C: Week 11
I was going to write an analysis of both my session with C and the disaster on Thursday night, but mid-post, the C stuff is already 1,700 words, and I’m getting tired of typing. I’ll therefore write just about the C session for now. I will try and post an analysis of the psychotic cutting episode tomorrow – certainly this week.
Well, well, well. Hard to know where to start this. The first thing I will say is that this is probably not as comprehensive or perhaps as accurate as I would like, as I am writing, relatively speaking, quite a bit after the fact. I made notes on my session with C immediately after seeing him, but was cut off from completing these my MMcF’s arrival, and in any case I’m not sure I remembered it all even at that point. Anyway, I will do my best to be as accurate and as in-depth as I can, given the aforementioned circumstances.
Let me commence chronologically, insofar as my memory will allow.
As previously discussed here, I had prepared a rudimentary summary of the issues I have raised in this blog that I have previously either hidden from, or forgot to mention, to C. Well, I went in, sat opposite him and as usual he looked at me; he always wants me to start the discussions. I wasn’t sure where to start in this case. I had had all the rubbish with occupational health and work since I had last seen him, but on the other hand the issues hitherto discussed by me on this blog seemed to be to be wider issues. My reactions to work and OHS, my very absence from work and reason to be at OHS, are at least in part what need to be examined rather than specific events. If that makes any sense. Not that specific events are not important, especially if they are likely to have a long-term effect on me (and if I get dismissed from cunty work then that will be the case). But I hope you know what I mean anyway. Maybe this is just a rambling load of toss.
I told him about the work issues and told him about the list, which I then handed (folded) to him. I decided, despite the aforementioned deeper issues stuff, to begin with work. After all, my panic attack on Sunday night was predicated upon having to go to OHS. To be honest, we didn’t talk about work in as fine detail as I had initially expected (because we became so focused on the issues on the list, but I’ll come to that momentarily). However, he did ask me a few things – the first was, on the back of my having told him I “hoped all my colleagues will die”, he asked how I reconciled this with the fact that they have been, by and large, the best group of people with whom I have worked. I can’t remember my exact reaction but I think I tried to evade the question, but C wouldn’t let me. Eventually I was forced to concede that objectively I probably didn’t want them all to die, but I was so consumed by rage at the email from the Horse that I couldn’t see past it. C seemed to accept the logic of this, then ask me to describe my panic attack re: OHS.
I told him I didn’t know, which was probably not entirely true, but then did do him the courtesy of trying to find the right words. I will not repeat myself from the entry I made then, as what I told him was essentially a paraphrased version of that (it is here, for anyone that hasn’t read it or doesn’t remember its content). What I will say is that I was a wee bit surprised by the sensations I experienced as I discussed the panic attack with him. Again, I felt panicked and breathless, my racing thoughts were disjointed and rambling, I felt scared and open to attack. It was nowhere near as intense as Sunday’s episode, of course, because at least C was there. And it did pass when I stopped talking about it, pretty much, but during the time I did describe it, some of its intensity must have come across to C, as he commented on it. Mind you, does it take about seven or eight years of third-level education to observe that a panic attack can be intense? But I don’t want to insult C, so I will shut up on that.
Perhaps the demonstration of this intensity was what led to the next element of the meeting, though if I’m honest I don’t entirely remember how. Even though I felt objectively that perhaps we should concentrate more on the matters of work and OHS, my visceral reaction to those matters was broadly clinical, save for the intense melodrama of the panic attack bit. So I am not sure what I said, but I must have referenced something on the list of issues, prompting C to gesture towards the piece of paper sitting on the anonymous little table that separates him and I – the one that houses the tissues for when you start blubbing like a baby. He asked if he should read the list. I said something like, “I’m not sure, because it mentions you,” but he went ahead and unfolded the sheet anyway and proceeded to read the material therein, sometimes verbally, sometimes not.
I think the first point he really drew on was my reference to mania and delirium. He had only had a cursory awareness of any of that until this point, as it was of course something that I had deliberately hidden from him. He then of course drew on the point of my protecting him, and asked me to explain.
I don’t know if this is a widespread phenomenon in client-therapist relationships, but I suppose it must be if Behind the Couch (BTC) was writing about it in the first place. I do know Introspective over at the Conversations with my Head blog has experienced this – anyone else? Answers on a postcard to the Serial Insomniac. Anyway, I told C that since commencing my work with him I have thrown myself into reading stuff on therapy and the nature of the therapeutic relationship, including BTC’s excellent blog. I told him that I would not have consciously realised that I protect him from information that he really should have were it not for the very well-observed entry in question. He asked why I felt I was doing it.
The short answer to that of course is that I don’t know; not consciously anyhow. Through the course of the therapy in which we have engaged, I have been struck by how malevolent and belligerent so much of my behaviour and thoughts are. I can therefore only surmise that my instinct to protect C, one of the few people in this world than can help me at the present time, is two-fold; firstly, my protecting is selfish – I reckon my mind has an irrational fear of him abandoning me (more on this later) and as such it feels he will realise what a cunt and freak I am, and he will dump me and leave me to slit my wrists in the metaphorical gutter. The second probable reason is more altruistic; I feel a bad enough an individual as things are that I don’t want to inflict my twisted thoughts on another human being, particularly him.
I know this is ridiculous. I know it is. C is an intelligent, trained and very well-educated doctor of psychology. This is his job. It is what he does. That is his point, professionally speaking, in the world. He is trained to deal with all this nonsense. If he experiences any form of countertransference regarding my fucked up mind, and there is no reason to even think that he does in the first place, I know rationally that that’s his problem, and that should be discussed in supervision sessions with his boss.
This is my mental dichotomy, you see. I know all of this rationally, but no amount of rationalising ever convinces that ’emotional’ and thoroughly disturbed part of my brain that what is rational is probably the reality of a situation. My mind is not presently controlled by logical forces. I do not want to hurt or upset the man, and therefore it has been easier – for me, and in my own twisted estimation, for him – to withhold information from him. To protect him. Pathetic!!!
We kept leaving then coming back to this issue, but for the sake of easier referencing I will group all this protection related stuff together.
We discussed my difficulty in trusting people. The reality is that, despite the fact I know almost nothing about him, I do trust him, almost implicitly. He said to me that he had found me to be very forthright with him, and although he hadn’t been aware of all the stuff on the list, he knew that I had told him stuff I hadn’t told anyone else – in what sense, therefore, was I protecting him? Did he not know already that my mind was considerably diseased? (Not his words, incidentally, though it would’ve been funny if they had been. Another aside is that he appeared to be amused by my heading the list “Problems Related to Being Mental” – he semi-laughed over my use of the word mental. I am not very PC.).
My response to this was that, yes, I had essentially been honest and open with him – but that this had been, largely at least, in terms of the content of my monologues to him. The thing is, my behaviour has been comparatively subdued in front of him. He asked what I meant, and I stated whilst I had broken down several times, I hadn’t really exhibited the physical or maniacal symptoms of my madness that I sometimes do outside his office, or at the very least that I sometimes want to exhibit. I said there had been times in our weekly meetings when I had wanted to scream and rant, kick his stupid filing cabinet, run around his office and bang my head off the wall. I said I that sometimes wanted to sit in the chair and just scream and cry and shake and rock back and forth.
I fell silent and let him digest the information, but upon looking around the room, I noticed two coat-hangers on the back of his door, and had this vision of my running towards them and impaling my skull on one. I found this pretty hilarious, and started laughing in what was, on reflection, probably a maniacal way. I told C about the imagery, telling him that my finding it amusing was presumably a defence mechanism (another example of me second-guessing him, trying to do his job for him – up to him surely to analyse whether or not this is a defence mechanism? More on this shortly) and said that I supposed it wasn’t really funny, but the very fucked-up part of my mind which has increasing levels of control over me certainly thought it was. C replied, “…it would be horrific.” I was upset then as I thought I had upset him, though I didn’t want him to know I was upset that he was (possibly) upset, in case he then felt guilty for making me feel upset because he was possibly upset. I think I did make a cursory apology, though I don’t remember entirely. Either way, I otherwise hid it – successfully I think. More protecting.
“So,” he began. “There are some very strong emotions going through your head.”
“Emotions?” I laughed. “It’s not emotional – it’s psychotic.”
C queried the way in which it was psychotic, or perhaps what I meant by the term. I sat in thought for some time; having done some study of mental health whilst I was at university, I was searching for the exact definition of the term as taught whilst there (see here if you are interested). I told C I was trying to remind myself of this to see how my proposed behaviour fitted in with the definition, and that I was struggling since it was several years since I studied the subject, but he told me to forget the official semantics and concentrate on what I felt. So I said it was mad. Irrational. Thoroughly abnormal. Basically fucked-up.
He read on and picked up on my reference to “over-intellectualising”. I was horrified when he asked for clarification on who was over-intellectualising. The poor man thought I was accusing him of doing so, which I certainly was not, and I hope I was emphatic in refuting that suggestion. In our third and final assessment session, C warned me that as two intelligent people we needed to be careful that we did not let our discussions become of an intellectual bent, something that he felt was potentially an “attractive [prospect] for both of us”. He has gently reminded me of this once or twice since, but he has never indulged in any sort of overtly academic discussion himself. He has struck a fine balance, actually; on the one hand, he has simply provided therapy and a listening ear and hasn’t engaged in deep philosophising or intellectual discourse, but at no point has he patronised me or made me feel small/stupid either. The therapy wouldn’t have lasted long had he been the kind of individual to have done that, like the stupid fucking bitches from the Crisis Response Team were when I first had this breakdown (I’ll write about this when I finally write my much hyped and fabled post on all the therapists I’ve seen to date – suffice to say now that they are not what I spent nine years paying 11% of my salary towards).
In a way my horror at his misinterpretation of my comments on over-intellectualism was mirrored when he later asked me if I thought he was incapable of dealing with me. He was wondering was this why I was protecting him. Of course I do not think that. I do not think that at all. He is the first therapist I have had that is capable of dealing with me. I tried to reinforce to him that I was very much of the view that he was eminently capable, and again went on that it is my fear that I will upset him that drives this. Aside: do I want to mother him? That would be some rather disturbing transference. But do I though? Parents protect their children from the truth. Does my behaviour resemble that? I didn’t ask him this and don’t intend to, but it is a thought in my head as I write this. That would be weird since I don’t even much like children, but then if I were mothering C, he would be (I’m guessing) an early-30-something year old child, which might be better. I profoundly hope this is not the case.
In other discussion, he asked me about my references to suicide ideation and self-harm. At that stage, of course, my arms were perfectly intact, but I told him had I been alone on the Sunday I had the major panic attack, the situation could have been different. I also voiced concern that I hadn’t cut myself for years, and that I was disturbed that I had developed a new fixation with doing so. However, in a ridiculous self-congratulatory demonstration of my arms’ intactness, I showed them to him, exclaiming, “look, no cuts!” Oh, how the worm turns. I shall be interested to see his reaction to the newly created cuts the next time I see him. The thing is, although he didn’t specifically say this and I could be completely off the mark, I got the impression from whatever it was C said on this matter (and I have no recollection of what it actually was) that he felt that, most of the time, even though my mind is conflicted, I am usually rational enough to prevent myself from engaging in this pursuit. Maybe he doesn’t think that, I don’t know; I just inferred that that was his view. If I am right, then his assessment would be pretty accurate. I am usually rational enough not to cut, whether visions of doing so pervade so many of my waking thoughts or not. But clearly I am not always so rational. Have I let him down? I have let everyone else down. I don’t want to add C to the list. Fuck.
The only time I actually became tearful during this session was when I was discussing my inability to help my friends in times when they are in trouble. I do not know why this in particular distressed me; perhaps it matters more when it’s about other people and it doesn’t when it is just me, cos, after all, I am (in part of my mind’s view, anyway) a pugnacious, malignant, spiteful and useless piece of twisted shit. The thing is, the specific incident that I was recalling and describing (the one that brought the tears to the fore) was one of my friends being grateful for my help and support. In my view, as a practical person with a very male brain in many ways, support is not enough. The problem has not been solved by me, so therefore I am crap. I still think this, both logically and emotionally. However, is it not odd that someone’s gratitude sends me into a flood of tears? Clearly my insecurities believe that I am not someone that is worthy of receiving thanks or, for the want of a much better word, ‘niceness’.
Anyway, I dried my tears and tried to convince C that I was fine. He appeared slightly bemused by this suggestion, as clearly I am not fine, period. I confessed that, even though he wants to get me to a point where I can express and exhibit emotion to someone other than him, that I could never foresee a time where I could envisage this being a possibility. And I really can’t. If C ever does get me to that stage, he’ll make Derren Brown look like an amateur mind-bender (physically C reminds me a bit of Derren Brown, actually, or at least what Derren Brown used to look like. Is this a sign, or is this me exhibiting another ‘psychic iPod’ delusion…here we go with that…).
Towards the conclusion of the allocated 50 minutes, C asked me about the signs/portents I see. I exemplified by quoting the tale of my psychic iPod from here. He saw fit to investigate whether or not I really believed that the iPod was reading my mind. I wanted to lie to him. I so much wanted to lie to him. That would defeat the point of his presence though, and it would surely be a betrayal of any trust he has in me. So I admitted that yes, for a very few brief seconds, part of me does think the iPod does see into my mind, or is at least disturbed enough by what it does to consider that as a possibility. Thankfully then rationality returns, and returns quickly, but nevertheless this is not good. I think that this directly led on to his mention of a psychiatrist, though I don’t think this was his only reason for bringing this subject up.
The poor sod tentatively said that he was not the “only mental health resource” and said he was aware that Lovely GP had made a referral to a psychiatrist. Naturally, my (internal) reaction was that C obviously thought I was so off my head that he needed the assistance of white-coated scary people to deal with me, but before voicing this concern, I let him finish. He said that obviously he had links with the psychiatric fuckwits and that he could chase them up, or if the referral had been lost in the ether, he could make it himself. He paused momentarily, at which point I said I would be grateful if he would do this. He then continued, reading my mind (or more likely making an educated guess as to what I was thinking, given our previous discussions) that I wasn’t to take these comments as some sort of suggestion that he would abandon me, or that he thought I was completely mad (not his exact words, but that’s essentially what he meant). “It’s just another aspect of mental health services that may be able to help you,” he said (I’m paraphrasing). He pointed out that one of their roles is to prescribe medication; clearly what I got from my GP is not working at all, which is not Lovely GP’s fault as he is not a psychiatric specialist. A psychiatrist with their (supposed) expertise can sort this out, hopefully. “Just another service that may be able to help you,” reinforced C. I told him to go ahead and phone the knobs, and stated again that I would be grateful for it.
Before I left I said, “can I ask you a question?”, to which he replied, “you can ask me anything.” (Part of me was tempted to play a silly game here and ask him the name of his first pet or something, but of course I didn’t). I said, “I know you’re not a psychiatrist and are thus not medically qualified to make psychiatric diagnoses. Nevertheless, you are an educated and trained clinical psychologist. Ergo, in your clinical judgment, what is wrong with me? This isn’t just depression and anxiety, is it?”
When he had said that I could ask him anything, I assumed there was an implicit understanding between us that he would give me a straight answer, but alas it seems parliament’s loss is the National Health Service’s gain. He completely avoided the question, to my considerable annoyance. I let him ramble on for a few minutes – “labels can be helpful to have but it’s my role to find the reasons for your emotional dilemmas and work with you to find ways of combating your distress” etc etc etc, blah blah blah, yadda yadda yadda – all the time intending to tell him when he had finished that I had asked a straight question and would he please just give me a fucking straight answer. But then he said something that completely rationalised his position and I decided against challenging him. For the life of me, though, I cannot remember what it was he did say. It just made sense, though, so it was reasonable not to press him further. I just wish I could recall what it was. Grr. Bloody memory is shit thanks to being bloody mental.
Obviously, so much of our session on Thursday became an analysis of the strange client-therapist relationship that I presently share with C. He knows now that I protect him, and he also observed from the list of mentalist problems that I think I am worryingly reliant on him. I was expecting to be embarrassed by a conversation of this nature, but I wasn’t particularly. He did ask me how I did feel, however (and admittedly this was in relation to the whole session, not just the protection issues), and really the best description I could come up with was ‘frustrated’. Apparently this had been evident to him.
The thing is, he is away next week. I am sure you can guess that I am not happy about this. The last time he was unavailable he had a supervision session, but he did not explain the reason for his absence this incoming week. I assume he is on leave. It is horrendous that I am annoyed about this. The man is entitled to a life! I am not his life! Nor should I be! My fixation with and reliance on therapy is evidently bordering on (if not already in the realms of) obsessional. The only comfort right now is that I am not alone in terms of feeling like this; if anyone is interested, there is a very good book on the client-therapist relationship by a woman called Deborah Lott, called In Session: The Bond Between Women and Their Therapists that explores this and many other issues in an extremely astute way. Many women in Lott’s book experienced distress when the therapist was away. Stuff I’ve read online seems to suggest the same is true of many others. So I am not alone. That is the only comfort. So if that is the comfort, what is the antidote? I assume it can only be continuing therapy, and focusing at times on my reliance on C and how I will survive without him. Fortunately C has already suggested further work in this area, so I can only hope that, over time, we will get there.
(PS. This has been a mammoth entry. Why do I need to over-analyse my sessions with C? Sorry for boring anybody that managed to read this far. I am sure most fled many paragraphs ago!).
This entry was posted on Sunday, 17 May, 2009 at 5:17 pm and is filed under C, Everyday Life, Moods, Psychotherapy with tags anger, anxiety, bipolar disorder, borderline personality disorder, bpd, clinical depression, cutting, depression, insanity, insomnia, madness, major depressive disorder, mania, manic depression, mental health, mentalhealth, panic, panic attack, psychiatry, psychology, Psychotherapy, sadness, self harm, social anxiety, suicidal thoughts, suicide, suicide ideation, therapy, Work. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.