Mindful or Mindless? DBT and C: Week 14
I started writing the below on Thursday straight after C, but completely lost momentum at the bit where I was talking about telling C about my iPhone mood tracking from Tuesday. I intended to write more on Friday, but that most horrible and frightening of things, real life, interfered.
On Thursday night, I received word that a good friend of mine, CVM, was seriously ill. She had been in hospital for a few weeks but as I understand it her illness was not considered serious to the point where she was felt to be in significant danger. Horrifyingly, though, on Thursday her condition deteriorated significantly; she was critically ill and in ITU. Her family genuinely feared for her life. I will not go into details as I was asked not to, and even though this is for the most part an anonymous blog, I still have no desire to betray confidences.
Mercifully, she has pulled through. The last few days have been really hideous for me cos of this, so I cannot imagine how hard it must have been for her poor, lovely family. I feel privileged that they kept me in the loop throughout CVM’s most serious illness, and am so very thankful that she is going to be OK. She reads this blog fairly avidly (or at least did when she was not imprisoned in hospital) so I will not disappoint her by failing to put up the latest entry, so here we go…
Thursday has come to equal only one thing for me. *Drum Roll* — It’s the Cult of C! Yay!
Actually I am not that happy with Thursday’s session. As you will know I wasn’t that happy with last week’s, but that was my fault. On Thursday past I was annoyed with C, kind of, but of course then that lends itself to my being annoyed with myself because I am too cynical and should give what he is trying to do a chance.
I was busy on Thursday and of course more time has now elapsed so I am not sure that I will remember the meeting in as much detail as I would like, but it seemed to go on for an inordinately long time. It’s the first time I’ve felt that; usually the 50 minutes seems to go by so quickly.
As usual he wanted me to commence but I couldn’t think of anything to say to the man so I let him guide me. He started by discussing the DBT material. Although I find some of this useful in some ways I am still struggling to come to terms with it as an adequate method of psychotherapy. In fairness, C is keen not to abandon our psychodynamic-esque discussions, but he feels – rightly – that I need practical help too. I am just questioning whether or not this is the most appropriate form of practical assistance for me.
In any case, he said he thought the ‘distraction plan’ I had written was “very good” and that I had obviously put a lot of work into it. I felt validated by this and couldn’t help a slightly flattered smile, though I hope he didn’t see it. This is absolutely pathetic; regardless of my reliance on C, I do not want to be in the position where I need his vindication for everything I do, especially not some cack that I could have quite easily have come up with myself had I bothered to take the time. Anyway, though, apparently that is the next thing. I want C’s endorsement. Brilliant.
We discussed some of the points briefly, then he asked me if I felt I could actually put them into practice when I need distraction or when I go completely mental.
I postulated the belief that it was all well and good to sit in a rational and comparatively mellow frame of mind and write the stuff out, but that it perhaps wasn’t so easy when one actually went nuts. I told him about Tuesday night, about how depressed and angry I’d been watching the European election results (in particular the horrific news about the evil BNP‘s relative success) and how pathetically hyper and manic I’d become watching the Great Britain council election coverage, something that does not even affect me directly at all.
C didn’t seem overly concerned about my histrionics regarding the political matters. In fact he seemed surprised when I berated myself for becoming (positively) manic after watching the council elections. Perhaps he is a politics junkie-nerd too.
He did ask me to elaborate on Tuesday night, however; oddly, some part of me was reluctant to discuss this with him. Is this yet more protection or was I simply embarrassed? Whatever the case, I forced myself to read out to him the same stuff I wrote here on Wednesday (the edited version that didn’t mention him or Dr C) that was garnered from the mood tracker on my phone. A long discussion ensued, much of which I don’t remember.
C said it was as if I was talking about someone else. I was initially confused as to whether he meant the terminology I had employed when I wrote about my mania on the phone, or whether he was referring to my tone of voice when reading it back to him. When I asked for clarification, I found his answer ambiguous, so simply said that when I read the stuff back to myself I had found it unpleasant.
“Definitely!” exclaimed C, very emphatically. I was pleased at the time that he was taking an interest, but now I am worried by the passion he put into the statement. Have I contaminated his mind with mine?
I don’t really remember what happened next (I am writing this on Sunday) but I do remember him asking me how I felt about not sleeping. I said I was used to it, that unless I had sleepers I almost never slept. I told him that before I went off sick from work, I would have been awake all night, then got up and quite adequately fulfilled the duties of my job. I said, in passing, “It’s not a big issue. I’m used to it; I’m a serial insomniac.”
I don’t think it was my imagination; I am pretty certain that his eyebrow quivered ever so slightly at the use of he term ‘serial insomniac’. Does he read this blog? *WAVES MANIACALLY* HI C! WELCOME!!!!! Seriously, it was almost certainly a coincidence. But it’s not impossible; he does have a list of my mental fuckupperies that he knows was basically copied straight from this website – all he’d need to do is Google some of the specific terms therein. However, this is paranoia on my part, as ever. C has better things to do with his time. I am his client (Or am I his ‘patient’? Or, most annoyingly, ‘service user’? I fucking hate that one), not his life.
Obviously he did quiz me on what had caused my going completely doolally. If I wasn’t upset about the insomnia, what was annoying me? The answer was simply nothing. I just went mental. There was no reason, or at least there wasn’t consciously. I think I need to ask Dr C, my psychiatrist (more on her in a minute), for some anti-psychotics (if the old bag will give them to me that is) – it’s bad enough to end up in this state for a clear reason, but to experience it with no evident rationale whatsoever is very disturbing. Though I suppose I should be used to it by now.
I’m finding this really hard to write. I don’t remember what happened next with C. I do remember we talked about the Tuesday night episode for some time, but I don’t recall any of the content. I really should force myself to write up my psychotherapy sessions straight after they take place, but I just couldn’t do it for some reason on Thursday morning. I think it was probably simply exhaustion from yet another week of insomnia.
So, given that I can’t remember any of that crap, let’s move on. The next things I do remember were what made me angry.
He asked was I able to ground myself in the moment when I go mad and I laughed in his face as, self-evidently, I am not. I said that often when I go mental I pace back and forth and bang my head off the wall, although I didn’t on Tuesday night as I didn’t get out of bed (I’m such a lazy fuck that even going nuts can’t make me rise from my pit). I said that whilst the banging of my head on stuff was partly about causing myself deliberate pain, it was in many ways to achieve reorientation in the ‘here and now’.
C started into a monologue about ways to reorientate oneself (or “ground” oneself, as he put it) in a non-destructive way. I have already spoken about stuff like using ice cubes instead of cutting as a way to feel pain, but this stuff was less tangible and much more airy-fairy.
He made me focus on the sounds I could hear – the clock, cars and birds outside, the fan on his PC. He asked me to focus on the sound of his voice too. I interjected at this point by asking if he was trying to hypnotise me.
He took this remark as evidence of my cynicism about what he was doing, but asked me to go along with it anyway. I did as I was told. I don’t know…I had mixed views. On the one hand, focusing on his soft, gentle voice was rather hypnotic. But focusing on stuff like the clock / car is all I can do when I’m on my own, and I really wonder if that is enough to abate the madness when it comes.
C asked what I had thought of the excercise. I said that although his voice had a hypnotic quality, I largely thought the entire thing was “terribly silly”. He accepted that but asked me to bear with him. I heard myself acquiescing to this.
The second thing he wanted to show me was even worse. It was a breathing exercise. What a pile of patronising wank! I already know that you are supposed to try and control your breathing when you are in a panic! Sweet Jesus jumping Christ!
C went on demonstrate the technique. I watched and listened in horror as he closed his eyes and exhaled heavily. It seemed kind of indecent to me, and I almost felt slightly violated. (I know, I know. Only a diseased mind like mine could turn a simple breathing exercise into something dirty).
He asked me then to try it with him. Quite clearly he detected my reluctance to do so. He said, “you might feel a bit daft doing this.”
“Indeed,” I replied. “I feel like a twat just thinking about it.”
He muttered something about understanding that, but asked me to indulge him. I rolled my eyes and followed his lead.
It amazes me that some apparently well-established and regarded professor of psychology, Marsha Linehan, came up with this utter nonsense. I could have come up with this horsebollocks whilst decomposed, dead and chained to a fucking crane. It is as simplistic as taking a fucking piss in a fucking nappy.
To be fair, I can appreciate that advanced meditative techniques can be hard to master and potentially helpful for some people and for some problems, but really. Breathing in through my nose and out through my mouth is hardly a fucking revelation in psychotherapeutic treatment, is it?
I was completely mortified throughout the entire ‘exercise’ and even if the bloody thing did have any value in it, I wouldn’t have been able to realise it as my discomfort was so strong and palpable.
With this shite completed, thankfully, C said that he recognised I was very sceptical about it (no shit, Sherlock). However, intriguingly, he also stated that he felt part of me was interested in engaging with DBT and its inherent mindfulness.
Is this true? I agree that I need practical help as well as therapy that uncovers the roots of my problems. I am just not sure that this is the type of practical therapy into which I can buy.
A and I have a friend, G, who has a degree in psychology (though unfortunately he did not pursue the discipline professionally, which is a shame as he would have been a fabulous psychotherapist) and he is probably the most intelligent person I have ever met (and I am lucky enough to have met a number of brainiacs in the course of my life). G is extraordinarily knowledgeable of Eastern philosophies and religions, and when combined with his knowlege of psychology, he is the obvious candidate to speak to about all this. A asked him what he thought of DBT and mindfulness, and G responded saying that it was a very effective tool for some, but certainly not others. We are meeting him next Saturday night to analyse these matters. G is the most skilled debater I have ever known, and is remarkably persuasive. If he thinks DBT actually has value, then there is a chance he might be able to make me see that. At present, I have to admit that, with regret, C is not doing so.
In any event, C gave me the photocopies of the next chapter of the DBT book, which summarised the stupid exercises we’d been doing. I read it when I got home on Thursday morning and fuck me. If the session with C was irritating at times, this was infuriating.
Aside from its patronising tone and its espousal of the aforementioned breathing/grounding exercises, there is this pile of shit called Radical Acceptance. Now, in fairness, what I was reading is a very introductory discussion of this concept, but I felt that my intelligence had been insulted by it. Apparently, you have to tell yourself that “you can’t change the past” or “everything leads up to now” or “it’s a waste of time to fight what’s already occurred” or, my personal non-favourite, “the present moment is perfect, even if I don’t like what’s happening.”
The latter excepted, I already tell myself these things. I know I cannot change the past. I don’t fucking want to change the past. I do not have an IQ of -1,000,000. THIS STUFF IS FUCKING SHIT.
It goes on to ask you to formulate a radical acceptance plan. For example, read a controversial news story without being judgemental, or wait in traffic jams without becoming irate. Yes, cos it’s that easy, fuckstains.
It then asks you to come up with your own ideas of non-judgemental acceptance. I have written the following:
- Try to re-read this chapter without getting annoyed
- Try not to self-criticise re: being irate about this chapter
This sounds like sarcasm, but I mean it in all sincerity. If I can manage to read the chapter again without wanting to scream, the ideas may have some very small chance of having validity.
As well as this, the doctrine of radical acceptance as I understood it suggests that you have to lose part of your personality by deliberately choosing not to have opinions. If you stop being judgmental, don’t you cease to opine? If you cease to opine, do you not lose part of the very essence of your humanity?
Am I to sit here and say, “no problem that the economy is fucked. I shall not make a judgment on that. It’s OK that Ahmadinejad rigged the Iranian election and treats his ‘subjects’ as he does. I shall not judge that. Eastenders is not a programme that I despise. It exists and that’s all. I do not judge it. So Hitler killed millions of Jews, gay, disabled and non-Aryan people. I’m not going to judge him for that. I accept it all. I can do nothing about it and therefore it is all fine.”
Fucking complete toss! Sorry, but I’m raging that our economy is cunted! Ahmadinejad is a fucking twat. Eastenders defines manure. Hitler was murderous fucking maniac. This is what I think and I don’t give a flying fuck if Linehan, or McKay, Wood or Brantley (authors of the workbook in question) think I am being cynical, snide or otherwise cuntish for it (but of course they don’t, do they? Oh nooooooo! They are all perfect and non-fucking-judgmental, so they have no opinion on my opinions).
Aside from all the annoying concepts, the actual terminology and tone of the fucking book is as condescending as nursery school – in fact, nursery school probably assumes its “consumers” have more fucking wit than this book does. I think it thinks it is talking to fucking goldfish. I have written infuriated annotations all over it.
I don’t want to offend C, but I have to be honest with him. There may be some stuff that is useful in DBT, but one thing I cannot abide is being patronised, and as such at present this book is merely serving to create negativity rather than resolve it. Perhaps as it becomes more advanced, it assumes more intellectual prowess, so I suppose I will allow him to continue with it for now. But it would seriously need to improve its tone and writing-style for me to significantly re-evaluate my opinion of it.
C does know that I have considerable reservations, and was keen to remind me that this is still only a small part of our therapy. He does strongly feel that we need to continue with the more freeform psychodynamic-ish stuff, but recognises that this will not solve my acute problems right here and right now. As such some practical therapy is necessary. I do agree, but I am dubious about the form that that is presently taking.
In any event, before I left we discussed the psychiatrist, Dr C. C thinks that she is indeed willing to explore alternative medications with me, which is good as my time on a lower dosage of Citalopram (as instructed by her) has proven that it was no use whatsoever. C also seemed to think that perhaps she will actually give a diagnosis (or diagnoses), which had previously been in doubt. I told him how glad I was about this, as I really, really want to know what this/these illness(es) is/are.
Before he had the chance to butt in, I pre-empted his commentary and tried to enunciate why a diagnosis is important to me. I said I was unlikely to become fixated with a name for my mentalism as I don’t want to engage in labelling theory, nor did I wish to be defined by a nice shiny tag. Nevertheless, I said, I felt that I already am defined as an individual by being mental, and that a name for it would help me come to terms with that.
“In the absence of an official diagnosis, I am making them myself,” I told him. “I don’t think that’s healthy, do you?”
“No,” he conceded. “I actually think you have quite a sensible approach to this; being fixated with a label is obviously a negative thing, so your belief that you would not be consumed by that is encouraging.”
He went on to remind me that as a clinical psychologist, he was unqualified to diagnose (I fucking know, C!), but said that his department did have some questionaires which can indicate what your illness might be. Initially my interest was piqued by this, but then he stated that if I wanted to explore this, I would need to do so with one of his colleagues. This put me off. I have never met any of C’s collegues but I hate and fear them anyway. He is the only one I trust. Though thinking about it, would they be about when C is skiving off work in July? If so, they might be better than nothing, because I will collapse in a mess without him.
Ho-hum. I suppose my next move is just to try some of this mindful wank and see where we end up. I do look forward to G’s take on it.
Sorry this has been such a shite post. My memory is skewed. I willhave to force myself to write up the C sessions immeadiately after they take place in the future.
This entry was posted on Sunday, 14 June, 2009 at 6:02 pm and is filed under C, Everyday Life, Moods, Psychotherapy with tags anger, anxiety, benefits, bipolar disorder, borderline personality disorder, bpd, clinical depression, cutting, delusions, depersonalisation, depersonalization, depression, derealisation, derealization, Dialectical Behaviour Therapy, disability living allowance, dla, hallucinating, hallucinations, insanity, insomnia, madness, major depressive disorder, mania, manic depression, mental health, mentalhealth, mindfulness, panic, panic attack, psychiatry, psychology, Psychotherapy, sadness, self harm, social anxiety, social security, suicidal thoughts, suicide, suicide ideation, therapy. 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.