An Impasse – C: Week 26

It’s funny how really small things in therapy catch your attention sometimes. Today, he called me by my name at one point, which he never does except to call me in from the waiting room. I also noticed him bring out a bottle of still water from his briefcase at one point, which struck me as odd as he normally has sparkling water. Neither of these things matter. It’s just strange how such tiny things take on some significance in some settings.

This post should be interesting, given that the crux of the conversation between C and I today was Friday night’s happenings, which I am (stubbornly?) refusing to discuss here. How many words can I turn not-very-much into this time? [EDIT FROM LATER: Over 2,000 apparently!).

For contextual sense, let me tell you the following. I am utterly convinced that what happened on Friday night was a complete psychotic breakdown. I was totally disconnected from reality, I had a complete persecutory complex a la paranoid schizophrenia and I was having conversations with myself (though I note with contempt that bloody Tom didn’t turn up to help, the fucking self-serving, non-existent twat).

On the surface the session would appear thoroughly unhelpful. When C himself asked me how I was finding it, I was honest and admitted that it was “frustrating”. Essentially, in discussion with him regarding what I shall now term The Incident, we ended up fundamentally disagreeing with each other as to how future incidences of same could be dealt with.

I had asked right at the beginning of the session who I was meant to contact if things were as serious as they, especially on occasions where I was not due to see him for a good while. He said that whilst he was more than glad to discuss this with me, that he wanted us – together, he insisted – to find ‘a balance’ between getting other people involved, and finding ways that I could manage my mentalism.

At one point he wanked on and on about ‘strong emotions’, and I quite irritably interrupted him and said it had fuck all to do with ’emotions’. I said, “I know I have used the term ‘psychosis’ out of context here before, but I assure you I am using it in its most accurate sense now. I was completely disconnected from reality.”

I goaded him on how I was meant to predict psychoses. He said I couldn’t. I asked how, then, was I meant to prevent it happening. Apparently I am meant to deal with triggers as they arise regardless of where I think they might go.

He said, “you spoke about being irritable at other points last week, prior to The Incident – maybe we can think about what you might do in that circumstance so that it doesn’t escalate into something like this.”

“I’m permanently irritable,” I sneered. “I don’t normally turn into that, however, so I fail to see your point.” To be fair to C, I had made reference to something that annoyed me, and he seemed to think that The Incident was a direct result of that. It wasn’t; it was, at most, tangentially linked. I told him so.

I sighed, and advised him that he was seeing the situation entirely differently from the way I did, and to his credit he admitted this (without stating that one or other of us was correct). He agreed that by the time I got to this stage of madness that there was very little I could do to combat it (I had shown him the scars on my arm that were caused by flicking rubber band on my arm, as espoused by accursed DBT, to demonstrate that this had at least been tried, and had failed) and that in these circumstances, it was reasonable to get someone else involved.

So, C had his view, I had mine, and never were the twain going to meet. I was keen to reassure him that I didn’t necessarily disagree with him in general, just about this, and he was keen to reassure me that I wasn’t to think he was lecturing me or threatening to ‘sack’ me (a term used because I told him work are coming round on Tuesday to do just that – or so I think anyway – but I’ll talk about that at another point).

By this point I was relentlessly pulling at and playing with my hair, hiding behind it because I didn’t want him to see my face. I plaited it, wound it round my finger, straightened it out in front of my face, pulled it forcibly, pushed it away only then to drag it back. From behind it I said, in a tiny voice, “yes, well – you do know I have an abandonment complex.”

I don’t remember his exact response, but he did say he wasn’t abandoning me. But is he really not? If we’re not on the same level, how can we work together?

I was acutely aware of how childlike my hair-fiddling, voice and general sense of failed object relations all were. Fucking child. Fucking huffy immature little brat. Hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate. It’s classic borderline bullshit, isn’t it? The psychiatric establishment still thinks of those with BPD as immature and manipulative, doesn’t it? I don’t think that’s generally true, but it certainly is of me.

I kept wanting to ask C if he thought I was immature and childish but for some reason I never did. Perhaps I realised subconsciously that if he did think that, I would be hurt if he said so – or hurt, more likely, when he implied that was his view by failing to answer the question. Perhaps also I thought if he said that he didn’t think so that I wouldn’t believe him.

Immature or not, of course I dissolved into berating myself.

“I hate myself, I hate myself so fucking much,” I whinged.

Apparently that is “not helpful”.

This really pissed me off. “So what?” I raged at him. “It just is. Have you ever [done what I did on Friday night]?”

To my utter astonishment, he tilted his head and thought about this. “I don’t think so,” he eventually concluded. “I might have [done a version of it]…I don’t think so, but I’m not sure.”

A tactic? He couldn’t possibly have done it. I know you don’t know what it is that I’m on about, but really – it is completely inconceivable that he would ever have done this. And how can he not know? Unless you were suffering from the most severe type of amnesic psychosis, I am genuinely at a loss as to how you wouldn’t fucking know whether you had done this or not. It wasn’t something like forgetting to turn the lights off before you went to bloody bed.

Anyhow, he went on that OK, I can’t just decide not to hate myself, but that I should just “let it be there” and make no judgement on it, or something. More mindful wank.

“Alright,” I challenged. “How do I do that?”

“I don’t know,” he admitted.

“Well, that’s great, thanks.”

“I mean, I can’t give you an answer like that right now. It’s something we have to work on over time – we have to work out your triggers, how you’re feeling and whatnot, and develop strategies from there.”

Of course this means that because I hold back on just about everything, we haven’t been able to do the aforesaid in six entire months of therapy. I freely admit it. I dodge everything I don’t like or feel potentially upset by like it’s a fucking bullet. He knows, I know, you, dearest readers, know. It’s not that C is unskilled in getting stuff out of me; I have admitted much more to him than to any other therapist I’ve ever seen (or many people outside psychotherapy, for that matter). It’s just that I’ve become remarkably skilled myself in spotting exploratory techniques, however subtle, on the part of the questioner. Freud himself would find me an incredibly difficult patient.

Yet I regret it, because I know it misses the entire point of therapy. It’s just so damn difficult to ‘let it all out’, as it were. I simply cannot just make myself do it. But still…

“Fucking mental freak,” I intoned, darkly and angrily. “Wasting an hour of your time every week. Fucking useless mental, psychotic piece of shit. I have failed. I have failed me, and I have failed you.”

“Ah,” he said, sort of knowingly, as if a penny had dropped. Then, firmly and with (apparent) absolute sincerity, “I don’t think you’ve failed at all.”

That was reassuring, and I tried to smile, but by that point I had been overcome with a range of extreme perturbations and melancholia, and it was difficult. I managed a pathetic and incredibly small, “thank you.”

After a while – I don’t remember the exact context, but it was the characteristic disagreement of this session in some way – he said, “we’ve kind of reached an impasse, haven’t we?”

I agreed.

But he continued, shrugging slightly, “you know, that’s alright. We’re allowed to disagree. It happens in any social interaction.” He paused, waiting for me to look at him (I’d avoided eye contact with him for most of this session). When I finally returned my gaze to him, he made some sort of positive facial gesture, designed (I think) to reassure me.

We spent some time talking about who to contact when I go mental again. As I know, there’s the fuckwitted Crisis Team. I can call them (so I can be advised that a nice cup of tea and some rest and some meditation will profoundly change my life and stop me losing contact with reality). If I am seriously contemplating suicide, I have to go to casualty. Hmm, yes C, because if I’m trying to kill myself on impulse then that will be forefront in my mind.

When I went to protest this, he clearly knew that I was going to make the foregoing argument, and he pre-empted it by saying, “you have to; it’s your responsibility to do that,” echoing what he’d said when I begged him not to get LGP or VCB to section me in this session.

Then he asked me if I had had experience of Lifeline and/or the Samaritans. I responded in the affirmative.

“And how did you find them?” he queried.

“Well-intentioned,” I responded.

He smiled at that, which initially perplexed me, but it turned out that he was apparently pleased that I hadn’t just said that they were “useless” or “crap” or something.

“It’s simply my version of diplomacy,” I retorted. “It doesn’t mean I don’t think that they’re useless; it just means that they are well-intentioned. Well-intentioned does not equal effective.”

He went to his briefcase and took out a list of numbers, and looked at it for a few minutes. He asked if he wanted a photocopy of it. Thinking it might actually be useful, I agreed to this.

Of course, it was the end of the fucking session at this point. In a moment of uncharacteristic and surprisingly urgent self-concern, I suddenly came out with, “you know, there is so much more stuff that I need to have out with you. It’ll have to wait, of course, but I do.”

“OK,” he said, encouragingly.

I will regret having said this later, because I won’t want to discuss ‘more stuff’. I really don’t want to as it is, but at the minute I’m glad I made the remark, as it’s essentially unavoidable to have at least some of these uncomfortable discussions now that I’ve admitted I need to do so.

When I got to the car, I looked at the list of numbers. It was a pile of crap. Lifeline, SANE, The Samaritans. I could have found it all out for myself within about 10 seconds. To my incredible amusement, one of the ‘resources’ given was my soon-to-be-ex employers. Oh, the beautiful, dark irony. I laughed out loud, sitting alone in the driver’s seat, when I read that. One thing that was of some interest was the fact that the CMHT are apparently accessible via a referral from one’s GP. Therefore, I shall try and make an appointment with LGP before I am due one to see if I can get him to get me a social worker or CPN or something. Not that I think they’ll be much good, but anything’s better than nothing when C’s not available.

My final thoughts on this morning are more positive than you might think. One thing that maybe hasn’t come across in this post especially well is that, although the actual content of the discussion was somewhat fraught and to use C’s term, something of an impasse, I was fairly expressive with C, in a non-verbal way at least. I fought against tears throughout the meeting – and I won – but I did squirm, put my head in my hands, roll down the chair, throw my head back, play with my hair (as mentioned), and various other little things.

It doesn’t really sound like much, but it’s actually something of a turning point for me. I am almost always calm and measured with C, and today I really wasn’t. It’s not that it’s good to be upset or uncomfortable, but if I am going to be, then the best place to exhibit that is in psychotherapy. It might be dead on the six months mark of the process, but regardless, in a way I feel that it’s a minor breakthrough.

My next goal is to allow myself to be completely honest with him about everything, something that I have deliberately avoided to date. He knows many things that he ought to, but not all. Maybe eventually I’ll even be able to allow myself to cry and scream and rant as I often feel compelled to do, but always manage to resist. Maybe that’s optimistic, I don’t know. But I hope today was a start.

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8 Responses to “An Impasse – C: Week 26”

  1. I’m really struggling with this one. I can’t understand why C doesn’t know whether he did something or he didn’t. That just doesn’t make sense.

    It’s frustrating when you reach an impasse – it almost feels as if he isn’t accepting what you know to be the truth.

    I wish I could say something useful but all I can do is offer hugs x

    • I’m baffled by it too. There is simply no way he cannot know, unless he is prone to severe amnesia or psychoses. I would presume that they would nor let such an individual practice as a psychotherapist. It must be some sort of (misguided) tactic.

      Yes, this was kind of an invalidating session for me. Frankly, I think it was for him too, as a professional, but that isn’t my problem. I am glad about being able to be expressive, but I wish he’d stop thinking he knows best. He himself once told me that I was the expert in myself, so why doesn’t he listen to himself? I would find it a lot more helpful if he would suggest reasons for such dickish behaviour rather than toss on about mindfulness. All the best sessions have been the ones that reflect psychology, not new age faffy wank that isn’t even empirically tested to any signifcant extent.

      Anyway take care pet x

  2. Having gone through about 1 1/2 years of therapy with a good therapist, I learned that it’s okay to cry in such a safe environment. It’s tough to be that in touch with myself and safe enough with her for me to cry. I have some really bad childhood trauma underlying the mental illness, so it was tough to get in touch with that. I finally started to picture myself in my mind as a 2 year old girl (me as a little child) when I get really “down and dirty” in therapy. In my mind, she’s very unhappy. All she seems to want to do is cry. It’s strange to see myself as that little girl. But I know it’s me. I’ve progressed to the point where I (in my mind’s eye) walk over to her (me as a child) and pick her up. I carry her in my arms (in my mind’s eye) both in therapy and out. Not always, but sometimes. I know this all sounds bizarre and crazy. But it’s true. And it seems to work, because I feel so much better after I’ve carried her around. But I needed a good therapist to get me to that point. And I need to be honest with my therapist. Weird, huh?

  3. Oh yeah: None of that stuff about carrying myself around came from my therapist. It came directly from me, the minute I realized that I could actually see that little girl (in my mind’s eye).

    • That’s really interesting, CM, thank you. I don’t think it sounds bizarre at all 🙂 I do hope that I’ll be able to get to such a point in therapy. I do find my therapist helpful and insightful, but it’s going to take more time to break down the barriers that will allow me to get to such a point. It’s not his fault, but mine for withholding and defending him from getting where he needs to get. But he’s patient, and has assured me we’ll get there, so fingers crossed.

      Thanks for sharing your experience – I know how personal something like that is.

  4. It has been quite educational to me as I peruse your diatribes with C. As you already know, I am just beginning with a new therapist, so I’ve yet to establish any rapport. However, after the initial workup appt that I was required to attend as a condition of my release, I voluntarily chose to make a follow-up appt because (and as you so adroitly pointed out) she was honest enough to acknowledge the rage to which I admitted, and she did not try to bullshit me.

    However, what you experienced was invalidation from C (also noted elsewhere). How validating for BPD! In that action, he missed the boat entirely.

    You’ve apparently reached a point in your ongoing relationship with C where you must have a sense of trust established in order to be willing to bare everything in full view of knowing that you could be sectioned. Having just been released myself last week, I say today that I will never put myself in that vulnerable position. However, yet what does also occur to me is how can I truly expect any value to stem from any therapy I attempt if I am unwilling to do the same? A conundrum to be sure.

    • You’ve apparently reached a point in your ongoing relationship with C where you must have a sense of trust established in order to be willing to bare everything in full view of knowing that you could be sectioned. Having just been released myself last week, I say today that I will never put myself in that vulnerable position. However, yet what does also occur to me is how can I truly expect any value to stem from any therapy I attempt if I am unwilling to do the same? A conundrum to be sure.

      A good point well made. It’s incredibly difficult to trust anyone when you’re afflicted by these conditions we’re unfortunate enough to share, yet the major difficulty of most types of therapy is that this person is in many ways the person you know least in your entire life. Yet you are expected to offer incredibly intimate and personal information to them! The asymmetry of it is something with which I struggle a lot.

  5. The Elephant in the Room: One of the symptoms of mental illness can be paranoia, and we all know that it’s difficult to separate unwarranted paranoia from warranted. But to really benefit from therapy, we have to fight to keep unwarranted paranoia from raising its ugly head and ruining any chance of healing. The method of doing this is through counseling and meds. But we can’t start the healing process without making that leap of faith and trusting the therapist. Paranoia prevents this. We can’t make that leap because we’re paranoid, and we remain paranoid because we can’t make the leap. We’re stuck. The trick is how to become un-stuck.

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