunts” and told ‘They’ that he was going to “destroy” them.  Tom laughed agreeably and told ‘They’ to fuck themselves; ‘They’ were both insulted and incredulous.  ‘They’ called A a number of names that I no longer remember, continued to tell me to die, and although they didn’t ‘verbally’ say it, there was an intense sense in my head that ‘They’ found the notion that A could defeat ‘beings’ of such epic power an irritation and a source of amusement.

To cut what is already a very long story a wee bit shorter, eventually ‘They’ and Tom left.  A was disturbed; I was exhausted.  We were both worried about how this would turn out.

In fact, the possibility of voluntary admission was discussed.  My fear was not so much for myself – I don’t really matter to me, after all.  But ‘They’ hate A.  It turned out later that ‘They’ hate C too..  They’re more tolerant of Mum, but they still don’t like her.  ‘They’ haven’t met my friends yet, but I’m sure they’ll hate them too.  So, whilst if I want to do myself in I want it to be my decision and not theirs, and that side of things presents as an issue, my greater concern is that the complete control of ‘They’ over me would lead to harm of someone about whom I care.

I had an appointment with VCB today (more on that in a moment), and A and I both hoped that I could hold out to then before the drastic step of admission, but I did discuss that possibility with several individuals and, with a few qualifications, it was agreed amongst all that if ‘They’ returned with such hostility, that it was probably a good idea.

‘They’ did return a few days later.  ‘They’ were not demanding my death this time, nor the injury of anyone else, but they were chattering insults and laughing scornfully at a low level at the back of my head.  “Whore,” “cunt,” “slut,” “bitch” etc.  They were whispering spitefully and when A started into them again, the insults were then divided between him and me both.  But although distressing and unpleasant, there was no danger from this episode, so luckily I didn’t embark on a course to the bin.

‘They’ were there on Thursday morning when I went to see C.  This was the first time when I verbally spoke to them.  ‘They’ told me they thought he was a cunt, and I said to him, “they don’t like you.”

‘They’ got really mad at this; apparently, I was meant to tell C that he had been called a ‘cunt’ specifically.

“Tell him, tell him, tell him,” they ordered.

“Alright, for fuck’s sake, I know!” I yelled at them.  I’m not sure how C kept a straight face.

But they’ve not been there in a dangerous capacity since 31st October, thankfully, so I haven’t incarcerated myself.  As stated, I had an appointment with VCB today, which I had been anxiously waiting for thanks to ‘They’, but of which I was also simultaneously terrified, given as I am scared of VCB.

I was actually slightly surprised that she herself had the decency to see me today and not palm me off onto some minion.  Perhaps C told her about my threats of advocacy, media and contacting her boss from last time.  Anyhow, as usual I had developed my written list of symptoms from which she – unlike her stupid SHO – allowed me to work, recognising that it’s not always easy to remember everything.  She did quiz me on specifics – “what did ‘They’ say specifically?  Pretend you’re them talking,” or “what does Tom talk to you about?” – but mostly, she allowed me to speak freely about the last few weeks.

Essentially, the result of the meeting was that she wants me to decrease the Venlafaxine back to 75mg – not because of the hallucinations per se, as she actually does not seem to believe they are a side effect of it, but because being on 150mg hasn’t made any difference to the feelings of depression.  I’m not sure I like this.  I basically think Venlafaxine is crap (not to mention evil and insidious), but I’m scared of being on a low dose thereof again, and in particular I am petrified of a pseudo-discontinuation syndrome caused by a dosage reduction, despite VCB’s claims that there should not be any noticeable difference.  I am seeing LGP in the morning so will discuss this with him.

Secondly, and more helpfully, VCB says that the more recent hallucinations and delusions do represent outright psychoses.  Well, not that that in itself is nice – obviously it’s not, but it had a hopefully positive outcome.  She had been expecting to prescribe me a mood stabiliser today, but in light of the information I gave him, obviously decided that “a trial” of an anti-psychotic would be more appropriate.  I know how hideous side effects of such medications are, but frankly I’m glad because things as described above can’t go on.

She has decided upon 2.5mg of Olanzapine; she chose this drug because she thinks it’s better in terms of its secondary indication of mood stabilising than many of the other atypical anti-psychotics, despite most of the manufacturers’ claims that they all mood stabilise fabulously.  2.5mg is the lowest dose of this drug, but that’s fair enough I suppose.  VCB says it can be increased as necessary, but it is of course best to start on as low a dose as possible.  Unusually, she wants to see me in a month rather than six weeks.  Although she (obviously) didn’t bin me, this did suggest some concern on her part in my view.

I asked VCB if the revelations had any impact on my diagnoses, as I was aware that psychoses weren’t generally a feature of bipolar II, and whilst they are seen in BPD, it is usually (as far as I understand it) during episodes of considerable stress, which I hadn’t been experiencing especially during the development of ‘They’.  She said that she still felt the diagnosis was correct, as the episodes of psychosis have been transient, as is seen in borderline, rather than prolonged and sustained.  However, she did imply that she would be willing to reevaluate things in future, should the need arise.

She warned that the main side effect of Olanzapine is weight gain, which is not apparently caused just because the drug itself makes you fat, but because it increases your appetite.  She said that I have to try and develop methods of ignoring any new or unexpected bouts of hunger, which I suppose I can discuss with C.  She also recommended exercise (obviously I suppose), so when I get my windfall from work, I may rejoin the gym.  As a dolescum, I do get to use the local leisure centre for cheap, but it’s usually full of pricks all day long, whereas I know for a fact that the gym and its pool are both almost empty during the day.  In any case, I’ve lost a lot of weight recently, so whilst I don’t exactly want to regain any of it, I suppose I can deal with a little bit more whilst I try to address countering any new-found appetite.

A final side effect is strong sedation, but perhaps it won’t surprise you to learn that this would be a positive thing for me.  Unfortunately, apparently that tends to wear off as one gets used to the drugs, but hopefully I’ll have the lovely Zopiclone in waiting then.

I haven’t got the pills yet; I have to take VCB’s script to the GP’s for them to load it onto the system and then prescribe and sent to the pharmacy.  Had I done so today, I would not have got them until tomorrow anyway, and since I’m seeing LGP in the morning anyway, I can just get him to prescribe them directly.

So all in all the VCB was quite useful today – I just wish she’d make that state of affairs consistent.  Perhaps the best thing about this – and I know this is really sad and childish – is that she’s defied the NICE guidelines on BPD.  I suppose she had little choice given the circumstances, but she always wanted to adhere to them insofar as was possible.  But I think NICE are useless knobs, a waste of public money who sit about saying a lot about very little, so this pleases me.

Other Events

New Friend

On Wednesday 4th, I had the pleasure of meeting K (can we call her K?  There’s no other Ks on this blog, are there?), another BPD ‘diagnosee’ that I met via Twitter.  K is also from Northern Ireland, though now lives in England (she was here on a quick visit).

We spent a couple of great hours chatting over tea – the conversation was lively and wide-ranging, but in terms of mentalism specifically, it was a relief to discuss things with someone who has direct experience of many of the same problems I have.  I’ve relied on the internet for this to date, still do and probably always will – K and I agreed the temptation to catch the bus without the support of online friends would be considerably higher than it already is – but nevertheless it’s great to actually speak to someone in person that understands.

I would normally be very nervous about meeting someone new, as you can probably imagine from earlier ramblings.  However, I actually wasn’t with K, and even had I been, her easy-going charm would have relaxed me very quickly.  So thank you, K

GA

Fucking cunt of evil bastardry aunt GA was in situ for the second time within a few months last week.  Why come across the Atlantic twice in such a short timeframe?  Last week was for my cousin’s wedding, that was only organised recently.  Needless to say, I didn’t go.  I can’t presently think of circumstances that would in any way make me tolerate seeing that woman and her shit descendants.

What pisses me off when GA is here (and even when she isn’t) is that my mother wanks on about what a poisonous twat GA is – GA knows everything, GA always thinks it’s worse for her than for others, GA must interrupt people and be the focus of the conversation, etc – yet as soon as I open my mouth to make any vaguely critical remark about the old battleaxe, Mum rages at me for being so cruel about her.

Fuck that, and fuck GA.

Meh

There was another ‘other event’ that I wanted to add but alas its exact nature has evaded me.  Another time – in any case, I think I have drivelled on for long enough as usual.

Did I say something near the start of this post about ‘condensing’ my words?!

An Open Letter to My Therapist – C: Week 28

Dear C

Previous meetings, specifically that of today (Thursday 29 October), refer.  I should like to enquire as to what you feel that the mandate of our work together is.  It has been my long-held understanding that the point of psychotherapy is to improve the mental health and emotional difficulties of the personnel that the psychotherapeutic community refer to as ‘clients’, ‘patients’, or patronisingly, ’service users’.  I should be grateful if you could confirm that this perception is in fact an accurate representation of the nature of your profession.

Assuming that I am indeed correct in this apparently nefarious and naive assumption, I should like you to clarify exactly why the opposite seems to be so frequently the case as regards the relationship that we presently share.

You were, quite reasonably in my view, asked today to read some material prepared by me, primarily from my online journal.  A great deal of effort was put into a proper and considerably redacted construction of this diary by me, an effort that I deemed to be worthwhile owing to the fact that the diary records some very personal and incredibly painful memories, thoughts and feelings that I feel utterly incapable of expressing verbally.

I should imagine that from the interaction between us since your refusal to read these words this morning, that you realise that said refusal has distressed me considerably.  I hold you responsible for this, and therefore again would question the mandate of our relationship.

If you have failed to recognise that I am a highly intelligent individual, then let me remind you that I have a tested IQ of 148.  Therefore, I should assume that someone who has your own level of intelligence would be cognisant of the fact that I am thoroughly aware of the concept of therapeutic boundaries, and indeed that I am not the only person on whom you need to concentrate in your work.

Notwithstanding this, C, I feel that your rejection of this simple request was unreasonable and frankly unfair in the extreme.  Firstly, given as I am aware that you take notes on me, speak about me behind my back to VCB and quite possibly LGP and are willing to fill out administrative forms pertaining to my social security status, it surprises me that it would be considered inappropriate by you to take half an hour to read a few pages that would give you considerable insight into my past, and into my mind.  This is, after all, the crux of what you, as a clinical psychologist, are meant to be doing, is it not?  I fail to see how this breaks any boundaries, and given the relatively small timeframe required to complete the task, I do not feel that the level of effort required by you to complete this reading is unreasonable when weighed against the value you would obtain from it in terms of my psychotherapeutic treatment, which you are meant to be conducting.  Indeed, I believe that what you would gain from it is considerably disproportionate to the (in universal terms) infintessimal amount of time you would invest in it.

As I told you this morning, if you cannot be arsed to engage with the material, I would appreciate that honest response from you.  Instead, you claim that you were unwilling to participate in this exercise owing to the supposed fact that it would be “unhelpful” for me to fail to verbally articulate these details.  I believe this excuse to be what is colloquially termed a ‘cop-out’.

Whilst I could appreciate and understand this position were the behaviour of giving you written material consistent, as I pointed out several times I was giving you these documents on a one-off basis as a catalyst for discussion.  My apparently idealistic view was that you might read the stuff, then probe me on specifics therein, which I would then be unable to avoid discussing.  Instead, you chose to infer this isolated behaviour as the start of an entire methodology of avoidance on my part.

May I just point out again – as I did this morning – that I thoroughly and utterly resent the implication that I may behave like some silly little schoolgirl, passing you notes back and forth.  This was intended to be a one-off, and if you had given it a chance, it would indeed have been such a thing.

If you think that I am stupid enough not to recognise your probing on me passing you notes back and forth as an investigation of the transference I feel towards you, then pleased consider yourself corrected.  If you want to discuss the nature of transference, please just ask me.  I have been upfront and honest with you on this subject in the past and do not intend to discontinue such candour.  Please do not dress your enquiries up, as you later in the session did, as something vague and nebulous like, “what’s happening between us at the minute?”  (On a sidenote, this is a surprising question coming from a psychologist to a dolescum!).

At two points you enquired as to my position on your failure to accept my written work.  Whilst I do not remember the specific phrasing of the first such question, I do remember finding it offensive in the extreme, as there was an implied suggestion in your words that you would find any distress on my part as being manipulative.  You will recall that I told you that this insinuation was not welcomed by me.  Whilst you stated that you did not feel that the word ‘manipulation’ was appropriate, you did not, however, make a forthright denial that that was indeed what you thought my reaction might be.

When I am having a panic attack in your company, C, please do not condescend me with encouragement into practicing Zen buddhist breathing with you.  I find this an incredibly uncomfortable pursuit (no doubt you are curious as to why); for some reason, it creates a frisson (on my part) between us, and I find it horribly inappropriate.  I shall find my own methods of managing panic attacks, thank you.  I have been experiencing them for 12 years; I have known you for six months.

As I recall, the aforementioned panic attack led you to muse somewhat on the issue of my vulnerability, and the fact that I hide my face from you (by keeping my hair down) and fail to articulate some personal issues to you as I do not want to be vulnerable.  This is a rational position on my part.  I used a rape analogy to exemplify my point; that if I walk home alone at 3am, drunk, wearing a short skirt and a low-cut top, that I am putting myself at risk by virtue of my vulnerability (and for Christ’s sake, please do not read anything into that particular example.  Nor should you make the assumption that in this example ‘at risk’ equates with ‘deserves’.  That is not the case).  In fairness, this point was accepted by you, but was nevertheless diminished on the grounds that your office is a safe and confidential place that allows me to express a vulnerable side of myself with impunity.  Whilst I am willing to accept the good intentions of this statement, it is still and withall a fallacy, C.  Your office is not a safe place, and you are not a safe ‘object’ (in the psychological sense).  You are not safe because sooner or later, understandably, and by your own frank admission, you too will reject and abandon me, just like everybody else has done.

You will be aware that today was probably the first time in our entire relationship that I have expressed hostility beyond mild irritation towards you.  On that note, towards the end of the session, I found myself engaging in yet another self-vituperation, using a range of perjorative nouns and adjectives including, “dick,” “bitch”, “self-obsessed,” “hateful” and “monster”, amongst a multitude of others.  Whilst not denying these self-beliefs, I believe that this particular invective was actually a projection onto myself of my then-feelings towards you.  Arguably I could simply have stated how furious and disgusted I was with you, but then I would have caused myself even more distress, as I would have feared abandonment by you (even though I was ((am)) intensely angry with you) and wiould have felt horribly guilty (I feel guilty about everything).  So the fact that I manifested any hostility at all is somewhat remarkable.

Another related incident of note is that during the aforementioned invective, I accused myself of being a “childish brat, throwing toys out of the pram in all directions”.  You stated that this was “only part of [me].”  The strong suggestion to be inferred therefrom is that you agree with this assessment, at least to some extent.  I cannot criticise you for this position, as it is indubitably correct.  However, I have chosen to bring it up as an interesting reflection of the current state of our dyad.

At a juncture towards the end of the meeting, you asked for a second time how I felt vis a vis your failure to take my documentation.  I stated that I was “not best pleased.”

In future when I make an unambiguous statement of this nature, can you please accept my words without asking me to articulate further what it is that I mean.  I would think it unwise for me to give you my completely uninhibited view, which is that I think you’re a lazy, selfish, irresponsible piece of shit.  Beyond providing said view, there is little more I can add to the sentiments already expressed.

On a similar but unrelated note, when I am banging my fists on the chair and throwing my glasses on the floor, you are the Master of Understatement to suggest that I “must be quite agitated.”  Again, saying what you actually mean would be greatly appreciated.

I believe that you caused me an unnecessary amount of upset both in and outside of your company today.  In session with you, as observed, I was extremely agitated.  Your continual verbal pushing of me did not aid my psychological state in any way, unless you consider increasing mental pain to be a move towards better mental health.

I can recognise why you consider it imperative to investigate my reluctance to actually face my history and feelings with you directly, and why you want to find out why I find it so difficult to look at you, or to be looked at by you.  I do understand that.  Nevertheless, I fail to see how it is mutually exclusive to reading the documentation presented.

You were right in your assertion that I “want to connect with [you] in some way.”  I do not think it would be a massive leap of faith for that inference to be made based on the fact that I have been trying to find adequate therapy for 12 years.  My only wish is that you would be willing to meet me half-way on how that connection is achieved.  As you are so fond of pointing out, our alliance is a co-construction.

Finally, please do not assume that I fail to recognise that you have other work to do and a life to lead.  On the other hand, please do remember that through your own volition you have put yourself in a position of great power and responsibility, and that it is not reasonable from anyone’s point of view for you to knowingly abdicate from that.

In light of the strength of that responsibility, may I return to my original point, and question the exact point of psychotherapy.  A prompt, detailed and honest answer would be much appreciated.  Thank you.

Anyway, C, do take care of yourself* and I can’t wait to see you next week**.

Yours affectionately***

SI [hugs and kisses]****

Translations

*  I hope you contract some incredibly painful (though admittedly non-fatal) illness.
**  I’d certainly be unable to wait if I could find a baseball bat with spikes through it.
***  Fuck you, you balding, scrawny cuntfuck.
****  [slaps and punches]

Addendum

I am sure this negative attitude will be relatively ephemeral, but Christ almighty it is strong as of this moment.