Flogging a Dead Horse with C – Week 35

Christmas and the arrival of 2010 have seen some disruption to your usual service from SI. It seemed impossible to get a chance to write on the latest C session, given as these post seem to be the most ridiculously detailed.

This post shouldn’t be overly detailed, as a lot of it was repetitive bullshit regarding the annoyances of the previous week. Nevertheless, here we go.

Upon leaving C’s company the previous week, we had agreed that we would use week 35, the last week before a break of three weeks owing to Christmas, as a session to discuss how I would manage the so-called festive season.  In reality, that bit ended up taking approximately five minutes at the end, and although it was ever so slightly more helpful than some of the nonsense he’s come off with at other breaks (“breathe!”), it was still not entirely helpful.  But then again, he’s not my guardian, is he?  Much as I would like it that way.

I say we were flogging a dead horse because the majority of the discussion centred around the same crap we had discussed over the previous week (leave a comment or get in touch if you need the password) and the week before that, ie. my anger and distress about his decision to cut short my treatment, and my general disgust about the NHS’s abject failure to adequately treat me since I first sought help for my mental health problems.  I do understand that in some ways maybe C sees exploring my reactions to this as a form of projection or transference, and maybe in some ways it is: perhaps I feel so rejected and aggrieved because that’s how I was meant to feel about my father, uncle, ex, etc etc.

However, it endlessly frustrates me that I cannot just simply be angry because I have been so horribly fucked about by the health service.  Again, in this session, C reiterated that the 24 week limit (starting from tomorrow) was his decision; he said he was “not a robot” controlled by the NHS.

It completely contradicts all the stuff he says about my right to be annoyed and about how BPD should really be treated, and we went round and round in circles on how I could not reconcile his two contrasting views, and about how he either couldn’t or wouldn’t explain it properly.

I also, having decided as a result of the preceding week that he hated me, went to find out whether or not this was indeed the case.

I said, “if I ask you a question, will you promise not to answer with a question?”

He shifted uncomfortably, then admitted that he was unsure as to whether or not this was achievable.

I asked him anyway, on the proviso that if I thought he was “blagging” his way through his answer I would pull him up on it.

He did come off with the form bullshit such as, “why is it important for you to know that?” and whatnot, but I was pleased when he finally admitted that he too had found the preceding week “frustrating”.  So he is a human after all!

He said that I had been “very angry” with him, which I thought was unfair.  I told him that I genuinely hadn’t been angry with him, merely the system, until he confessed to having been the one that decided on the time limit.

“But you were angry with me then,” he pointed out.

“Yes,” I said.  “You had seemed so supportive of me prior to that; you agreed that my situation was wholly unfair.  Then you completely contradicted that by admitting to this arbitrary limit crap.”

And so back we went to flagellating that deceased equine.  More questioning demands from me, more bullet-dodging from him, no progress from either of us.

He had asked me in week 34 to seriously consider whether or not to continue with therapy, as I “had” to agree to the time limit as part of the contract (which strikes me as being quite unreasonable, as contracts are meant to be negotiated rather than forced in this type of setting).  Apparently if I don’t accept the limit, I cannot continue treatment.

“On that note,” I told him, “I am prepared to accept it, but only if you accept – because this works both ways – that I am going to fight it.”

He asked what I meant by ‘fighting’ it, prompting me to withdraw a copy of the letter to the advocacy groups out of my pocket.

“It’s only fair that you read that, given that you’re going to be involved,” I told him, handing the document over.  He took it and began reading.

I sat there and watched him reading it for a minute or two, then stood up and walked to the window, knowing perfectly well that he would almost certainly comment on this, as he had done two weeks previously.  Indeed, he didn’t disappoint.

“I’m wondering why you got up, SI…” he pondered, as he continued reading the letter.

“It’s not reflective of anything,” I spat cynically.  “I’m not denying my hurt or failing to face up to my problems.  I’m simply looking out the window whilst you are occupied with reading that.  Am I not allowed to get up, C?”

He shrugged and muttered something along the lines of that I was, in fact, allowed to get up, then continued reading in silence.

He eventually looked up and said, encouragingly, “it’s a good letter.  Who all are you going to send it to?”

I told him about the advocacy groups, Mindwise and the NI Association for Mental Health.

I was astonished – and delighted – when he then proceeded to actively encourage me to also send it to both the Chief Executive of my Trust, and the head of the mental health directorate of same.  In the end, he forgot to give me the person’s name, but as it turns out it’s been passed to him anyway (more details on how the letter has progressed in a future post).

C said, “you’ve also made reference there to people I think are in England – perhaps it would also be worth adding information about provision for personality disorders in other Northern Ireland Trusts.”

I asked him what such provision existed, knowing that people with the most serious PDs are in fact sent to specialist units in England as there are no facilities to treat them here at all.

C said a self-harm team exists in one of the other Trusts here.  “Although not everyone who self-harms has BPD, and not everyone with BPD self-harms, they would probably see a disproportionately high rate of people with your diagnosis,” he said.  “No such team exists in this Trust at the minute.  There’s discussion ongoing about making the existing team a regional, cross-Trust one, but it hasn’t yet come to anything.”

He talked on for a few minutes about plans our Trust has for action on personality disorders, and how they don’t seem to much be coming to fruition.  But the best part of the session was when he asked me if he could have a copy of the letter.

“I think it would be good for my line managers to know how you feel about all this,” he said.  He went on to say something (I don’t recall what) indicating that there might be some benefit to me in this, but was very quick to point out that it was my choice as to whether or not he did take a copy for them.  I readily agreed, of course, delighting in his apparent desire to act as my advocate to the bureaucrats above him.

Now, of course, I am convinced that he took the letter so he and his twatfaced bosses of evil can formulate some plan of self-defence in advance of hearing from the advocacy groups.  It was not in my interest at all – merely their own.  No doubt over the next few weeks we’ll see which way it actually is.

Eventually – I don’t remember how – I said that he must get sick of his job, what with all the whinging he would have to listen to.  “I accused you of being a sadist a few weeks back,” I said.  “Now I think you’re a mashochist.”

He accused me (sympathetically, to be fair to him) of splitting, which on reflection makes me slightly irritated, but at the time I agreed and called myself all the names of the day for employing this “silly psychological process.”

C leapt to my defence.  He said he knew that I had long since known I was guilty of splitting, but that it’s now “emotional for [me]”, not just something I recognise intellectually.  And it is OK, I do not need to berate myself for it, because I have suffered serious traumas, apparently, that have caused this defence mechanism (which is not silly, he contends) to develop.

On that note, as I recall it anyhow, we moved on to the discussion about the dreaded Christmas.

C’s advice was basically to get the fuck out if I felt anxious or overwhelmed.  I said that was easy to say, but he didn’t have to listen to my mother’s wrath if I did so.

He advised me to talk to her in advance, but I protested against this as well.  “When I told her about what happened with my uncle, she said I made it up to avoid going to his house,” I reminded C.  “So how can I justify my anxiety?”

“Blame your crowd phobia,” C said.  “She can’t be critical of that, can she?  There will be a crowd there, won’t there?

“Yes,” I replied.  “And they’re all part of the problem – it’s not all about my history with my uncle.  I have nothing in common with them and it’s a weird matriarchal set-up, where about 18 different generations all live under the same roof.  They’re freaks.”

He said, “are there children living there?”

I was horrified.  He was obviously wondering if anyone else is presently at risk from Paedo.

“Now you’re angry with me for putting the baby and all the other generations in danger.  I’m sorry,” I raced, in a bizarre panic.

C looked at me, his eyes wide-open.  “Where did that come from?” he enquired, surprised.

“Oh, you’re not angry with me?  Then I’m using you as a board for my anger at myself, am I?”

“OK, you’ve lost me,” he admitted.  “Just…just remember – get out.  Talk to your mother in advance, blame your crowd phobia if you have to, but if you feel yourself becoming tense, get out of there, even if only for a few minutes.  Allow yourself to be anxious about this.  How could you not be?”

And that, folks, was really that.  Of course, you know how ridiculously awful Christmas turned out to be, but I did remove myself from the others when I went so horribly mental, so I suppose I did at least follow the advice given.

As I was leaving, I wished him a Merry Christmas.  He said, admittedly cautiously, “you too,” causing me to laugh bitterly.  I think he knew that it was inevitable that the season would be utterly shite.

So, the three week gap is due to be over tomorrow.  Of course, I am convinced that C is dead again; either that or therapy will be cancelled due to the stupid, horrible, pointless fucking snow, and I need him so desperately at the minute.  Though I have not heard anything about a cancellation today, and I suppose I would have expected an advanced notification were the snow to fuck everything up on the monumental scale that it has in Britain.

The last time he was on holiday, in August, I didn’t miss him that much.  But this time I have, and I need him to help me pick up the pieces of the last few weeks.

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26 Responses to “Flogging a Dead Horse with C – Week 35”

  1. I don’t think I have anything particularly helpful to add to this. It sounds like the sort of situation where I could happily, and literally burst into flames.

    Your blog is wonderful by the way. I really mean that. You describe things very well.

    Lola x

    • I don’t think I have anything particularly helpful to add to this. It sounds like the sort of situation where I could happily, and literally burst into flames.

      I hear you. It is a big issue for me, and by dent of that I suppose it’s a big issue for therapy, but there are so many substantive issues that need to be investigated, and going over this time and time again overshadows that. I’ve told him, but it always seems to come back to this.

      Your blog is wonderful by the way. I really mean that. You describe things very well.

      I really appreciate that, Lola, thank you. Coming from someone as well respected as you in the blogosphere, it means an awful lot. I’m in good company 🙂

      Take care hun and thanks again xxx

  2. This all sounds bloody frustrating. He seems to jump around from being on your side, ie telling you who to send your complains letter to, and complaining about lack of provision for PDs, whilst at the same time clearly stating that it is HIM that is stopping your therapy, not the NHS etc. That would really confuse me, and piss me off. From reading your blog (I have actually read the entire thing over the last month or so….insomnia leads to me reading an excessive number of blogs, and when finding one I like, reading it from the start!), I don’t understand why he is ending your therapy, as you obviously still have lots of stuff to deal with. I suppose he must have reasons for it, but it then seems odd that he is encouraging you to send out a letter complaining about this.

    Oh, and I agree with Lola, your blog is fab (as is hers)!

    • I just don’t get it. I really don’t think I’m doing the black ‘n’ white thing here; there simply is no grey area. How can he make this decision so categorically, whilst then encouraging me to fight the NHS?

      A (my partner) thinks he has, in the most literal of senses, decided upon this, but in de facto terms it’s political; it’s come from on high. I think I may have postulated that to C in this session, in fact.

      Anyway, thanks hun – very kind words, very much appreciated 🙂 Glad to have you on board!

      xxx

      • No, you are not doing the black and white thing at all (says the girl who is told every session that she thinks in very black and white terms!). It just makes no bloody sense whatsoever. Did you query why he was encouraging you to complain about a decision that he made? It just seems a very odd thing to do.

        A could be right – he could have limits set on the length of time he is allowed to see patients generally or something like that, but if it actually is a decision come down from beloved management I don’t understand why he would keep telling you that it was his decision? Unless he is in fact desperate to feel that he has some control and power over his job, and achieves this sense by telling patients that he has made decisions that were actually nothing to do with him 😛

        xxx

        • I did query it the week before this session, but he failed to give a proper answer, as is typical. I always say he’d have made a consummate politican!

          I dunno. It’ll come up again I’m sure, but today we tackled more substantive issues, which was what I feared would be neglected. Just hope we can get somewhere…

          Take care 🙂 x

  3. Wotcher mate,

    Ok – I really don’t get this. Am I being extra thick?

    He supports your fighting the NHS to continue treatment, but he’s the one imposing the limit? Aren’t they (NHS, trusts etc) therefore just going to respond to your letter saying that C has the final decision so go complain to him?

    Muchos contradictory messages. Does my head in and he’s not even my shrink.

    Look forward to hearing the latest.

    X

    • Bah. See above to Bippidee. I don’t get the man at all myself. I so desperately want to challenge him on this again, because my ‘inability’ to understand it is driving me up the walls; however, the more we wank on about this issue, the more time we waste on the actual issues that I’m in bloody therapy for. Meh.

      Will keep you updated my dear. Take care xxx

  4. (Found your blog via mental nurse, hi!)

    Good on you for taking on the system a bit and writing the letter. I’m in England and having to fight like hell to get my therapy now I’ve moved to adult services, and I’m in a county with a BPD treatment programme, I just can’t get on to it! It must be really frustrating for you. Keep kicking though. Someone has to.

    itm xx

    • Great to have you on board fellow MN award winner 😀 Will be catching up on your own writing in the next few days 🙂

      It is frustrating being in this position – especially after having tried getting treatment since I was 13 – but I think I’d be even more pissed off if the facilities fully existed and I was denied the opportunity to use them. Admittedly, individual therapy, not specifically tailored to BPD, is what has worked best for me, but that’s not the point; if you have been given the diagnosis, these people should be giving you the treatment you need – and deserve. I really hope you have some success with this as soon as possible.

      Here’s to both keeping fighting! Take care xxx

  5. The NHS sucks big time. I wish I knew what to suggest but I’m just as confused as everyone else seems to be. What is he playing at? Confusion doesn’t really work as a therapeutic tool does it?

    Take care xxx

  6. “He was obviously wondering if anyone else is presently at risk from Paedo.” ?

    I’ve been mental for the last couple of months, so I haven’t been following your blog, but I am intrigued as to how you came to that conclusion.

    • We have discussed my worries about Paedo’s great-grandchild (soon to be great-grandchildren). In this session, I was describing what a freakshow my family is and about how about 7,380,947 generations live under the same roof.

      He asked, straight after this, if there were children living there. If I had reported what happened, it wouldn’t have mattered, because they wouldn’t have been in danger. Therefore, the potential risk to the various generations is my fault. He effectively asked were they in danger, so if he was seriously concerned then to me it followed that he would be seriously annoyed that any untoward behaviour could have been prevented.

  7. Must admit, I don’t get it either. Why would he put a limit on your sessions and then encourage you to fight the NHS? I’m new to your blog, so I haven’t worked my way back through previous posts yet, but why did he decide to put the limit on? Did he give you a reason?

    • I basically demanded reasons from him, but he was very careful not to answer definitively. One pretty dire one he did give was that he thinks it’s helpful to work towards ‘goals’. I don’t disagree, but I think goals should be something like achieving a by point b, not ending the whole damn thing altogether.

      However, the main reason I suspect, and he hinted at it but was careful not to state it explicitly, is simply NHS resources. He could just have come out and said that of course, but then there was a danger I might have asked about waiting lists, and I’m assuming he’s very well aware of the fact I refuse to acknowledge the existence of any other patients but me! In reality, he might have set this specific limit himself, but I think he’s been strongly influenced by his bosses despite what he may say.

      But all this trying to see it from his perspective doesn’t necessarily make it any less contradictory to me.

  8. I agree, it doesn’t make sense that he would want you to fight the NHS when he is the one who decided on what you are fighting for. I would ask why he didn’t give you a straight answer, but I think it must be written in some Therapist Handbook somewhere that they are not allowed to answer questions with anything other than more questions. 🙂

    And, snow a problem? Wow, I would have thought a place as far north as NI would be more used to snow…at least, more used to it than down here in Georgia! We have snow on the ground now, but it’s such a rare occurrence here that people go nuts and schools close because it throws people for a loop…oh well, I never claimed to be a genius.

    And yes, great blog!!!!

    • Straight answers are not something that C does very well. I decided to let it pass at the most recent session (about which I have yet to blog), opining that I would prefer to tackle some of the more “this is why I’m here in the first place” stuff, and it was a fairly productive session. Still, I know almost for a fact that this will come up again, so when it does, straight answers will be demanded 😉

      Re: snow, we’re protected by the Gulf Stream, so snow is relatively uncommon, certainly on this magnitude. But seriously, you’d think it was the apocalypse; the media are sensationalising the cold spell so that you’d think it was a disaster movie, and much of the UK and Ireland has ground to a halt. It is absolutely ridiculous – this is the 21st century!

      And thank you PQ 🙂 x

  9. Personally, I think a diagnosis of BPD is a cop-out on the part of the therapist. It’s a big reeking load of bull. It’s really just code for “I can’t accompany you into the true depth of your feelings about the atrocities that made you this way”. Save yourself, dear therapist – throw the fucking client under the bus and go home and have dinner because all is lovely in our fine world. jmho

    • To be fair, C was not the one to make the diagnosis (he is a psychologist – obviously the diagnosis was made by my psychiatrist). In fact it’s only very recently that C has even used the word ‘borderline’ with me – he used to wince if ever I said it.

      Nevertheless, I do agree that the diagnosis can be unhelpful at best; it’s horribly stigmatised and so frequently just given to ‘difficult’ patients. You are quite correct that it can just allows the shrink to say, “fucking borderline mental,” without examining the history. I don’t think I ever discussed the issues in any detail with my psychiatrist, though to be fair I think she did make the diagnosis rationally, rather than just seeing me as difficult (which I’m not ((with her anyway)) – I’m really rather passive).

      C and I are trying to tackle the issues that gave rise to all this crap, but it’s difficult for me with this limit hanging over the treatment, as I’ve lost a little bit of trust in him.

      At the end of the day I think the whole disciplines of psychiatry and applied clinical psychology are educated guesswork. I’m not sure I believe that any of them can be any help…but I guess I have to try.

      Take care, Ethereal x

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