Archive for borderline personality disorder

A Time of Not Being Suicidal?

Posted in Context with tags , , , , , , , , , , , on Tuesday, 19 January, 2010 by Pandora

In the last post, the lovely Karita who blogs at If Narky, Feed Profusely commented that she had never felt suicidal.  This got me thinking.  Was there a time when I didn’t?

I have had a fixation with death and dying from as far back as I can remember.  My mother was disturbed when as a four year old, I told her I wanted to be a forensic pathologist when I grew up (seriously).  Although I didn’t fulfill that dream, I did academically pursue what I thought would be a related discipline, the most interesting aspects of it being those that discussed death – including, indeed, a quite in-depth exploration of suicide in a sociology class.

I cannot say whether or not I actually wanted to die myself when I was four, but I wouldn’t rule it out.

It was certainly the case in my later childhood.  I first tried to kill myself when I was about nine or 10.  I have a very vivid memory of it; I tried to strangle myself behind the closed door of my bedroom.  Clearly this was a ludicrous attempt, but an attempt it was nevertheless, and I remember the despair and frustration I felt when it became evident that my actions would fail to bring about their intended result.  I was distraught at the prospect of my life continuing.

Since then, I’ve tried walking in front of vehicles, taken two overdoses (which saw me hospitalised), tried to slit my wrists*, ankles and elbows, hanging myself and suffocation.  I think that’s it.  (* Including, of course, the incident from Friday).

I know what you’re thinking.  Anyone who’s serious about committing suicide wouldn’t have such a number of silly attempts under their belt; they plan their death, and that’s that.  Fair enough.  I can only defend myself by saying that in most of the cases, the most serious ones at least, the desire to not exist felt serious.  The most serious attempt was a massive overdose when I was about 16, which did nearly kill me.  A couple of these attempts were gestures or based on circumstantial factors, I admit – but mostly they weren’t.

When I wasn’t actually actively trying to top myself, I was probably thinking about it.  I can honestly say that I’ve almost certainly fantasised and/or ‘planned’ my suicide for every day of my adult and adolescent life, and a lot of my late childhood too.  This even includes periods of mania and contentment.

In short, this is how I perceive normality – to all intents and purposes, I have never known anything else.  I’ve been sitting here for a while trying to imagine what it’s like to not feel suididal, and it’s just beyond the bounds of my imagination.

Well, there’s more proof – as if it were needed – that I’m a headbin 😉

Tomorrow is my first appointment with NewVCB, about which I will blog as soon as I can.  I don’t know whether to be amused or incredulous by the fact that my first appointment with this woman will be in the wake of a suicide attempt.  And then I have to face C on Thursday, and that will not be fun in the least.  Alas.

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Suicide Attempt Epic Fail

Posted in Moods, Triggers with tags , , , , , , , , , , , , , , , , , , , on Sunday, 17 January, 2010 by Pandora

*** STANDARD TRIGGER WARNING: POSSIBLY TRIGGERING MATERIAL IS UPCOMING; I HEREBY ADVISE YOU AGAINST READING IT IF YOU FEEL THAT IT MAY SET YOU OFF…BUT I KNOW YOU’RE GOING TO READ IT ANYWAY, SO THAT’S A BIT POINTLESS, BUT I PROBABLY LIKE YOU BECAUSE I LIKE EVERYONE THAT I KNOW READS THIS DRIVEL, SO PLEASE DON’T HURT YOURSELF.  NOT BECAUSE OF INADEQUATE LITTLE ME ANYWAY.  IF YOU DO SO I WILL HAVE TO COME ROUND TO YOUR HOUSE AND SHOUT AT YOU AND/OR KILL KITTENS AND/OR CLUB BABY SEALS AND/OR SLEEP WITH RICK MAYALL.  NOW YOU WOULDN’T WANT THAT WOULD YOU, SO EITHER DON’T READ THIS SHIT OR A LEAST MAKE SURE YOU ARE NOT COMPLETELY MENTAL AT THE TIME OF DOING SO.  OK?  OK.  THNXBAI. ***

I’m sure that most of you are familiar with what I did on Friday night(well, technically, Saturday morning) given my bizarre running commentary on same on Twitter.  Of course, not everyone who reads this blog uses Twitter, but nevertheless, you can derive the basics from the title of this post.

It wasn’t a “cry for help” or some sort of silly borderline strop.  It was an absolutely pathetic attempt, I will admit that, but it was a nonetheless serious attempt.  I genuinely wanted to die.  I did.  No bullshit, straight up – death, not attention, was what I sought.

Nothing especially bad had happened on Friday – I was just miserable for most of the day.  I met A for dinner and a few drinks, which was pleasant actually, and when we got home, we listened to some music and were generally rather contented.  But I kept thinking how much easier things would be if I wasn’t in existence.  Not just for me – although I admit that was a major motivating factor – but for everyone.  I add nothing to anyone’s life.  A million people could tell me otherwise, but I’d never believe them.  I am a worthless, useless slut of sheer, unadulterated and fetid disgustingness.  Or at least that’s what I thought then.

So when A went to bed, circa 1.15am, I laid into myself with the scalpel.  Few parts of my body are unaffected – self-harm is strongly in evidence on ankles, arms, abdomen (there words there, just slashes elsewhere), elbows – the works really.  As I was doing it, I thought that I might as well go one step further and slit my wrists, the hopeful and intended result being my bleeding to death.

Now, people could say, “but a serious suicide attempt requires planning, and this was an impulsive act.”  I do accept that, and can see why it looks like nothing more than a pathetic gesture.  All I can say to convince people otherwise is that it felt absolutely and completely genuine at the time.  I wanted to die.  I really did.  I always remember (or rather don’t) the nothing that I experienced under general anaesthesia when I had an operation a while back.  I longed so fervently for that nothing again – and for it to be a permanent state.

So, I took a few minutes to write a note to my mother and A, with acknowledgements of a few friends, then went in search of an analgesic spray that I keep for sprains and the like.  An attempted suicide is not like self-harm; it’s not performed in the pursuit of pain.  No, pain was not a commodity that I lacked, so I sought to minimise more of it.

I’ve read this on the suicide newsgroups, but I was nevertheless surprised (or at least I am retrospectively) by how calm and contented I felt having made the decision to kill myself.  It was reassuring and comforting to know that I would not have to continue with this sorry excuse for a life, that there would soon be nothing.  Nothing was all I wanted.

I cut my left wrist first.  I tried to cut deep, but my skin was ungraciously unco-operative, refusing to slit to any meaningful degree.  This irritated me considerably, but I let it pass and decided to return to it.  So off I moved to my right wrist, which curiously proved considerably easier.  I’m generally right handed, so wielding a scalpel with my left hand would not be the most obviously effective way to garner a major life-threatening wound.  But initially, I thought I’d spotted success.

I was captivated by the blood.  It was the most blood I have ever seen from a deliberate act of self-harm.  Dark, and think, and oozing, and beautiful.  It completely mesmerised me, and I could almost feel my life ebbing away with it.  That was an eminent comfort to me, and I felt moved and calmed, yet slightly euphoric.  God, what a beautiful and welcoming thing death seemed to be!

But wait.  The blood was oozing, not spurting.  That meant that I had failed to sever a major artery, and rationality came flooding back: if one is going to off themselves by cutting, they really should cut vertically on their arms, not horizontally as I had done.  Vein cuts generally won’t lead to a successful suicide, and indeed artery ones don’t always either. Plus such wounds can lead to nerve damage in one’s hands if they fail to bring about death.  This was the shittest suicide attempt in the world!

I was filled with self-disgust, but even more than that, irri-fucking-tation.  Not anger or fury, but irritation.  I was irritated that my peaceful comfort in an imminent death had been shattered.  For fuck’s sake, I can’t even kill myself with any fucking gusto!

I sought advice on Twitter (that well-known bastion of medical knowledge), still watching the blood ooze heavily from my wrist.  The consensus was that it wouldn’t off me, but that I should go to Accident and Emergency nevertheless and get the thing stitched.

I considered this.  The thing wasn’t going to kill me, self-evidently, but it may have led to nerve damage.  If I was, however unfortunately, going to remain alive, then I might as well do so with a functioning right hand.  I rang a taxi to take me to the hospital, which is less than five minutes’ drive away.

Whilst waiting for it, I cleaned both wounds up a bit (although superficial, the left one was bleeding satisfactorily) and bandaged the right one as best I could.  The bleeding was still very heavy though, and before the taxi even arrived, it needed changed.

I called up the stairs to A to tell him that I had been advised to go to Casualty.  He got up and told me that he was coming with me, a suggestion against which I protested, though admittedly rather mildly.

I don’t remember the taxi trip at all, and have only the vaguest recollection of checking in at the A and E reception.  I remember telling the woman that my suicide attempt was one of the most pathetic in history, and being surprised by how much data she was able to access on me from her computer (1984 is with us, readers).  I also recall that the waiting time was estimated at seven hours, but for some reason I allowed myself to believe that it would never come to that.  How absolutely and completely wrong this assumption proved to be.

To be fair to them, I was very quickly seen by a triage nurse, who opined that the slit on my right wrist probably needed stitches.  She put steri-strips on it to close it as much as possible until such times as I was seen by a doctor.  She was a young girl – I’d guess younger than I am – and was remarkably sympathetic.  I was bawling my eyes out like a bloody baby by this stage, but this girl did not try and rush me, nor patronise nor judge me.  She simply listened and tried her best to be supportive.  Alas, though, eventually I had to go back to the waiting room.

And so it began.  The mind-numbing, seemingly endless, hideously interminable wait.  It is, I imagine, exactly what the final wait on death row is like – though at least if you’re a suicidal, schizo bitch you can expect a satisfactory outcome at the end of that particular interim period.  I had no idea what to expect at the end of this one.

Wait.  Wait.  Wait.

Heat.  Heat.  Heat.

Atrophying mind.  Atrophying mind.  Atrophying mind.

If swear to God that if one wasn’t suicidal to begin with, it was enough to make them so.  I can’t describe why it was so bad, but it was.  It really was.  Thank God for Twitter (on which I will remark later) on my mobile, though of course the bloody thing’s battery packed in on me eventually, leaving me once more to the doom and nothingness that was Casualty.  Well, I know earlier I was extolling the virtues of nothingness, but that particular brand of nothingness has the decency to lack consciousness.  The A and E version does not demonstrate such wonder.

After the seven hour mark had passed, I went back to the desk and asked was I going to get seen.  By this point it was after 9am.  The woman consulted with a doctor and, interestingly, he almost immediately proceeded to take me through the double doors of doom.  I’ve said it before, but I’ve wondered are there gas chambers through there.  I felt like I was walking the plank.

I was led to a room that, aside from the lack of bars, did a wonderfully accurate impersonation of a prison cell.  It, like the waiting room, was painted (if you could call it that) in one of those bland non-colours that are designed to half-sedate people into compliance.  Just like they have in customs halls at airports.  I was utterly exhausted, mentally and physically, yet my agitation just increased more on arrival in this room.  I found myself barely able to even speak to the doctor, though he seemed like an amicable enough man.

Amicable…but competent?  I’m not sure.  He asked a few questions then went to call the liaison team from the bin, without examining my wrist.  I called him back and asked him did it not require stitches.  He looked at it, in a horribly cursory sort of way (without even removing the steri-strips), then declared that that with which it was already dressed was “quite adequate”.

Again, I’m not sure.  The cut was pretty deep and the resulting blood loss, whilst not life-threatening, had been relatively considerable.  It wasn’t as deep as the (accidental) cut to my finger a few months ago, but it wasn’t that far off it.  Lovely GP told me that I should have had that injury stitched, so I was surprised at this doctor’s belief that this one didn’t such treatment.  I was especially surprised that he didn’t remove the steri-strips to check.

Surprised, yes, but at the time I was so indescribably fed up and so unbearably consumed by exhaustion that I didn’t care.  I just wanted to go home (so any attempt to admit me to the bin would not have gone down well, not that I’m sure I’d have had the energy to fight the bastards).  I said so to the doctor, who said that he wanted the psychiatric liaison woman to see me.  I asked how soon that was anticipated.

“Oh, she’ll be over shortly,” he said nonchalantly but apparently genuinely.  Based on that premise, I agreed to stay and meet the woman in question.  I went to get A and brought him back to the cell, where at least he was able to sit in a slightly more comfortable chair.  I used much of the time between the departure of the doctor and the arrival of the mental woman to apologise to A.  I was horrified that I had put him through such trauma.  From my own perspective, I didn’t – and frankly don’t – give a toss about my suicide attempt, but I absolutely abhor myself for putting him through it.  I kept telling him that his life was better before he met me, which as far as I can tell it indubitably was.  He denied it, claiming that he had been lonely prior to the crossing of our paths.  But surely loneliness is preferable to having to tolerate a borderline freak with a scalpel fetish on a daily basis?

There was plenty of time for such apologies.  Plenty indeed.  The doctor left my cell about 9.15am, and the woman from psychiatry finally arrived just before 1pm, after three enquiries from A to staff about her whereabouts.  If anything this waiting was even worse than the seven hour one of earlier; perhaps it was because we were so completely brain-dead exhausted by then, or perhaps it was simply because the ‘examining’ physician had strongly suggested that the wait for this woman would be pretty short.  It must be that, in A and E, anything under three years is short.  Absolute fucking shit.

Anyway, eventually she did arrive, just as I had finally persuaded A to leave.  I figured there was no point in both of us losing even more of our wills to live (not that I had any in the first place, but you know what I mean), and in any case the poor cats needed fed.  So as I went to a “more private” room with the woman, off A went.

She was a nice woman, but perhaps unsurprisingly was about as useful as a rolled-up election manifesto being shoved up my arse.  We discussed what has stressed me of late (Christmas, C’s dickery, just general mentalism), self-harm in general, the history of my mentalism, my physical health, my weight (“it’s not uncommon in people who’ve been sexually abused to deliberately but unconsciously become overweight, so as they make themselves – in their eyes – less attractive to potential abusers”, apparently) and current eating habits (don’t eat – binge – throw up), and other related wank that I don’t really remember.  She did keep asking if I still wanted to die, and I kept being very careful with my response.  On the one hand, I didn’t want to lie to this woman who was being understanding and down-to-Earth with me, but on the other I didn’t want to say ‘yes’, and find myself sectioned.  I doubt that I would have been, given the low level of resources that this Trust seems to have devoted to mental health difficulties (this isn’t my usual Trust, for the record, as this all took place at A’s house and my normal Trust is based on my address at my mother’s house), but it was always a horrible possibility.  So I just said that I didn’t know.

I told her about C’s intention to cut my psychotherapy short and about VCB constantly fucking me about.  I also told her that I now have a new VCB, a woman who I am to meet for the first time on Wednesday.  The liaison woman reckoned she knows NewVCB, and says if it is indeed the same woman that she is “lovely – really bubbly and friendly.”  That’s better than her predecessor I agree, but ‘bubbly’?  How does a mental who’s just tried to catch the bus deal with someone chirping about and loving life?  Fuck.

The long and the short of it is that she is going to ring LGP, NewVCB and, crucially for me, C, tomorrow morning to report on Friday’s occurrences.  I say ‘crucially’ regarding C as I profoundly do not want him to know about this.  A and A’s best mate W (who A was keeping in touch with during this whole episode via text message) both place the blame for my suicide attempt solely at C’s door.  Naturally I have been trying to defend C.  I have my own psychological agency; he is not responsible for my actions.  A agrees, but still strongly believes that what he feels is C’s ineptitude has at least “precipitated” this.  I don’t know what I think.  I just don’t know how I am going to face the man after this.  I don’t see why I should be so mortified – after all, A, W, all my Twitter friends and now all my blog readers have been party to the most minor of details in relation to this, and C will know a mere few (unless I confide further in him, which as of this writing does not seem likely).  I suppose that I am worried that he too will think that I did what I did solely because of him, and I don’t want him thinking (knowing?) that he has that level of power over me.

Anyway, the woman told me that when I got home I was to give the scalpel and its associated blades to A.  I protested most vehemently against this.

“If I want to kill myself, I’ll find a way,” I said.  “Removing the scalpel will not prevent that, but it will prevent the only real outlet I have for calming my mentalism when it’s at its worst; non-suicidal self-harm.”

She said, “have you ever been referred to a self-harm team?”

I responded in the negative, and she said that she would, therefore, try and refer me to one.  It is difficult because I officially live with my mother, and therefore in a different Trust area – my Trust, surprise surprise, doesn’t have a self-harm team (one thing I ranted about in the advocacy letter, at C’s suggestion).  Nevertheless, she said, she will try.  So I suppose that was one positive to come out of the whole awful experience.  As I said to her, I actually don’t want to stop self-harming as things presently stand; it is the only way to cope sometimes.  What I do want, though, is to want to want to stop it.  I don’t put much faith in these self-harm team people really, but it is at least an avenue to explore.

She once again asked if I had any thoughts of going home and trying again to kill myself, and once again I made some sort of ambiguous noise.  However, she took this as a ‘yes’, and to that end took me back to the doctors’ station to seek my discharge, which was instantly given without any further examination or questioning.  I left, and walked home alone.  I had been there 12 hours, and not a thing of any use – save for the possible self-harm team referral – had occurred.

When I got home I found evidence of what happened all over the living room floor.  Mercifully, there were no blood stains on the carpet, but there were maybe eight tissues that were absolutely saturated.  Blades lay scattered everywhere, though the scalpel itself was curiously absent and has remained elusive (A swears he didn’t find it).  I tidied the place up, grateful that A had been seemingly oblivious to it all.  He had had enough trauma.

I found him in bed listening to the radio.  I crawled in beside him and begged for his forgiveness, and I am very lucky to be able to report that it was granted, on the proviso that I don’t do this again.  I promised I wouldn’t, though A wonders if that is a promise that can be kept given how strong the compulsion to die can be at times.

All I can say is that I will try my best.  I really will try my best.  To look at it from a cynical perspective, I really don’t want to have to go through 12 hours of unmitigated hospital shite like that again.  The inadequacy and comical inefficiency of the NHS never ceases to amaze me.  I mean, OK – had there been some big emergency in, I could have understood the waiting there like complete numpties for 28 years – but there wasn’t.  There were a handful of other minor injuries, so it was just complete and utter shit.

How do I feel now, about 30 hours after getting home?  I feel remarkably not-too-shit, though there seems to be a permanent, cynical sneer across my face (though that was quite possibly there long before Friday night).  I still think the world is a shithole and that my life is a mess, but I am simultaneously touched by the generosity of some people, both out there in the ether and here, in ‘real life’.  See here and here for just some examples of individuals that prove that Twitter is very, very far from the facile, meaningless shite that many in the media present it as.  I fully believe that were it not for Twitter, I may well have successfully killed myself in the last nine months – not on Friday probably, admittedly, but at some juncture.  It is the best support group that I can imagine.

W and of course, in a beyond-words sort of way, A, also prove that maybe, in the midst of all the darkness, there are some people who make this existence less shit.  I am grateful that people care.  I hate my life, very profoundly do I hate it, but in terms of having people to give a shit, I am glad to declare myself a fortunate individual.

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The Advocacy Saga Continues…

Posted in C, Context, Psychotherapy with tags , , , , , , , , , , , on Thursday, 14 January, 2010 by Pandora

Following on from the original letter to the advocacy charities and the inadequate response received, here is the latest. I will also be sending the original letter to my Trust’s Patient Council.

Hopefully I will not have any more two-posts-in-one-day-marathons for a while.

Dear Admin Woman Who Wrote to Me the Other Week

Re: Advocacy

Thank you for your letter dated 4 January in response to mine of 17 December. I must confess to feeling very disappointed by the surprisingly brief response of your advocate; however, I did take the advice given, and I discussed the matter with both my consultant and, again, my clinical psychologist [actually, I didn’t discuss this with the consultant, as I don’t see her until Wednesday, but they will never know. C absolutely assures me that it is not the consultant’s decision, but his].

Both advise me that the length of treatment provided by the psychologist is decided upon by the psychologist himself and not the psychiatrist as your colleague believed. My psychologist unfortunately maintains his position of ceasing psychotherapy after the period previously specified (now 22 weeks from today), despite acknowledging that my illness should really be treated through long-term therapy. This contradictory position is a clear illustration of what seems to be unwillingness on the part of the Trust to prioritise and allocate adequate resources to the treatment of mental illness.

In light of the above, can I please again ask that your advocacy service looks at this case. I am very concerned that if treatment is halted prematurely that not only will I have failed to have made any significant progress, but that in fact my mental health will be seriously negatively affected. Arguably, given the number of difficult issues that therapy brings up for an individual, starting but not completing a full course of therapy is more damaging to a patient than receiving no treatment at all. I would be extremely grateful for your help, as I do not feel that I have the cognitive resources to fight this battle against what amounts to medical negligence myself.

To summarise, the decision to cut short my treatment has no proper basis in a clinical analysis of my condition. The clinical literature is very clear that borderline personality disorder requires more intensive and longer duration treatment than I am being offered. I would suggest that this is an illustration that the Trust is not appropriately prioritising the allocation of resources to the treatment of mental health difficulties. I would hope and expect that this is a matter of concern to Mindwise and look forward to hearing from you soon.

Thank you in advance.

Yours etc.

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Protected: Pointlessly Stupid Navel-Gazing Repetitive Nonsense – C: Week 37

Posted in C, Moods, Psychotherapy, Triggers with tags , , , , , , , , , , , , , , , on Thursday, 14 January, 2010 by Pandora

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Changing My Name

Posted in Context, Everyday Life, Moods with tags , , , , , , , , on Wednesday, 13 January, 2010 by Pandora

If you follow me on Twitter, you may have seen the other day that I had asked the Twitterverse how difficult it was to change one’s name by deed poll (it turns out that it’s actually very easy, if logistically something of a pain in the arse).

I have been thinking about changing my surname for ages – at least two years.  During that time I’ve been fairly to absolutely sure of the new name that I would adopt, and I think I have thought through all the ramifications of the whole thing properly.

Despite what many people think, there is no official or central register of name changes in the UK.  Theoretically, you can simply write a letter yourself stating your intention to use a new name, though that tends not to work much in practice when you involve banks and passport agencies and the like.  The lack of such a register means that you have to inform everyone yourself – preferably using certified copies of your deed poll – of your new name.

This includes passport agencies, driving licensing authorities, the health service (and specific services therein that you use), banks, credit and ‘store’ cards, insurance companies, utility companies, pension companies – the list goes on.  That’s not even considering your personal contacts.  It’s a profound logistical hassle.

But, for me, it is worth it.  I have long since hated the fact that I have links to my father via my name, as of course the man was a detestable piece of shit.  This was exacerbated after the whole kerfuffle over V’s will; I don’t want to share the same name as my American relatives either, after them virtually glorifying my ‘father’ and then stealing my bloody money.  I want to sever connections with that whole side of the family absolutely and completely, and this gesture is a symbolic way of doing so.

Furthermore, my surname is a completely shit one.  So much so that it was the brunt of endless verbal pestering when I was at school, which wasn’t exactly fun (not that that was what made me so inherently miserable there, but the name-calling and teasing certainly didn’t help).

I haven’t discussed changing my name with with C, although I probably should.  Perhaps this can be touched upon briefly tomorrow.  I did discuss it in some detail with Margaret, the CBT therapist I saw in 2008, and she felt that if I was prepared to go through the hassle of informing everyone, that changing my name could bring some “closure” [hate that word] on the many mental health issues I have that are attributable (at least in part) to V.  To be honest, I think that’s a very simplistic way of looking at it – changing my name is not going to change what he did to me, nor to my mother.  However, it’s one thing I can do to publicly acknowledge that I want no part in his legacy.  A token gesture, some might say, but I think it’s an important one.

I determined towards the end of last year that if I was going to do it, I was going to do it in 2010.  So yesterday (as intimated last night on Twitter) I took a deep breath, filled in the online deed poll application, and – after dithering a bit – hit ‘submit’.

The lack of a central register means that my name is not changed at all until I sign and date the deed poll (which should be with me by early next week), and in practice it remains unchanged until I send the certified copies to the aforementioned agencies and they update their systems, my cards, etc.  But I’ve taken the first step – and as I said, it’s a big step, in my view, as I have lived with this name for over 26 years.

I’m really nervous about what I am doing, but it’s a new start in a kind of symbolic way, and to that end I’m terribly excited too.

So up yours, V, and up yours, V’s family, for contributing to my being completely batshit mad.  Shortly I will have no links with you whatsoever other than my mother and genetics, and I cannot wait.

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Vulnerability and Self-Disgust with C – Week 36

Posted in C, Moods, Psychotherapy, Triggers with tags , , , , , , , , , , , , , , , , , , , , , , , , on Tuesday, 12 January, 2010 by Pandora

Thursday was the first day back to therapy after C’s Christmas break.  It was a successful session in a long-term sort of way, but was nevertheless very traumatic for me, tackling as it did a lot of hurt and vulnerabilities that I don’t want to face nor admit to.  There was nothing specific that was so stressful about it, but as I said to C towards the end, I felt very “battered and bruised”.

I was glad to see C again, having missed him and craved his protection over the three weeks since I last saw him.  However, he has committed a cardinal sin.  He has grown a beard.  Not like the goatee, Derren Brown-esque beard he had when we first met, but a full-on, proper beard.  I’ve nothing especially against beards, but honestly – he looks like something out of a children’s illustrated Bible.  When he came to the waiting room to get me, I was aghast to be greeted by Jesus (or Judas if you prefer, he could be either).  It took me a quite a while to stop fixating on this newly arrived hirsute feature.

As has been the case since C has been back in VCB’s stomping ground (as there is building work going on in his office), we opened by taking a few moments to compose ourselves.  The waiting room in the place is usually full of people, unlike that for C’s proper office which is always empty.  The people unsettle me, and C has realised now that he has to give me a few minutes for this anthropophobic anxiety to abate somewhat.

Of course, I had C anxiety as well.  I always feel nervous before I see him, and it was especially strong on Thursday given that I had not seen him for three weeks.  To that end, initially I was stubbornly refusing to speak in anything other than one word answers to questions.

Eventually, he asked me how Christmas had been.

“I’m not going to discuss that,” I brattishly declared.  I knew, of course, that he would follow that up with a question as to why I was not going to discuss that, so before he got the chance to do so, I changed the subject and told him about the latest troubles with the health service.

The first thing was the whole bullshit about the GP talking down to me, just after I’d last seen C.  I told him all about it, going so far as to re-enact some of the mannerisms that Dr Arsehole had employed during his irritable rant towards me.  This was before the reply to my complaint had arrived.

“How dare someone earning as much as a GP does behave in that fashion?” I raged.  “How dare the jumped-up twat speak to me like that?”

“How were you in the room with him?” asked C.

“Pathetic,” I admitted.  “I just sat there and took it.  I did try to argue with him at one point, but he just kept on and on, and I backed down.  As I was leaving, I even thanked him!  A reckons I need to discuss my remarkable ability to be so horribly passive with you.”

The second NHS issue, which I’ve only mentioned in passing here, is that apparently VCB is no longer my consultant psychiatrist.  When I last saw her in November, she said she’d see me again in a month, which she didn’t (surprise surprise).  Then, when I finally did get a letter inviting me for an appointment with Psychiatry, it merely said that I had an appointment on 20 January with Dr M, not VCB.  It made no reference as to the change of individual whatsoever.

C said, “as far as I know there’s been a shake-up in Psychiatry in terms of geographical location.  They’ve changed the boundaries that each consultant operates in.  Is that what happened?”

“No one told me anything, so I wouldn’t know,” I spat, disgusted.

“I’m not going to lie to you,” I continued, “I’m not VCB’s biggest fan.  But at least I had some sort of relationship with her – I knew her, and she was at least in some ways familiar with my case, so this is incredibly frustrating.  It strikes me that Psychiatry is possibly the worst branch of medicine in which such nonchalance and disruption should be in evidence, what with issues of trust and attachment being so much a part of certain illnesses.

“But what do I know,” I added bitterly.  “I’m just the mental that sits opposite you people.”

“Is that how you see yourself?” C jumped in.

The truthful answer to this is that I don’t know.  The comment had been intended as a slight on the Psychiatric “service” and indeed on mental health services on the NHS in general, but of course I exist in a perpetual state of self-loathing and self-disgust, whether im- or explicit, so yes, it probably is – to some extent – how I see myself.

I told him so, adding that I have no right to be mental because what has happened to me is so considerably less serious than that to which many others have been subjected.  This came up a couple of times in the session – basically I feel guilty for being a mental when other people who’ve endured worse aren’t or, if they are, then they have more right to be than I.

C mulled it over for a minute or two, then said, “one thing about you is that you’re defined by contradictions.  You mentioned earlier about being passive – there is that side, yet there’s another side that can be extremely assertive in the right circumstances.  It’s the same with your belief that you are somehow not entitled to be a mentalist [interesting use of that word, I thought].  You hate yourself for being this way, you think you have no right – yet you will fight to the death to get the treatment to which you feel you are entitled.”

“It’s hardly rocket science, though,” I responded.  “In some ways, whether or not I’m entitled to be mad is irrelevant; the fact is, I am.  Regardless of the reasons for that, I should be entitled to treatment, under the foundations on which this health service was based.  If I kicked that wall over there and broke my toe, the stupid manner in which I broke my toe would be irrelvant to those treating me; I would still be entitled to their medical attention.  I don’t see why it should be different for one’s mental health.”

“It shouldn’t,” he agreed.

Oh really?  OK then, why are you cutting short my fucking therapy?  Not that I brought up that issue specifically, because I didn’t want to engage in the pointless navel-gazing that had been the previous session.  If our time is limited, it must be used effectively.

Anyhow, I don’t remember how he phrased it, but basically he said that a person’s history and indeed how they respond to it is completely relative.  He said that we can only develop from our own experiences and, essentially, that I really shouldn’t beat myself up for being mental.  Later on in the session, he almost went so far as to say that I have every right to be, but I’ll come to that later.

Of course, I can rationally accept a lot of this, and indeed I know that certain mental illnesses with which I have been diagnosed are thought to exist in individuals who are biologically predisposed to having them, the symptoms manifesting after some sort of psychosocial trigger.  So of course I am not to be blamed for being mental…says Rational Me.  In-Control-Irrational-and-Ironically-Mental Me does not agree.

We also discussed how the anger I feel is sometimes misplaced.  I contend absolutely that my anger towards the health service is completely just, so that’s not one such example, but I will fly into a genuinely murderous rage at either myself or, say, my mother (particularly my mother) for something ridiculously stupid like dropping a pen – yet I am not angry at my uncle.  I am angry at my father, but that miserable sod had the audacity to die, so I’m hardly likely to be able to direct that towards him.

Of course, mention of my uncle in the context of anger was A Very Bad Move.  C said, “so, are you going to tell me what happened at Christmas?”

I glared at him.  “Did I not already say that I don’t want to talk about that?” I sneered, eventually.

“You did, yes.”  He looked at me enigmatically.

Oh, but you can read my mind, can’t you C?  Saying that I didn’t want to talk about it is some sort of conspiratorial Newspeak for, “I want to discuss that with you in intimate and excruciating detail”, isn’t it?!

“You don’t want to tell me about your Christmas, do you?  No – you don’t.  So why should I tell you about mine?” I challenged.

It was meant mainly as a sarcastic and rhetorical question, but he answered anyway.  “If we met in other circumstances, that’s probably exactly the conversation we’d be having,” he mused.  “But I know that you know that this circumstance has to be one-sided.”

As it happens, I do know, thanks very much – and I don’t like it and it isn’t fair.  And yet it protects me from the probable sheer ordinariness of this man that I so pathetically look up to.  But that’s another matter.  I told him, truthfully, that if we met socially, I would still not be telling him the specifics of what happened at Christmas.

Actually, if I’m 100% honest, of course I wanted to discuss it with him (in his capacity as my psychotherapist) – aspects of it anyway.  I was horribly mortified (as well as disturbed) by what ‘They’ wanted me to do on Christmas Night, and didn’t especially want to outline that in specific terms, but I did want to tell him of the fear and anguish that took me to that point.  Yet I felt absolutely unable to give myself permission to do so.

We sat in silence for a bit.  I knew he would break me sooner or later, but I decided to fight him anyway.  I was thinking about the psychoses, which led me to question how I had described them here on WordPress.  In doing so, I was reminded that I won an award for this blog on New Year’s Day from the fabulous Mental Nurse blog.

“My blog won an award,” I randomly blurted out at him, with thinly-disguised pride.

C seemed quite excited by this news and congratulated me, then paused.  “I really want to ask you more about this,” he began, “But I’m wondering if we shouldn’t leave it until later – I don’t want to avoid the issue of Christmas.”

I wanted to avoid the issue of Christmas.  It’s my fucking therapy, can’t I talk about what I like?

But I gave up the fight, and gave the man what he wanted.  “There were issues with the voices,” I admitted finally, tapping my head (as if he didn’t know what voices I damn well meant).

“OK,” he started.  “What sort of ‘issues’?”

“No, no, no, we’re not going down that road.  It’s enough that you know that the day was stressful and I went doolally in the evening, though mercifully not in front of the 3,820,691 people with whom I was forced to spend the whole sorry day.”

“But how could it not have been traumatic?” C asked.  “I really fail to see how it could not have been, what with you having to see and interact with your uncle.”

“You’ve built it to be all about him,” I replied.  “It’s not – not entirely.  To say my family is a freakshow is to insult freakshows.  I just cannot put into words how fucked up and weird they all are, and how much I have nothing in common with them.”

“I remember you saying before that their ‘weirdness’ was difficult to convey, but I do have some sense of that.”

“They’re worse in a collective,” I continued.  “As individuals – well, I can’t pretend I’m their biggest fans, but they’re more tolerable.  But their group dynamic is seriously – epically [not that that’s a word] – bizarre.”

Moving away from this slightly, C went back to the voices.  I told him that I had already said I was not going into that and requested that he left it be.

“I’m not really so concerned about what they actually said,” he told me.  “At present I’m more interested in why you don’t want to tell me about it.”

I should have been expecting such a question, but I hadn’t been.  I thought about it for a moment.

“I’m very aware that we’re sitting in Psychiatric Outpatients and that the bin’s over there,” I said, leaving him to infer the rest.  “I can’t get away quickly here.  At least in your normal office I have time to flee before you all catch me.”

I got the usual spiel of crap about how he would only call a psychiatrist or my GP if I was at a serious and imminent risk of harming myself.  Or others, he added, almost as an afterthought.  I laughed bitterly.

I don’t remember the exact discussion that followed, but he seemed to have established that on Christmas Night it was ‘others’ that ‘They’ were trying to get me to hurt.  He never said it straight out, and I never confirmed it, but there seemed to be a shared, implicit understanding that this was what had occurred.  He sought to reassure me in as strong terms as he’s allowed to that he would not call anyone to have me sectioned unless he thought that such harm was absolutely imminent.

“I don’t believe you,” I told him.

Ouch.  I think that one cut him a little (no pun intended, not that I’ve been too bad vis-a-vis self-harm of late).  He asked why I doubted him.

In part, it is because I feel that some of the trust has been broken between us, owing to the whole uncertainty over the continuation of treatment – though in fairness, he was good in this session and I feel it might have been built up a little again.  Other reasons are just how terrible the episode was – I mean, I was told to kill a fucking not-quite-two year old, how much worse does it get? – and the fact that I’m preposterously paranoid.  Probably the simplest reason is that I often genuinely feel that I should be fucking sectioned, though I really, really don’t want to be.

In any case, I do believe that C wouldn’t section me unless he felt it absolutely imperative, yet I don’t believe it at the same time.  I believe two absolutely polar opposite things simultaneously – not an unknown state for me.  I told him so, and he seemed to understand that.

For some reason, presumably relating to all the discussion about Paedo and the multitudinous weirdness of the McF dynasty, C and I ended up discussing how my mother didn’t believe me about the sexual abuse, and about how she seems to go out of her way sometimes to put me down, or to compare me (negatively) to others (particularly SL, who she seems to fucking idolise).

C said, “it seems to me that your mother has been severely traumatised by her relationship with your father.”  Now, I genuinely don’t recall what he said next, but I think it was something along the lines that she therefore seeks solace in the McFs and, despite what she may say, finds it hard to believe that they are capable of fault – even when it’s rape of her daughter.  I don’t want to put words in C’s mouth, though, so don’t take that as gospel.  Of course, whilst I cannot disagree with the aforesaid conjecture, my own take on things is that she will always remember that I am my father’s daughter (she will even say it from time to time when she wants to hurt me).  In any case, I am certainly not the daughter that she would have wanted.

I agree with C that she is completely traumatised (not that she’d admit it herself), but was surprised by him coming out and telling me that was his view in such forthright terms.  In any event, this tangent didn’t especially add much to the session, except to exacerbate the rawness of the hurt I was already feeling.

So that was his next tactic – the perennial, “how are you feeling?”

I couldn’t verbalise it at first.  I just felt so something, so indefinably sad and upset and low.  He quietly encouraged me to try harder to express it more exactly.

Eventually, through gritted teeth, I seethed, “I feel hurt and sorry for myself and vulnerable, are you happy now?”

Unfortunately he thought this comment was sarcastic, intended as a snide take on what he wanted to hear.  Admittedly, the manner in which I had said it could easily have been taken that way, though it was meant to have come across as a dramatic, “there!  I’m finally admitting the truth!  I’m deflated but this is progress, isn’t that fantabulous?” kind of gesture (fail!).  I apologised, and advised him that the content of my comment was serious.

Yes, I admitted to being vulnerable.  What I didn’t admit, of course, is that I want C to protect me from all that which makes me vulnerable.  I want him to put his arms around me, stroke my hair, tell me in his gentle voice I will be OK, and protect me from all the bad that exists in the world.  Of course I didn’t tell him that, but admitting to this hideous vulnerability that I’ve been repressing for I don’t-know-how-long was a start.

“Unwillingness to feel or express feeling of these things is very common in people who’ve been brought up in abusive and traumatic backgrounds,” he told he, tilting his head to gauge my reaction.

“‘Abused’,” I repeated wistfully, looking away.  The branches of the trees outside were blowing back and forth in the wind, stripped bare of their leaves.  I felt as emotionally naked in front of C as they looked.

“You don’t think you’ve been abused?” he checked, apparently confused.

“No,” I replied quietly.

“You were sexually abused by your uncle!” C said, determinedly.

“And I responded to that and other things by dissociating and emotionally numbing myself.  Fat lot of good it’s done me.”

“It probably did at the time, though.  It was a means of self-preservation during those times.”

There was a pause, then I randomly spat out, “I disgust myself.  My vulnerability disgusts me.  I disgust me.  Fucking schizo bitch!”

“You’re one of the most self-critical people I’ve ever known,” C told me, taking a very slight tone of authority.  “My worry is that this is a major stumbling block.  I really think if we can develop some self-compassion in you, it will help a lot.”

“You said a moment ago that dissociation etc was a means of self-preservation.  It ties in with the psychology discussed in a book I’ve been reading.  It is, shock horror, a self-help book, one designed to teach you strategies to soothe yourself when you go mental.”

C was delighted by this.  He asked me if it was any good, my response being that a lot of it (as with any such text) was “wank”, but that despite this, there were some good, and vaguely intelligently written, parts to it.

The thing is, I’m not always as critical of myself as I seem to be in psychotherapy.  I can only surmise that that is when the truth really comes out.  The raw, visceral nature of everything that’s gone or is wrong with my life is so palpable and explicit in those 50 minutes, and the true depth of my self-hate is exposed.  Eugh.

He went on to say that it was not desirable to rid me of my “sarcasm and [my] wit” (he said I was witty!!!  Smiley me!), but that he thought aspects of that fed into my lack of self-compassion, and that we needed to strike a balance.

“And I’m encouraged by the fact that you’re trying,” he concluded.

I left feeling psychologically battered and bruised, even so much as allowing myself a tear as I drove home (how self-compassionate), but I was also quietly encouraged and reassured.

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Victories and Failures: Updates on *Those* Letters

Posted in Context, Everyday Life, Moods with tags , , , , , , , , , , , , , , , , , , on Saturday, 9 January, 2010 by Pandora

Let’s deal with these chronolgically and, coincidentally, in order of bad to good.

FAIL

On 17 December, I wrote to two mental health advocacy groups (Mindwise and the Northern Ireland Association for Mental Health) regarding the whole ‘you can only have 24 more sessions’ bullshit with C.  Both have now responded, and both have represented something of an epic fail.

Mindwise simply told me to discuss the matter with my consultant psychiatrist, as “they would be the ones making the decision”.  Well, I will, when I see my (new!) consultant on 20 January (over a month late, might I add).  However, as regular readers will know, Psychiatry have been one of the problems I’ve been having with the NHS during this most recent breakdown (though to be fair, this was not outlined in the letter).

Talk about passing the fucking buck.  It was simply a case of pushing responsibility onto someone else, and not wanting to tackle my case themselves.  Is it because I is borderline?  Everyone hates a borderline, innit.

Should the meeting with the psychiatrist not yield results, though, I am going to write pompously back to these tossers and demand their assistance.  Either that or the media will be learning of their incompetence and unwillingness to help a mentally ill individual, which is exactly what they exist for.

I heard from NIAMH yesterday.  Apparently, their advocacy service does not operate in my Trust area.

Forgive me, but is it not the NORTHERN FUCKING IRELAND Association for Mental Health?!  At no point does the name of the charity remotely infer that it is not operational across the entire country.  How, then, can they not operate in my Trust area?  Is it because I is borderline?  Everyone hates a borderline, innit.

In fairness, at least they did suggest some sort of action I could take.  They said I should try the Trust’s Patient Council service, who apparently deal with matters like this.

I will heed their advice, especially given that a Twitter friend had some results via the Patient Council in his area, but not until I have heard back from the Trust, who were copied in on the original letter.

POSSIBLE WIN

As you know, the advocacy letter was copied to the Chief Executive of the Trust.  Not wanting to be arsed himself, the individual in question passed my letter to the Director of Mental Health services.

This bloke wrote back to me a few weeks ago, telling me that he had requested more information and that he would be in touch once he had received same.  I have not heard more from him yet, but am hopeful that the mere act of kicking up a fuss like this and threatening to contact the politicians and the media might be enough to get some action from him.

I won’t hold my breath, of course, but I will cross my fingers.

WIN

HAHAHAHAHAHAHA!  Asshole GP has backed down!

Apparently, Dr Bellend/Twatbag/Arsehole/whatever-else-I-called-him “would like to apologise” and accepts that his attitude fell short of “desirable [surely ‘necessary’?] professional standards”.  Ha!  Muah-ha-ha-ha-ha-ha!

The letter went so far as to offer me the opportunity to meet the Practice Manager and Dr Knobjockey to further discuss the matter.  I will not accept the invitation, but I suppose it was good of them to offer it.

As I have generally been well supported by the practice (recently, at least), I won’t be a dick over this.  I’ll write back and accept Dr Fuckwit’s apology, and just hope that I won’t have to see him again.

MEH

And that, folks, is the latest news on that front.  I feel smugly satisfied about the GP letter result, but of course am rather disappointed that the advocacy charities are not actually doing anything that remotely resembles advocacy.  But we shall see how this continues to play out over the next few weeks.

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